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Kognitive Reservekapazität und ihre Bedeutung für Auftreten und Verlauf der Demenz

verfasst von: PD Dr. R. Perneczky, P. Alexopoulos, G. Schmid, C. Sorg, H. Förstl, J. Diehl-Schmid, A. Kurz

Erschienen in: Der Nervenarzt | Ausgabe 3/2011

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Zusammenfassung

Die fortschreitende Hirnschädigung bei neurodegenerativen Erkrankungen wie der Alzheimer-Krankheit ist ohne Zweifel die Hauptursache der klinischen Demenzsymptome. Der Zusammenhang zwischen Hirnschädigung und Symptomatik ist jedoch nicht linear. Bestimmte interindividuelle Unterschiede wie eine gute Schulbildung oder ein großes Hirnvolumen bedingen eine höhere Widerstandsfähigkeit gegen die Hirnpathologie. Dieses Phänomen wird als kognitive Reservekapazität (KR) bezeichnet. Menschen mit hoher KR haben ein geringeres Demenzrisiko, wobei sowohl passive als auch aktive Reservekonzepte diskutiert werden. Bei der passiven KR geht man von hirnstrukturellen Besonderheiten wie einer höheren Neuronen- oder Synapsenzahl aus, die einen größeren Puffer gegen Verluste darstellen. Erst wenn eine bestimmte Verlustgrenze durch eine fortschreitende Hirnschädigung überschritten wird, treten Symptome auf. Neben dem passiven Konzept werden auch aktive Mechanismen diskutiert, die unabhängig von rein strukturellen Unterschieden zur längeren Aufrechterhaltung der kognitiven Leistungsfähigkeit beitragen. Bei kognitiv gesunden Menschen führen diese Mechanismen zur Adaption der Hirnaktivität bei Steigerung des Schwierigkeitsgrades einer Aufgabe; bei fortschreitender Neurodegeneration kompensieren diese Mechanismen die Schädigung. Menschen mit hoher KR zeigen dabei eine effizientere Aktivierung bei derselben Aufgabe und können dadurch das normale kognitive Leistungsniveau länger aufrecht erhalten.

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Titel: Kognitive Reservekapazität und ihre Bedeutung für Auftreten und Verlauf der Demenz
verfasst von: PD Dr. R. Perneczky
P. Alexopoulos
G. Schmid
C. Sorg
H. Förstl
J. Diehl-Schmid
A. Kurz
Publikationsdatum: 01.03.2011
Verlag: Springer-Verlag
Erschienen in: Der Nervenarzt / Ausgabe 3/2011
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI: https://doi.org/10.1007/s00115-010-3165-7

Neu in den Fachgebieten Neurologie und Psychiatrie

16.04.2024 | Maligne primäre ZNS-Tumoren | Nachrichten

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Kognitive Reservekapazität und ihre Bedeutung für Auftreten und Verlauf der Demenz

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