nach oben

Erschienen in:

13.03.2020 | Original Communication

Autonomic dysfunction is associated with neuropsychological impairment in Lewy body disease

verfasst von: Rocío Del Pino, Ane Murueta-Goyena, Marian Acera, Mar Carmona-Abellan, Beatriz Tijero, Olaia Lucas-Jiménez, Natalia Ojeda, Naroa Ibarretxe-Bilbao, Javier Peña, Iñigo Gabilondo, Juan Carlos Gómez-Esteban

Erschienen in: Journal of Neurology | Ausgabe 7/2020

Einloggen, um Zugang zu erhalten

Abstract

Objective

This study aimed to analyze the association of autonomic dysfunction with cognition, depression, apathy, and fatigue in Lewy body disease (LBD).

Methods

We included 61 patients [49 with idiopathic Parkinson’s disease, 7 with dementia with Lewy bodies, and 5 E46K-SNCA mutation carriers] and 22 healthy controls. All participants underwent a comprehensive battery of neuropsychological and clinical measures, autonomic symptom assessment with the SCOPA-AUT, analysis of non-invasive hemodynamic parameters during deep breathing, the Valsalva maneuver, and a 20-min tilt test, and electrochemical skin conductance measurement at rest (Sudoscan). Student’s t tests were used to assess group differences, and bivariate correlations and stepwise linear regressions to explore associations between autonomic function, cognition, depression, apathy, and fatigue.

Results

Compared to controls, patients who had significant impairment (p < 0.05) in cognition, higher depression, apathy, and fatigue, more autonomic symptoms and objective autonomic dysfunction, reduced deep breathing heart rate variability [expiratory-to-inspiratory (E/I) ratio], prolonged pressure recovery time, and lower blood pressure in Valsalva late phase II and phase IV, while 24.1% had orthostatic hypotension in the tilt test. Autonomic parameters significantly correlated with cognitive and neuropsychiatric outcomes, systolic blood pressure during the Valsalva maneuver predicting apathy and depression. The E/I ratio was the main predictor of cognitive performance (17.6% for verbal fluency to 32.8% for visual memory).

Conclusion

Cardiovascular autonomic dysfunction is associated with cognitive and neuropsychiatric impairment in LBD, heart rate variability during deep breathing and systolic blood pressure changes during the Valsalva procedure are the main predictors of neuropsychological performance and depression/apathy symptoms, respectively.

Nur mit Berechtigung zugänglich

Schapira AHV, Chaudhuri KR, Jenner P (2017) Non-motor features of Parkinson disease. Nat Rev Neurosci 18(7):435–450. https://doi.org/10.1038/nrn.2017.62 CrossRefPubMed

Bernal-Pacheco O, Limotai N, Go CL, Fernandez HH (2012) Nonmotor manifestations in Parkinson disease. The Neurologist 18(1):1–16. https://doi.org/10.1097/NRL.0b013e31823d7abb CrossRefPubMed

Berganzo K, Tijero B, Gonzalez-Eizaguirre A, Somme J, Lezcano E, Gabilondo I, Fernandez M, Zarranz JJ, Gomez-Esteban JC (2016) Motor and non-motor symptoms of Parkinson's disease and their impact on quality of life and on different clinical subgroups. Neurologia (Barcelona, Spain) 31(9):585–591. https://doi.org/10.1016/j.nrl.2014.10.010 CrossRef

Tijero B, Gomez-Esteban JC, Lezcano E, Fernandez-Gonzalez C, Somme J, Llorens V, Martinez A, Ruiz-Martinez J, Foncea N, Escalza I, Berganzo K, Aniel-Quiroga MA, Ruiz V, Teran N, Kaufmann H, Zarranz JJ (2013) Cardiac sympathetic denervation in symptomatic and asymptomatic carriers of the E46K mutation in the alpha synuclein gene. Parkinsonism Relat Disord 19(1):95–100. https://doi.org/10.1016/j.parkreldis.2012.08.001 CrossRefPubMed

Bosboom JL, Stoffers D, Wolters E (2004) Cognitive dysfunction and dementia in Parkinson's disease. J Neural Transm (Vienna, Austria: 1996) 111(10–11):1303–1315. https://doi.org/10.1007/s00702-004-0168-1 CrossRef

