Levodopa-induced dyskinesias in Parkinson's disease: etiology, impact on quality of life, and treatments.
Levodopa is the most effective agent to alleviate motor dysfunction in Parkinson's disease but its long-term use is associated with the development of dyskinesias. Although the pathogenic processes behind the development of levodopa-induced dyskinesias are still being elucidated, it appears that chronic administration of this short-lived agent results in nonphysiologic pulsatile stimulation of striatal neurons and abnormal firing patterns in the basal ganglia. Dyskinesias have been associated with decreased quality of life, and a number of methodologies to evaluate severity of dyskinesias are now available. Strategies to avoid, reduce, or eliminate dyskinesias include providing more continuous dopaminergic stimulation, administering an antidyskinetic agent, and surgery. Several new compounds that may provide an antidyskinetic effect are also under investigation.
Encarnacion
Elmyra V
EV
Department of Neurology, Texas A&M Health Sciences Center, Scott and White National Parkinson Foundation Plummer Movement Disorders Center, Temple, TX, USA.
Hauser
Robert A
RA
D000368:Aged; D000818:Animals; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology; D001479:Basal Ganglia / Q000187:drug effects / Q000503:physiopathology; D003342:Corpus Striatum / Q000187:drug effects / Q000503:physiopathology; D046690:Deep Brain Stimulation; D004298:Dopamine / Q000502:physiology; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000494:pharmacology; D004334:Drug Administration Schedule; D004409:Dyskinesia, Drug-Induced / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control / Q000523:psychology / Q000628:therapy; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology; D015337:Multicenter Studies as Topic; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy / Q000628:therapy; D011788:Quality of Life; D017470:Receptors, Glutamate / Q000502:physiology; D012720:Severity of Illness Index; D005680:gamma-Aminobutyric Acid / Q000502:physiology
D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D018691:Excitatory Amino Acid Antagonists; D017470:Receptors, Glutamate; D007980:Levodopa; D005680:gamma-Aminobutyric Acid; D004298:Dopamine