Therapieansätze zur Behandlung der Demenz bei neurologischen Erkrankungen

C Nölker; R Dodel

doi:10.1055/s-0038-1628843

Nervenheilkunde, Table of Contents

Nervenheilkunde 2010; 29(11): 769-772
DOI: 10.1055/s-0038-1628843

Kognitive Störungen

Schattauer GmbH

Therapieansätze zur Behandlung der Demenz bei neurologischen Erkrankungen

Therapeutic approaches for the treatment of cognitive dysfunction and dementia in neurological disorders

C Nölker

¹Neurologische Klinik, Philipps-Universität Marburg

,

R Dodel

¹Neurologische Klinik, Philipps-Universität Marburg

› Author Affiliations

Abstract

Zusammenfassung

Kognitive Störungen bei neurologischen Erkrankungen sind häufig und führen zu einer deutlichen Einschränkung der Lebensqualität der betroffenen Patienten. Nur wenige randomisierte und doppelblinde Studien liegen vor, die eine Behandlung der kognitiven Defizite bei neurologischen Erkrankungen als primäres Zielkriterium hatten. Für die Parkinsonkrankheit mit Demenz liegt eine Zulassung für den Cholinesterasehemmer Rivastigmin vor. Für die Behandlung kognitiver Defizite beim Schlaganfall oder der Multiplen Sklerose stehen keine zugelassenen Medikamente zur Verfügung. Für die Wirksamkeit von Programmen zur Rehabilitation der Kognition sind nur wenige kontrollierte Studien durchgeführt worden. In diesem Übersichtsartikel soll der gegenwärtige Stand der Behandlung von kognitiven Störungen beim M. Parkinson, dem Schlaganfall und der Multiplen Sklerose dargestellt werden.

Summary

Cognitive disturbances in neurological disorders are common and lead to a considerable reduction in the quality of life of affected patients. Only a few randomized, double-blind studies are currently available, where cognition was used as a primary outcome measure. Currently, only the cholinesterase inhibitor rivastigmine has been marketed for the treatment of dementia in Parkinson’s disease. For the treatment of cognitive deficits in stroke or multiple sclerosis no approved drugs are presently available. Furthermore, only a few controlled studies have been carried out for the efficacy of rehabilitation of cognition. In this review article we review the current state of the treatment of cognitive disturbances in respect to Parkinson’s disease, stroke and multiple sclerosis.

