New approaches to therapy.
Identifieur interne : 001624 ( Main/Exploration ); précédent : 001623; suivant : 001625New approaches to therapy.
Auteurs : Jonathan Brotchie [Canada] ; Peter JennerSource :
- International review of neurobiology [ 0074-7742 ] ; 2011.
English descriptors
- KwdEn :
- Animals, Antipsychotic Agents (adverse effects), Dopamine (metabolism), Dyskinesia, Drug-Induced (drug therapy), Dyskinesia, Drug-Induced (metabolism), Dyskinesia, Drug-Induced (pathology), Excitatory Amino Acid Antagonists (therapeutic use), Humans, Levodopa (adverse effects), Parkinson Disease (drug therapy), Receptors, Biogenic Amine (metabolism).
- MESH :
- chemical , adverse effects : Antipsychotic Agents, Levodopa.
- chemical , metabolism : Dopamine, Receptors, Biogenic Amine.
- drug therapy : Dyskinesia, Drug-Induced, Parkinson Disease.
- metabolism : Dyskinesia, Drug-Induced.
- pathology : Dyskinesia, Drug-Induced.
- chemical , therapeutic use : Excitatory Amino Acid Antagonists.
- Animals, Humans.
Abstract
L-DOPA-induced dyskinesia (LID) is a major complication of the treatment of Parkinson's disease (PD). LID comprises two major components, the priming process responsible for its onset and the expression of involuntary movements that underlies its clinical manifestation. The mechanisms responsible for these components are partially understood and their biochemical basis is being unraveled but avoidance and treatment remain an issue. In this chapter, we review what is known about the involvement of dopaminergic systems in LID and the way in which dopaminergic therapy can be used to avoid the onset of LID or to reverse or suppress involuntary movements once these have been established. The involvement of specific dopamine receptor subtypes, continuous dopaminergic stimulation (CDS) and continuous drug delivery (CDD) is reviewed. However, a major role is emerging in the avoidance and suppression of LID through the use of nondopaminergic mechanisms and we consider the present and future use of glutamatergic drugs, serotoninergic agents, adenosine antagonists and others as a means of improving therapy. There is compelling basic science supporting a role for nondopaminergic approaches to LID but at the moment the translational benefit to PD is not being achieved as predicted. There needs to be further consideration of why this is the case and how in future, both experimental models of dyskinesia and clinical trial design can be optimized to ensure success.
DOI: 10.1016/B978-0-12-381328-2.00005-5
PubMed: 21907085
Affiliations:
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LID comprises two major components, the priming process responsible for its onset and the expression of involuntary movements that underlies its clinical manifestation. The mechanisms responsible for these components are partially understood and their biochemical basis is being unraveled but avoidance and treatment remain an issue. In this chapter, we review what is known about the involvement of dopaminergic systems in LID and the way in which dopaminergic therapy can be used to avoid the onset of LID or to reverse or suppress involuntary movements once these have been established. The involvement of specific dopamine receptor subtypes, continuous dopaminergic stimulation (CDS) and continuous drug delivery (CDD) is reviewed. However, a major role is emerging in the avoidance and suppression of LID through the use of nondopaminergic mechanisms and we consider the present and future use of glutamatergic drugs, serotoninergic agents, adenosine antagonists and others as a means of improving therapy. There is compelling basic science supporting a role for nondopaminergic approaches to LID but at the moment the translational benefit to PD is not being achieved as predicted. There needs to be further consideration of why this is the case and how in future, both experimental models of dyskinesia and clinical trial design can be optimized to ensure success.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><noCountry><name sortKey="Jenner, Peter" sort="Jenner, Peter" uniqKey="Jenner P" first="Peter" last="Jenner">Peter Jenner</name></noCountry><country name="Canada"><noRegion><name sortKey="Brotchie, Jonathan" sort="Brotchie, Jonathan" uniqKey="Brotchie J" first="Jonathan" last="Brotchie">Jonathan Brotchie</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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