CLINICAL AND BIOLOGICAL PREDICTION OF ADVERSE DISEASE COURSE IN PARKINSON’S DISEASE AND ATYPICAL PARKINSONIAN SYNDROMES AS A BASIS FOR PERSONALIZED PREVENTION OF FUNCTIONAL DECOMPENSATION

Rakhimbaeva G.S.; Okhunova D.A.

doi:10.31149/ijnps.v4i9.2987

Authors

Rakhimbaeva G.S. Tashkent State Medical University, Tashkent, Uzbekistan
Okhunova D.A. Tashkent State Medical University, Tashkent, Uzbekistan

DOI:

https://doi.org/10.31149/ijnps.v4i9.2987

Keywords:

Parkinson’s Disease, Atypical Parkinsonism, NfL, α-synuclein, caspase-1, MMP-9, IL-6, NGF, Biomarkers, Functional Decompensation, Prognosis

Abstract

Predicting the individual trajectory of Parkinson’s disease (PD) and atypical parkinsonian syndromes (APS) is becoming a central challenge in contemporary neurology. Clinical stage does not always reflect the rate at which functionally significant events accumulate: recurrent falls, freezing of gait, dysphagia, cognitive–executive and autonomic impairment, dependence on others, and hospitalizations. This review examines a multimarker approach integrating NfL, α-synuclein, caspase-1, MMP-9, IL-6, and NGF. These markers address complementary pathogenic pathways: neuroaxonal injury, synucleinopathy, inflammasome activation, systemic and neurovascular inflammation, and neurotrophic reserve. NfL has the strongest supporting prognostic evidence, whereas inflammatory and neurotrophic markers are best considered components of an integrated model requiring clinical validation. Moving from the prediction of isolated symptoms to the time to the first clinically significant event of functional decompensation, followed by risk-profile–guided prevention, appears promising.

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