Skip to main content
Erschienen in: Current Neurology and Neuroscience Reports 5/2018

01.05.2018 | Movement Disorders (S Fox, Section Editor)

Lewy Body Disease: Clinical and Pathological “Overlap Syndrome” Between Synucleinopathies (Parkinson Disease) and Tauopathies (Alzheimer Disease)

verfasst von: Clovis Foguem, Patrick Manckoundia

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 5/2018

Einloggen, um Zugang zu erhalten

Abstract

Lewy body disease (LBD) is a neurodegenerative disease resulting in dementia. It shares clinical and pathological features with Parkinson disease (PD), the most frequent synucleinopathy, Parkinson disease dementia (PDD), and Alzheimer disease (AD), a tauopathy. Even though the diagnostic criteria for these neurodegenerative diseases are clearly established, and recently revised for LBD, their precise clinical diagnosis is often difficult because LBD, PD, PDD, and AD share epidemiological, clinical, and pathological characteristics. This manuscript discusses current understanding of overlapping symptoms and the particular features of LBD, PD, and AD. It also describes features that could facilitate the diagnosis of each of these diseases. We concluded that the concept of neurodegenerative “overlap” syndrome, which includes the accepted diagnosis of LBD, may be taken in account and should contribute to clarifying LBD and definitions of close differential diagnoses. This should allow clinicians to suspect LBD at an earlier stage and provide better patient care.
Literatur
1.
Zurück zum Zitat Geser F, Wenning GK, Poewe W, McKeith I. How to diagnose Lewy body disease: state of the art. Mov Disord. 2005;20(Suppl 12):S11–20.CrossRefPubMed Geser F, Wenning GK, Poewe W, McKeith I. How to diagnose Lewy body disease: state of the art. Mov Disord. 2005;20(Suppl 12):S11–20.CrossRefPubMed
2.
Zurück zum Zitat McKeith I, Mintzer J, Aarsland D, Burn D, Chiu H, Cohen-Mansfield J, et al. Lewy body disease. Lancet Neurol. 2004;3:19–28.CrossRefPubMed McKeith I, Mintzer J, Aarsland D, Burn D, Chiu H, Cohen-Mansfield J, et al. Lewy body disease. Lancet Neurol. 2004;3:19–28.CrossRefPubMed
4.
Zurück zum Zitat •• Foguem C, Kamsu-Foguem B. Neurodegeneration in tauopathies and synucleinopathies. Rev Neurol (Paris). 2016;172(11):709–14. Foguem and Kamsu-Foguem described the physiopathology (accumulation of one or more aggregated proteins as the molecular signature) of the three main disease groups constituting the majority of neurodegenerative diseases as tauopathies (Alzheimer’s disease), alpha-synucleinopathies (Parkinson’s disease) and diseases due to repetitions of glutamine (Huntington’s disease). They suggested that in the future, innovative strategies to elaborate suitable diagnostic and therapeutic approaches for neurodegenerative diseases would be found.CrossRef •• Foguem C, Kamsu-Foguem B. Neurodegeneration in tauopathies and synucleinopathies. Rev Neurol (Paris). 2016;172(11):709–14. Foguem and Kamsu-Foguem described the physiopathology (accumulation of one or more aggregated proteins as the molecular signature) of the three main disease groups constituting the majority of neurodegenerative diseases as tauopathies (Alzheimer’s disease), alpha-synucleinopathies (Parkinson’s disease) and diseases due to repetitions of glutamine (Huntington’s disease). They suggested that in the future, innovative strategies to elaborate suitable diagnostic and therapeutic approaches for neurodegenerative diseases would be found.CrossRef
