Search

Hintergrund: Seit der Einführung von Disease-Management-Programmen (DMP) in Deutschland hat sich die Versorgung von chronisch kranken Patient:innen verbessert. Eine Möglichkeit, das Potenzial der DMPs weiter zu fördern, ist die Stärkung des Selbstmanagements der Patient:innen. Hierzu [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Additional file 2. Example of patient feedback - original version.

Additional file 4. Modified GLTEQ.

Additional file 1. Original version of informed consent.

Parkinson's Disease (PD) is a neurodegenerative disorder leading to typical motor as well as a range of non-motor symptoms, including cognitive decline mainly characterized by executive deficits. The latter are known to appear years before the typical motor signs, thus representing the prodromal phase of PD. However, appropriate methods for measuring executive dysfunction in this context are not well established yet. Traditionally, executive performance is associated with frontal structures. Here, we investigated prodromal, early PD patients and healthy controls regarding their executive functioning on the behavioral and neural level, measured by the Trail-Making-Test (TMT) combined with functional near-infrared spectroscopy. We observed significantly reduced neural activity in the right dorsolateral prefrontal cortex within PD patients compared to controls completing the TMT-A and -B in contrast to the TMT-C, but no differences on a behavioral level. These promising results need to be confirmed and checked for reliability in future studies to extend the spectrum of markers applied in prodromal PD.

Additional file 3. Example of patient feedback - English translation.

Hintergrund und Stand der internationalen Forschung: Disease Management Programme (DMPs) sind strukturierte Programme zur evidenzbasierten Behandlung chronisch kranker Patienten. Die DMPs der Gesetzlichen Krankenversicherung verbessern die Versorgungsprozesse und sind patientenzentriert. Trotz positiver[zum vollständigen Text gelangen Sie über die oben angegebene URL], 19. Deutscher Kongress für Versorgungsforschung (DKVF)

In our aging society, research into neurodegenerative processes is of great interest. Thereby, cortical activation under different neurocognitive conditions is considered to be a promising predictor. Against this background, the executive functions of a total of 250 healthy older adults (53–84 years) have been investigated using the Trail Making Test (TMT) and functional near-infrared spectroscopy in a block design. We investigated effects of age on the performance and cortical blood oxygenation during the TMT. Since it is assumed that older people may compensate for cognitive deficits by slowing their processing speed, we additionally analyzed the cortical blood oxygenation per solved item. Our results showed a significant decrease in processing speed in older participants compared to middle-aged individuals, however, also lower error rates during TMT part A. On a neurophysiological level, we observed increased cortical blood oxygenation in the older participants when completing the TMT. Finally, with respect to the combined measurement (O₂Hb/item), no significantly higher hemodynamic cortical response per item was found within the older participants. The results confirm a deterioration of cognitive performance and an increase of cortical activity with increasing age. The findings are discussed in the light of current research. CA extern

Background Frontotemporal dementia is an increasingly studied disease, the underlying functional impairments on a neurobiological level of which have not been fully understood. Patients with the behavioral-subtype frontotemporal dementia (bvFTD) are particularly challenging for clinical measurements such as functional imaging due to their behavioral symptoms. Here, an alternative imaging method, functional near-infrared spectroscopy (fNIRS), is introduced to measure task-related cortical brain activation based on blood oxygenation. The current study investigated differences in cortical activation patterns of patients with bvFTD, Alzheimer’s dementia (AD), and healthy elderly subjects measured by fNIRS. Method Eight probable bvFTD patients completed the semantic, phonological, and control conditions of a verbal fluency task. Eight AD patients and eight healthy controls were compared on the same task. Simultaneously, an fNIRS measurement was conducted and analyzed using a correction method based on the expected negative correlation between oxygenated and deoxygenated hemoglobin. Results Healthy controls show an increase in cortical activation measured in frontoparietal areas such as the dorsolateral prefrontal cortex. The activation pattern of patients with AD is similar, but weaker. In contrast, bvFTD patients show a more frontopolar pattern, with activation of Broca’s area, instead of the dorsolateral prefrontal cortex and the superior temporal gyrus. The frontoparietal compensation mechanisms, seen in the healthy elderly, were missing in bvFTD patients. Conclusion Different frontoparietal cortical activation patterns may indicate a correlate of diverse pathophysiological mechanisms of AD and bvFTD during verbal fluency processing. The AD pattern is weaker and more similar to the healthy pattern, whereas the bvFTD pattern is qualitatively different, namely more frontopolar and without frontoparietal compensation activation. It adheres to a change of cortical activation during the course of the disease. Electronic supplementary material The online version of this article (doi:10.1186/s13195-016-0224-8) contains supplementary material, which is available to authorized users.