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Hirnbildgebungsmarker

Bedeutung für Differenzialdiagnostik und therapeutische Entscheidungen in der personalisierten Psychiatrie

Neuroimaging markers

Their role for differential diagnosis and therapeutic decisions in personalized psychiatry

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Zusammenfassung

Im Kontext der personalisierten Psychiatrie nimmt das Interesse an der Entwicklung von Hirnbildgebungsmarkern für die Differenzialdiagnostik und -therapie psychischer Störungen zu. In diesem Artikel werden neue Bildgebungsmarker für die Alzheimer-Diagnostik und insbesondere multifunktionelle magnetresonanztomographische Studien bei Patienten mit schizophrenen und affektiven Psychosen berichtet. Unter Verwendung experimenteller Schlüsselparadigmen zur gezielten Untersuchung pathophysiologisch relevanter neurofunktioneller Systeme können hierbei sowohl Unterschiede als auch Gemeinsamkeiten zwischen den diagnostischen Kategorien aufgezeigt werden. Ferner werden Forschungsansätze zur Weiterentwicklung der Klassifikation von Psychosen auf Basis einer präziseren Charakterisierung des neurofunktionellen und pathophysiologischen Phänotyps vorgestellt. Multivariate Verfahren können zur Identifizierung komplexerer, diagnostisch und/oder prognostisch relevanter Bildgebungsmarker beitragen. Schließlich werden Beispiele für die Anwendung von Hirnbildgebungsmarkern zur individualisierten Auswahl der Therapie präsentiert.

Summary

In the context of personalized psychiatry there is growing interest in the development of neuroimaging markers for differential diagnosis and individualized therapy of mental disorders. This article reports on new neuroimaging markers for the diagnosis of Alzheimer’s disease and particularly recent multi-functional magnetic resonance imaging (m-fMRI) studies in patients with schizophrenic and affective psychoses. Using experimental key paradigms for targeted assessment of pathophysiologically relevant neurofunctional systems, these studies reveal both differences and commonalities between the diagnostic categories. In addition, the article outlines research strategies for further development of the classification of major psychoses on the basis of a more precise characterization of the neurofunctional and pathophysiological phenotype. Multivariate approaches may help to identify more complex neuroimaging markers relevant for diagnosis and/or prognosis. Finally, some examples will be presented for the use of neuroimaging markers in the individualized choice of therapy.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Vertragshonorare und Reisekostenübernahmen durch AstraZeneca, Bristol Myers Squibb, Janssen, Lilly, Otsenka, Pfizer.

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  1. Zentrum für Translationale Forschung in Systemischen Neurowissenschaften und Psychiatrie, Klinik für Psychiatrie und Psychotherapie, Georg-August-Universität Göttingen, von-Siebold-Str. 5, 37075, Göttingen, Deutschland

    O. Gruber

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Gruber, O. Hirnbildgebungsmarker. Nervenarzt 82, 1404–1413 (2011). https://doi.org/10.1007/s00115-011-3347-y

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