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Klinisch-validierte molekulare Biomarker neurodegenerativer Demenzerkrankungen

verfasst von: Prof. Dr. J. Wiltfang

Erschienen in: Der Nervenarzt | Ausgabe 11/2014

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Zusammenfassung

Die liquorbasierte neurochemische Demenzdiagnostik (CSF-NDD) ist zwischenzeitlich auf dem S3-Niveau evidenzbasiert validiert, und sie wird mit spezifischer Indikationsstellung für die verbesserte Früh- und Differenzialdiagnostik der multigenetischen (sporadischen) Alzheimer-Demenz (AD) von den gemeinsamen Demenzleitlinien der neuropsychiatrischen Fachgesellschaften empfohlen. Mittels CSF-NDD ist auch eine prädiktive Diagnostik der drohenden AD bei Hochrisikopatienten im Prodromalstadium der leichten kognitiven Beeinträchtigung („mild cognitive impairment“, MCI) möglich. Da bisher aber keine (sekundär)präventive Therapie der AD zur Verfügung steht, wird der Einsatz der CSF-NDD für die molekular prädiktive Demenzdiagnostik von neuropsychiatrischen Leitlinien nicht empfohlen (http://www.DGPPN.de). Die molekulare Diagnostik der präklinischen AD mittels CSF-NDD und [18F]Amyloid-Positronenemissionstomographie hat allerdings schon jetzt einen hohen Stellenwert innerhalb der klinischen Therapieforschung, da auf diese Weise vielversprechende (sekundär)präventive Therapieansätze im klinischen Modell systematisch untersuchbar werden. Zwischenzeitlich zeichnet sich auch ab, dass die Etablierung einer blutbasierten molekularen Frühdiagnostik der AD mittels Multiplex-Assays wahrscheinlich wird. Bisher konnten vielversprechende Assays jedoch nicht konsistent von unabhängigen Arbeitsgruppen validiert werden und im Gegensatz zur CSF-NDD steht eine blutbasierte Diagnostik neurodegenerativer Demenzen noch nicht zur Verfügung.

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Titel: Klinisch-validierte molekulare Biomarker neurodegenerativer Demenzerkrankungen
verfasst von: Prof. Dr. J. Wiltfang
Publikationsdatum: 01.11.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Der Nervenarzt / Ausgabe 11/2014
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-014-4086-7

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