Horst Przuntek - Böcker

At the time when "Parkinson's Disease" is diagnosed in a patient, roughly two thirds of dopaminergic neurons of substantia nigra are already degenerated. The onset of the disease must, therefore, be much earlier. This book deals with early diagnosis and early preventive treatment which may sustain the process underlying the disease. By use of psychometric, kinesiologic, physiologic, histologic, biochemical, endocrinologic, pharmacologic and imaging techniques, including positron-emission tomography and brain mapping, specialists tried to focus on new diagnostic criteria. New methods including psychometric evaluation, apparative measurement of movement, analysis of peripheral blood and urinary constituents have supplemented this approach. It has been agreed that early preventive therapy consists of low dosis of L-DOPA plus benserazide, L-deprenyl and dopaminergic agonists.

Expert clinicians and basic scientists with a special interest in Parkinson's disease review the current state of science and clinical therapeutics of the disease. Therefore these articles represent an authorative review of the current state of knowledge regarding preclinical course and symptomatology, subtypes with their impact on the pathology, genetic alterations, novel mechanisms of neuronal cell death, diagnostic tools and old and novel therapeutic approaches with respect to neuroprotection and neuroregeneration in Parkinson's disease. Particular emphasis has been placed on a novel antiparkinsonian drug called budipine with various modes of action also influencing altered non dopaminergic systems in Parkinson's disease. It is evident, that many questions on the cause, course and treatment of Parkinson's disease are still unanswered and therefore the ideal way to treat a parkinsonian patient remains to be defined.

Expert clinicians and basic scientists with a special interest in Parkinson’s disease review the current state of science and clinical therapeutics of the disease. Therefore these articles represent an authorative review of the current state of knowledge regarding preclinical course and symptomatology, subtypes with their impact on the pathology, genetic alterations, novel mechanisms of neuronal cell death, diagnostic tools and old and novel therapeutic approaches with respect to neuroprotection and neuroregeneration in Parkinson’s disease. Particular emphasis has been placed on a novel antiparkinsonian drug called budipine with various modes of action also influencing altered non dopaminergic systems in Parkinson’s disease. It is evident, that many questions on the cause, course and treatment of Parkinson’s disease are still unanswered and therefore the ideal way to treat a parkinsonian patient remains to be defined.

Expert clinicians and basic scientists with a special interest in Parkinsons disease review the current state of science and clinical therapeutics of the disease. Therefore these articles represent an authorative review of the current state of knowledge regarding preclinical course and symptomatology, subtypes with their impact on the pathology, genetic alterations, novel mechanisms of neuronal cell death, diagnostic tools and old and novel therapeutic approaches with respect to neuroprotection and neuroregeneration in Parkinsons disease. Particular emphasis has been placed on a novel antiparkinsonian drug called budipine with various modes of action also influencing altered non dopaminergic systems in Parkinsons disease. It is evident, that many questions on the cause, course and treatment of Parkinsons disease are still unanswered and therefore the ideal way to treat a parkinsonian patient remains to be defined.

Das Buch besch{ftigt sich mit Grenzgebieten zwischen Psychiatrie und Neurologie. Es geht um diagnostische und therapeutische Fragen, die in der allt{glichen Versorgungssituation immer wieder auftauchen und die f}r eine kompetente Antwort nur im interdisziplin{ren Gespr{ch zwischen Psychiatern und Neurologen gefunden werden kann. Das Buch enth{lt die Referate und die Diskussionen einer Tagung, an der namhafte deutsche Neurologen und Psychiater aus verschiedenen Universit{tskliniken teilgenommen haben. Thematische Schwerpunkte waren dyskinetische St|rungen, katatone St|rungen, K|rpergef}hlsst|rungen, Krampfanf{lle, therapeutische Risiken von Psychopharmaka.

Mit zunehmender Spezialisierung von Psychiatrie und Neurologie und der dadurch bedingten Auflösung des einheitlichen Faches Nervenheilkunde werden die Grenzbereiche zwischen beiden Fächern ein diagnostisches und therapeutisches Problem. Dieser Band enthält Beiträge sowie die wichtigsten Diskussionsbemerkungen der zweiten "Begegnungs-Tagung" zwischen Psychiatern und Neurologen. Thematische Schwerpunkte sind Gen-Diagnostik, Diagnose, Differentialdiagnose und Therapie der Demenz, organische Depressionen und ihre Differentialdiagnose, Plasmaspiegelbestimmungen von Pharmaka in der Neurologie und Psychiatrie sowie Prädiktion des Therapieerfolges bei neurologischen und psychiatrischen Erkrankungen.

Many extrapyramidal motor diseases result from underlying neurodegenerative processes, which however are very advanced at the time the clinical diagnosis is made. From animal experiments it seems likely that we may soon have several substances that provide neuroprotective effects, but that their therapeutic use must be as early as possible. This fact was the starting point for the meeting, held at Chiemsee, that formed the basis of this book. The idea was to develop in­ strumental methods that, first, permit an earlier diagnosis by drawing on the experience of experts and, second, provide a better resolution of successful therapy than the currently used methods. As early as 1886, Charcot tried to differentiate the tremor of polysclerosis and Parkinson patients by using a drum developed by Marey, a physiologist. Subse­ quently, many apparatuses were developed to better identify movement disorders, initially for diagnostic purposes. Most of these methods proved to be inferior to the skill of experienced observers. In the last two decades, however, both the technical advances made in measuring methods and the improvements achieved in methods of evaluation have led to marked advances in the quantification of motor dis­ turbances. An objective of the symposium held at Chiemsee and of this book is to provide an overview of the procedures that are currently commonly used for extrapyramidal movement disorders, and to identify their potential and limitations.

Die Vielfalt der angewandten Methoden in der nichtmedikamentösen adjuvanten Therapie spiegelt das Bestreben in den Parkinsonkliniken mit rehabilitativem Charakter wider, Lebensqualität und Wohlbefinden chronisch Kranker und deren Angehöriger zu verbessern. Die auf einem Treffen der deutschen Parkinsonkliniken vorgestellten Therapien zeigen, dass bei Parkinsonpatienten neue Lebensinhalte gegeben und neue Interessen geweckt werden können.