<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<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">neurojour</journal-id><journal-title-group><journal-title xml:lang="ru">Неврологический журнал имени Л.О. Бадаляна</journal-title><trans-title-group xml:lang="en"><trans-title>L.O. Badalyan Neurological Journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2686-8997</issn><issn pub-type="epub">2712-794X</issn><publisher><publisher-name>ФГАУ «НМИЦ здоровья детей» Минздрава России</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.46563/2686-8997-2025-6-4-182-194</article-id><article-id custom-type="edn" pub-id-type="custom">bletts</article-id><article-id custom-type="elpub" pub-id-type="custom">neurojour-202</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>ОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ORIGINAL INVESTIGATIONS</subject></subj-group></article-categories><title-group><article-title>Результаты двухлетнего комплексного наблюдения за пациентами со спинальной мышечной атрофией, получившими генную терапию препаратом онасемноген абепарвовек на пресимптоматической стадии заболевания</article-title><trans-title-group xml:lang="en"><trans-title>Results of a two-year comprehensive follow-up in patients with spinal muscular atrophy who received gene therapy with onasemnogen abeparvovec at the presymptomatic stage of the disease</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9562-3774</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кузенкова</surname><given-names>Людмила Михайловна</given-names></name><name name-style="western" xml:lang="en"><surname>Kuzenkova</surname><given-names>Lyudmila M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, профессор, начальник центра детской психоневрологии, врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия; Клинический институт детского здоровья имени Н.Ф. Филатова ФГАОУ ВО «Первый МГМУ имени И.М. Сеченова» Минздрава России (Сеченовский университет), 119435, Москва, Россия</p></bio><bio xml:lang="en"><p>DSc (Medicine), professor, Head, Center for child neuropsychiatry and neurorehabilitation, neurologist, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation; N.F. Filatov Clinical Institute of Children’s Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russian Federation</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7269-9100</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Куренков</surname><given-names>Алексей Львович</given-names></name><name name-style="western" xml:lang="en"><surname>Kurenkov</surname><given-names>Aleksey L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, зав. лаб. нервных болезней, врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>DSc (Medicine), Head, Laboratory of nervous diseases, neurologist, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8381-8793</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Увакина</surname><given-names>Евгения Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Uvakina</surname><given-names>Eugeniya V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, зав. отделением психоневрологии и нейрореабилитации, заместитель директора по научной работе, врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>PhD (Medicine), Head, Department of neuropsychiatry and neurorehabilitation, neurologist, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7893-1863</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фисенко</surname><given-names>Дарья Андреевна</given-names></name><name name-style="western" xml:lang="en"><surname>Fisenko</surname><given-names>Daria A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p><p>e-mail: fisenko.daria@mail.ru</p></bio><bio xml:lang="en"><p>Neurologist, Center of child psychoneurology, National Medical Research Center of Children’s Health, Moscow, 119991, Russian Federation</p><p>e-mail: fisenko.daria@mail.ru</p></bio><email xlink:type="simple">fisenko.daria@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8750-9285</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Черников</surname><given-names>Владислав Владимирович</given-names></name><name