H J Gertz

University of Leipzig , Leipzig, Saxony, Germany

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Publications (70)128.24 Total impact

  • M. Berwig, H. Leicht, K. Hartwig, H. J. Gertz
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    ABSTRACT: Background: Cognitively impaired or demented patients may have difficulty performing the complex and multidimensional appraisal required by self-ratings (SR) of quality of life (QoL). Even healthy subjects often refer to their current mood state for QoL self-assessment. Therefore, it is hypothesized that patients rely on current mood state as a reference point for QoL SR, and that the degree of reliance increases with the level of cognitive impairment. Methods: Two consecutive samples of 14 patients with mild cognitive impairment (MCI) and 16 patients with Alzheimer’s disease (AD) were examined using the self-rated Dementia-Quality of Life (DEMQoL), a multidimensional mood state questionnaire (MDBF-A, Mehrdimensionaler Befindlichkeitsfragebogen), and the Mini-Mental State Examination (MMSE; MCI: mean = 25.1, SD = 2.1; AD: mean = 20.3, SD = 2.7). Results: As expected, correlations between current mood state and QoL SR (DEMQoL) were highly significant in AD patients but not in MCI patients. The degree of association for all significant correlations was also significantly higher in AD than in MCI patients. Conclusions: The results indicate that SR of QoL are more affectively distorted in AD than MCI. Mood state questionnaires may be an alternative to QoL questionnaires for AD patients, in particular if mood state ratings can be averaged across several points of assessment thus enhancing their validity. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
    GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry. 02/2011; 24(1):45-51.
  • H.-J. Gertz, A. Kurz
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    ABSTRACT: Die Alzheimer-Krankheit (AK) ist ein progredient verlaufender histopathologisch definierter neurodegenerativer Prozess, dessen klinische Manifestation sich in das Stadium der leichten kognitiven Beeinträchtigung (LKB) sowie in das Stadium der Demenz unterteilen lässt. Nach ICD-10 ist die Diagnose der AK an die Manifestation des Demenzsyndroms gebunden. Auch die Indikation medikamentöser Therapien ist auf das Demenzstadium beschränkt. Die diagnostischen Methoden haben sich in den vergangene Jahren dramatisch verbessert. Dazu gehören die Darstellung der Atrophie des medialen Temporallappens im MRT, die Messung von τ- und β-Amyloid im Liquor, die Visualisierung kortikaler Stoffwechseldefizite in der Positronenemissionstomographie (PET) mit [18F]-Fluoro-2-desoxy-D-Glucose (FDG) sowie die sich abzeichnende Möglichkeit, Amyloidablagerungen im Gehirn mithilfe von PET-Liganden in vivo sichtbar zu machen. Mithilfe dieser Verfahren kann heute die Diagnose AK mit großer Sicherheit bereits im Stadium der LKB gestellt werden. Aus dem damit verbundenen Auseinanderdriften von diagnostischen Möglichkeiten und therapeutischen Optionen ergeben sich zahlreiche neue Fragen bezüglich der möglichen Vor- und Nachteile der Frühdiagnose für den einzelnen Patienten. Wesentlich scheint es zu sein, die Patienten in die Entscheidung zur Frühdiagnostik mit einzubeziehen und die Begrenztheit bzw. das Fehlen therapeutischer Optionen im Stadium der LKB bei AK klarzustellen.
    Der Nervenarzt 01/2011; 82(9). · 0.80 Impact Factor
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    ABSTRACT: To better understand the seemingly contradictory plasma beta-amyloid (Abeta) results in Alzheimer's disease (AD) patients by using a newly developed plasma Abeta assay, the INNO-BIA plasma Abeta forms, in a multicenter study. A combined retrospective analysis of plasma Abeta isoforms on mild cognitive impairment (MCI) from three large cross-sectional studies involving 643 samples from the participating German and Swedish centers. Detection modules based on two different amino (N)-terminal specific Abeta monoclonal antibodies demonstrated that Abeta in plasma could be reliable quantified using a sandwich immunoassay technology with high precision, even for low Abeta42 plasma concentrations. Abeta40 and Abeta42 concentrations varied consistently with the ApoE genotype, while the Abeta42/Abeta40 ratio did not. Irrespective of the decrease of the Abeta42/Abeta40 ratio with age and MMSE, this parameter was strongly associated with AD, as defined in this study by elevated hyperphosphorylated (P-tau181P) levels in cerebrospinal fluid (CSF). A highly robust assay for repeatedly measuring Abeta forms in plasma such as INNO-BIA plasma Abeta forms might be a useful tool in a future risk assessment of AD.
    The Journal of Nutrition Health and Aging 04/2009; 13(3):205-8. · 2.39 Impact Factor
