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Levodopa‐induced dyskinesia in Parkinsons disease: clinical features pathogenesis prevention and treatment

机译:帕金森氏病中左多巴诱发的运动障碍:临床特征发病机制预防和治疗

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摘要

Levodopa is the most effective drug for treating Parkinson's disease. However, long‐term use of levodopa is often complicated by significantly disabling fluctuations and dyskinesias negating its beneficial effects. Younger age of Parkinson's disease onset, disease severity, and high levodopa dose increase the risk of development of levodopa‐induced dyskinesias (LID). The underlying mechanisms for LID are unclear though recent studies indicate the importance of pulsatile stimulation of striatal postsynaptic receptors in their pathogenesis. The non‐human primates with MPTP‐induced parkinsonism serve as a useful model to study dyskinesia. Once established, LID are difficult to treat and therefore efforts should be made to prevent them. The therapeutic and preventative strategies for LID include using a lower dosage of levodopa, employing dopamine agonists as initial therapy in Parkinson's disease, amantadine, atypical neuroleptics, and neurosurgery. LID can adversely affect the quality of life and increase the cost of healthcare.
机译:左旋多巴是治疗帕金森氏病最有效的药物。但是,左旋多巴的长期使用通常会因明显地使波动性丧失和运动障碍而抵消其有益作用,从而使这种情况变得复杂。帕金森氏病发病年龄越小,疾病的严重程度以及左旋多巴的高剂量增加了左旋多巴诱发的运动障碍(LID)的风险。尽管最近的研究表明,脉动刺激纹状体突触后受体在其发病机理中的重要性,但LID的潜在机制尚不清楚。具有MPTP诱发的帕金森病的非人类灵长类动物是研究运动障碍的有用模型。一旦建立,LID很难治疗,因此应努力预防。 LID的治疗和预防策略包括使用较低剂量的左旋多巴,多巴胺激动剂作为帕金森氏病,金刚烷胺,非典型抗精神病药和神经外科手术的初始疗法。 LID会对生活质量产生不利影响,并增加医疗保健成本。

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