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Risk Factors for Levodopa-Induced Dyskinesia

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Levodopa-Induced Dyskinesia in Parkinson's Disease

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Abstract

Levodopa-induced dyskinesia (LID) is a disabling motor complication of chronic dopaminergic therapy in patients with Parkinson’s disease (PD). The most important risk factor for LID is levodopa therapy: longer treatment duration and high daily levodopa dose. Longer duration of PD, more severe disease, and younger age at PD onset are also significant risk factors. However, there is a profound interindividual difference in the susceptibility to LID; thus, discoveries from recent genetic association studies are worth reviewing although they are limited because of small sample size, lack of replication, and poor pathophysiological backgrounds. Three major suggestions from the studies are as follows: first, a DRD2 gene haplotype with the functional consequence of a low generalized activity on the presynaptic D2 receptor may be associated with high risk of dyskinesia; second, a DRD3 variant with low receptor-binding affinity may be associated with the diphasic form of dyskinesia; and third, a COMT low-activity allele may be associated with earlier onset of dyskinesia. Further investigations on other genes regarding dopaminergic and nondopaminergic modulators in the basal ganglia would enhance our understanding of LID susceptibility as well as reveal the possible mechanism of it.

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Authors and Affiliations

  1. Department of Neurology, Seoul National University-Seoul Metropolitan Government Boramae Medical Center, Boramae 5, Dongjak-gu, Seoul, 156-707, South Korea

    Jee-Young Lee MD

  2. Department of Neurology, College of Medicine, Seoul National University, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea

    Jee-Young Lee MD

  3. Department of Neurology, Seoul National University Hospital, College of Medicine, Seoul National University, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, South Korea

    Beom S. Jeon MD, PhD

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  1. Jee-Young Lee MD
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Correspondence to Beom S. Jeon MD, PhD .

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  1. Toronto Western Hospital, Toronto, Ontario, Canada

    Susan H. Fox

  2. Toronto Western Hospital, Toronto, Ontario, Canada

    Jonathan M. Brotchie

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Lee, JY., Jeon, B.S. (2014). Risk Factors for Levodopa-Induced Dyskinesia. In: Fox, S., Brotchie, J. (eds) Levodopa-Induced Dyskinesia in Parkinson's Disease. Springer, London. https://doi.org/10.1007/978-1-4471-6503-3_4

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  • DOI: https://doi.org/10.1007/978-1-4471-6503-3_4

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