Journal of Alzheimers Disease & Parkinsonism
Open Access

Abstract

Parkinson’s disease is a neurodegenerative disorder that affects approximately 1% of people over the age of 60 years.
Levodopa is standard, and often initial, therapy for patients with this condition. However, with continued treatment and as
the disease progresses, up to 80% of patients experience ‘wearing-off’ symptoms, dyskinesia and other motor complications.
Younger age of Parkinson’s disease onset, disease severity, and high levodopa doses increase the risk of development of
levodopa‐induced dyskinesia (LID). Recent studies indicate the importance of pulsatile stimulation of striatal postsynaptic
receptors in pathogenesis of LID. The non‐human primates with MPTP‐induced Parkinsonism serve as a useful model to study
dyskinesia. Once established, LID is difficult to treat and, therefore, efforts should be made to prevent it. The therapeutic and
preventative strategies for LID include using a lower dosage of levodopa, employing dopamine agonists as initial therapy in
Parkinson’s disease such as amantadine, use of atypical neuroleptics and neurosurgery. In recent studies, among 124 patients
with Parkinson’s disease, 87 (70%) had received a levodopa preparation. Among these 87 patients, 28% were experiencing
treatment-induced dyskinesias and 40% showed response fluctuations. The newer, non-ergoline dopamine agonists such as
pramipexole and ropinirole have undergone extensive studies to evaluate their efficacy as monotherapy in early Parkinson’s
disease. Amantadine is a non-competitive NMDA receptor antagonist shown to lower dyskinesia scores and improve motor
complications in patients with Parkinson’s disease when given adjunctively with levodopa. These newer agonists are ideal
initial symptomatic medications, primarily because they delay the onset of levodopa-induced motor fluctuations. So, it can be
concluded that there is less chances of developing dyskinesia when patient is on newer anti parkinsonian drugs as compared
to older agents.

Biography

Sanjay Jaiswal has completed his MD from RNT Medical College, Udaipur, India and DM Neurology from Institute of Medical Sciences BHU, Varanasi, India. He is
a Consultant Neurologist at Jaiswal Hospital and Neuro Institute, Kota, Rajasthan, India. He has published several papers in reputed journals and has been serving
as a Faculty in most of the neurology conferences. He has got an extensive experience of organizing and conducting conferences in the field of neurology and has
been awarded by State Government for the contribution to social welfare.