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    ABSTRACT: Mild Cognitive Impairment (MCI) is a prevalent problem in the elderly and many patients show predictors of rapid cognitive decline ("MCI-plus"). MCI-plus represents a syndrome with growing importance in an ageing society, which will increasingly affect primary medicine and most other clinical specialties. We will have to face the dilemma of fast progress in the field of neurodiagnostics with innovative therapeutic strategies lagging behind. Psychological and medical co-morbidity in MCI-plus will therefore offer important opportunities to delay and to avoid the manifestation of dementia. We will review and discuss current training and treatment options including symptomatic and causal interventions.
    DMW - Deutsche Medizinische Wochenschrift 02/2009; 134(1-2):39-44. · 0.65 Impact Factor
  • M Berwig, H Leicht, H J Gertz
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    ABSTRACT: The present study investigates the effect of anosognosia (impaired insight for an illness) and cognitive deficits on the reliability and validity of self-rated Quality of Life (QoL) in Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD). Cross-sectional study. Cross-sectional study with a consecutive clinical sample from a memory clinic in Leipzig (Germany). 27 patients (aged 65 years or above) with a diagnosis of either MCI (N=12) or AD (N=15), each together with a caregiver. The patients' QoL was measured using the Dementia Quality of Life self and proxy ratings (DEMQoL and DEMQoLproxy). The degree of anosognosia was rated by means of the Clinical Insight Rating Scale (CIR). In addition the Mini-Mental-State Examination (MMSE), and for diagnostic purposes the Bayer Activities of Daily Living Scale (B-ADL) and the Consortium to Establish a Registry of Alzheimer;s Disease (CERAD) word list were applied. In accordance with the results of Ready et al. (1), patients with impaired insight were found to produce less reliable QoL ratings than those with unimpaired insight. The validity (concordance between self- and proxy QoL ratings) is influenced by cognitive deficits, anosognosia and the interaction between these factors. Data which are based on dementia patients' QoL self-ratings need to be interpreted with caution when anosognosia is present.
    The Journal of Nutrition Health and Aging 02/2009; 13(3):226-30. · 2.39 Impact Factor
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    ABSTRACT: Long-term studies will be pivotal in order to examine the efficacy of preventive and early therapeutic interventions during the preclinical phase of dementia. Biomarkers will be of importance due to the large sample sizes and the necessary logistic efforts, high drop-out rates and slow clinical progression. The validity of functional and even structural imaging methods is currently investigated with early and promising results; it is presently unclear whether conventional csf-markers of Alzheimer's disease (beta-amyloid and tau-proteins) are sufficiently sensitive to monitor the effects of early interventions. It also remains doubtful whether modifications of these methods will ever be useful and available for practical purposes.
    DMW - Deutsche Medizinische Wochenschrift 02/2009; 134(3):88-91. · 0.65 Impact Factor
  • Journal of The Neurological Sciences - J NEUROL SCI. 01/2009; 285.
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    ABSTRACT: CONTEXT: Cognitive or depressive disorders are frequently noted in patients with Parkinson disease (PD) and may be related to altered signaling through alpha4beta2*-nicotinic acetylcholine receptors (alpha4beta2*-nAChRs). OBJECTIVE: To assess the availability of alpha4beta2*-nAChRs and their relationship to mild cognitive and mild depressive symptoms in vivo in patients with PD. DESIGN: Crossover comparison between patients with PD and healthy volunteers (control group) using the alpha4beta2*-nAChR-specific radioligand 2-[(18)F]fluoro-3-(2[S]-2-azetidinylmethoxy)-pyridine (2-[(18)F]FA-85380) and positron emission tomography. SETTING: Departments of Neurology and Nuclear Medicine, University of Leipzig, Leipzig, Germany. PARTICIPANTS: Twenty-two nonsmoking patients with PD and 9 nonsmoking healthy volunteers. MAIN OUTCOME MEASURES: Level of 2-[(18)F]FA-85380 binding potential (2-FA BP), a measure of alpha4beta2*-nAChR availability. The relationship between severity of cognitive symptoms as rated using the Mini-Mental State Examination and DemTect scale and the level of depressive symptoms as indicated using the Beck Depression Inventory, and 2-FA BP were assessed. RESULTS: In patients with PD compared with healthy volunteers, there was widespread reduced 2-FA BP, especially in the midbrain, pons, anterior cingulate cortex, frontoparietal cortex, and cerebellum. In subgroups of patients with PD with possible depression, reduced 2-FA BP was most pronounced in the cingulate cortex and frontoparieto-occipital cortex, whereas in patients with PD with mild cognitive impairment, 2-FA BP was reduced in the midbrain, pons, and cerebellum. In patients with PD, the strongest associations between depressive symptoms and reduced 2-FA BP were noted in the anterior cingulate cortex, putamen, midbrain, and occipital cortex. In contrast, cognitive symptoms correlated only weakly with reduced 2-FA BP in the thalamus, midbrain, temporal cortex, hippocampus, and cerebellum. CONCLUSIONS: There is a broad reduction of alpha4beta2*-nAChR availability in patients with PD without clinically manifest dementia or depression compared with healthy volunteers. Reduced alpha4beta2*-nAChR binding in patients with PD within the subcortical and cortical regions is associated with the severity of mild cognitive or depressive symptoms. These results provide novel in vivo evidence for a role of the cholinergic neurotransmission in psychiatric comorbidity of PD.
