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Aktuelle Neurologie 2003; 30(3): 118-126
DOI: 10.1055/s-2003-38272
Originalarbeit
© Georg Thieme Verlag Stuttgart · New York

Exekutivfunktionsleistungen bei Patienten mit multipler Sklerose

Executive Functions in Patients with Multiple SclerosisH.  Hildebrandt1, 2 , B.  Brokate3 , M.  Lanz1 , T.  Ternes1, 2 , C.  Timm1
  • 1Zentralkrankenhaus Bremen-Ost, Neurologie (CA Prof. Schwendemann), Bremen
  • 2Universität Oldenburg, Klinische und Gesundheitspsychologie, Oldenburg
  • 3Zentralkrankenhaus Bremen-Ost, Zentrum für Psychiatrie und Psychotherapie, Bremen
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Publication History

Publication Date:
27 March 2003 (online)

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Zusammenfassung

Kognitive Defizite bei multipler Sklerose (MS) haben in den letzten Jahren wachsende Beachtung gefunden. In dieser Untersuchung verglichen wir die Leistung von 40 MS-Patienten und 18 Kontrollpersonen anhand von Verfahren zu den Exekutivfunktionen, zum sprachlichen Gedächtnis und zur kognitiven Verarbeitungsgeschwindigkeit. Außerdem wurde das Ausmaß der depressiven Symptomatik und der psychosomatischen Beschwerden in der MS-Gruppe erhoben. Ausgangspunkt war die These, dass die häufige Lage der MS-spezifischen Entzündungsherde im Bereich des periventrikulären Marklagers speziell zu Einbußen im Arbeitsgedächtnis und in den Exekutivfunktionen führen sollte. Das Ergebnis zeigte eine deutliche Korrelation des klinischen Status der Patienten (EDSS-Wert) mit der kognitiven Verarbeitungsgeschwindigkeit und der Abrufleistung des sprachlichen Gedächtnisses. Patienten mit sekundär chronisch progredienter MS waren in praktisch allen Exekutivfunktionsparametern beeinträchtigt. Für die Gesamtgruppe der MS-Patienten wie für die Gruppe mit schubförmiger MS fand sich dagegen ein signifikanter Unterschied in einer einfachen Arbeitsgedächtnis- und in einer Reaktionswechselaufgabe, d. h. in zwei Aspekten der Exekutivfunktionen. Die Studie zeigt, dass kognitive Defizite bei MS-Patienten signifikant gehäuft auftreten und es möglich sein könnte, klinisches Stadium, Verlaufsform und allgemeine Erkrankung an MS mittels spezifischer neuropsychologischer Verfahren zu differenzieren.

Abstract

During the last years, research on cognitive deficits in patients with multiple sclerosis (MS) has been intensified. Since MS-specific lesions are often found in the periventricular cerebral white matter, impairments in working memory and executive functions should prevail. The present study compares 40 MS patients and 18 controls in tests on executive function, verbal memory and attention. In addition we gathered data on depression and the extent of psychosomatic complaints in the MS group. The analysis revealed a significant correlation between the patients' clinical status (EDSS score), attention, and free recall. Patients with secondary chronic progressive MS were impaired in virtually all parameters of executive functions. We found a significant difference in a simple working memory task and a reaction alteration task for the MS group as a whole and for the group with relapsing-remitting MS. MS patients therefore suffer from cognitive deficits in considerable numbers. Our results demonstrate that it may be possible to differentiate the stages of MS and make assessments of the course and type of the disease by means of specific neuropsychological procedures.

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PD Dr. phil. Helmuth Hildebrandt

Universität Oldenburg · FB 5 - Psychologie

Postfach 2503

26111 Oldenburg

Email: helmut.hildebrandt@uni-oldenburg.de

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