Levodopa-induced dyskinesia in Parkinson disease: Current and evolving concepts.
review · Level V
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- Record sourced from PubMed, PMID 30357892.
- Also identified by DOI 10.1002/ana.25364.
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Abstract
Levodopa-induced dyskinesia is a common complication in Parkinson disease. Pathogenic mechanisms include phasic stimulation of dopamine receptors, nonphysiological levodopa-to-dopamine conversion in serotonergic neurons, hyperactivity of corticostriatal glutamatergic transmission, and overstimulation of nicotinic acetylcholine receptors on dopamine-releasing axons. Delay in initiating levodopa is no longer recommended, as dyskinesia development is a function of disease duration rather than cumulative levodopa exposure. We review current and in-development treatments for peak-dose dyskinesia but suggest that improvements in levodopa delivery alone may reduce its future prevalence. Ann Neurol 2018;84:797-811.
Medical subject headings
- Antiparkinson Agents
- Dyskinesia, Drug-Induced
- Levodopa
- Parkinson Disease