5.
Zurück zum Zitat McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017;89(1):88–100.CrossRefPubMedPubMedCentral McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, et al. Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017;89(1):88–100.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, et al. Consensus guidelines for the clinical and pathologic diagnosis of Lewy body disease (LBD): report of the consortium on LBD international workshop. Neurology. 1996;47(5):1113–24.CrossRefPubMed McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, et al. Consensus guidelines for the clinical and pathologic diagnosis of Lewy body disease (LBD): report of the consortium on LBD international workshop. Neurology. 1996;47(5):1113–24.CrossRefPubMed
7.
Zurück zum Zitat McKeith IG, Dickson DW, Lowe J, Emre M, O'Brien JT, Feldman H, et al. Diagnosis and management of Lewy body disease: third report of the LBD Consortium. Neurology. 2005;65(12):1863–72.CrossRefPubMed McKeith IG, Dickson DW, Lowe J, Emre M, O'Brien JT, Feldman H, et al. Diagnosis and management of Lewy body disease: third report of the LBD Consortium. Neurology. 2005;65(12):1863–72.CrossRefPubMed
8.
Zurück zum Zitat Nelson PT, Jicha GA, Kryscio RJ, Abner EL, Schmitt FA, Cooper G, et al. Low sensitivity in clinical diagnoses of Lewy body disease. J Neurol. 2010;257(3):359–66.CrossRefPubMed Nelson PT, Jicha GA, Kryscio RJ, Abner EL, Schmitt FA, Cooper G, et al. Low sensitivity in clinical diagnoses of Lewy body disease. J Neurol. 2010;257(3):359–66.CrossRefPubMed
9.
Zurück zum Zitat Mollenhauer B, Förstl H, Deuschl G, Storch A, Oertel W, Trenkwalder C. Lewy body and parkinsonian dementia: common, but often misdiagnosed conditions. Dtsch Arztebl Int. 2010;107(39):684–91.PubMedPubMedCentral Mollenhauer B, Förstl H, Deuschl G, Storch A, Oertel W, Trenkwalder C. Lewy body and parkinsonian dementia: common, but often misdiagnosed conditions. Dtsch Arztebl Int. 2010;107(39):684–91.PubMedPubMedCentral
10.
Zurück zum Zitat Bianchi AJ, Guépet-Sordet H, Manckoundia P. Changes in olfaction during ageing and in certain neurodegenerative diseases: up-to-date. Rev Med Interne. 2015;36(1):31–7.CrossRefPubMed Bianchi AJ, Guépet-Sordet H, Manckoundia P. Changes in olfaction during ageing and in certain neurodegenerative diseases: up-to-date. Rev Med Interne. 2015;36(1):31–7.CrossRefPubMed
11.
Zurück zum Zitat Perl DP, Olanow CW, Calne D. Alzheimer’s disease and Parkinson’s disease: distinct entities or extremes of a spectrum of neurodegeneration? Ann Neurol. 1998;44(3 Suppl 1):S19–31.CrossRefPubMed Perl DP, Olanow CW, Calne D. Alzheimer’s disease and Parkinson’s disease: distinct entities or extremes of a spectrum of neurodegeneration? Ann Neurol. 1998;44(3 Suppl 1):S19–31.CrossRefPubMed
13.
Zurück zum Zitat Waters CH. Lewy body disease: diagnosis and management of Parkinson’s disease. Prof Commun. 2008:76–7. Waters CH. Lewy body disease: diagnosis and management of Parkinson’s disease. Prof Commun. 2008:76–7.
16.
Zurück zum Zitat Kurtz AL, Kaufer DI. Dementia in Parkinson’s disease. Curr Treat Options Neurol. 2011;13:242–54.CrossRefPubMed Kurtz AL, Kaufer DI. Dementia in Parkinson’s disease. Curr Treat Options Neurol. 2011;13:242–54.CrossRefPubMed
17.
Zurück zum Zitat Ince PG, Perry EK, Morris CM. Lewy body disease: a distinct non-Alzheimer dementia syndrome? Brain Pathol. 1998;8(2):299–324.CrossRefPubMed Ince PG, Perry EK, Morris CM. Lewy body disease: a distinct non-Alzheimer dementia syndrome? Brain Pathol. 1998;8(2):299–324.CrossRefPubMed