Goldman JG, Williams-Gray C, Barker RA, Duda JE, Galvin JE (2014) The spectrum of cognitive impairment in Lewy body diseases. Mov Disord 29(5):608–621. https://doi.org/10.1002/mds.25866 CrossRefPubMedPubMedCentral

Emre M (2003) Dementia associated with Parkinson's disease. The Lancet Neurol 2(4):229–237CrossRef

Gomperts SN (2016) Lewy body dementias: dementia with Lewy bodies and Parkinson Disease Dementia. Continuum (Minneapolis, Minn) 22(2 Dementia):435–463. https://doi.org/10.1212/con.0000000000000309 CrossRef

Aarsland D, Creese B, Politis M, Chaudhuri KR, Ffytche DH, Weintraub D, Ballard C (2017) Cognitive decline in Parkinson disease. Nat Rev Neurol 13(4):217–231. https://doi.org/10.1038/nrneurol.2017.27 CrossRefPubMedPubMedCentral

10.

Pillon B, Dubois B, Agid Y (1996) Testing cognition may contribute to the diagnosis of movement disorders. Neurology 46(2):329–334. https://doi.org/10.1212/wnl.46.2.329 CrossRefPubMed

11.

Hansch EC, Syndulko K, Cohen SN, Goldberg ZI, Potvin AR, Tourtellotte WW (1982) Cognition in Parkinson disease: an event-related potential perspective. Ann Neurol 11(6):599–607. https://doi.org/10.1002/ana.410110608 CrossRefPubMed

12.

Pena J, Ibarretxe-Bilbao N, Garcia-Gorostiaga I, Gomez-Beldarrain MA, Diez-Cirarda M, Ojeda N (2014) Improving functional disability and cognition in Parkinson disease: randomized controlled trial. Neurology 83(23):2167–2174. https://doi.org/10.1212/wnl.0000000000001043 CrossRefPubMedPubMedCentral

13.

Pluck GC, Brown RG (2002) Apathy in Parkinson's disease. J Neurol Neurosurg Psychiatry 73(6):636–642. https://doi.org/10.1136/jnnp.73.6.636 CrossRefPubMedPubMedCentral

14.

Jasinska-Myga B, Putzke JD, Wider C, Wszolek ZK, Uitti RJ (2010) Depression in Parkinson's disease. Can J Neurol Sci Le journal Canadien des sciences neurologiques 37(1):61–66. https://doi.org/10.1017/s0317167100009665 CrossRef

15.

Jost WH (2003) Autonomic dysfunctions in idiopathic Parkinson's disease. J Neurol 250(Suppl 1):I28–30. https://doi.org/10.1007/s00415-003-1105-z CrossRefPubMed

16.

Berg D, Postuma RB, Adler CH, Bloem BR, Chan P, Dubois B, Gasser T, Goetz CG, Halliday G, Joseph L, Lang AE, Liepelt-Scarfone I, Litvan I, Marek K, Obeso J, Oertel W, Olanow CW, Poewe W, Stern M, Deuschl G (2015) MDS research criteria for prodromal Parkinson's disease. Mov Disord 30(12):1600–1611. https://doi.org/10.1002/mds.26431 CrossRefPubMed

17.

Kaufmann H, Goldstein DS (2013) Autonomic dysfunction in Parkinson disease. Handbf Clin Neurol 117:259–278. https://doi.org/10.1016/b978-0-444-53491-0.00021-3 CrossRef

18.

Velseboer DC, de Haan RJ, Wieling W, Goldstein DS, de Bie RM (2011) Prevalence of orthostatic hypotension in Parkinson's disease: a systematic review and meta-analysis. Parkinsonism Relat Disord 17(10):724–729. https://doi.org/10.1016/j.parkreldis.2011.04.016 CrossRefPubMedPubMedCentral

19.

Palma JA, Gomez-Esteban JC, Norcliffe-Kaufmann L, Martinez J, Tijero B, Berganzo K, Kaufmann H (2015) Orthostatic hypotension in Parkinson disease: how much you fall or how low you go? Mov Disord 30(5):639–645. https://doi.org/10.1002/mds.26079 CrossRefPubMedPubMedCentral

20.

