Abstract
Motor complications (dyskinesias and motor fluctuations) are a common and disabling problem of dopaminergic therapy in Parkinson’s disease, which are often difficult to treat with the current therapeutic strategies. It has been proposed that continuous dopaminergic delivery could reduce the emergence of motor complications, which has been tried with levodopa intestinal infusion or subcutaneous apomorphine infusion. In selected refractory cases, surgical approaches such as deep brain stimulation should be considered. Ongoing clinical and preclinical research tried to lead the field into the discovery of other therapeutic targets and strategies that might prevent or reduce motor complications. These include drugs targeting non-dopaminergic systems (e.g. glutamatergic, serotonergic, noradrenergic, adenosinergic and cholinergic systems), gene therapy for delivering neurotrophic factors or critical enzymes for dopamine synthesis, and cell therapy. These studies found variable results, some of them promising, with the possibility of new therapeutic armamentarium in the management of Parkinson’s disease in the near future.
Keywords: Levodopa, motor complications, motor fluctuations, Parkinson disease, peak-dose dyskinesia.
CNS & Neurological Disorders - Drug Targets
Title:Motor Complications in Parkinson’s Disease: A Comprehensive Review of Emergent Management Strategies
Volume: 12 Issue: 7
Author(s): Susana Marques de Sousa and João Massano
Affiliation:
Keywords: Levodopa, motor complications, motor fluctuations, Parkinson disease, peak-dose dyskinesia.
Abstract: Motor complications (dyskinesias and motor fluctuations) are a common and disabling problem of dopaminergic therapy in Parkinson’s disease, which are often difficult to treat with the current therapeutic strategies. It has been proposed that continuous dopaminergic delivery could reduce the emergence of motor complications, which has been tried with levodopa intestinal infusion or subcutaneous apomorphine infusion. In selected refractory cases, surgical approaches such as deep brain stimulation should be considered. Ongoing clinical and preclinical research tried to lead the field into the discovery of other therapeutic targets and strategies that might prevent or reduce motor complications. These include drugs targeting non-dopaminergic systems (e.g. glutamatergic, serotonergic, noradrenergic, adenosinergic and cholinergic systems), gene therapy for delivering neurotrophic factors or critical enzymes for dopamine synthesis, and cell therapy. These studies found variable results, some of them promising, with the possibility of new therapeutic armamentarium in the management of Parkinson’s disease in the near future.
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Cite this article as:
Sousa Marques de Susana and Massano João, Motor Complications in Parkinson’s Disease: A Comprehensive Review of Emergent Management Strategies, CNS & Neurological Disorders - Drug Targets 2013; 12 (7) . https://dx.doi.org/10.2174/18715273113129990086
DOI https://dx.doi.org/10.2174/18715273113129990086 |
Print ISSN 1871-5273 |
Publisher Name Bentham Science Publisher |
Online ISSN 1996-3181 |
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