{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T11:54:27Z","timestamp":1722426867961},"reference-count":19,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Was ist neu?<\/jats:title><jats:p>\n          Klinik\u2002Die Pr\u00e4valenz des idiopathischen Parkinson Syndroms (IPS) wird sich bis 2030 verdoppeln. Das IPS ist nicht mehr als eine in sich geschlossene Krankheitsentit\u00e4t zu betrachten. Monogenetische Formen k\u00f6nnen klinisch identisch zu dem sporadischen IPS erscheinen. Eine Mutation im Glucozerebrosidase-Gen l\u00e4sst sich bei &gt;\u200a5\u200a% der Patienten nachweisen und steigert das Risiko an Parkinson zu erkranken um 8\u201320-mal.<\/jats:p><jats:p>\n          COVID-19\u2002Die Corona-Pandemie hat zu einer Verschlechterung der Symptomatik vieler Parkinson-Patienten gef\u00fchrt. In der Zeit hat man gelernt, dass Videosprechstunden sich f\u00fcr die Betreuung von Parkinson-Patienten eignen. Auch die motorischen Symptome sind gut zu beurteilen.<\/jats:p><jats:p>\n          Pharmakotherapie\u2002Die schon Jahrzehnte bestehende Kontroverse, ob der Einsatz von Levodopa hinausgez\u00f6gert werden sollte, bildete erneut den Hintergrund einer aufwendigen Studie. Bei Vergleich zwischen fr\u00fchem versus verz\u00f6gerten Beginn von Levodopa konnte nach ca. 2 Jahren kein signifikanter Unterschied im Parkinson-Schwergrad festgestellt werden. Auch die Rate an Dyskinesien war nicht unterschiedlich. Unter Dopaminagonisten kam es in einer Studie mit &gt;\u200a400 Patienten innerhalb von 5 Jahren zu einer H\u00e4ufigkeit von 52\u200a% von Impulskontrollst\u00f6rungen. In den letzten 10 Jahren sind in Deutschland f\u00fcr die Parkinson-Therapie nur 2 neue Substanzen auf den Markt gekommenen, beide mit der Indikation Zusatztherapie zu Levodopa bei Patienten mit Wirkungsschwankungen.<\/jats:p><jats:p>\n          Ger\u00e4te unterst\u00fctzte Therapien\u2002Der Einsatz der tiefen Hirnstimulation und Medikamentenpumpen bei Patienten mit Levodopa-Wirkungsfluktuationen w\u00e4chst, denn an diesem Punkt des Krankheitsverlaufs angekommen, nehmen Patienten auch invasive Therapien im Kauf, die die Unabh\u00e4ngigkeit verl\u00e4ngern und optimieren k\u00f6nnen. Patienten, die Levodopa mehr als 5-mal t\u00e4glich ben\u00f6tigen und trotz optimaler nicht Levodopa-basierter Therapien schwere, st\u00f6rende OFF-Phasen (&gt;\u200a2 Stunden am Tag) haben, k\u00f6nnen prinzipiell diese Therapieoptionen erw\u00e4gen. \u00dcber 90\u200a% der Patienten ziehen es vor, an der Entscheidungsfindung beteiligt zu sein, welche der Ger\u00e4te-unterst\u00fctzten Therapie zum Einsatz kommt.<\/jats:p><jats:p>\n          Evidenzbasierte aktivierende Therapien und netzwerkbasierte Versorgungsmodelle\u2002Parkinson-Stadien- und symptomfokussierte, leitlinienbasierte Physiotherapie wirken sich positiv auf Krankheitsverlauf, Alltagsleistungen und Lebensqualit\u00e4t aus und vermindern die Sturzgefahr. Berufsgruppen- und Sektoren-\u00fcbergreifende Netzwerke erweisen sich als effektiv, St\u00fcrze und Krankenhauseinweisungen zu senken.<\/jats:p>","DOI":"10.1055\/a-1646-6321","type":"journal-article","created":{"date-parts":[[2022,3,15]],"date-time":"2022-03-15T23:42:17Z","timestamp":1647387737000},"page":"337-343","source":"Crossref","is-referenced-by-count":1,"title":["Parkinson-Syndrom"],"prefix":"10.1055","volume":"147","author":[{"given":"Andres","family":"Ceballos-Baumann","sequence":"additional","affiliation":[{"name":"Abt. f\u00fcr Neurologie und klinische Neurophysiologie mit Parkinson-Fachklinik, Sch\u00f6n Klinik M\u00fcnchen Schwabing"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,3,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1016\/S1474-4422(18)30295-3","article-title":"Global, regional, and national burden of Parkinson's disease, 1990-2016: a systematic 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