18.
Zurück zum Zitat Ferchichi S, Giraud M, Smagghe A. La démence à corps de Lewy. Rev Gériatr. 2000;25(7):493–8. Ferchichi S, Giraud M, Smagghe A. La démence à corps de Lewy. Rev Gériatr. 2000;25(7):493–8.
19.
Zurück zum Zitat Mrak RE, Griffin WS. Lewy body disease: definition, diagnosis, and pathogenic relationship to Alzheimer’s disease. Neuropsychiatr Dis Treat. 2007;3(5):619–25.PubMedPubMedCentral Mrak RE, Griffin WS. Lewy body disease: definition, diagnosis, and pathogenic relationship to Alzheimer’s disease. Neuropsychiatr Dis Treat. 2007;3(5):619–25.PubMedPubMedCentral
21.
Zurück zum Zitat Chen Y, Garcia GE, Huang W, Constantini S. The involvement of secondary neuronal damage in the development of neuropsychiatric disorders following brain insults. Front Neurol. 2014;5:22.PubMedPubMedCentral Chen Y, Garcia GE, Huang W, Constantini S. The involvement of secondary neuronal damage in the development of neuropsychiatric disorders following brain insults. Front Neurol. 2014;5:22.PubMedPubMedCentral
22.
Zurück zum Zitat Metzler-Baddeley C. A review of cognitive impairments in Lewy body disease relative to Alzheimer’s disease and Parkinson’s disease with dementia. Cortex. 2007;43(5):583–600.CrossRefPubMed Metzler-Baddeley C. A review of cognitive impairments in Lewy body disease relative to Alzheimer’s disease and Parkinson’s disease with dementia. Cortex. 2007;43(5):583–600.CrossRefPubMed
23.
Zurück zum Zitat Forno LS, Barbour PJ, Norville RL. Presenile Lewy body disease and neurofibrillary tangles. Arch Neurol. 1978;35(12):818–22.CrossRefPubMed Forno LS, Barbour PJ, Norville RL. Presenile Lewy body disease and neurofibrillary tangles. Arch Neurol. 1978;35(12):818–22.CrossRefPubMed
24.
Zurück zum Zitat •• Peelaerts W, Bousset L, Van der Perren A, Moskalyuk A, Pulizzi R, Giugliano M, et al. α-Synuclein strains cause distinct synucleinopathies after local and systemic administration. Nature. 2015;522(7556):340–4. Peelaerts et al. studies misfolded protein aggregates which represent a continuum with overlapping features in neurodegenerative diseases, but differences in protein components and affected brain regions. They demonstrated that distinct α-SYN strains display differential seeding capacities, inducing strain-specific pathology and neurotoxic phenotypes.CrossRefPubMed •• Peelaerts W, Bousset L, Van der Perren A, Moskalyuk A, Pulizzi R, Giugliano M, et al. α-Synuclein strains cause distinct synucleinopathies after local and systemic administration. Nature. 2015;522(7556):340–4. Peelaerts et al. studies misfolded protein aggregates which represent a continuum with overlapping features in neurodegenerative diseases, but differences in protein components and affected brain regions. They demonstrated that distinct α-SYN strains display differential seeding capacities, inducing strain-specific pathology and neurotoxic phenotypes.CrossRefPubMed
25.
Zurück zum Zitat Galasko D, Saitoh T, Xia Y, Thal LJ, Katzman R, Hill LR, et al. The apolipoprotein E allele epsilon 4 is overrepresented in patients with the Lewy body variant of Alzheimer’s disease. Neurology. 1994;44:1950–1.CrossRefPubMed Galasko D, Saitoh T, Xia Y, Thal LJ, Katzman R, Hill LR, et al. The apolipoprotein E allele epsilon 4 is overrepresented in patients with the Lewy body variant of Alzheimer’s disease. Neurology. 1994;44:1950–1.CrossRefPubMed
26.
27.
