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Neurologie up2date 2024; 07(03): 209-223
DOI: 10.1055/a-2127-2547
Bewegungsstörungen

Subtypen der Parkinson-Krankheit

Georg Ebersbach
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Parkinson ist ein Krankheitsbild mit von Mensch zu Mensch sehr unterschiedlichen Symptomkonstellationen und Verlaufsformen. Im klinischen Alltag werden oft für die Gesamtgruppe der Betroffenen definierte Therapiestrategien eingesetzt, die dann allerdings zu sehr variablen Ergebnissen führen. Die Definition von verschiedenen Parkinson-Subtypen soll dazu dienen, den individuellen Krankheitsverlauf besser einschätzen zu können und die für verschiedene Untergruppen am besten geeigneten Behandlungsmöglichkeiten zu finden.
Kernaussagen

  • Motorische Subtypen (z.B. tremordominant versus PIGD=postural Instabiliy/Gait Disorder) haben unterschiedliche prognostische und therapeutischen Konsequenzen.

  • Das Alter bei Erkrankungsbeginn ist eine wichtige Determinante für den Krankheitsverlauf und die Pharmakoresponsivität.

  • Nicht-motorische Symptome können für eine therapeutisch relevante Definition von Subtypen verwendet werden.

  • Bei den genetisch definierten Subtypen haben GBA- und LRRK2-Mutationen besonders große Bedeutung.

  • Durch moderne statistische Verfahren können aus einer hohen Zahl klinischer Variablen therapierelevante Subtypen abgeleitet werden.

Schlüsselwörter

Parkinson-Krankheit - Bewegungsstörungen - neurologische Erkrankung - Levodopa - postural Instability and Gait Disorder


Publication History

Article published online:
09 September 2024

© 2024. Thieme. All rights reserved.

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