Does dopamine still have a leading role in advanced Parkinson's disease after subthalamic stimulation?
The role of endogenous dopamine in severe Parkinson's disease is often underestimated. We report on a case of acute general motor worsening induced by the ingestion of fluphenazine in a parkinsonian patient successfully treated with STN DBS. Other etiologies were ruled out. Clinical improvement was gradual and fully reversible 4 days after discontinuation of the antidopaminergic drug. We suggest that residual striatal and extrastriatal dopaminergic pathways still play a paramount role in mediating central neurotrasmissions that may take part in STN DBS's mechanism of action.
Jabre
Mazen
M
Parkinson, Memory and Movement Disorders Center, Notre Dame des Secours Hospital, Byblos/Jbail, Lebanon.
Nohra
George
G
Damier
Philippe
P
Bejjani
Boulos-Paul
BP
D000328:Adult; D046690:Deep Brain Stimulation / Q000379:methods; D004298:Dopamine / Q000502:physiology*; D018492:Dopamine Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D020531:Subthalamic Nucleus / Q000473:pathology / Q000601:surgery*
D018492:Dopamine Antagonists; D004298:Dopamine