Dyskinesia - Advances in the Understanding of Pathophysiology and Possible Treatment Options

Abstract

The degeneration of nigrostriatal dopaminergic neurons in Parkinson’s disease gives rise to tremor and slowness of movement, cardinal motor symptoms of the disease that can be alleviated by the dopamine precursor L-DOPA. Despite this, long-term L-DOPA treatment is hampered by the development of abnormal involuntary movements, i.e. dyskinesia, in the majority of patients. The pathophysiology of dyskinesia is complex and multifactorial, but excessive swings in extracellular dopamine causing aberrant plasticity in dopaminoceptive neurons are attributed a primary role. To date there are few effective treatment alternatives for patients with Parkinson’s disease experiencing dyskinesia, representing an unmet therapeutic need in the treatment strategy of the disease. This article reviews recent findings from both clinical and pre-clinical studies and their impact on the search for novel therapeutic approaches to levodopa-induced dyskinesia.