An approach to the continuous dopaminergic stimulation in Parkinson's disease

Isr Med Assoc J. 2012 Mar;14(3):175-9.

Abstract

Dopaminergic neurons in the basal ganglia normally fire in a continuous manner, maintaining the striatal dopamine concentration at a relatively constant level. In Parkinson's disease, dopaminergic treatment produces a discontinuous stimulation, inducing an intermittent pulsatile activation of the striatal receptors. It is likely that the oscillations in the dopamine level in the striatum contribute to the development of motor complications. Treatment with long-acting dopaminergic agents, or providing a more continuous dopaminergic effect in the striatum, has been associated with fewer clinical motor complications. This review describes the state-of-the-art approach to achieve the desired continuous dopaminergic stimulation, providing patients with the best clinical effect and probably minimal motor complications.

Publication types

  • Review

MeSH terms

  • Antiparkinson Agents / adverse effects
  • Antiparkinson Agents / therapeutic use*
  • Delayed-Action Preparations
  • Dopamine Agonists / adverse effects
  • Dopamine Agonists / therapeutic use*
  • Drug Therapy, Combination
  • Dyskinesia, Drug-Induced / prevention & control*
  • Humans
  • Levodopa / adverse effects
  • Levodopa / therapeutic use*
  • Parkinson Disease / drug therapy*

Substances

  • Antiparkinson Agents
  • Delayed-Action Preparations
  • Dopamine Agonists
  • Levodopa