Kognitive Störungen und Fatigue bei Patienten mit Multipler Sklerose - Über den Einsatz subjektiver und objektiver Screeningverfahren

Die Multiple Sklerose gilt als eine der häufigsten neurologischen Erkrankungen des frühen und mittleren Erwachsenenalters. Die Ursachen der Erkrankung sind bislang ungeklärt. Als gesichert gilt, dass es sich sowohl um eine neuroinflammatorische als auch neurodegenerative Erkrankung des zentralen Nervensystems handelt, bei der es zu multiplen, zeitlich und örtlich disseminierten Demyelinisierungen unterschiedlichster Lokalisation kommt. Diese bedingen auf klinischer Ebene, neben vielfältigen physischen Symptomen, kognitive Teilleistungsstörungen und psychosoziale Beeinträchtigungen wie eine Depression und Zustände abnormer Ermüdbarkeit (Fatigue). Da der Krankheitsausbruch für die meisten Patienten in eine Lebensphase der beruflichen und sozialen Etablierung und Neuorientierung fällt, stellen v.a. die neurokognitiven Probleme und die Fatigue für einen Großteil der Betroffenen unüberwindbare Hürden dar. Es ist daher von besonderer Relevanz, diese Symptome bereits frühzeitig im Krankheitsgeschehen zu erfassen. Um eine zuverlässige kosten- und zeitökonomische Diagnostik in der klinischen Routine sicherzustellen, wurden subjektive und objektive Screeningverfahren entwickelt, über deren Einsatz bei Multipler Sklerose im Folgenden berichtet wird.

Multiple sclerosis belongs to one of the common neurological diseases of early and middle adulthood. Though the etiology of the disease is still unknown, most findings indicate a combined inflammatory as well as neurodegenerative component with multiple demyelinations at different brain sites being distributed in time and space. These lesions may lead to a variety of symptoms, such as cognitive deficits, depression and fatigue. Since the disease affects individuals during their psychosocial and vocational settlement the symptoms may strongly interfere with daily activities, thus influencing quality of life. Assessment of these symptoms already in early stages of the disease is therefore of high relevance. To provide reliable cost and time economic diagnosis in clinical routine, subjective as well as objective screening methods have been developed. The present article will review on the application of these tools in MS.

Key words

Neurocognition - fatigue - multiple sclerosis - screening instruments

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