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Fortschr Neurol Psychiatr 2021; 89(07/08): 363-373
DOI: 10.1055/a-1099-9332
Übersichtsarbeit

Empfehlungen zur neuropsychologischen Diagnostik beim Morbus Parkinson

Guidelines for the Neuropsychological Assessment of Patients with Parkinson’s Disease
Inga Liepelt-Scarfone 
1   Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Tübingen, Deutschland
2   Abteilung Neurodegeneration, Hertie Institut für Klinische Forschung, Tübingen, Deutschland
,
Susanne Gräber
1   Deutsches Zentrum für Neurodegenerative Erkrankungen, Standort Tübingen, Deutschland
3   Zentrum für ambulante Rehabilitation am Universitätsklinikum Tübingen, Deutschland
,
Elke Kalbe
4   Medizinische Psychologie: Neuropsychologie und Genderforschung & Center für Neuropsychologische Diagnostik und Intervention, Universitätsklinikum Köln, Köln, Deutschland
,
Oliver Riedel
5   Abteilung Klinische Epidemiologie, Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH, Bremen, Deutschland
,
Hubert Ringendahl
6   Klinik für Neurologie und klinische Neurophysiologie, Helios Universitätsklinikum Wuppertal, Universitäts Witten/Herdecke, Wuppertal, Deutschland
,
Nele Schmidt
7   Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein Campus Kiel, Kiel, Deutschland
,
Karsten Witt
8   Forschungszentrum Neurosensorik, Carl von Ossietzy Universität Oldenburg, Universitätsklinik für Neurologie, Oldenburg, Deutschland
,
Sandra Roeske
9   Deutsches Zentrum für Neurodegenerative Erkrankungen, Bonn, Deutschland
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Zusammenfassung

Hintergrund Das Vorliegen von leichten kognitiven Störungen bei der Parkinson Erkrankung ist aktuell der beste Prädiktor für die Entwicklung einer Demenz bei Morbus Parkinson. Expertengruppen der Movement Disorder Society haben für die Diagnose leichter kognitiveStörungen und Parkinson Demenz standardisierte diagnostische Verfahren vorgeschlagen. Diese können aufgrund fehlender Übersetzungen oder geeigneter Normen nicht ohne weiteres auf den deutschsprachigen Raum angewendet werden.

Fragestellung Entwicklung evidenzbasierter Empfehlungen zur deutschsprachigen neuropsychologischen Diagnostik bei Morbus Parkinson.

Methode Anhand einer ersten systematischen Literaturrecherche wurden Empfehlungen (Konsensuskriterien, Guidelines und Reviews) zur neuropsychologischen Diagnostik zusammengetragen. In einer zweiten Literaturrecherche wurden normierte neuropsychologische Testverfahren in deutschsprachigen Studien identifiziert. Berechnet wurde die Effektstärke dieser Tests zur Diskrimination zwischen Gesunden und Parkinson-Patienten bzw. Parkinson-Patienten mit verschiedenen kognitiven Diagnosen (ohne kognitive Störungen, mit leichten kognitiven Störungen und mit Demenz).

Ergebnisse Nach Volltextsuche wurden 48 neuropsychologische Tests aus 127 Artikeln zu Testempfehlungen extrahiert. In der zweiten Literaturrecherche wurden aus 1716 Artikeln final 23 in das Review aufgenommen. Die höchsten Effektstärken zur Diskrimination der neuropsychologischen Leistung von Gesunden und Parkinson-Patienten wurden für Tests in den Domänen Exekutivfunktionen, Aufmerksamkeit und visuell-kognitive Leistungen ermittelt. Testempfehlungen der Autoren basieren auf den Ergebnissen beider Literaturrecherchen und ermöglichen eine Level-II Diagnose für Patienten mit leichten kognitiven Störungen und Parkinson Demenz.

Diskussion Die vorliegenden Empfehlungen haben das Potential für eine Verbesserung der deutschsprachigen standardisierten neuropsychologischen Testdiagnostik bei Parkinson-Patienten.

Abstract

Background Presence of mild cognitive impairment is currently the best predictor for the development of Parkinson’s disease dementia. Diagnostic criteria for both Parkinson’s with mild cognitive impairment and Parkinson’s disease dementia have been suggested by the Movement Disorder Society. However, not all cognitive tests recommended are available in the German language with proper standard values.

Objectives To define evidence-based guidelines for neuropsychological assessment of patients with Parkinson’s disease in German.

Methods Two systematic literature searches were conducted. First, articles that presented international guidelines (consensus papers or reviews) for the application of standardized neuropsychological assessments for the diagnosis of cognitive impairment in Parkinson’s disease were selected. Of those, only neuropsychological assessments in German language with normative values referring either to a German, Austrian, or Swiss population were considered. Second, articles comparing test performances of healthy controls vs. Parkinson’s disease and/or different cognitive Parkinson’s disease subtypes (e.g. no cognitive impairment, Parkinson’s with mild cognitive impairment, Parkinson’s disease dementia) were selected. Effect sizes for group differentiation were calculated.

Results Out of 127 full-text articles reviewed, 48 tests were identified during the first literature search. In the second search, 1716 articles were reviewed and 23 papers selected. The strongest effect sizes for group discrimination were revealed for tests assessing executive function, attention, and visuo-cognitive abilities. Based on the results of the two literature searches, consensus guidelines were defined by the authors, allowing for Level-II diagnosis for Parkinson’s with mild cognitive impairment and Parkinson’s disease dementia. Conclusions: The presented guidelines may have the potential to standardize and improve the neuropsychological assessment of Parkinson’s disease patients in German speaking countries.

Schlüsselwörter

Parkinson’s Disease - Neuropsychology - Assessments - Cognition - Dementia

Keywords

Parkinson Erkrankung - Neuropsychologie - Assessments - Kognition - Demenz

Zusatzmaterial



Publication History

Article published online:
09 February 2021

© 2021. Thieme. All rights reserved.

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