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Gusev E.I.
Pirogov National Research Medical University
Blokhin V.E.
Koltsov Institute of Developmental Biology RAS
Vartanov S.A.
Moscow School of Economics of the Lomonosov Moscow State University
Martynov M.U.
Pirogov Russian National Research Medical University;
Federal Center of Brain Research and Neurotechnology of the Federal Medical Biological Agency
Katunina E.A.
Federal Center of Brain and Neurotechnologies;
Pirogov Russian National Research Medical University
Alessenko A.V.
Institute of Biochemical Physic of the Russian Academy of Sciences
Denisova I.A.
Moscow School of Economics of the Lomonosov Moscow State University
Pavlova E.N.
Koltsov Institute of Developmental Biology RAS
Polterovich V.M.
Moscow School of Economics of the Lomonosov Moscow State University;
Central Economic and Mathematical Institute of the Russian Academy of Sciences
Kucheryanu V.G.
Institute of General Pathology and Pathophysiology
Shupik M.A.
Institute of Biochemical Physic of the Russian Academy of Sciences
Nodel M.R.
Sechenov First Moscow State Medical University
Kalinkin A.L.
Medical Research and Education Center of Lomonosov Moscow State University
Sokolov S.A.
Lomonosov Moscow State University
Chubarova T.V.
Institute of Economics of the Russian Academy of Sciences
Shakleina M.V.
Moscow School of Economics of the Lomonosov Moscow State University
Pronina T.S.
Koltsov Institute of Developmental Biology of the Russian Academy of Sciences
Ugrumov M.V.
Koltsov Institute of Developmental Biology RAS
Development of early diagnosis of Parkinson’s disease and comprehensive economic analysis of the effect of its implementation
Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(1): 9‑20
Views: 2924
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To cite this article:
Gusev EI, Blokhin VE, Vartanov SA, et al. . Development of early diagnosis of Parkinson’s disease and comprehensive economic analysis of the effect of its implementation. S.S. Korsakov Journal of Neurology and Psychiatry.
2021;121(1):9‑20. (In Russ.)
https://doi.org/10.17116/jnevro20211210119
The paper summarizes the literature and author’s data on the development of early (preclinical) diagnosis of Parkinson’s disease (PD). Implementation of this diagnosis will promote the use of preventive therapy and change investments in diagnosis and treatment of patients. The paper declares that at present the only approach to early diagnosis of PD is positron-emission tomography of the nigrostriatal dopaminergic system, but it cannot be used for preventive examination due to its high cost. The authors consider that a less specific, but more promising approach to the development of early diagnosis of PD is the search for markers in body fluids, mainly in the blood, in patients at the prodromal stage of PD. Indeed, a number of markers as changes in the level of metabolites of monoamines, sphingolipids, urates, and indicators of oxidative stress were found in patients selected for the risk group of the prodromal stage of PD, according to characteristic premotor symptoms. In addition, it is assumed that the search for blood markers at an earlier — pre-prodromal stage is possible only in animal models of PD at the early preclinical stage. This approach can also be used to verify blood markers identified in patients at the clinical stage of PD. It is also evident that the complex socio-economic factors influencing the incidence of PD is different in developed versus developing countries. The societal and medical costs of Parkinson’s are huge and efforts to improve early preclinical diagnosis of PD will lead to considerable economical and societal benefits. For instance this will allow efficient selection of patients for preclinical diagnostic tests. To assess the effectiveness of this strategy considering the uncertainty of socio-economic issues, a modification of the «cost-utility» analysis is proposed. For the first time, a Markov model of PD including preclinical diagnostic tests and possible neuroprotective therapy was developed and studied. Analytical outcomes of this process suggest that the idea of developing a new multimodal strategy is promising from a socio-economic point of view.
Keywords:
Authors:
Gusev E.I.
Pirogov National Research Medical University
Blokhin V.E.
Koltsov Institute of Developmental Biology RAS
Vartanov S.A.
Moscow School of Economics of the Lomonosov Moscow State University
Martynov M.U.
Pirogov Russian National Research Medical University;
Federal Center of Brain Research and Neurotechnology of the Federal Medical Biological Agency
Katunina E.A.
Federal Center of Brain and Neurotechnologies;
Pirogov Russian National Research Medical University
Alessenko A.V.
Institute of Biochemical Physic of the Russian Academy of Sciences
Denisova I.A.
Moscow School of Economics of the Lomonosov Moscow State University
Pavlova E.N.
Koltsov Institute of Developmental Biology RAS
Polterovich V.M.
Moscow School of Economics of the Lomonosov Moscow State University;
Central Economic and Mathematical Institute of the Russian Academy of Sciences
Kucheryanu V.G.
Institute of General Pathology and Pathophysiology
Shupik M.A.
Institute of Biochemical Physic of the Russian Academy of Sciences
Nodel M.R.
Sechenov First Moscow State Medical University
Kalinkin A.L.
Medical Research and Education Center of Lomonosov Moscow State University
Sokolov S.A.
Lomonosov Moscow State University
Chubarova T.V.
Institute of Economics of the Russian Academy of Sciences
Shakleina M.V.
Moscow School of Economics of the Lomonosov Moscow State University
Pronina T.S.
Koltsov Institute of Developmental Biology of the Russian Academy of Sciences
Ugrumov M.V.
Koltsov Institute of Developmental Biology RAS
Received:
05.10.2020
Accepted:
16.10.2020
List of references:
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