Neurokognition psychiatrischer Patienten

Zusammenfassung

Kognitive, mnestische und emotionale Funktionen können bei psychiatrischen Patienten beeinträchtigt sein. In diesem Beitrag werden zunächst verschiedene neuropsychologische Funktionen vorgestellt, schwerpunktmäßig Lernen und Gedächtnis sowie exekutive Funktionen. Anschließend werden Einbußen dieser Bereiche und deren neurale Korrelate bei schizophrenen, depressiven und alkoholabhängigen Patienten sowie Personen mit Korsakow-Syndrom beschrieben. Auf Hirnebene lassen sich für neuropsychologische Änderungen sowohl neurochemische als auch strukturelle Abweichungen demonstrieren, die zumeist Teile des Stirnhirns sowie limbische und dienzephale Strukturen einbeziehen.

Abstract

Cognitive, mnestic, and emotional disturbances can occur in a wide range of psychiatric patients. Both neurochemical alterations as well as structural brain abnormalities can be neural correlates of neuropsychological dysfunctions in these patients. In this paper, we give an introduction to neuropsychological domains with a focus on different kinds of memory and executive functions. Thereafter, we describe neurocognitive deteriorations in patients with schizophrenia, depression, alcohol addiction, and Korsakoff's syndrome. Brain alterations affect primarily parts of the frontal lobe, especially the dorsolateral prefrontal and the orbitofrontal cortex. This can be seen in volume reduction, glucose hypometabolism, or dysfunctions of dopaminergic fronto-striatal loops. Furthermore, structural or functional changes of hippocampal formation, anterior cingulate gyrus, amygdala, and different thalamic nuclei are also involved in neurocognitive disturbances of psychiatric patients.

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