БОЛЕЗНЬ ПАРКИНСОНА: КОМПЛЕКСНАЯ КЛИНИКО-НЕВРОЛОГИЧЕСКАЯ ОЦЕНКА ДВИГАТЕЛЬНЫХ И НЕМOТОРНЫХ НАРУШЕНИЙ, ПРОГНОЗИРОВАНИЕ ПРОГРЕССИРОВАНИЯ И ПЕРСОНАЛИЗИРОВАННЫЕ ПОДХОДЫ К ЛЕЧЕНИЮ

Background. Parkinson's disease is a chronic progressive neurodegenerative disorder characterized by impaired nigrostriatal dopamine transmission, basal ganglia dysfunction, and a broad spectrum of motor and nonmotor manifestations. Although bradykinesia, rigidity, and resting tremor remain central to clinical diagnosis, long-term functional outcomes are strongly influenced by cognitive impairment, sleep disturbances, autonomic dysfunction, postural instability, and complications of dopaminergic treatment. Clinical and molecular heterogeneity highlights the need for individualized diagnostic, prognostic, and therapeutic strategies. Materials and Methods. A narrative analytical review of international clinical guidelines, prospective cohort studies, randomized controlled trials, systematic reviews, and meta-analyses was conducted. Clinical diagnostic criteria, molecular biomarkers, motor and cognitive assessment, pharmacological treatment, continuous drug-delivery systems, deep brain stimulation, and neurorehabilitation were examined. Results. Major motor and nonmotor phenotypes, prognostic characteristics, and functional assessment methods were systematically analyzed. Comparative analyses addressed dopaminergic treatment, management of cognitive and autonomic disorders, deep brain stimulation, and multidisciplinary rehabilitation. Six analytical tables and an original conceptual framework, PARK-FUNCTION, were developed to integrate clinical, neurological, biological, and functional parameters. Conclusion. Comprehensive Parkinson's disease management requires systematic evaluation of motor and nonmotor manifestations, timely recognition of treatment-related complications, and individualized rehabilitation. Molecular biomarkers and adaptive neuromodulation offer emerging opportunities for personalized care but cannot replace comprehensive clinical assessment. Prospective validation of the proposed framework is necessary.

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