    Arch Gen Psychiatry. 01/2009; 66(8):866-77.
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    ABSTRACT: Half the patients with mild cognitive impairment (MCI) will develop dementia over a four-year period. The scientific literature was searched and analysed for predictors of rapid decline (MCI-plus) in patients with MCI. The most important predictors of fast cognitive deterioration were found to be: old age, previous rapid decline, severity and multiplicity of cognitive deficits, somatic co-morbidity, vascular and Alzheimer-type changes in the brain, Alzheimer-type cerebrospinal fluid findings and apolipoprotein E4 polymorphism. Many patients with MCI suffer from anxiety, depression or apathy and subtle, but subjectively significant, difficulties in the activities of daily living. It is concluded that MCI-plus offers a window for medical and psychological prophylaxis and rehabilitation.
    DMW - Deutsche Medizinische Wochenschrift 03/2008; 133(9):431-6. · 0.65 Impact Factor
  • H.-J. Gertz, M. Berwig
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    ABSTRACT: Die Forderung nach Erfassung der Lebensqualität (LQ) von Demenzpatienten wird zunehmend von Gesundheitsbehörden vorgetragen, insbesondere auch für medikamentöse Interventionsstudien [6, 70]. Von klinisch-psychiatrischer Seite hat eine kritische Diskussion über die Möglichkeiten, die LQ von Demenzpatienten zu erfassen, bisher kaum stattgefunden. Ausgehend von den spezifischen Defiziten, die das Demenzsyndrom definieren, wird analysiert, in wie weit eine demenzkranke Person zur Bewertung ihrer eigenen LQ in der Lage ist. Obwohl die subjektive Bewertung den Goldstandard der LQ-Messung darstellt [12, 56, 72], sind die Möglichkeiten von Demenzpatienten, zu einer zuverlässigen subjektiven Einschätzung der LQ zu kommen, sehr begrenzt. Beim derzeitigen Kenntnisstand scheint es sinnvoll zu sein, sich an objektiv erhebbare Daten zu halten. Die Frage der Lebensqualität von Demenzpatienten muss normativ gesellschaftlich gelöst werden und kann nicht auf subjektiven Bewertungen von kognitiv kranken Menschen beruhen. The assessment of quality of life (QoL) in patients suffering from dementia is increasingly called for by public health authorities, particularly for pharmacological intervention studies. From a clinical point of view, until now a critical discussion about determining the QoL of dementia patients has scarcely taken place. The extent to which a demented patient may be able to assess his or her own QoL is analysed with regard to the specific deficits associated with the dementia syndrome. Although a subjective assessment represents the gold standard of Qol measurement, the capacity to provide a reliable subjective QoL estimation is limited in dementia patients. Given the present state of knowledge, it seems reasonable to adhere to objectively measurable data. The question of QoL in dementia must be solved normatively and cannot be based on the subjective assessment of cognitively impaired persons.
    Der Nervenarzt 01/2008; 79(9):1023-1035. · 0.80 Impact Factor
  • Deutsche Medizinische Wochenschrift - DEUT MED WOCHENSCHR. 01/2008; 133(16):852-852.
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    ABSTRACT: Hippocampal atrophy on magnetic resonance imaging (MRI) is an early characteristic of Alzheimer's disease. However, hippocampal atrophy may also occur in other dementias, such as frontotemporal lobar degeneration (FTLD). To investigate hippocampal atrophy on MRI in FTLD and its three clinical subtypes, in comparison with Alzheimer's disease, using volumetry and a visual rating scale. 42 patients with FTLD (17 frontotemporal dementia, 13 semantic dementia, and 12 progressive non-fluent aphasia), 103 patients with Alzheimer's disease, and 73 controls were included. Hippocampal volumetry and the easily applicable medial temporal lobe atrophy (MTA) rating scale were applied to assess hippocampal atrophy. Multivariate analysis of variance for repeated measures showed an effect of diagnostic group on hippocampal volume. There was a significant diagnosis by side (left v right) interaction. Both FTLD and Alzheimer's disease showed hippocampal atrophy compared with controls. Results of the visual MTA rating scale confirmed these findings. Within the FTLD subtypes there were marked differences in hippocampal atrophy. Frontotemporal dementia and semantic dementia showed bilateral hippocampal atrophy, and in semantic dementia the left hippocampus was smaller than in Alzheimer's disease. No significant hippocampal atrophy was detected in non-fluent progressive aphasia. Hippocampal atrophy is not only a characteristic of Alzheimer's disease but also occurs in FTLD. The three clinical subtypes of FTLD show different patterns of hippocampal atrophy.
