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Marklagerveränderungen bei neurodegenerativen und vaskulären Demenzerkrankungen

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Zusammenfassung

Die Zuordnung einer Demenzerkrankung zu einem neurodegenerativen Pathomechanismus, wie der Demenz vom Alzheimer-Typ (DAT) oder einem vaskulären Pathomechanismus, kann trotz der Verfügbarkeit bildgebender Verfahren Probleme bereiten. Überlappungen neurodegenerativer und vaskulärer Mechanismen sind häufig. Mikroangiopathische Veränderungen des Marklagers finden sich bei einem hohen Anteil von Patienten mit der klinischen Verlaufsform einer Demenz vom Alzheimer-Typ. Es ist unklar, ob es sich um eine Koinzidenz zweier Pathomechanismen handelt oder ob eine wechselseitige Beeinflussung stattfindet. Die hohe Sensitivität der Magnetresonanztomographie bei der Erfassung mikroangiopathischer Veränderungen des Marklagers könnte dazu führen, dass zu vaskuläre Demenzerkrankungen häufig diagnostiziert werden. Der Einfluss mikroangiopathischer Veränderungen des Marklagers auf den Demenzverlauf wird kontrovers diskutiert. Die vorgelegte Arbeit gibt eine Übersicht über die aktuellen Konzepte zum Stellenwert von Marklagerveränderungen bei Demenzerkrankungen.

Abstract

Due to a significant overlap of the two syndromes, differentiation of degenerative dementia of the Alzheimer-type from vascular dementia may be difficult even when imaging studies are available. White matter changes occur in many patients suffering from Alzheimer's disease.

Little is known about the impact of white matter changes on the course and clinical presentation of Alzheimer's disease. High sensitivity of MRI in the detection of white matter alterations may account for over-diagnosing vascular dementia. The clinical significance of white matter alterations in dementia is still a matter of debate. The article reviews current concepts about the role of white matter alterations in dementia.

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Authors and Affiliations

  1. Arbeitsgruppe Gerontopsychiatrie, Universitäts-Nervenklinik Homburg (Saar)

    T. Supprian, H. Kessler, W. Retz, M. Rösler & P. Falkai

  2. Institut für gerichtliche Psychologie und Psychiatrie, Universität des Saarlandes, Homburg (Saar)

    W. Retz & M. Rösler

  3. Abteilung für Neuroradiologie, Universitätskliniken des Saarlandes, Homburg (Saar)

    I. Grunwald & W. Reith

  4. Arbeitsgruppe Gerontopsychiatrie, Universitäts-Nervenklinik, Psychiatrie und Psychotherapie, 66421 , Homburg (Saar)

    T. Supprian

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  1. T. Supprian
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  2. H. Kessler
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Correspondence to T. Supprian.

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Supprian, T., Kessler, H., Retz, W. et al. Marklagerveränderungen bei neurodegenerativen und vaskulären Demenzerkrankungen. Radiologe 43, 543–551 (2003). https://doi.org/10.1007/s00117-003-0916-5

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