Zurück zum Zitat Bohnen NI, Albin RL. The cholinergic system and Parkinson disease. Behav Brain Res. 2011 Aug 10;221(2):564–73.CrossRefPubMed Bohnen NI, Albin RL. The cholinergic system and Parkinson disease. Behav Brain Res. 2011 Aug 10;221(2):564–73.CrossRefPubMed
28.
Zurück zum Zitat McKeith IG, Burn DJ, Ballard CG, Collerton D, Jaros E, Morris CM, et al. Lewy body disease. Semin Clin Neuropsychiatry. 2003;8(1):46–57.CrossRefPubMed McKeith IG, Burn DJ, Ballard CG, Collerton D, Jaros E, Morris CM, et al. Lewy body disease. Semin Clin Neuropsychiatry. 2003;8(1):46–57.CrossRefPubMed
29.
Zurück zum Zitat Nagahama Y, Okina T, Suzuki N, Matsuda M. Neural correlates of psychotic symptoms in Lewy body disease. Brain. 2010;133(Pt 2):557–67.CrossRefPubMed Nagahama Y, Okina T, Suzuki N, Matsuda M. Neural correlates of psychotic symptoms in Lewy body disease. Brain. 2010;133(Pt 2):557–67.CrossRefPubMed
30.
Zurück zum Zitat Tröster AI. Neuropsychological characteristics of Lewy body disease and Parkinson’s disease with dementia: differentiation, early detection, and implications for “mild cognitive impairment” and biomarkers. Neuropsychol Rev. 2008;18(1):103–19.CrossRefPubMed Tröster AI. Neuropsychological characteristics of Lewy body disease and Parkinson’s disease with dementia: differentiation, early detection, and implications for “mild cognitive impairment” and biomarkers. Neuropsychol Rev. 2008;18(1):103–19.CrossRefPubMed
31.
Zurück zum Zitat Rolinski M, Fox C, Maidment I, McShane R. Cholinesterase inhibitors for Lewy body disease, Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev. 2012;3:CD006504. Rolinski M, Fox C, Maidment I, McShane R. Cholinesterase inhibitors for Lewy body disease, Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev. 2012;3:CD006504.
32.
Zurück zum Zitat Aarsland D, Litvan I, Salmon D, Galasko D, Wentzel-Larsen T, Larsen JP. Performance on the dementia rating scale in Parkinson’s disease with dementia and Lewy body disease: comparison with progressive supranuclear palsy and Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2003;74(9):1215–20.CrossRefPubMedPubMedCentral Aarsland D, Litvan I, Salmon D, Galasko D, Wentzel-Larsen T, Larsen JP. Performance on the dementia rating scale in Parkinson’s disease with dementia and Lewy body disease: comparison with progressive supranuclear palsy and Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2003;74(9):1215–20.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Noe E, Marder K, Bell KL, Jacobs DM, Manly JJ, Stern Y. Comparison of Lewy body disease to Alzheimer’s disease and Parkinson’s disease with dementia. Mov Disord. 2004;19(1):60–7.CrossRefPubMed Noe E, Marder K, Bell KL, Jacobs DM, Manly JJ, Stern Y. Comparison of Lewy body disease to Alzheimer’s disease and Parkinson’s disease with dementia. Mov Disord. 2004;19(1):60–7.CrossRefPubMed
34.
Zurück zum Zitat Vieira RT, Caixeta L, Machado S, Caxeita M. Dementia in Parkinson’s disease: a clinical review. Am J Neurosci. 2011;2(1):35–47. Vieira RT, Caixeta L, Machado S, Caxeita M. Dementia in Parkinson’s disease: a clinical review. Am J Neurosci. 2011;2(1):35–47.
35.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMed Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.CrossRefPubMed
36.