name-style="western" xml:lang="en"><surname>Chernikov</surname><given-names>Vladislav V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, зав. отделением диагностики и восстановительного лечения, начальник методического аккредитационно-симуляционного центра, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>PhD (Medicine), Head, Department of diagnostics and rehabilitation treatment, Head, Methodological accreditation and simulation center, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8923-4652</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семикина</surname><given-names>Елена Леонидовна</given-names></name><name name-style="western" xml:lang="en"><surname>Semikina</surname><given-names>Elena L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, зав. лабораторным отделом, гл. науч. сотр., врач лабораторной диагностики, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>DSc (Medicine), Head, Laboratory department, chief researcher, doctor of laboratory diagnostics, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9697-500X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Попович</surname><given-names>София Георгиевна</given-names></name><name name-style="western" xml:lang="en"><surname>Popovich</surname><given-names>Sofia G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Врач-невролог, мл. науч. сотр. ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>Junior researcher, neurologist, Department of neuropsychiatry and neurorehabilitation, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8506-2064</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бурсагова</surname><given-names>Бэлла Ибрагимовна</given-names></name><name name-style="western" xml:lang="en"><surname>Bursagova</surname><given-names>Bella I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, врач-невролог, ст. науч. сотр. ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>PhD (Medicine), neurologist, Department of neuropsychiatry and neurorehabilitation, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6084-4892</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Глоба</surname><given-names>Оксана Валерьевна</given-names></name><name name-style="western" xml:lang="en"><surname>Globa</surname><given-names>Oxana V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, врач-невролог, ст. науч. сотр. ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>PhD (Medicine), senior researcher, neurologist, Department of neuropsychiatry and neurorehabilitation, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-2227-7069</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Андреенко</surname><given-names>Наталья Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Andreenko</surname><given-names>Natalya V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>PhD (Medicine), neurologis, Department of neuropsychiatry and neurorehabilitation, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1574-2050</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Абдуллаева</surname><given-names>Луизат Муслимовна</given-names></name><name name-style="western" xml:lang="en"><surname>Abdullaeva</surname><given-names>Luizat M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Врач-невролог, мл. науч. сотр. лаб. детских редких наследственных болезней ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>Junior researcher, neurologist, Department of neuropsychiatry and neurorehabilitation, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-3712-974X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Курова</surname><given-names>Юлия Александровна</given-names></name><name name-style="western" xml:lang="en"><surname>Kurova</surname><given-names>Julia A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>Neurologist, Department of neuropsychiatry and neurorehabilitation, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0001-8978-6833</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Адалимова</surname><given-names>Надежда Сергеевна</given-names></name><name name-style="western" xml:lang="en"><surname>Adalimova</surname><given-names>Nadezhda