Störungen von Affekt und Kognition bei Patienten mit Multipler Sklerose

Zusammenfassung

Depression, Fatigue und Kognitionsstörungen sind Symptome der Multiplen Sklerose (MS), die oft bereits zu Beginn der Erkrankung auftreten und die Lebensqualität der MS-Patienten erheblich beeinträchtigen können. Während die Pathogenese von Depression und Fatigue weiterhin ungeklärt ist, zeigen die Kognitionsstörungen eine gute Korrelation mit der zerebralen Atrophie. Mehrere Studien und die klinische Erfahrung belegen die Wirksamkeit von Antidepressiva bei MS-Patienten mit Depression sowie von Amantadin und Modafinil bei Fatigue. Die immunmodulatorische Therapie mit Interferon-ß (IFN-ß) kann die Progredienz der zerebralen Atrophie und der kognitiven Defizite verlangsamen. Weiterhin weist eine Studie darauf hin, dass auch Acetylcholinesterasehemmer wirksam sein könnten. Entsprechend ihrer Bedeutung für die Lebensqualität der Patienten sollten Depression, Fatigue und kognitive Störungen bei der Behandlung und Erforschung der MS stärkere Berücksichtigung finden.

Summary

Depression, fatigue and cognitive impairment are common symptoms of patients with multiple sclerosis (MS), which frequently occur early in the disease course and exert a strong impact on quality of life. While the pathogenesis of depression and fatigue is still unknown, cognitive impairment correlates well with cerebral atrophy. Clinical experience and a few studies demonstrate the effectiveness of antidepressants in MS patients with depression and of amantadine and modafinil in MS patients with fatigue. The immunomodulatory therapy with interferon-ß (IFN-ß) slows the progression of cerebral atrophy and cognitive impairment. In addition one study indicates, that acetylcholinesterase inhibitors may be effective. According to their importance in everyday life depression, fatigue and cognitive deficits should be considered more adequately in research and therapeutic approaches.

Schlüsselwörter

Multiple Sklerose - Depression - Fatigue - kognitive Störungen

Keywords

Multiple sclerosis - depression - fatigue - cognitive impairment

• Literatur

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