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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2019-18-61-70</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-4937</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПАРКИНСОНИЗМ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PARKINSONISM</subject></subj-group></article-categories><title-group><article-title>Ранние стадии болезни Паркинсона: особенности диагностики и терапии</article-title><trans-title-group xml:lang="en"><trans-title>Early stages of Parkinson’s disease: aspects of the diagnosis and therapy</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7416-9050</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пилипович</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Pilipovich</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> Пилипович Анна Александровна, к.м.н., доцент кафедры нервных болезней</p><p>119991,  Москва, ул. Трубецкая, д. 8, стр. 2 </p></bio><bio xml:lang="en"><p>Anna A. Pilipovich, Cand. of Sci. (Med.), Associate Professor, Chair for Nervous Diseases, Institute for Professional Education</p><p>8, Bldg. 2, Trubetskaya St., Moscow, 119991</p></bio><email xlink:type="simple">aapilipovich@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Институт профессионального образования Первого Московского государственного медицинского университета имени И.М. Сеченова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal State Autonomous Educational Institution of Higher Education «I.M. Sechenov First Moscow State Medical University» of the Ministry of Health of the Russian Federation (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>30</day><month>11</month><year>2019</year></pub-date><volume>0</volume><issue>18</issue><fpage>61</fpage><lpage>70</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Пилипович А.А., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Пилипович А.А.</copyright-holder><copyright-holder xml:lang="en">Pilipovich A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/4937">https://www.med-sovet.pro/jour/article/view/4937</self-uri><abstract><p>Болезнь Паркинсона (БП) – второе по частоте нейродегенеративное заболевание, характеризующееся неуклонным прогрессированием и приводящее к стойкой инвалидизации. Известно, что между началом отмирания клеток в определенных структурах нервной системы и появлением клинических признаков заболевания может пройти более 10 лет, и за это время утрачивается большая часть дофаминергических нейронов. Выявление пациентов в период между предполагаемым началом потери дофаминергических клеток и появлением клинического паркинсонизма может иметь решающее значение для разработки эффективных стратегий нейропротективного лечения. В настоящее время ученые всего мира уделяют особое внимание поиску надежных клинических, нейровизуализационных, молекулярных маркеров, которые могли бы помочь диагностировать БП на ранних стадиях, отличать ее от других патологических состояний, отслеживать прогрессирование, выявлять положительный ответ терапии. В статье сделан обзор современного состояния проблемы ранней диагностики и поиска ранних клинических признаков, доклинических биохимических, генетических и нейровизуализационных маркеров БП, приведены основные современные направления терапии БП: разобрана симптоматическая фармакотерапия, восполняющая дофаминергический дефицит и способная сгладить двигательные и некоторые немоторные симптомы паркинсонизма, а также некоторые возможности нейропротекторного лечения. В частности, подробно описана роль амантадинов, приводится зарубежный и отечественный опыт их применения в качестве монотерапии и комплексного лечения БП. Дается разбор клинического случая терапии начальной стадии БП препаратом ПК-Мерц.</p></abstract><trans-abstract xml:lang="en"><p>Parkinson’s disease (PD) is the second most common neurodegenerative disease that is characterized by steady progression and results into persistent disability. It has been known that more than 10 years may elapse between the onset of cell death in certain structures of the nervous system and the onset of clinical symptoms of the disease, and most of the dopaminergic neurons are lost during this period. The identification of patients in the period between the expected onset of dopaminergic cell loss and the onset of clinical parkinsonism may be crucial for the development of effective neuroprotective treatment strategies. The scientists around the world are currently paying special attention to the search for reliable clinical, neuroimaging and molecular markers that could help diagnose PD in the early stages, distinguish it from other pathological conditions, track progression, and detect a positive response to therapy. The article provides an overview of the status update on the problem of early diagnosis and search for early clinical signs, preclinical biochemical, genetic and neuroimaging markers of PD, the main modern directions of PD therapy. Symptomatic pharmacotherapy, which compensates for dopaminergic deficiency and is able to alleviate motor and some nonmotor symptoms of parkinsonism, as well as some neuroprotective treatment options, have been analysed. Among other factors, the role of amantidines is described in detail. The foreign and domestic experience of their use as monotherapy and complex treatment of PD is presented. The author provides an analysis of the clinical case of PK-Merz therapy of the initial stage of PD.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>болезнь Паркинсона</kwd><kwd>нейродегенеративные заболевания</kwd><kwd>маркеры паркинсонизма</kwd><kwd>амантадин</kwd><kwd>ПК-Мерц</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Parkinson’s disease</kwd><kwd>neurodegenerative diseases</kwd><kwd>markers of parkinsonism</kwd><kwd>amantadine</kwd><kwd>PK-Merz</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">El-Agnaf O.M.A., Salem S.A., Paleologou K.E., Curran M.D., Gibson M.J., Court J.A. et al. Detection of oligomeric forms of (-synuclein protein in human plasma as a potential biomarker for Parkinson’s disease. FASEB J. 2006;20:419–425. 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