S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>Neurologist, Department of neuropsychiatry and neurorehabilitation, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-4368-432X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Николенко</surname><given-names>Дарья Сергеевна</given-names></name><name name-style="western" xml:lang="en"><surname>Nikolenko</surname><given-names>Daria S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>Neurologist, Department of neuropsychiatry and neurorehabilitation, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5657-7851</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лялина</surname><given-names>Анастасия Андреевна</given-names></name><name name-style="western" xml:lang="en"><surname>Lyalina</surname><given-names>Anastasia A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Врач-невролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>Neurologist, Department of psychoneurology and neurorehabilitation of the National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7609-0936</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Комарова</surname><given-names>Ольга Викторовна</given-names></name><name name-style="western" xml:lang="en"><surname>Komarova</surname><given-names>Olga V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, первый зам. директора, и.о. руководителя Института подготовки медицинских кадров, врач-нефролог, ФГАУ «НМИЦ здоровья детей» Минздрава России, 119991, Москва, Россия</p></bio><bio xml:lang="en"><p>DSc (Medicine), nephrologist, First deputy director, Acting head, Institute of Medical Personnel Training, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России; Клинический институт детского здоровья имени Н.Ф. Филатова ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)<country>Россия</country></aff><aff xml:lang="en">National Medical Research Center of Children’s Health of the Ministry, Health of the Russian Federation; N.F. Filatov Clinical Institute of Children’s Health, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, 119435, Russian Federation<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России<country>Россия</country></aff><aff xml:lang="en">National Medical Research Center of Children’s Health of the Ministry, Health of the Russian Federation<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>31</day><month>01</month><year>2026</year></pub-date><volume>6</volume><issue>4</issue><fpage>182</fpage><lpage>194</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Кузенкова Л.М., Куренков А.Л., Увакина Е.В., Фисенко Д.А., Черников В.В., Семикина Е.Л., Попович С.Г., Бурсагова Б.И., Глоба О.В., Андреенко Н.В., Абдуллаева Л.М., Курова Ю.А., Адалимова Н.С., Николенко Д.С., Лялина А.А., Комарова О.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Кузенкова Л.М., Куренков А.Л., Увакина Е.В., Фисенко Д.А., Черников В.В., Семикина Е.Л., Попович С.Г., Бурсагова Б.И., Глоба О.В., Андреенко Н.В., Абдуллаева Л.М., Курова Ю.А., Адалимова Н.С., Николенко Д.С., Лялина А.А., Комарова О.В.</copyright-holder><copyright-holder xml:lang="en">Kuzenkova L.M., Kurenkov A.L., Uvakina E.V., Fisenko D.A., Chernikov V.V., Semikina E.L., Popovich S.G., Bursagova B.I., Globa O.V., Andreenko N.V., Abdullaeva L.M., Kurova J.A., Adalimova N.S., Nikolenko D.S., Lyalina A.A., Komarova O.V.</copyright-holder><license 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.neuro-journal.ru/jour/article/view/202">https://www.neuro-journal.ru/jour/article/view/202</self-uri><abstract><sec><title>Введение</title><p>Введение. Использование генной терапии у пациентов со спинальной мышечной атрофией (СМА) привело к значительному улучшению прогнозов двигательного развития. Включение СМА в расширенный неонатальный скрининг в России позволило не только максимально рано выявлять пациентов, но и для части из них стала доступна генная терапия на пресимптоматической стадии (ПС) заболевания.</p><p>Цель исследования — оценить в условиях реальной клинической практики эффективность генной терапии при 2-летнем катамнестическом наблюдении за пациентами со СМА, получивших лечение препаратом онасемноген абепарвовек на СМА-ПС.