Cutsforth-Gregory JK, Low PA (2019) Neurogenic orthostatic hypotension in parkinson disease: a primer. Neurol Ther 8(2):307–324. https://doi.org/10.1007/s40120-019-00152-9 CrossRefPubMedPubMedCentral

21.

Low PA (2008) Prevalence of orthostatic hypotension. Clin Auton Res 18(Suppl 1):8–13. https://doi.org/10.1007/s10286-007-1001-3 CrossRefPubMed

22.

Guo Y, Xu W, Liu FT, Li JQ, Cao XP, Tan L, Wang J, Yu JT (2019) Modifiable risk factors for cognitive impairment in Parkinson's disease: A systematic review and meta-analysis of prospective cohort studies. Mov Disord 34(6):876–883. https://doi.org/10.1002/mds.27665 CrossRefPubMed

23.

Stankovic I, Petrovic I, Pekmezovic T, Markovic V, Stojkovic T, Dragasevic-Miskovic N, Svetel M, Kostic V (2019) Longitudinal assessment of autonomic dysfunction in early Parkinson's disease. Parkinsonism Relat Disord. https://doi.org/10.1016/j.parkreldis.2019.07.008 CrossRefPubMed

24.

Sforza M, Assogna F, Rinaldi D, Sette G, Tagliente S, Pontieri FE (2018) Orthostatic hypotension acutely impairs executive functions in Parkinson's disease. Neurol Sci 39(8):1459–1462. https://doi.org/10.1007/s10072-018-3394-2 CrossRefPubMed

25.

De Pablo-Fernandez E, Tur C, Revesz T, Lees AJ, Holton JL, Warner TT (2017) Association of autonomic dysfunction with disease progression and survival in Parkinson disease. JAMA neurology 74(8):970–976. https://doi.org/10.1001/jamaneurol.2017.1125 CrossRefPubMedPubMedCentral

26.

Centi J, Freeman R, Gibbons CH, Neargarder S, Canova AO, Cronin-Golomb A (2017) Effects of orthostatic hypotension on cognition in Parkinson disease. Neurology 88(1):17–24. https://doi.org/10.1212/wnl.0000000000003452 CrossRefPubMedPubMedCentral

27.

Fanciulli A, Strano S, Colosimo C, Caltagirone C, Spalletta G, Pontieri FE (2013) The potential prognostic role of cardiovascular autonomic failure in alpha-synucleinopathies. Eur J Neurol 20(2):231–235. https://doi.org/10.1111/j.1468-1331.2012.03819.x CrossRefPubMed

28.

Oka H, Toyoda C, Yogo M, Mochio S (2011) Cardiovascular dysautonomia in de novo Parkinson's disease without orthostatic hypotension. Eur J Neurol 18(2):286–292. https://doi.org/10.1111/j.1468-1331.2010.03135.x CrossRefPubMed

29.

Rocchi C, Pierantozzi M, Galati S, Chiaravalloti A, Pisani V, Prosperetti C, Lauretti B, Stampanoni Bassi M, Olivola E, Schillaci O, Stefani A (2015) Autonomic function tests and MIBG in Parkinson's disease: correlation to disease duration and motor symptoms. CNS Neurosci Ther 21(9):727–732. https://doi.org/10.1111/cns.12437 CrossRefPubMedPubMedCentral

30.

Perez T, Tijero B, Gabilondo I, Luna A, Llorens V, Berganzo K, Acera M, Gonzalez A, Sanchez-Ferro A, Lezcano E, Zarranz JJ, Gomez-Esteban JC (2015) Cardiocirculatory manifestations in Parkinson's disease patients without orthostatic hypotension. J Hum Hypertens 29(10):604–609. https://doi.org/10.1038/jhh.2014.131 CrossRefPubMed

31.

Wang Y, Zhao X, O'Neil A, Turner A, Liu X, Berk M (2013) Altered cardiac autonomic nervous function in depression. BMC Psychiatry 13:187. https://doi.org/10.1186/1471-244x-13-187 CrossRefPubMedPubMedCentral

32.

Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55(3):181–184. https://doi.org/10.1136/jnnp.55.3.181 CrossRefPubMedPubMedCentral

33.

McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, Salmon DP, Lowe J, Mirra SS, Byrne EJ, Lennox G, Quinn NP, Edwardson JA, Ince PG, Bergeron C, Burns A, Miller BL, Lovestone S, Collerton D, Jansen EN, Ballard C, de Vos RA, Wilcock GK, Jellinger KA, Perry RH (1996) Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology 47(5):1113–1124. https://doi.org/10.1212/wnl.47.5.1113 CrossRefPubMed

34.

McKeith IG, Dickson DW, Lowe J, Emre M, O'Brien JT, Feldman H, Cummings J, Duda JE, Lippa C, Perry EK, Aarsland D, Arai H, Ballard CG, Boeve B, Burn DJ, Costa D, Del Ser T, Dubois B, Galasko D, Gauthier S, Goetz CG, Gomez-Tortosa E, Halliday G, Hansen LA, Hardy J, Iwatsubo T, Kalaria RN, Kaufer D, Kenny RA, Korczyn A, Kosaka K, Lee VM, Lees A, Litvan I, Londos E, Lopez OL, Minoshima S, Mizuno Y, Molina JA, Mukaetova-Ladinska EB, Pasquier F, Perry RH, Schulz JB, Trojanowski JQ, Yamada M (2005) Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 65(12):1863–1872. https://doi.org/10.1212/01.wnl.0000187889.17253.b1 CrossRefPubMed

35.

Litvan I, Goldman JG, Troster AI, Schmand BA, Weintraub D, Petersen RC, Mollenhauer B, Adler CH, Marder K, Williams-Gray CH, Aarsland D, Kulisevsky J, Rodriguez-Oroz MC, Burn DJ, Barker RA, Emre M (2012) Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines. Mov Disord 27(3):349–356. https://doi.org/10.1002/mds.24893 CrossRefPubMedPubMedCentral

36.

Evatt ML, Chaudhuri KR, Chou KL, Cubo E, Hinson V, Kompoliti K, Yang C, Poewe W, Rascol O, Sampaio C, Stebbins GT, Goetz CG (2009) Dysautonomia rating scales in Parkinson's disease: sialorrhea, dysphagia, and constipation–critique and recommendations by movement disorders task force on rating scales for Parkinson's disease. Mov Disord 24(5):635–646. https://doi.org/10.1002/mds.22260 CrossRefPubMedPubMedCentral

37.

Novak P (2011) Quantitative autonomic testing. J Vis Exp. https://doi.org/10.3791/2502 CrossRefPubMedPubMedCentral

38.

Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology (1996). Neurology 46 (5):1470. doi:10.1212/wnl.46.5.1470

39.

Casellini CM, Parson HK, Richardson MS, Nevoret ML, Vinik AI (2013) Sudoscan, a noninvasive tool for detecting diabetic small fiber neuropathy and autonomic dysfunction. Diabetes Technol Ther 15(11):948–953. https://doi.org/10.1089/dia.2013.0129 CrossRefPubMedPubMedCentral

40.

Allcock LM, Kenny RA, Mosimann UP, Tordoff S, Wesnes KA, Hildreth AJ, Burn DJ (2006) Orthostatic hypotension in Parkinson's disease: association with cognitive decline? Int J Geriatr Psychiatry 21(8):778–783. https://doi.org/10.1002/gps.1562 CrossRefPubMed

41.

Peralta C, Stampfer-Kountchev M, Karner E, Kollensperger M, Geser F, Wolf E, Seppi K, Benke T, Poewe W, Wenning GK (2007) Orthostatic hypotension and attention in Parkinson's disease with and without dementia. J Neural Transm (Vienna, Austria: 1996) 114(5):585–588. https://doi.org/10.1007/s00702-006-0615-2 CrossRef

42.

Robertson AD, Messner MA, Shirzadi Z, Kleiner-Fisman G, Lee J, Hopyan J, Lang AE, Black SE, MacIntosh BJ, Masellis M (2016) Orthostatic hypotension, cerebral hypoperfusion, and visuospatial deficits in Lewy body disorders. Parkinsonism Relat Disord 22:80–86. https://doi.org/10.1016/j.parkreldis.2015.11.019 CrossRefPubMed

43.

