November 2010
Calabresi P, Filippo MD,
Ghiglieri V, Tambasco N, Picconi B
Levodopa
is the most effective drug for the treatment of Parkinson's disease.
However, the long-term use of this dopamine precursor is complicated by
highly disabling fluctuations and dyskinesias.
Although preclinical and
clinical findings suggest pulsatile stimulation of striatal postsynaptic
receptors as a key mechanism underlying levodopa-induced dyskinesias,
their pathogenesis is still unclear. In recent years, evidence from
animal models of Parkinson's disease has provided important information
to understand the effect of specific receptor and post-receptor
molecular mechanisms underlying the development of dyskinetic movements.
Recent preclinical and clinical data from promising lines of research
focus on the differential role of presynaptic versus postsynaptic
mechanisms, dopamine receptor subtypes, ionotropic and metabotropic
glutamate receptors, and non-dopaminergic neurotransmitter systems in
the pathophysiology of levodopa-induced dyskinesias.