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В исследование были включены 35 ребёнка со СМА, с генетически верифицированным диагнозом СМА без развития симптомов заболевания. Диагноз СМА был установлен при проведении пилотного проекта расширенного неонатального скрининга или с 01.01.2023 в рамках расширенного неонатального скрининга. Диагноз был верифицирован при проведении молекулярно-генетического исследования — у всех детей была выявлена делеция 7-го и/или 8-го экзонов гена SMN1 в гомозиготном состоянии. Все пациенты получили генную терапию препаратом онасемноген абепарвовек, средний возраст на момент проведения терапии составил 2,00 ± 0,94 мес (95% ДИ 1,68–2,32), min — 1,00, max — 5,00. Проводилась комплексная оценка клинических (основные этапы моторного развития по критериям ВОЗ, оценка по шкалам HINE-2 и CHOP-INTEND), электронейромиографических (латентность, амплитуда и площадь негативного пика дистального М-ответа при электрической стимуляции локтевого нерва на запястье, скорость распространения возбуждения по двигательным волокнам локтевого нерва на предплечье) и биохимических (уровни лёгких и тяжёлых цепей нейрофиламентов (НФ) в сыворотке крови) показателей у пациентов со СМА-ПС до инициации генной терапии и через 6, 12, 18 и 24 мес после её проведения.</p></sec><sec><title>Результаты</title><p>Результаты. Пациенты со СМА-ПС в нашем исследовании как до, так и после проведения генной терапии имели моторное развитие в соответствии с возрастными нормами и достоверно не отличались от детей без неврологической патологии. При сравнительном анализе электронейромиографических показателей детей со СМА и группы здоровых детей установлено, что у пациентов ср СМА-ПС на фоне генной терапии статистически значимых различий не получено. При проведении сравнительного анализа уровней лёгких и тяжёлых цепей НФ в сыворотке крови пациентов со СМА-ПС до проведения генной терапии и 76 неврологически здоровых детей, полученных в недавнем исследовании, показано, что медиана уровня лёгких цепей НФ при СМА была достоверно (p &lt; 0,001) выше: 6,00 [Q1; Q3 — 6,00; 31,43] и 4,00 [2,50; 9,57] пг/мл соответственно. В то же время уровень тяжёлых цепей НФ при сравнении пациентов со СМА-ПС до проведения генной терапии со здоровыми сверстниками достоверно не отличался. Применение онасемногена абепарвовека у пациентов со СМА-ПС приводило к статистически значимому снижению уровня лёгких цепей НФ в сыворотке крови. Максимальное снижение показателей НФ отмечалось через 3–6 мес после проведения генной терапии.</p></sec><sec><title>Заключение</title><p>Заключение. Проведение генной терапии с применением препарата онасемноген абепарвовек у пациентов со СМА-ПС позволило предупредить развитие симптомов заболевания и формировать основные этапы моторного развития в соответствии с критериями ВОЗ.</p><p>Соблюдение этических стандартов. На проведение данного исследования было получено разрешение локального этического комитета ФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава России (протокол заседания ЛЭК № 10 от 06.10.2022).</p></sec><sec><title>Участие авторов</title><p>Участие авторов:Кузенкова Л.М., Куренков А.Л., Увакина Е.В., Фисенко Д.А. — концепция и дизайн статьи, написание текста, редактирование;Черников В.В. — статистическая обработка данных, редактирование.Все соавторы — редактирование, утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.</p></sec><sec><title>Конфликт интересов</title><p>Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.</p></sec><sec><title>Финансирование</title><p>Финансирование. Исследование не имело спонсорской поддержки.</p></sec><sec><title>Поступила 06</title><p>Поступила 06.11.2025Принята к печати 01.12.2025Опубликована 31.01.2026</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. The use of gene therapy in patients with spinal muscular atrophy (SMA) has led to a significant improvement in the prognosis of motor development. The inclusion of SMA in the expanded neonatal screening in the Russian Federation allowed not only identifying patients as early as possible, but also gene therapy at the presymptomatic stage of the disease became available for some of them.