Research
Print page Print page
Switch language
Bispebjerg Hospital - a part of Copenhagen University Hospital
Published

The acute brain response to levodopa heralds dyskinesias in Parkinson disease

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Melanopsin retinal ganglion cell loss in Alzheimer's disease

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. 25-Hydroxyvitamin D and symptomatic ischemic stroke: An Original Study and Meta-Analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Nonfasting triglycerides, cholesterol, and ischemic stroke in the general population

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Timing and topography of cerebral blood flow, aura, and headache during migraine attacks

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Regulation of regional cerebral blood flow during and between migraine attacks

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. A Contrast-Adaptive Method for Simultaneous Whole-Brain and Lesion Segmentation in Multiple Sclerosis

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Discrete finger sequences are widely represented in human striatum

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Paroxysmal Cranial Dyskinesia and Nail-Patella Syndrome Caused by a Novel Variant in the LMX1B Gene

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

OBJECTIVE: In Parkinson disease (PD), long-term treatment with the dopamine precursor levodopa gradually induces involuntary "dyskinesia" movements. The neural mechanisms underlying the emergence of levodopa-induced dyskinesias in vivo are still poorly understood. Here, we applied functional magnetic resonance imaging (fMRI) to map the emergence of peak-of-dose dyskinesias in patients with PD.

METHODS: Thirteen PD patients with dyskinesias and 13 PD patients without dyskinesias received 200mg fast-acting oral levodopa following prolonged withdrawal from their normal dopaminergic medication. Immediately before and after levodopa intake, we performed fMRI, while patients produced a mouse click with the right or left hand or no action (No-Go) contingent on 3 arbitrary cues. The scan was continued for 45 minutes after levodopa intake or until dyskinesias emerged.

RESULTS: During No-Go trials, PD patients who would later develop dyskinesias showed an abnormal gradual increase of activity in the presupplementary motor area (preSMA) and the bilateral putamen. This hyperactivity emerged during the first 20 minutes after levodopa intake. At the individual level, the excessive No-Go activity in the predyskinesia period predicted whether an individual patient would subsequently develop dyskinesias (p < 0.001) as well as severity of their day-to-day symptomatic dyskinesias (p < 0.001).

INTERPRETATION: PD patients with dyskinesias display an immediate hypersensitivity of preSMA and putamen to levodopa, which heralds the failure of neural networks to suppress involuntary dyskinetic movements.

Original languageEnglish
JournalAnnals of Neurology
Volume75
Issue number6
Pages (from-to)829-36
Number of pages8
ISSN0364-5134
DOIs
Publication statusPublished - Jun 2014

    Research areas

  • Aged, Antiparkinson Agents, Brain, Brain Mapping, Decision Making, Dyskinesia, Drug-Induced, Female, Head Movements, Humans, Image Processing, Computer-Assisted, Levodopa, Male, Middle Aged, Neuropsychological Tests, Oxygen, Parkinson Disease, Psychomotor Performance, Reaction Time, Time Factors

ID: 44733929