Paschali A, Messinis L, Kargiotis O, Lakiotis V, Kefalopoulou Z, Constantoyannis C, Papathanasopoulos P, Vassilakos P (2010) SPECT neuroimaging and neuropsychological functions in different stages of Parkinson's disease. Eur J Nucl Med Mol Imaging 37(6):1128–1140. https://doi.org/10.1007/s00259-010-1381-9 CrossRefPubMed

44.

Chung SJ, Bae YJ, Jun S, Yoo HS, Kim SW, Lee YH, Sohn YH, Lee SK, Seong JK, Lee PH (2019) Dysautonomia is associated with structural and functional alterations in Parkinson disease. Neurology 92(13):e1456–e1467. https://doi.org/10.1212/wnl.0000000000007181 CrossRefPubMed

45.

Rocchi C, Placidi F, Liguori C, Del Bianco C, Lauretti B, Diomedi M, Pisani A, Mercuri NB, Izzi F (2018) Daytime autonomic activity in idiopathic rapid eye movement sleep behavior disorder: a preliminary study. Sleep Med 52:163–167. https://doi.org/10.1016/j.sleep.2018.08.023 CrossRefPubMed

46.

Postuma RB, Lang AE, Massicotte-Marquez J, Montplaisir J (2006) Potential early markers of Parkinson disease in idiopathic REM sleep behavior disorder. Neurology 66(6):845–851. https://doi.org/10.1212/01.wnl.0000203648.80727.5b CrossRefPubMed

47.

Schmidt C, Herting B, Prieur S, Junghanns S, Schweitzer K, Globas C, Schols L, Reichmann H, Berg D, Ziemssen T (2009) Valsalva manoeuvre in patients with different Parkinsonian disorders. J Neural Transm (Vienna, Austria: 1996) 116(7):875–880. https://doi.org/10.1007/s00702-009-0239-4 CrossRef

48.

Fereshtehnejad SM, Lökk J (2014) Orthostatic hypotension in patients with Parkinson's disease and atypical parkinsonism. Parkinson's Dis. https://doi.org/10.1155/2014/475854 CrossRef

49.

Carmona-Abellan M, Gabilondo I, Murueta-Goyena A, Khurana V, Tijero B, Luquin MR, Acera M, Del Pino R, Gardeazabal J, Martinez-Valbuena I, Sanchez-Pernaute R, Gomez-Esteban JC (2019) Small fiber neuropathy and phosphorylated alpha-synuclein in the skin of E46K-SNCA mutation carriers. Parkinsonism Relat Disord 65:139–145. https://doi.org/10.1016/j.parkreldis.2019.05.038 CrossRefPubMed

50.

Siepmann T, Illigens BM-W, Barlinn K (2016) Alpha-synuclein in cutaneous small nerve fibers. Neuropsychiatr Dis Treat 12:2731–2735. https://doi.org/10.2147/NDT.S117423 CrossRefPubMedPubMedCentral

51.

Amino T, Orimo S, Itoh Y, Takahashi A, Uchihara T, Mizusawa H (2005) Profound cardiac sympathetic denervation occurs in Parkinson disease. Brain Pathol (Zurich, Switzerland) 15(1):29–34. https://doi.org/10.1111/j.1750-3639.2005.tb00097.x CrossRef

52.

Seidel K, Mahlke J, Siswanto S, Kruger R, Heinsen H, Auburger G, Bouzrou M, Grinberg LT, Wicht H, Korf HW, den Dunnen W, Rub U (2015) The brainstem pathologies of Parkinson's disease and dementia with Lewy bodies. Brain Pathol (Zurich, Switzerland) 25(2):121–135. https://doi.org/10.1111/bpa.12168 CrossRef

53.

Palma JA, Carmona-Abellan MM, Barriobero N, Trevino-Peinado C, Garcia-Lopez M, Fernandez-Jarne E, Luquin MR (2013) Is cardiac function impaired in premotor Parkinson's disease? A retrospective cohort study. Mov Disord 28(5):591–596. https://doi.org/10.1002/mds.25431 CrossRefPubMed

54.

