Stimulationsverfahren zur Behandlung von Demenzen

Zusammenfassung

Aufgrund steigender Fallzahlen der Alzheimer-Erkrankung und bislang eher mäßigem Erfolg der verfügbaren symptomatischen und kausalen pharmakologischen Therapien besteht ein erheblicher Bedarf, nicht-pharmakologische Behandlungsmöglichkeiten zu erforschen. Im Bereich der nicht-invasiven Hirnstimulation (non-invasive brain stimulation; NIBS) wurden verschiedene Verfahren untersucht, insbesondere die transkranielle Magnetstimulation und die transkranielle elektrische Stimulation. Zusätzlich wird derzeit die Tiefe Hirnstimulation (deep brain stimulation; DBS) als innovatives Verfahren zur gezielten Neuromodulation erforscht. Nicht-invasiven und invasiven Ansätzen gemein ist der Versuch, neuronale Aktivität zu modulieren und kognitiv-mnestische Funktionen zu verbessern. Durch sekundäre Mechanismen wie die Langzeit-Potenzierung bei NIBS oder Neurogenese bei DBS könnten auch längerfristige positive Effekte erzielt werden. Präklinische und klinische Studien ergaben bereits vielversprechende Ergebnisse bei Patientinnen und Patienten in frühen Stadien der Alzheimer-Erkrankung. Inkonsistente Studien- und Stimulationsprotokolle sowie kleine Stichproben erschweren jedoch die Bewertung der Wirksamkeit. Weitere Forschungsbemühungen sind angebracht, um einen zeitnahen Einzug nicht-invasiver oder invasiver neuromodulatorischer Ansätze in die klinische Praxis zu ermöglichen.

Abstract

Due to the increasing number of cases of Alzheimer’s disease and the relatively moderate success with the available symptomatic and causal pharmacological therapies, there is a considerable need to explore non-pharmacological treatment options. In the field of non-invasive brain stimulation (NIBS), various methods have been investigated, particularly transcranial magnetic stimulation and transcranial electrical stimulation. In addition, deep brain stimulation (DBS) is currently being researched as an innovative method for targeted neuromodulation. Both non-invasive and invasive approaches aim to modulate neuronal activity and improve cognitive-mnestic functions. Secondary mechanisms such as long-term potentiation in NIBS or neurogenesis in DBS could also achieve long-term positive effects. Preclinical and clinical studies have already shown promising results in patients in early stages of Alzheimer’s disease. However, inconsistent study and stimulation protocols and small sample sizes make it difficult to assess efficacy. Further research is warranted to enable the use of non-invasive or invasive neuromodulatory approaches in clinical practice in the near future.

Schlüsselwörter

Alzheimer-Demenz - nicht-invasive Hirnstimulation - Tiefe Hirnstimulation

Key words

Alzheimer’s disease - non-invasive brain stimulation - deep brain stimulation

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