Demenzen

H. Kretzschmar

doi:10.1055/s-0038-1628683

Nervenheilkunde, Table of Contents

Nervenheilkunde 2009; 28(09): 583-592
DOI: 10.1055/s-0038-1628683

Neuropathologie

Schattauer GmbH

Demenzen

Dementia

H. Kretzschmar

¹Zentrum für Neuropathologie und Prionforschung, LMU München

› Author Affiliations

Abstract

Zusammenfassung

Fortschritte in der biochemischen und molekularbiologischen Forschung haben Zusammenhänge in der Diagnostik der neurodegenerativen Krankheiten erkennen lassen. Neue Antikörper sind verfügbar geworden, die für pathologische Ablagerungen bei bestimmten Krankheiten oder Krankheitsgruppen spezifisch sind. Dadurch lassen sich diese Veränderungen morphologisch mit höherer Spezifität und zudem leichter erkennen als zu Zeiten, in denen die morphologische Diagnostik auf nur wenig spezifischen Färbungen, insbesondere Versilberungen, beruhte. Zum anderen wurde in den letzten Jahren mehr als zuvor versucht, pathologische Veränderungen quantitativ oder semiquantitativ zu erfassen und mit klinischen Veränderungen zu korrelieren. Dies hat zu einer besseren gegenseitigen Abgrenzung ähnlicher Krankheitsbilder geführt, sodass zunächst nur unscharf abgrenzbare Krankheitsbilder auch morphologisch besser unterscheidbar sind. Die Erkenntnis, dass das Protein TDP-43 bei einem Großteil der FTLD und allen Formen der ALS abgelagert wird, hat zu neuer Sicherheit in der Diagnostik und zu neuer Nomenklatur geführt.

Summary

Progress in biochemical and molecular biological research has made possible new insights into the diagnosis of neurodegenerative diseases. New antibodies specific for pathological deposits in certain disease entities have become available. This has contributed to a much higher specificity and ease of recognition of these changes compared to the diagnosis in times of silver staining of histological sections. In addition there have been serious efforts in recent times to quantitatively or semiquantitatively assess pathological changes and to correlate these with clinical findings. This has led to a much sharper definition of diseases in such a way that formerly less well defined disorders have become much better distinguishable morphologically. In particular the finding that the protein TDP-43 is found in inclusions in many FTLD cases and almost all forms of ALS has contributed to the reliability of diagnosis and has also ushered in a new nomenclature.

Schlüsselwörter

Neurodegeneration - Demenz - Neuropathologie

Keywords

Neurodegeneration - dementia - neuropathology

Full Text

References

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