Zurück zum Zitat Bezdicek O, Michalec J, Nikolai T, Havránková P, Roth J, Jech R, et al. Clinical validity of the Mattis Dementia Rating Scale in differentiating mild cognitive impairment in Parkinson’s disease and normative data. Dement Geriatr Cogn Disord. 2015;39(5–6):303–11.CrossRefPubMed Bezdicek O, Michalec J, Nikolai T, Havránková P, Roth J, Jech R, et al. Clinical validity of the Mattis Dementia Rating Scale in differentiating mild cognitive impairment in Parkinson’s disease and normative data. Dement Geriatr Cogn Disord. 2015;39(5–6):303–11.CrossRefPubMed
37.
Zurück zum Zitat Marson DC, Dymek MP, Duke LW, Harrell LE. Subscale validity of the Mattis Dementia Rating Scale. Arch Clin Neuropsychol. 1997;12(3):269–75.CrossRefPubMed Marson DC, Dymek MP, Duke LW, Harrell LE. Subscale validity of the Mattis Dementia Rating Scale. Arch Clin Neuropsychol. 1997;12(3):269–75.CrossRefPubMed
38.
Zurück zum Zitat Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a frontal assessment battery at bedside. Neurology. 2000;55(11):1621–226.CrossRefPubMed Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a frontal assessment battery at bedside. Neurology. 2000;55(11):1621–226.CrossRefPubMed
39.
Zurück zum Zitat Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, et al. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56(9):1143–53.CrossRefPubMed Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, et al. Practice parameter: diagnosis of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56(9):1143–53.CrossRefPubMed
40.
Zurück zum Zitat Bibl M, Esselmann H, Lewczuk P, Trenkwalder C, Otto M, Kornhuber J, et al. Combined analysis of CSF tau, Aβ42, Aβ1–42% and Aβ1–40% in Alzheimer’s disease: Lewy body disease and Parkinson’s disease dementia. Int J Alzheimers Dis. 2010. Bibl M, Esselmann H, Lewczuk P, Trenkwalder C, Otto M, Kornhuber J, et al. Combined analysis of CSF tau, Aβ42, Aβ1–42% and Aβ1–40% in Alzheimer’s disease: Lewy body disease and Parkinson’s disease dementia. Int J Alzheimers Dis. 2010.
41.
Zurück zum Zitat Blennow K, Hampel H. CSF markers for incipient Alzheimer’s disease. Lancet Neurol 2003; 2 (10): 605–613. Blennow K, Hampel H. CSF markers for incipient Alzheimer’s disease. Lancet Neurol 2003; 2 (10): 605–613.
42.
Zurück zum Zitat Andersson M, Zetterberg H, Minthon L, Blennow K, Londos E. The cognitive profile and CSF biomarkers in Lewy body disease and Parkinson’s disease dementia. Int J Geriatr Psychiatry. 2011;26(1):100–5.CrossRefPubMed Andersson M, Zetterberg H, Minthon L, Blennow K, Londos E. The cognitive profile and CSF biomarkers in Lewy body disease and Parkinson’s disease dementia. Int J Geriatr Psychiatry. 2011;26(1):100–5.CrossRefPubMed
43.
Zurück zum Zitat von Gunten A, Meuli R. Delineating Lewy body disease: can magnetic resonance imaging help? Front Neurol Neurosci. 2009;24:126–34.CrossRef von Gunten A, Meuli R. Delineating Lewy body disease: can magnetic resonance imaging help? Front Neurol Neurosci. 2009;24:126–34.CrossRef
44.
Zurück zum Zitat Lee JE, Park HJ, Park B, Song SK, Sohn YH, Lee JD, et al. A comparative analysis of cognitive profiles and white-matter alterations using voxel-based diffusion tensor imaging between patients with Parkinson's disease dementia and Lewy body disease. J Neurol Neurosurg Psychiatry. 2010;81(3):320–6.CrossRefPubMed Lee JE, Park HJ, Park B, Song SK, Sohn YH, Lee JD, et al. A comparative analysis of cognitive profiles and white-matter alterations using voxel-based diffusion tensor imaging between patients with Parkinson's disease dementia and Lewy body disease. J Neurol Neurosurg Psychiatry. 2010;81(3):320–6.CrossRefPubMed
45.
