Dystonia and levodopa-induced dyskinesias in Parkinson's disease: Is there a connection?

NEUROBIOLOGY OF DISEASE

卷:132

Review

Calabresi, Paolo^1,2  Standaert, David G.³ 

[1] Univ Perugia, Santa Maria della Misericordia Hosp, Dept Med, Neurol Clin, I-06132 Perugia, Italy

[2] IRCCS Fdn Santa Lucia, Rome, Italy

[3] Univ Alabama Birmingham, Dept Neurol, Birmingham, AL 35294 USA

关键词: Dystonia;    Dyskinesia;    Levodopa;    Basal ganglia;    Cerebellum;    Dopamine;    Acetylcholine;    Plasticity;   

DOI  :  10.1016/j.nbd.2019.104579

来源: Elsevier

【 摘 要 】

Dystonia and levodopa-induced dyskinesia (LID) are both hyperkinetic movement disorders. Dystonia arises most often spontaneously, although it may be seen after stroke, injury, or as a result of genetic causes. LID is associated with Parkinson's disease (PD), emerging as a consequence of chronic therapy with levodopa, and may be either dystonic or choreiform. LID and dystonia share important phenomenological properties and mechanisms. Both LID and dystonia are generated by an integrated circuit involving the cortex, basal ganglia, thalamus and cerebellum. They also share dysregulation of striatal cholinergic signaling and abnormalities of striatal synaptic plasticity. The long duration nature of both LID and dystonia suggests that there may be underlying epigenetic dysregulation as a proximate cause. While both may improve after interventions such as deep brain stimulation (DBS), neither currently has a satisfactory medical therapy, and many people are disabled by the symptoms of dystonia and LID. Further study of the fundamental mechanisms connecting these two disorders may lead to novel approaches to treatment or prevention.

【 授权许可】

Free