Parkinson’s disease. Focus on early stages
https://doi.org/10.14412/2074-2711-2023-3-95-103
Abstract
The review presents current data on the peculiarities of the neurodegenerative process in the early stages of Parkinson’s disease (PD) and considers the hypothesis of the presence of body-first and brain-first subtypes of the disease onset. The earliest manifestations of the disease include symptoms such as parasomnia, constipation, hyposmia, anxiety-depressive disorder, daytime sleepiness, color perception changes, cognitive dysfunction, and mild motor manifestations. The diagnosis of PD can be made when characteristic motor manifestations occur: hypokinesia, rest tremor, muscle rigidity. Substantia nigra ultrasound, magnetic resonance imaging in SWI mode, and functional neuroimaging methods are used as confirmatory methods. The approach to the treatment of early stages of PD is age dependent. Patients over 70 years of age are recommended to start therapy with levodopa; younger patients – with dopamine receptor agonists (ADR), amantadines, MAO-B inhibitors. The mechanisms of ADR action, the possibility of their influence on the motor and non-motor symptoms of PD are analyzed. A special place is given to piribedil, which, due to the dual mechanism of action, has a positive effect on cognitive functions, depression, apathy, as well as a minimal effect on daytime sleepiness.
Supporting agencies: This article has been supported by Servier
About the Authors
E. A. Katunina
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of Russia
Russian Federation
Competing Interests:
Russian Federation
Elena Anatolyevna Katunina - Department of Neurology, Neurosurgery, and Medical Genetics N.I. Pirogov RNRMU; Department of Neurodegenerative Diseases FCBN.
1, Ostrovityanovа St., Moscow 117997; 1, Ostrovityanovа St., Build 10, Moscow 117513
Competing Interests:
The conflict of interest has not affected the results of the investigation
Z. A. Zalyalova
The conflict of interest has not affected the results of the investigation
Russian Federation
Competing Interests:
Russian Federation
49, Butlerovа St., Kazan 420012; 65, Nikolayа Ershovа St., Kazan 420061
Competing Interests:
The conflict of interest has not affected the results of the investigation
D. V. Pokhabov
V.F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia; Federal Siberian Research Clinical Center, FMBA of Russia
Russian Federation
Competing Interests:
Russian Federation
Department of Nervous System Diseases V.F. Voyno-Yasenetsky Krasnoyarsk SMU; Center of innovative neurology, extrapyramidal diseases and botulinum therapy, FSR CC, FMBA of Russia.
1, Partisanа Zheleznyakа St., Krasnoyarsk 660022; 26, Kolomenskaya St., Krasnoyarsk 660037
Competing Interests:
The conflict of interest has not affected the results of the investigation
M. Z. Ivanova
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of Russia
Russian Federation
Competing Interests:
Russian Federation
Department of Neurology, Neurosurgery, and Medical Genetics N.I. Pirogov RNRMU; Department of Neurodegenerative Diseases FCBN.
1, Ostrovityanovа St., Moscow 117997; 1, Ostrovityanovа St., Build 10, Moscow 117513
Competing Interests:
The conflict of interest has not affected the results of the investigation
A. M. Semenova
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of Russia
Russian Federation
Competing Interests:
Russian Federation
Department of Neurology, Neurosurgery, and Medical Genetics N.I. Pirogov RNRMU; Department of Neurodegenerative Diseases FCBN.
1, Ostrovityanovа St., Moscow 117997; 1, Ostrovityanovа St., Build 10, Moscow 117513
Competing Interests:
The conflict of interest has not affected the results of the investigation
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For citations:
Katunina EA, Zalyalova ZA, Pokhabov DV, Ivanova MZ, Semenova AM. Parkinson’s disease. Focus on early stages. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2023;15(3):95-103. (In Russ.) https://doi.org/10.14412/2074-2711-2023-3-95-103
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