Continuous dopamine-receptor stimulation in advanced Parkinson's disease

John G. Nutt, José A. Obeso, Fabrizo Stocchi

Research output: Contribution to journalReview article

150 Scopus citations

Abstract

Intermittent or pulsatile dopamine-receptor stimulation is postulated to induce plastic changes in motor systems that are responsible for the development of the motor fluctuations and dyskinesia that complicate long-term L-dopa therapy of Parkinson's disease. As a corollary to this hypothesis, continuous dopamine-receptor stimulation can avoid or reverse these complications. Such continuous stimulation is unlikely to mimic completely the normal function of the dopaminergic system, but should avoid the supra-physiological swings in extracellular dopamine that accompany intermittent L-dopa dosing. The concern is that this continuous stimulation might induce tolerance rather than sensitization to some effects of L-dopa. Open clinical trials support the value of continuous dopaminergic stimulation in Parkinson's disease with established motor complications, but rigorous studies, although experimentally difficult, are needed.

Original languageEnglish (US)
Pages (from-to)S109-S115
JournalTrends in Neurosciences
Volume23
Issue number10 SUPPL.
DOIs
StatePublished - Jan 1 2000

ASJC Scopus subject areas

  • Neuroscience(all)

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