[Evaluation of the contribution of the importance of neuroimaging for the diagnostics of dementias--comparison to the psychological diagnostics].
OBJECTIVE
While psychology is accepted as a necessary component of the dementia diagnostics, the extended clinical diagnostics with neuroimaging is differently estimated. The goal of the study is the quantification of the individual contribution of the two different methods.


METHODS
Of 100 patients the diagnosis of entrance, the neurological, the psychological, and the final clinical diagnosis were documented. For both imaging and psychology the sensitivity, specificity, and the positive predictive value were computed. The diagnostic of each method was determined from the change of the final in relation to the initial clinical diagnosis. The neuroradiological investigation took place with MRI, the psychological examination used both usual power and special speed tests.


RESULTS
The extended clinical diagnostics led for 26 % of the patients to the change of the clinical diagnosis. Imaging and psychology supplied different own but supplementing contributions. In the case of annihilation imaging contributed with 73.3 %, psychology with 54.1 % to the diagnosis of a neurodegenerative dementia, whereas the contributions to the diagnosis of a vascular dementia were 83.3 % and 70.8 %, respectively. However psychology diagnosed and quantified the dementia. The contribution of neuroimaging consisted in the differential diagnosis of the dementias. Organic causes of symptomatic dementias and vascular encephalopathy without dementia but with consequences for a secondary prophylaxis were additional information also.


CONCLUSIONS
Psychology improves the diagnostic accuracy of dementias. Neuroimaging improves the differential diagnosis of dementias and supplies additional clinically relevant findings. In the qualified diagnostics and differential diagnostics of the dementias both methods are indispensable.
Hentschel
F
F
Abteilung Neuroradiologie, Zentralinstitut für seelische Gesundheit, Fakultät für klinische Medizin Mannheim der Universität Heidelberg. hentsche@zi-mannheim.de
Kreis
M
M
Damian
M
M
Syren
M
M
Krumm
B
B
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D001284:Atrophy; D001921:Brain / Q000473:pathology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008432:Mathematical Computing; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D010348:Patient Care Team; D011594:Psychometrics; D012680:Sensitivity and Specificity