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Aktuelle Neurologie 2004; 31(8): 396-403
DOI: 10.1055/s-2004-828373
Kognitive Neurologie
© Georg Thieme Verlag KG Stuttgart · New York

Ereigniskorrelierte Potenziale in der kognitiven Neurologie

Event-Related Potentials in Cognitive NeurologyM.  Ullsperger1 , D.  Y.  von Cramon2
  • 1Max-Planck-Institut für Kognitions- und Neurowissenschaften, Leipzig
  • 2Tagesklinik für kognitive Neurologie, Universität Leipzig
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Publikationsverlauf

Publikationsdatum:
29. September 2004 (online)

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Zusammenfassung

Im vorliegenden Artikel werden Ziele, Anwendbarkeit und Voraussetzungen des Einsatzes ereigniskorrelierter Hirnpotenziale (EKP) in der kognitiven Neurologie sowie in der klinischen Forschung diskutiert. Es wird beleuchtet, welche Erwartungen man an die Untersuchung mit EKPs stellen kann, und was bei der Interpretation der Daten zu beachten ist. Spezielles Augenmerk wird auf die kognitiven EKPs gerichtet, deren Einsatz sich im klinischen Kontext - von der klinischen Grundlagenforschung abgesehen - bisher noch nicht breit durchgesetzt hat. Für zwei mit kognitiven Prozessen korrelierende EKP-Komponenten werden Erfolg versprechende klinische Anwendungsbeispiele exemplarisch herausgestellt und die Möglichkeiten des breiteren Einsatzes diskutiert. Auch wenn die Erhebung kognitiver EKP-Komponenten in der Klinik mit mehr Aufwand verbunden ist als die Messung früher evozierter Potenziale, werden sie einen zunehmend breiteren Einsatz in der kognitiven Neurologie erfahren. Insbesondere in longitudinal angelegten Untersuchungen, aber auch bei spezifischen diagnostischen Fragestellungen können sie einen entscheidenden Beitrag liefern. Speziell sind Therapievalidierung, Verlaufsbeobachtung und vergleichende Studien verschiedener therapeutischer Ansätze hervorzuheben. Um diese Ziele erreichen zu können, sind Standardisierungen der Ableit- und Stimulationsbedingungen sowie spezifische, hypothesengeleitete Fragestellungen erforderlich.

Abstract

The present article discusses aims, feasibility, and prerequisites of investigations using event-related brain potentials (ERPs) in Cognitive Neurology and clinical research. It sheds light on the issues of what can be expected from ERP measures and what needs to be taken into account for data interpretation. Specific attention is directed on cognitive ERPs which are not widely used in the clinical context - except for clinical basic research. Promising examples for using two ERP components associated with cognitive processes are discussed with respect to clinical utility. Even though collecting cognitive ERP data is more demanding than measuring early evoked potentials, they will certainly be used more in Cognitive Neurology in the future. Cognitive ERPs are well suited particularly for longitudinal studies, but also for specific diagnostic questions. Specifically, they provide tools to validate therapeutic effects, to objectively measure the clinical course, and to perform comparative studies of different therapeutic approaches. To meet these aims, a standardization of data collection and stimulus presentation as well as specific, hypothesis-driven questions are required.

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1 Da dieselbe Potenzialverteilung auf der Kopfoberfläche von unterschiedlichen Kombinationen generierender Strukturen durch Aufsummierung und Volumenleitung erzeugt werden kann, lässt sich aus einer gemessenen Skalptopographie nicht eindeutig bestimmen, welche Hirnstrukturen an der Bildung des untersuchten EKP beteiligt sind.

2 Hierbei handelt es sich streng genommen um die P3a-Komponente, die mit der Orientierungsreaktion assoziiert ist, da die Patienten ihre Aufmerksamkeit nicht willentlich auf die Zielreize richten können und somit den Stimuli nur passiv ausgesetzt werden.

Dr. med. Markus Ullsperger

Max-Planck-Institut für Kognitions- und Neurowissenschaften

Stephanstraße 1 a

04103 Leipzig

eMail: ullsperg@cbs.mpg.de