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Levodopa‐induced dyskinesias in Parkinson's disease: Is sensitization reversible?
Author(s) -
Bejjani BoulosPaul,
Arnulf Isabelle,
Demeret Sophie,
Damier Philippe,
Bonnet AnneMarie,
Houeto JeanLuc,
Agid Yves
Publication year - 2000
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/1531-8249(200005)47:5<655::aid-ana16>3.0.co;2-#
Subject(s) - levodopa , subthalamic nucleus , parkinson's disease , deep brain stimulation , sensitization , medicine , dopaminergic , striatum , anesthesia , dyskinesia , dystonia , stimulation , psychology , dopamine , disease , neuroscience
Levodopa‐induced dyskinesias (LIDs) in patients with Parkinson's disease are considered to result from the severity of dopaminergic denervation in the striatum, which is an irrevocable phenomenon, and sensitization induced by long‐term intermittent administration of levodopa. Taking advantage of the 64% reduction of levodopa treatment allowed in 12 Parkinson's disease patients by continuous high‐frequency stimulation of the subthalamic nucleus, we evaluated the severity of parkinsonian motor disability and LIDs during two levodopa challenges performed before the surgical implantation of the stimulation electrodes and after 8.8 months of continuous bilateral subthalamic nucleus stimulation that was interrupted 2 hours before the levodopa test. Motor disability during the “off” and “on” drug periods was unchanged. The severity of LIDs during the “on” period and dystonia during the “off” period decreased by 54% and 62%, respectively. The reduced severity of LIDs in the absence of subthalamic nucleus stimulation demonstrates that the sensitization phenomenon resulting from long‐term intermittent levodopa administration is partially reversible. Ann Neurol 2000;47:655–658