Motor and Nonmotor Complications of Levodopa: Phenomenology, Risk Factors, and Imaging Features

K. Ray Chaudhuri*, Werner Poewe, David Brooks

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

83 Citations (Scopus)


Despite enormous advances in our current understanding of PD since James Parkinson described the “shaking palsy” 200 years ago, l-dopa, in clinical use since the 1960s, remains the gold standard of treatment. Virtually every patient with PD requires varying doses of l-dopa to manage motor and some nonmotor symptoms and retain an acceptable quality of life. However, after a period of treatment with l-dopa, a number of problems emerge; the key ones are motor and nonmotor fluctuations, a range of dyskinesias, and a combination of both. Nonmotor complications can range from behavioral problems to sensory, autonomic, and cognitive issues. Even with a wealth of data, both in animal models and in vivo imaging that address the pathophysiology of l-dopa-related motor and nonmotor complications, the treatment remains challenging and is an unmet need. Although refinement in types of dopamine replacement therapy and delivery systems have improved the management of l-dopa-related complications, the search for the ideal treatment continues.

Original languageEnglish
Pages (from-to)909-919
Number of pages11
JournalMovement Disorders
Issue number6
Publication statusPublished - 1 Jun 2018


  • dyskinesias
  • fluctuations
  • levodopa
  • nonmotor
  • Parkinson's disease
  • personalized medicine


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