Kim JS, Oh YS, Lee KS, Kim YI, Yang DW, Goldstein DS (2012) Association of cognitive dysfunction with neurocirculatory abnormalities in early Parkinson disease. Neurology 79(13):1323–1331. https://doi.org/10.1212/WNL.0b013e31826c1acd CrossRefPubMedPubMedCentral

55.

Forte G, Favieri F, Casagrande M (2019) Heart rate variability and cognitive function: a systematic review. Front Neurosci 13:710. https://doi.org/10.3389/fnins.2019.00710 CrossRefPubMedPubMedCentral

56.

Solopchuk O, Sebti M, Bouvy C, Benoit CE, Warlop T, Jeanjean A, Zenon A (2018) Locus Coeruleus atrophy doesn't relate to fatigue in Parkinson's disease. Sci Rep 8(1):12381. https://doi.org/10.1038/s41598-018-30128-y CrossRefPubMedPubMedCentral

57.

Remy P, Doder M, Lees A, Turjanski N, Brooks D (2005) Depression in Parkinson's disease: loss of dopamine and noradrenaline innervation in the limbic system. Brain J Neurol 128(Pt 6):1314–1322. https://doi.org/10.1093/brain/awh445 CrossRef

58.

Loued-Khenissi L, Preuschoff K (2015) Apathy and noradrenaline: silent partners to mild cognitive impairment in Parkinson's disease? Curr Opin Neurol 28(4):344–350. https://doi.org/10.1097/wco.0000000000000218 CrossRefPubMed

59.

Olivola E, Brusa L, Rocchi C, Schillaci O, Liguori C, Cerroni R, Pierantozzi M, Chiaravalloti A, Stefani A, Stocchi F (2018) Does fatigue in Parkinson's disease correlate with autonomic nervous system dysfunction? Neurol Sci 39(12):2169–2174. https://doi.org/10.1007/s10072-018-3569-x CrossRefPubMed

60.

Chou KL, Gilman S, Bohnen NI (2017) Association between autonomic dysfunction and fatigue in Parkinson disease. J Neurol Sci 377:190–192. https://doi.org/10.1016/j.jns.2017.04.023 CrossRefPubMedPubMedCentral

61.

Sambati L, Calandra-Buonaura G, Poda R, Guaraldi P, Cortelli P (2014) Orthostatic hypotension and cognitive impairment: a dangerous association? Neurol Sci 35(6):951–957. https://doi.org/10.1007/s10072-014-1686-8 CrossRefPubMed

Titel: Autonomic dysfunction is associated with neuropsychological impairment in Lewy body disease
verfasst von: Rocío Del Pino
Ane Murueta-Goyena
Marian Acera
Mar Carmona-Abellan
Beatriz Tijero
Olaia Lucas-Jiménez
Natalia Ojeda
Naroa Ibarretxe-Bilbao
Javier Peña
Iñigo Gabilondo
Juan Carlos Gómez-Esteban
Publikationsdatum: 13.03.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 7/2020
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-09783-7

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

18.04.2024 | Arterielle Hypertonie | Nachrichten

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Autonomic dysfunction is associated with neuropsychological impairment in Lewy body disease

Abstract

Objective

Methods

Results

Conclusion

Leitlinien kompakt für die Neurologie

Neu im Fachgebiet Neurologie

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Manche Gestagene können das Risiko für Meningeome erhöhen

Parkinson: Größere Studie bestätigt Genauigkeit von Hauttest

Update Neurologie

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Objective

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2020

Normalized grip strength is a sensitive outcome measure through all stages of Duchenne muscular dystrophy

Management of functional neurological disorder

Laparoscopic sleeve gastrectomy improves brain connectivity in obese patients

Genetic correlations and causal inferences in ischemic stroke

Spatial metabolic profiles to discriminate dementia with Lewy bodies from Alzheimer disease

Efficacy and safety of incobotulinumtoxinA in post-stroke upper-limb spasticity in Japanese subjects: results from a randomized, double-blind, placebo-controlled study (J-PURE)

Leitlinien kompakt für die Neurologie

Neu im Fachgebiet Neurologie

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

Manche Gestagene können das Risiko für Meningeome erhöhen

Parkinson: Größere Studie bestätigt Genauigkeit von Hauttest

Update Neurologie