Autonome Diagnostik bei der Amyotrophen Lateralsklerose

Zusammenfassung

Bei der Amyotrophen Lateralsklerose (ALS) handelt sich um eine neurodegenerative Multisystemerkrankung. Diese äußert sich neben den motorischen Defiziten mit nicht-motorischen Symptomen. Hierzu zählen auch autonome Störungen, die von veränderter Schweißsekretion über Tachykardie bis zu gastrointestinalen Symptomen reichen. Autonome Störungen können mit verschiedenen Methoden, wie Selbsterhebungsfragebögen, Messung der Herzfrequenzvariabilität, QTc-Intervallmessung, Erhebung der sudomotorischen Funktion und Sonographie des Nervus vagus erfasst werden, die in diesem Artikel dargestellt werden. Die bislang bei der ALS eingesetzten Methoden der autonomen Diagnostik ergeben zum Teil deutlich divergierende Ergebnisse über die Aktivität des Sympathikus im Krankheitsverlauf. Relevante autonome Störungen scheinen zumeist erst im fortgeschrittenen Krankheitsstadium aufzutreten, wobei multizentrische Studien mit longitudinalem Ansatz ausstehen.

Abstract

Amyotrophic lateral sclerosis represents a neurodegenerative multi-systemic disease. Patients present non-motoric symptoms beside the well-known motoric deficits. Autonomic disturbances are part of the non-motoric symptoms, e. g. changes in perspiration, tachycardia and gastrointestinal symptoms. Autonomic disorders are measurable by different methods such as self-assessment questionnaire, heart frequency variability, QTc measurement, sudomotoric function evaluation and vagus nerve sonography, which are presented in this article. The methods of autonomic diagnostics in ALS display divergent results regarding the sympathetic function during course of disease. Relevant autonomic disorders seem to appear in advanced disease. However, longitudinal multicentre studies for autonomic disorders in ALS are pending.

Schlüsselwörter

Amyotrophe Lateralsklerose - Autonome Störung - Nicht-motorische Symptome - Autonomer Sturm

Key words

amyotrophic lateral sclerosis - autonomic disorder - non-motor symptoms - autonomic storm

Publication History

Article published online:
14 March 2023

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