Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by a preferential
degeneration of dopaminergic neurons in the substantia nigra pars compacta. This results in a profound
decrease of striatal dopamine (DA) levels, which in turn leads to the cardinal motor symptoms
of PD; muscle rigidity, hypo- and bradykinesia and resting tremor. Even 50 years after its initial use,
the DA precursor levodopa (L-dopa), is still the most effective medical therapy for the symptomatic
treatment of PD. Long-term L-dopa treatment is however, unfortunately associated with undesirable
side effects such as motor fluctuations and dyskinesias. Furthermore, despite the disease alleviating
effects of L-dopa, it is still discussed whether L-dopa has a neurotoxic or neuroprotective effect on dopaminergic
neurons. Here we review the history of L-dopa, including its discovery, development and
current use in the treatment of PD. We furthermore review current evidence of the L-dopa-induced
side effects and perspectives of L-dopa treatment in PD compared to other established treatments such
as DA-agonists and the inhibitors of catechol-o-methyltransferase and monoamine oxidase B.
Keywords: Dopamine, dopaminergic, substantia nigra, L-dopa, dyskinesia, Parkinson’s Disease (PD).
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