</p></sec><sec><title>Objective</title><p>Objective. To evaluate the effectiveness of gene therapy in real clinical practice during 2 years of follow-up of SMA patients treated with onasemnogen abeparvovec at the presymptomatic stage of the disease.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study included thirty five SMA children, with a genetically verified diagnosis of SMA without developing symptoms of the disease. The diagnosis of SMA was established during the pilot project of the extended neonatal screening or from 01/01/2023 as part of the extended neonatal screening. The diagnosis was verified during DNA diagnostics. Deletion of exons 7 and/or 8 of the SMN1 gene in the homozygous state was detected in all children. All patients received gene therapy with onasemnogen abeparvovec, the average age at the time of therapy was 2.00 ± 0.94 months (95% CI 1.68–2.32), min — 1.00, max — 5.00. A comprehensive assessment was conducted of clinical (the motor development milestones according to WHO, HINE-2 and CHOP-INTEND scores), electroneuromyographic (latency, amplitude and area of the negative peak of the compound muscle action potential during electrical stimulation of the ulnar nerve on the wrist; the motor nerve conduction velocity of the ulnar nerve on the forearm) and biochemical parameters (levels of light and heavy chains of neurofilaments (NF) in blood serum in SMA patients at the presymptomatic stage before initiation of gene therapy and after 6, 12, 18, and 24 months after its implementation.</p></sec><sec><title>Results</title><p>Results. In our study, SMA patients at the presymptomatic stage, both before and after gene therapy, had motor development in accordance with age norms and did not significantly differ from children without neurological pathology. A comparative analysis of the electroneuromyographic parameters in SMA children and a group of healthy children revealed no statistically significant differences in patients at the presymptomatic stage of SMA on the background of gene therapy. A comparative analysis of the levels of light and heavy NF chains in the blood serum in SMA patients at the presymptomatic stage before gene therapy and 76 neurologically healthy children obtained in a recent study showed the level of light NF chains in SMA to be significantly higher (p &lt; 0.001) — Me — 6.00, Q1; Q3 = 6.00; 31.43 pg/ml and Me — 4.00, Q1; Q3 = 2.50; 9.57 pg/ml, respectively. At the same time, the level of heavy NF chains did not significantly differ when comparing SMA patients at the presymptomatic stage before gene therapy with healthy peers. The use of onasemnogen abeparvovec in SMA patients at the presymptomatic stage led to a statistically significant decrease in the level of light chains NF in the blood serum. The maximum decrease in NF was observed 3–6 months after the gene therapy.</p></sec><sec><title>Conclusion</title><p>Conclusion. Carrying out gene therapy using the onasemnogen abeparvovek in SMA patients at the presymptomatic stage made it possible to prevent the development of symptoms of the disease and achieve the main stages of motor development milestones according to WHO criteria.</p><p>Compliance with ethical standards. Permission to conduct this study was obtained from the local ethics committee of the National Medical Research Center for Children’s Health (Minutes of the Local ethics committee, meeting No. 10 dated 10/06/2022).</p></sec><sec><title>Contribution</title><p>Contribution:Kuzenkova L.M., Kurenkov A.L., Uvakina E.V., Fisenko D.A. — concept and design of research, writing, editing;Chernikov V.V. — statistical data processing, editing.All co-authors are responsible for the integrity of all parts of the manuscript and approval of its final version.</p></sec><sec><title>Funding</title><p>Funding. The study had no sponsorship.</p></sec><sec><title>Conflict of interest</title><p>Conflict of interest. The authors declare no conflict of interest.