95 Diagnostik und Therapie von exekutiven Dysfunktionen bei neurologischen Erkrankungen

Diener,; Berlit,; Deuschl, Günther; Elger,; Hacke,; Hufschmidt,; Mattle,; Meier,; Oertel,; Reichmann,; Schmutzhard,; Wallesch,; Weller, Richard

doi:10.1055/b-0034-37878

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“…Due to retrospective data collection, the number of patients on which the evaluation of distinct neuropsychological functions is based, varies considerably. However, we have only included data from tests applied in at least seven patients to be able to present the cognitive domains of attention, memory, and executive functions with its respective functions according to neuropsychological diagnostic guidelines (see Müller & Klein, 2014 ; Sturm, 2014 ; Thöne-Otto, 2009 ). Nevertheless, it would have been desirable to include nonverbal recognition memory in our test battery and to obtain more data on problem solving and divided attention.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, results of different tests measuring the same cognitive construct were combined. Furthermore, we included data of all tests, which were applied in at least seven patients, to be able to present the cognitive domains of attention, memory, and executive functions according to neuropsychological diagnostic guidelines (see Müller & Klein, 2014 ; Sturm, 2014 ; Thöne-Otto, 2009 ). An overview of the applied tests and definitions of the neuropsychological constructs can be found in the Appendix.…”

Section: Methodsmentioning

confidence: 99%

“…There is some evidence that ALE affects also other executive functions, such as word fluency or selective attention (see e.g., Frisch, Malter, Elger, & Helmstaedter, 2013 ; Hansen et al, 2016 ; Heine et al, 2018 ). In addition to the limbic system, working memory is associated with the lateral prefrontal, the supplementary motor, and the parietal cortex ( D’Esposito, Postle, Ballard, & Lease, 1999 ; D’Esposito, Postle, & Rypma, 2000 ; Müller & Klein, 2014 ). Word fluency is associated with the thalamus and anterior cingulate cortex as well as a wide bi-hemispherical cortical network ( Tucha, Smely, & Lange, 1999 ).…”

Section: Introductionmentioning

confidence: 99%

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Neuropsychological Performance in Autoimmune Limbic Encephalitis: Evidence from an Immunotherapy-Naïve Cohort

Mueller

Langenbruch

Rau

et al. 2022

Archives of Clinical Neuropsychology

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Objective Autoimmune limbic encephalitis (ALE) is characterized by memory impairment, psychiatric symptoms, and epileptic seizures. Though, the neuropsychological profile of ALE is not yet well defined. However, there is some evidence that neuropsychological impairments might exceed those related to the limbic system and that different autoantibodies (AABs) are associated with distinguishable pattern of neuropsychological impairments. We provide a comprehensive presentation of neuropsychological performance of ALE in an immune therapy-naïve sample. Methods We retrospectively analyzed 69 immunotherapy-naïve ALE-patients (26 seropositive—[8 LGI1-, 4 CASPR2-, 2 GABAB-R-, 3 Hu-, 4 GAD65-, 2 Ma2-, 2 unknown antigen, and 1 Yo-AABs] and 43 seronegative patients, mean age 56.0 years [21.9–78.2], mean disease duration 88 weeks [0–572]). Neuropsychological evaluations comprised of the domains memory, attention, praxis, executive functions, language, social cognition, and psychological symptoms. We compared these functions between seronegative −, seropositive patients with AABs against intracellular neural antigens and seropositive patients with AABs against surface membrane neural antigens. Results No effect of AAB group on neuropsychological performance could be detected. Overall, ALE predominantly presents with deficits in long-term memory and memory recognition, autobiographical-episodic memory loss, impairment of emotion recognition, and depressed mood. Furthermore, deficits in praxis of pantomimes and imitations, visuo-construction, and flexibility may occur. Conclusion ALE shows a wide spectrum of neuropsychological impairments, which might exceed the limbic system, with no evidence of differences between AAB groups. Neuropsychological assessment for diagnosing ALE should include long-term memory, memory recognition, autobiographical-episodic memory, emotion recognition, and a detailed investigation of depression.

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Section: Discussionmentioning

confidence: 99%