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Erschienen in: psychopraxis. neuropraxis 4/2016

01.09.2016 | Neurologie

„Time is brain“ bei der schubförmigen Multiplen Sklerose

Aktuelle Behandlungskonzepte in der Immuntherapie

verfasst von: Prof. Dr. R. Linker, B.-A. Kallmann, C. Kleinschnitz, P. Rieckmann, M. Mäurer, S. Schwab

Erschienen in: psychopraxis. neuropraxis | Ausgabe 4/2016

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Zusammenfassung

Hintergrund

Trotz der diametral unterschiedlichen Zeitskalen, in denen sich die Krankheitsprozesse und -folgen bei der Multiplen Sklerose (MS) und beim ischämischen Schlaganfall manifestieren, zeigen sich konzeptionelle Parallelen zwischen beiden Erkrankungen, die für das Management der MS richtungsweisend sind: Entzündliche Erkrankungsaktivität und konsekutive Neurodegeneration führen zu potenziell irreversibler Gewebeschädigung und damit zu bleibender Behinderung. Dementsprechend sind eine frühzeitige Detektion von Erkrankungsaktivität und eine zeitnahe Intervention bzw. Therapieoptimierung ausschlaggebend für eine Verbesserung der langfristigen Prognose, was sich mit dem in der Akuttherapie des ischämischen Schlaganfalls geprägten Begriff „time is brain“ griffig beschreiben lässt.

Ergebnisse und Diskussion

Bei der MS beinhaltet ein „Time-is-brain“-Konzept den Wert einer frühen Immuntherapie nach Diagnosestellung sowie die Notwendigkeit eines sensitiven strukturierten Monitorings in Verbindung mit frühzeitiger Therapieoptimierung bei Nachweis von Krankheitsaktivität unter Therapie. Das übergeordnete Ziel der Therapie im gesamten Erkrankungsverlauf der MS ist dabei die bestmögliche und anhaltende Kontrolle jeglicher erfassbarer Krankheitsaktivität, insbesondere in der frühen Erkrankungsphase. Im Alltag kann die intersektorale Kooperation in regionalen MS-Netzwerken mit spezialisierten Zentren dazu beitragen, die verfügbaren hochwirksamen Medikamente mit ihren jeweils eigenen Nutzen-Risiko-Profilen optimal einzusetzen und damit die Aussicht auf eine langfristige Stabilisierung der Lebensqualität der MS-Patienten zu erhöhen.
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Metadaten
Titel
„Time is brain“ bei der schubförmigen Multiplen Sklerose
Aktuelle Behandlungskonzepte in der Immuntherapie
verfasst von
Prof. Dr. R. Linker
B.-A. Kallmann
C. Kleinschnitz
P. Rieckmann
M. Mäurer
S. Schwab
Publikationsdatum
01.09.2016
Verlag
Springer Vienna
Erschienen in
psychopraxis. neuropraxis / Ausgabe 4/2016
Print ISSN: 2197-9707
Elektronische ISSN: 2197-9715
DOI
https://doi.org/10.1007/s00739-016-0332-z