</p></sec><sec><title>Received</title><p>Received: November 6, 2024Accepted: December 1, 2024Published: January 31, 2025</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>спинальная мышечная атрофия</kwd><kwd>пресимптоматическая стадия</kwd><kwd>неонатальный скрининг</kwd><kwd>генная терапия</kwd><kwd>онасемноген абепарвовек</kwd><kwd>этапы моторного развития по ВОЗ</kwd><kwd>шкала HINE-2</kwd><kwd>шкала CHOP-INTEND</kwd><kwd>электронейромиография</kwd><kwd>нейрофиламенты</kwd></kwd-group><kwd-group xml:lang="en"><kwd>spinal muscular atrophy</kwd><kwd>presymptomatic stage</kwd><kwd>neonatal screening</kwd><kwd>gene therapy</kwd><kwd>onasemnogen abeparvovek</kwd><kwd>motor development milestones according to WHO</kwd><kwd>HINE-2 score</kwd><kwd>CHOP-INTEND score</kwd><kwd>electroneuromyography</kwd><kwd>neurofilaments</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">Mercuri E., Sumner C.J., Muntoni F., Darras B.T., Finkel R.S. Spinal muscular atrophy. Nat. Rev. Dis. Primers. 2022; 8(1): 52. https://doi.org/10.1038/s41572-022-00380-8</mixed-citation><mixed-citation xml:lang="en">Mercuri E., Sumner C.J., Muntoni F., Darras B.T., Finkel R.S. Spinal muscular atrophy. Nat. Rev. Dis. Primers. 2022; 8(1): 52. https://doi.org/10.1038/s41572-022-00380-8</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Yeo C.J.J., Tizzano E.F., Darras B.T. Challenges and opportunities in spinal muscular atrophy therapeutics. Lancet Neurol. 2024; 23(2): 205–18. https://doi.org/10.1016/S1474-4422(23)00419-2</mixed-citation><mixed-citation xml:lang="en">Yeo C.J.J., Tizzano E.F., Darras B.T. Challenges and opportunities in spinal muscular atrophy therapeutics. Lancet Neurol. 2024; 23(2): 205–18. https://doi.org/10.1016/S1474-4422(23)00419-2</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Schroth M.K., Deans J., Bharucha Goebel D.X., Burnette W.B., Darras B.T., Elsheikh B.H., et al. Spinal muscular atrophy update in best practices: recommendations for treatment considerations. Neurol. Clin. Pract. 2025; 15(1): e200374. https://doi.org/10.1212/CPJ.0000000000200374</mixed-citation><mixed-citation xml:lang="en">Schroth M.K., Deans J., Bharucha Goebel D.X., Burnette W.B., Darras B.T., Elsheikh B.H., et al. Spinal muscular atrophy update in best practices: recommendations for treatment considerations. Neurol. Clin. Pract. 2025; 15(1): e200374. https://doi.org/10.1212/CPJ.0000000000200374</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Al-Zaidy S.A., Kolb S.J., Lowes L., Alfano L.N., Shell R., Church K.R., et al. AVXS-101 (Onasemnogene Abeparvovec) for SMA1: comparative study with a prospective natural history cohort. J. Neuromuscul. Dis. 2019; 6(3): 307–17. https://doi.org/10.3233/JND-190403</mixed-citation><mixed-citation xml:lang="en">Al-Zaidy S.A., Kolb S.J., Lowes L., Alfano L.N., Shell R., Church K.R., et al. AVXS-101 (Onasemnogene Abeparvovec) for SMA1: comparative study with a prospective natural history cohort. J. Neuromuscul. Dis. 2019; 6(3): 307–17. https://doi.org/10.3233/JND-190403</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Kirschner J., Bernert G., Butoianu N., De Waele L., Fattal-Valevski A., Haberlova J., et al. 2024 update: European consensus statement on gene therapy for spinal muscular atrophy. Eur. J. Paediatr. Neurol. 2024; 51: 73–8. https://doi.org/10.1016/j.ejpn.2024.06.001</mixed-citation><mixed-citation xml:lang="en">Kirschner J., Bernert G., Butoianu N., De Waele L., Fattal-Valevski A., Haberlova J., et al. 2024 update: European consensus statement on gene therapy for spinal muscular atrophy. Eur. J. Paediatr. Neurol. 2024; 51: 73–8. https://doi.org/10.1016/j.ejpn.2024.06.001</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Петрухин А.С. Развитие нервной системы у новорожденных и детей раннего возраста. Методика исследования. Синдромы поражения. В кн.: Детская неврология. Том 1. М.: ГЭОТАР-Медиа; 2018: 199–221.</mixed-citation><mixed-citation xml:lang="en">Petrukhin A.S. Development of the nervous system in newborns and young children. Research methodology. Lesion syndromes. In: Pediatric Neurology. Volume 1 [Detskaya nevrologiya. Tom 1]. Moscow: GEOTAR-Media; 2018: 199–221. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Фисенко Д.А., Куренков А.Л., Кузенкова Л.М., Черников В.В., Увакина Е.В., Бурсагова Б.И. и др. Нормативные показатели стимуляционной электромиографии у детей раннего возраста. Неврологический журнал имени Л.О. Бадаляна. 2023; 4(4): 193–9. https://doi.org/10.46563/2686-8997-2023-4-4-193-199 https://elibrary.ru/bawhuc</mixed-citation><mixed-citation xml:lang="en">Fisenko D.A., Kurenkov A.L., Kuzenkova L.M., Chernikov V.V., Uvakina E.V., Bursagova B.I., et al. Normative parameters of motor nerve conduction studies in infants. Nevrologicheskii zhurnal imeni L.O. Badalyana. 2023; 4(4): 193–9. https://doi.org/10.46563/2686-8997-2023-4-4-193-199 https://elibrary.ru/bawhuc (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Фисенко Д.А., Кузенкова Л.М., Куренков А.Л., Семикина Е.Л., Увакина Е.В., Черников В.В. и др. Динамика уровней лёгких и тяжёлых цепей нейрофиламентов в сыворотке крови детей со спинальной мышечной атрофией на фоне применения генной терапии. Неврологический журнал имени Л.О. Бадаляна. 2025; 6(1): 26–36. https://doi.org/10.46563/2686-8997-2025-6-1-26-36 https://elibrary.ru/usswzn</mixed-citation><mixed-citation xml:lang="en">Fisenko D.A., Kuzenkova L.M., Kurenkov A.L., Semikina E.L., Uvakina E.V., Chernikov V.V., et al. Trend in blood serum levels of light and heavy chains of neurofilaments in infants with spinal muscular atrophy against background of the use of gene therapy. Nevrologicheskii zhurnal imeni L.O. Badalyana. 2025; 6(1): 26–36. https://doi.org/10.46563/2686-8997-2025-6-1-26-36 https://elibrary.ru/usswzn (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Strauss K.A., Farrar M.A., Muntoni F., Saito K., Mendell J.R., Servais L., et al. Onasemnogene abeparvovec for presymptomatic infants with three copies of SMN2 at risk for spinal muscular atrophy: the Phase III SPR1NT trial. Nat. Med. 2022; 28(7): 1390–7. https://doi.org/10.1038/s41591-022-01867-3</mixed-citation><mixed-citation xml:lang="en">Strauss K.A., Farrar M.A., Muntoni F., Saito K., Mendell J.R., Servais L., et al. Onasemnogene abeparvovec for presymptomatic infants with three copies of SMN2 at risk for spinal muscular atrophy: the Phase III SPR1NT trial. Nat. Med. 2022; 28(7): 1390–7. https://doi.org/10.1038/s41591-022-01867-3</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Strauss K.A., Farrar M.A., Muntoni F., Saito K., Mendell J.R., Servais L., et al. Onasemnogene abeparvovec for presymptomatic infants with two copies of SMN2 at risk for spinal muscular atrophy type 1: the Phase III SPR1NT trial. Nat. Med. 2022; 28(7): 1381–9. https://doi.org/10.1038/s41591-022-01866-4</mixed-citation><mixed-citation xml:lang="en">Strauss K.A., Farrar M.A., Muntoni F., Saito K., Mendell J.R., Servais L., et al. Onasemnogene abeparvovec for presymptomatic infants with two copies of SMN2 at risk for spinal muscular atrophy type 1: the Phase III SPR1NT trial. Nat. Med. 2022; 28(7): 1381–9. https://doi.org/10.1038/s41591-022-01866-4</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Day J.W., Finkel R.S., Chiriboga C.A., Connolly A.M., Crawford T.O., Darras B.T., et al. Onasemnogene abeparvovec gene therapy for symptomatic infantile-onset spinal muscular atrophy in patients with two copies of SMN2 (STR1VE): an open-label, single-arm, multicentre, phase 3 trial. Lancet Neurol. 2021; 20(4): 284–93. https://doi.org/10.1016/S1474-4422(21)00001-6</mixed-citation><mixed-citation xml:lang="en">Day J.W., Finkel R.S., Chiriboga C.A., Connolly A.M., Crawford T.O., Darras B.T., et al. Onasemnogene abeparvovec gene therapy for symptomatic infantile-onset spinal muscular atrophy in patients with two copies of SMN2 (STR1VE): an open-label, single-arm, multicentre, phase 3 trial. Lancet Neurol. 