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Ansätze zur Frühbehandlung bei degenerativen Hirnerkrankungen

  • K. Herholz
Conference paper
Part of the Bayer-ZNS-Symposium book series (BAYERZNS, volume 13)

Zusammenfassung

Trotz eines besseren Verständnisses von Pathogenese und Pathophysiologie degenerativer Erkrankungen des Gehirns haben sich bislang kaum unmittelbare, klinisch nutzbare therapeutische Ansatzpunkte gezeigt. Die Effektivität einer pharmakologischen Frühbehandlung solcher Erkrankungen, insbesondere der Demenz vom Alzheimer-Typ (DAT) und des M. Parkinson, im Sinne einer Neuroprotektion ist weiterhin nicht eindeutig belegt. Vorbeugende Maßnahmen betreffen in erster Linie die Nahrungsmittelauswahl, bei der auf einen hohen Anteil an Radikalfängern, hauptsächlich Vitamin E, geachtet werden sollte. Bei M. Parkinson scheinen insbesondere MAO-B-Hemmer (Selegilin) und Amantadin den Krankheitsverlauf günstig beeinflussen zu können; jedoch ist die verlaufsbeeinflussende von einer symptomatischen Wirkung bisher nicht sicher abzugrenzen. Zur Frühbehandlung des M. Alzheimer kommen neben Selegilin, hochdosiertem Vitamin E und Gingko-biloba-Extrakt auch nichtsteroidale Antiphlogistika und eine Östrogensubstitution (bei Frauen) in Betracht; allerdings fehlen weiterhin aussagefähige Daten sowohl über den Zeitpunkt des Behandlungsbeginns als auch zur Wirkungs-Nebenwirkungs-Relation, so daß auch hier noch keine eindeutigen Empfehlungen möglich sind.

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© Springer-Verlag Berlin Heidelberg 1998

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  • K. Herholz

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