Zurück zum Zitat Tsuboi Y, Uchikado H, Dickson DW. Neuropathology of Parkinson’s disease dementia and Lewy body disease with reference to striatal pathology. Parkinsonism Relat Disord. 2007;13(3):S221–4.CrossRefPubMed Tsuboi Y, Uchikado H, Dickson DW. Neuropathology of Parkinson’s disease dementia and Lewy body disease with reference to striatal pathology. Parkinsonism Relat Disord. 2007;13(3):S221–4.CrossRefPubMed
46.
Zurück zum Zitat • Han D, Wang Q, Gao Z, Chen T, Wang Z. Clinical features of Lewy body disease in 35 Chinese patients. Transl Neurodegener. 2014;3(1):1. Han et al., through a meta-analyses of 18 studies, investigate the clinical features of dementia with Lewy bodies (DLB) in a Chinese population. They found dementia, fluctuating cognition, recurrent visual hallucinations, and spontaneous features of Parkinsonism as DLB clinical core features. Neuropsychological, neuroimaging, and EEG examinations may improve the diagnostic accuracy and discriminate DLB from other dementias.CrossRefPubMedPubMedCentral • Han D, Wang Q, Gao Z, Chen T, Wang Z. Clinical features of Lewy body disease in 35 Chinese patients. Transl Neurodegener. 2014;3(1):1. Han et al., through a meta-analyses of 18 studies, investigate the clinical features of dementia with Lewy bodies (DLB) in a Chinese population. They found dementia, fluctuating cognition, recurrent visual hallucinations, and spontaneous features of Parkinsonism as DLB clinical core features. Neuropsychological, neuroimaging, and EEG examinations may improve the diagnostic accuracy and discriminate DLB from other dementias.CrossRefPubMedPubMedCentral
47.
Zurück zum Zitat Koeppe RA, Gilman S, Junck L, Wernette K, Frey KA. Differentiating Alzheimer’s disease from Lewy body disease and Parkinson’s disease with (+)-[11C]dihydrotetrabenazine positron emission tomography. Alzheimers Dement. 2008;4(1 Suppl 1):S67–76.CrossRefPubMed Koeppe RA, Gilman S, Junck L, Wernette K, Frey KA. Differentiating Alzheimer’s disease from Lewy body disease and Parkinson’s disease with (+)-[11C]dihydrotetrabenazine positron emission tomography. Alzheimers Dement. 2008;4(1 Suppl 1):S67–76.CrossRefPubMed
Metadaten
Titel
Lewy Body Disease: Clinical and Pathological “Overlap Syndrome” Between Synucleinopathies (Parkinson Disease) and Tauopathies (Alzheimer Disease)
verfasst von
Clovis Foguem
Patrick Manckoundia
Publikationsdatum
01.05.2018
Verlag
Springer US
Erschienen in
Current Neurology and Neuroscience Reports / Ausgabe 5/2018
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-018-0835-5

Weitere Artikel der Ausgabe 5/2018

Current Neurology and Neuroscience Reports 5/2018 Zur Ausgabe

Epilepsy (CW Bazil, Section Editor)

Infantile Spasms—Have We Made Progress?

Movement Disorders (S Fox, Section Editor)

Managing Gait, Balance, and Posture in Parkinson’s Disease

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Ein hohes soziales Niveau ist mit die beste Versicherung gegen eine Demenz. Noch geringer ist das Demenzrisiko für Menschen, die sozial aufsteigen: Sie gewinnen fast zwei demenzfreie Lebensjahre. Umgekehrt steigt die Demenzgefahr beim sozialen Abstieg.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Thrombektomie auch bei großen Infarkten von Vorteil

16.05.2024 Ischämischer Schlaganfall Nachrichten

Auch ein sehr ausgedehnter ischämischer Schlaganfall scheint an sich kein Grund zu sein, von einer mechanischen Thrombektomie abzusehen. Dafür spricht die LASTE-Studie, an der Patienten und Patientinnen mit einem ASPECTS von maximal 5 beteiligt waren.

Update Neurologie

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