Levodopa‐induced dyskinesia in Parkinson disease: Current and evolving concepts

著者: Alberto J. Espay, Francesca Morgante, Aristide Merola, Alfonso Fasano, Luca Marsili, Susan H. Fox, Erwan Bézard, Barbara Picconi, Paolo Calabresi, Anthony E. Lang - Annals of Neurology 2018 被引用: 340

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.