Neuropsychologische Differenzialdiagnostik degenerativer Demenzen

S. A. Wolf

doi:10.1055/s-0028-1109464

Fortschritte der Neurologie · Psychiatrie, Table of Contents

Fortschr Neurol Psychiatr 2009; 77(7): 376-388
DOI: 10.1055/s-0028-1109464

Übersicht

Neuropsychologische Differenzialdiagnostik degenerativer Demenzen

Neuropsychological Differential Diagnosis of Degenerative DementiasS. A. Wolf¹

¹Klinik für Neurologie (Universitätsklinikum Magdeburg (Direktor: Prof. Dr. med. C.-W. Wallesch)

Abstract

Zusammenfassung

Die neuropsychologische Differenzialdiagnostik der degenerativen Demenzen erreicht eine hohe Sensitivität und Spezifität, sodass mit ihr in sehr vielen Fällen bereits in frühen Krankheitsstadien eine korrekte Zuordnung verschiedener Demenzsyndrome möglich ist. In Zusammenschau des aktuellen Forschungsstands lässt sich die Alzheimer-Demenz von Formen der Frontotemporalen Lobärdegeneration sowie der Vaskulären Demenz durch die bei Morbus Alzheimer typischerweise stärker und früher beeinträchtigten mnestischen, visuell-perzeptiven und visuo-konstruktiven Leistungen abgrenzen. Bei den Frontotemporalen Lobärdegenerationen und Vaskulären Demenzen dominieren gegenüber der Alzheimer-Demenz schwerere exekutive Dysfunktionen in den meisten kontrollierten empirischen Studien. Die Frontotemporalen Lobärdegenerationen sind zusätzlich durch deutlichere Verhaltensauffälligkeiten, sprachliche Beeinträchtigungen und semantische Störungen gekennzeichnet. Die neuropsychologische Demenzabklärung trägt in relevantem Ausmaß zur Früherkennung, Differenzialdiagnostik und evidenzbasierten Behandlung von Demenzsyndromen bei. Im Zuge der Entwicklung und Verfügbarkeit spezifischer antidementiver Therapien wird die frühzeitige differenzialdiagnostische Demenzabklärung weiter an Bedeutung gewinnen.

Abstract

Neuropsychological differential diagnosis of degenerative dementias is characterized by high sensitivity and specificity which allows syndrome assignment in most instances in early stages. According to the empirical evidence, Alzheimer’s disease can be discriminated from frontotemporal lobar degeneration and from vascular dementia by quality and severity of memory deficits and also by the presence of visuo-perceptive and visuo-constructive deficits. In frontotemporal lobar degeneration and vascular dementia executive dysfunctions predominate in most controlled empirical studies. Moreover, in frontotemporal lobar degeneration severe aphasic and semantic impairments can be observed. Neuropsychological assessment contributes to the early detection, differential diagnosis and evidence-based treatment of dementia syndromes to a considerable extent. Once more specific treatments are available, the early differential diagnosis of degenerative dementias will become highly important.

Schlüsselwörter

Alzheimer-Demenz - Frontotemporale Demenz - Primär Progrediente Aphasie - Semantische Demenz - Vaskuläre Demenz - Neuropsychologie

Key words

Alzheimer’s disease - frontotemporal dementia - primary progressive aphasia - semantic dementia - vascular dementia - neuropsychology

Full Text

References

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Simone A. Wolf

Diplom-Psychologin/Diplom-Psychogerontologin, Institut für Klinische Psychologie Bürgerhospital Stuttgart

Tunzhofer Str. 14 – 16

70191 Stuttgart

Email: si.wolf@klinikum-stuttgart.de