    Journal of Neurology Neurosurgery &amp Psychiatry 05/2006; 77(4):439-42. · 4.92 Impact Factor
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    ABSTRACT: Hippocampal atrophy is a marker of Alzheimer disease (AD). It remains unclear whether this holds true for younger patients as well. Hippocampal volume was measured on MRI scans of 103 clinically diagnosed AD patients and 73 controls (aged 51 to 85 years). Aging and AD were independently associated with smaller hippocampal volume. Both young and old AD patients have hippocampal atrophy abnormal for age. Age-dependent criteria for hippocampal atrophy, suggestive of AD, are needed.
    Neurology 02/2006; 66(2):236-8. · 8.25 Impact Factor
  • NeuroImage 01/2006; 31. · 6.25 Impact Factor
  • NeuroImage 01/2006; 31. · 6.25 Impact Factor
  • Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren - ROFO-FORTSCHR RONTGENSTRAHL. 01/2006; 178.
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    NeuroImage 01/2006; 31. · 6.25 Impact Factor
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    ABSTRACT: The volume of the amygdala is reduced in advanced Alzheimer's disease (AD). However, there is controversy whether amygdala atrophy is present in mild AD and in the transitional phase between health and the onset of dementia. The aim of this prospective longitudinal study was to investigate whether amygdala atrophy is present in subjects with questionable dementia and mild dementia and whether amygdala volume is associated with the future rate of cognitive change, that is the annual change in the Mini Mental State Examination (MMSE). At baseline, volumes of the amygdala were measured in 97 participants aged 70-87 years (40 controls, 33 patients with questionable dementia, 24 patients with mild AD) using magnetic resonance imaging. Eighty-six participants were clinically re-examined after 2.3 years on average. At baseline, significant differences in mean amygdala volume were found between controls and participants with mild AD. There was no significant correlation between the longitudinal annual change in MMSE and the baseline amygdala volume in any of the three groups.
    Journal of the Neurological Sciences 12/2005; 238(1-2):71-4. · 2.24 Impact Factor
  • MMW Fortschritte der Medizin 11/2005; 147(42):51.
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    ABSTRACT: BACKGROUND AND ISSSUES: Ginkgo biloba-extracts are often used in therapy of patients with dementia. In this study, benefit and structure of Ginkgo biloba-extract EGb 761 in treatment of patients with dementia was examined. For the assessment of quality of life of care-taking relatives and patients as well as treatment costs were documented. The study was conducted as a non-randomised, two-armed cohort study with an open design for 683 slightly or moderately demented patients, aged between 65 and 80 years. Society's perspective was taken. Barthel-Index and MMST were also documented. Because of significant differences at inclusion of both cohorts, a matched-pairs-analysis and multiple regression analysis conducted. According to PLC a significant improvement in quality-of-life of care-taking relatives (p < 0.001) and patients (positive mood p = 0.018, negative mood p < 0.001) was only observed in the Ginkgo-cohort. Also Barthel-Index indicated an improvement in the Ginkgo-cohort (p < or = 0,001). MMST-scores increased significantly only in the Ginkgo-cohort (p < 0.001). Average total cost per patient amounted to 3.614,75 euro in the standard-cohort, whereas these costs per patient in the Ginkgo-cohort amounted to 3.031,78 euro (p = 0.067). Results were confirmed by matched-pairs-analysis. Ginkgo treatment has a valid place in caretaking structure of health services. Gingko attributes to a higher quality of life for both care-takers and patients, the progression of disease is slowed down and treatment costs are lower.
    MMW Fortschritte der Medizin 11/2005; 147 Suppl 3:127-33.

Publication Stats

1k Citations
128.24 Total Impact Points

Institutions

  • 1996–2009
    • University of Leipzig
      • • Klinik und Poliklinik für Psychiatrie und Psychotherapie
      • • Department für Nuklearmedizin
      Leipzig, Saxony, Germany
  • 2005
    • Karolinska Institutet
      Solna, Stockholm, Sweden
  • 2004
    • Universität Regensburg
      Ratisbon, Bavaria, Germany
    • French National Centre for Scientific Research
      Lutetia Parisorum, Île-de-France, France
  • 1999–2002
    • Paul-Flechsig-Institut für Hirnforschung
      Leipzig, Saxony, Germany
  • 2000
    • University of Cambridge
      • Department of Psychiatry
      Cambridge, ENG, United Kingdom
  • 1991–1995
    • Freie Universität Berlin
      • Department of Psychiatry
      Berlín, Berlin, Germany