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

TY - JOUR

T1 - Motor and Nonmotor Complications of Levodopa

T2 - Phenomenology, Risk Factors, and Imaging Features

AU - Ray Chaudhuri, K.

AU - Poewe, Werner

AU - Brooks, David

PY - 2018/6/1

Y1 - 2018/6/1

N2 - 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.

AB - 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.

KW - dyskinesias

KW - fluctuations

KW - levodopa

KW - nonmotor

KW - Parkinson's disease

KW - personalized medicine

UR - http://www.scopus.com/inward/record.url?scp=85050483245&partnerID=8YFLogxK

U2 - 10.1002/mds.27386

DO - 10.1002/mds.27386

M3 - Review article

C2 - 30134055

AN - SCOPUS:85050483245

SN - 0885-3185

VL - 33

SP - 909

EP - 919

JO - Movement Disorders

JF - Movement Disorders

IS - 6

ER -