Premium
Levodopa‐induced dyskinesia in Parkinson disease: Current and evolving concepts
Author(s) -
Espay Alberto J.,
Morgante Francesca,
Merola Aristide,
Fasano Alfonso,
Marsili Luca,
Fox Susan H.,
Bezard Erwan,
Picconi Barbara,
Calabresi Paolo,
Lang Anthony E.
Publication year - 2018
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/ana.25364
Subject(s) - levodopa , dyskinesia , dopamine , neuroscience , parkinson's disease , stimulation , medicine , nicotinic agonist , serotonergic , glutamatergic , psychology , disease , serotonin , receptor , glutamate receptor
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