Schlüsselwörter

Kognition - M. Parkinson - Multiple Sklerose - Schlaganfall

Keywords

Dementia - cognition - Parkinson’s disease - multiple sclerosis - stroke

Full Text

References

Literatur
1 Aarsland D. et al. Memantine in patients with Parkinson’s disease dementia or dementia with Lewy bodies: a double-blind, placebo-controlled, multicentre trial. Lancet Neurol 2009; 08: 613-618.
2 Chiaravalloti N. D, DeLuca J. Cognitive impairment in multiple sclerosis. Lancet neurology 2008; 07: 1139-1151.
3 Christodoulou C. et al. Treatment of cognitive impairment in multiple sclerosis: is the use of acetylcholinesterase inhibitors a viable option?. CNS drugs 2008; 22: 87-97.
4 Christodoulou C. et al. Effects of donepezil on memory and cognition in multiple sclerosis. Journal of the neurological sciences 2006; 245: 127-136.
5 Chui H. C. Subcortical ischemic vascular dementia. Neurologic clinics 2007; 25: 717-740.
6 Emre M, Aarsland D, Albanese A, Byrne E. J, Deuschl G, De Deyn P. P, Durif F, Kulisevsky J, van Laar T, Lees A, Poewe W, Robillard A, Rosa M. M, Wolters E, Quarg P, Tekin S, Lane R. Rivastigmine for dementia associated with Parkinson’s disease. N Engl J Med 2004; 351: 2509-2518.
7 Geisler M. W, Sliwinski M, Coyle P. K, Masur D. M, Doscher C, Krupp L. B. The effects of amantadine and pemoline on cognitive functioning in multiple sclerosis. Archives of neurology 1996; 53: 185-188.
8 Kalbe E, Kaesberg S, Kessler J. Neuropsychologische Therapie bei Demenzpatienten: was ist sinnvoll. Fortschritte der Neurologie Psychologie 2010; 78: 519-531.
9 Kavirajan H, Schneider L. S. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet neurology 2007; 06: 782-792.
10 Lyros E, Messinis L, Papageorgiou S. G, Papathanasopoulos P. Cognitive dysfunction in multiple sclerosis: the effect of pharmacological interventions. International review of psychiatry 2010; 22: 35-42.
11 Maidment I, Fox C, Boustani M. Cholinesterase inhibitors for Parkinson’s disease dementia. Cochrane Database Syst Rev 2006; 25: CD004747.
12 McKeith I, Del Ser T, Spano P, Emre M, Wesnes K, Anand R, Cicin-Sain A, Ferrara R, Spiegel R. Efficacy of rivastigmine in dementia with Lewy bodies: a randomised, double-blind, placebo-controlled international study. Lancet 2000; 356: 2031-2036.
13 McKeith I. G, Dickson D. W, Lowe J, Emre M. et al. Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium. Neurology 2005; 65: 1863-1872.
14 Morrow S. A, Kaushik T, Zarevics P, Erlanger D, Bear M. F, Munschauer F. E, Benedict R. H. The effects of L-amphetamine sulfate on cognition in MS patients: results of a randomized controlled trial. Journal of neurology 2009; 256: 1095-1102.
15 O’Brien A. R, Chiaravalloti N, Goverover Y, Deluca J. Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: a review of the literature. Archives of physical medicine and rehabilitation 2008; 89: 761-769.
16 Oertel W, Poewe W, Wolters E, De Deyn P. P, Emre M, Kirsch C, Hsu C, Tekin S, Lane R. Effects of rivastigmine on tremor and other motor symptoms in patients with Parkinson’s disease dementia: a retrospective analysis of a double-blind trial and an open-label extension. Drug Saf 2008; 31: 79-94.
17 Patti F, Amato M. P, Bastianello S. et al. Effects of immunomodulatory treatment with subcutaneous interferon beta-1a on cognitive decline in mildly disabled patients with relapsing-remitting multiple sclerosis. Multiple sclerosis 2010; 16: 68-77.
18 Riedel O, Klotsche J, Spottke A, Deuschl G, Forstl H, Henn F, Heuser I, Oertel W, Reichmann H, Riederer P, Trenkwalder C, Dodel R, Wittchen H. U. Frequency of dementia, depression, and other neuropsychiatric symptoms in 1,449 outpatients with Parkinson’s disease. Journal of neurology 2010; 257: 1073-1082.
19 Rossini P. M, Pasqualetti P, Pozzilli C, Grasso M. G, Millefiorini E, Graceffa A, Carlesimo G. A, Zibellini G, Caltagirone C. Fatigue in progressive multiple sclerosis: results of a randomized, double-blind, placebo-controlled, crossover trial of oral 4-aminopyridine. Multiple sclerosis 2001; 07: 354-358.
20 Sailer M, Heinze H. J, Schoenfeld M. A, Hauser U, Smid H. G. Amantadine influences cognitive processing in patients with multiple sclerosis. Pharmacopsychiatry 2000; 33: 28-37.
21 Shaygannejad V, Janghorbani M, Ashtari F, Zanjani H. A, Zakizade N. Effects of rivastigmine on memory and cognition in multiple sclerosis. The Canadian journal of neurological sciences 2008; 35: 476-481.
22 Weinstein A, Schwid S. R, Schiffer R. B, McDermott M. P, Giang D. W, Goodman A. D. Neuropsychologic status in multiple sclerosis after treatment with glatiramer. Archives of neurology 1999; 56: 319-324.
23 Grace J. et al. Long-Term use of rivastigmine in patients with dementia with Lewy bodies: an openlabel trial. Int Psychogeriatr 2001; 13: 199-205.
24 Maclean L. E. et al. Dementia with Lewy bodies treated with rivastigmine: effects on cognition, neuropsychiatric symptoms, and sleep. Int Psychogeriatr 2001; 13: 277-288.
25 Flechter S. et al. Cognitive dysfunction evaluation in multiple sclerosis patients treated with interferon beta-1b: an open-label prospective 1 year study. Isr Med Assoc J 2007; 09: 457-459.