2021; 20(4): 284–93. https://doi.org/10.1016/S1474-4422(21)00001-6</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Desguerre I., Barrois R., Audic F., Barnerias C., Chabrol B., Davion J.B., et al. Real-world multidisciplinary outcomes of onasemnogene abeparvovec monotherapy in patients with spinal muscular atrophy type 1: experience of the French cohort in the first three years of treatment. Orphanet. J. Rare Dis. 2024; 19(1): 344. https://doi.org/10.1186/s13023-024-03326-3</mixed-citation><mixed-citation xml:lang="en">Desguerre I., Barrois R., Audic F., Barnerias C., Chabrol B., Davion J.B., et al. Real-world multidisciplinary outcomes of onasemnogene abeparvovec monotherapy in patients with spinal muscular atrophy type 1: experience of the French cohort in the first three years of treatment. Orphanet. J. Rare Dis. 2024; 19(1): 344. https://doi.org/10.1186/s13023-024-03326-3</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Weiß C., Becker L.L., Friese J., Blaschek A., Hahn A., Illsinger S., et al. Efficacy and safety of gene therapy with onasemnogene abeparvovec in children with spinal muscular atrophy in the D-A-CH-region: a population-based observational study. Lancet Reg. Health Eur. 2024; 47: 101092. https://doi.org/10.1016/j.lanepe.2024.101092</mixed-citation><mixed-citation xml:lang="en">Weiß C., Becker L.L., Friese J., Blaschek A., Hahn A., Illsinger S., et al. Efficacy and safety of gene therapy with onasemnogene abeparvovec in children with spinal muscular atrophy in the D-A-CH-region: a population-based observational study. Lancet Reg. Health Eur. 2024; 47: 101092. https://doi.org/10.1016/j.lanepe.2024.101092</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">De Vivo D.C., Bertini E., Swoboda K.J., Hwu W.L., Crawford T.O., Finkel R.S., et al. Nusinersen initiated in infants during the presymptomatic stage of spinal muscular atrophy: Interim efficacy and safety results from the Phase 2 NURTURE study. Neuromuscul. Disord. 2019; 29(11): 842–56. https://doi.org/10.1016/j.nmd.2019.09.007</mixed-citation><mixed-citation xml:lang="en">De Vivo D.C., Bertini E., Swoboda K.J., Hwu W.L., Crawford T.O., Finkel R.S., et al. Nusinersen initiated in infants during the presymptomatic stage of spinal muscular atrophy: Interim efficacy and safety results from the Phase 2 NURTURE study. Neuromuscul. Disord. 2019; 29(11): 842–56. https://doi.org/10.1016/j.nmd.2019.09.007</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Crawford T.O., Swoboda K.J., De Vivo D.C., Bertini E., Hwu W.L., Finkel R.S., et al. Continued benefit of nusinersen initiated in the presymptomatic stage of spinal muscular atrophy: 5-year update of the NURTURE study. Muscle Nerve. 2023; 68(2): 157–70. https://doi.org/10.1002/mus.27853</mixed-citation><mixed-citation xml:lang="en">Crawford T.O., Swoboda K.J., De Vivo D.C., Bertini E., Hwu W.L., Finkel R.S., et al. Continued benefit of nusinersen initiated in the presymptomatic stage of spinal muscular atrophy: 5-year update of the NURTURE study. Muscle Nerve. 2023; 68(2): 157–70. https://doi.org/10.1002/mus.27853</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Servais L., Day J.W., De Vivo D.C., Kirschner J., Mercuri E., Muntoni F., et al. Real-world outcomes in patients with spinal muscular atrophy treated with Onasemnogene Abeparvovec monotherapy: findings from the RESTORE registry. J. Neuromuscul. Dis. 2024; 11(2): 425–42. https://doi.org/10.3233/JND-230122</mixed-citation><mixed-citation xml:lang="en">Servais L., Day J.W., De Vivo D.C., Kirschner J., Mercuri E., Muntoni F., et al. Real-world outcomes in patients with spinal muscular atrophy treated with Onasemnogene Abeparvovec monotherapy: findings from the RESTORE registry. J. Neuromuscul. Dis. 2024; 11(2): 425–42. https://doi.org/10.3233/JND-230122</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Kariyawasam D.S., D’Silva A.M., Sampaio H., Briggs N., Herbert K., Wiley V., et al. Newborn screening for spinal muscular atrophy in Australia: a non-randomised cohort study. Lancet Child Adolesc. Health. 2023; 7(3): 159–70. https://doi.org/10.1016/S2352-4642(22)00342-X</mixed-citation><mixed-citation xml:lang="en">Kariyawasam D.S., D’Silva A.M., Sampaio H., Briggs N., Herbert K., Wiley V., et al. Newborn screening for spinal muscular atrophy in Australia: a non-randomised cohort study. Lancet Child Adolesc. Health. 2023; 7(3): 159–70. https://doi.org/10.1016/S2352-4642(22)00342-X</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
