Parkinson’s disease. Focus on early stages

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...

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Main Authors: E. A. Katunina, Z. A. Zalyalova, D. V. Pokhabov, M. Z. Ivanova, A. M. Semenova
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2023-07-01
Series:Неврология, нейропсихиатрия, психосоматика
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Online Access:https://nnp.ima-press.net/nnp/article/view/2036
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author E. A. Katunina
Z. A. Zalyalova
D. V. Pokhabov
M. Z. Ivanova
A. M. Semenova
author_facet E. A. Katunina
Z. A. Zalyalova
D. V. Pokhabov
M. Z. Ivanova
A. M. Semenova
author_sort E. A. Katunina
collection DOAJ
description 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.
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2310-1342
language Russian
publishDate 2023-07-01
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series Неврология, нейропсихиатрия, психосоматика
spelling doaj-art-27e241caf8b041eb9e26f4eec416d00b2025-08-20T02:16:18ZrusIMA-PRESS LLCНеврология, нейропсихиатрия, психосоматика2074-27112310-13422023-07-011539510310.14412/2074-2711-2023-3-95-1031385Parkinson’s disease. Focus on early stagesE. A. Katunina0Z. A. Zalyalova1D. V. Pokhabov2M. Z. Ivanova3A. M. Semenova4N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of RussiaThe conflict of interest has not affected the results of the investigationV.F. Voyno-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia; Federal Siberian Research Clinical Center, FMBA of RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of RussiaN.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of RussiaThe 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.https://nnp.ima-press.net/nnp/article/view/2036parkinson’s diseaseinitial stagesdopamine receptor agonistspiribedil
spellingShingle E. A. Katunina
Z. A. Zalyalova
D. V. Pokhabov
M. Z. Ivanova
A. M. Semenova
Parkinson’s disease. Focus on early stages
Неврология, нейропсихиатрия, психосоматика
parkinson’s disease
initial stages
dopamine receptor agonists
piribedil
title Parkinson’s disease. Focus on early stages
title_full Parkinson’s disease. Focus on early stages
title_fullStr Parkinson’s disease. Focus on early stages
title_full_unstemmed Parkinson’s disease. Focus on early stages
title_short Parkinson’s disease. Focus on early stages
title_sort parkinson s disease focus on early stages
topic parkinson’s disease
initial stages
dopamine receptor agonists
piribedil
url https://nnp.ima-press.net/nnp/article/view/2036
work_keys_str_mv AT eakatunina parkinsonsdiseasefocusonearlystages
AT zazalyalova parkinsonsdiseasefocusonearlystages
AT dvpokhabov parkinsonsdiseasefocusonearlystages
AT mzivanova parkinsonsdiseasefocusonearlystages
AT amsemenova parkinsonsdiseasefocusonearlystages