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Myths and realities of continuous dopaminergic stimulation.
Psychiatr Danub. 2011 Mar; 23(1):80-3.PD

Abstract

Motor fluctuations and dyskinesia in later stages of Parkinson's disease (PD) are caused by pharmacokinetic as well as pharmacodynamic factors, intermittent dopaminergic stimulation being one of the most important. In the healthy brain, dopamine neurons in the substantia nigra pars compacta fire tonically at a steady rate of about 4 cycles/second. In later stages of PD, steady firing is replaced by pulsatile stimulation which causes molecular and physiologic changes in the basal ganglia. Continuous dopaminergic stimulation has been shown to dramatically improve motor fluctuations and dyskinesia by modifications of oral treatment (dopamine agonists, smaller, more frequent levodopa doses, controlled-release formulation of levodopa, addition of agents that slow down the catabolism of dopamine, such as inhibitors of catechol-O-methyl transferase and monoamine oxidase), transdermal delivery (rotigotine), infusion therapies (intravenous levodopa, subcutaneous application of apomorphine and lisuride, duodenal infusion of levodopa) and deep brain stimulation of the subthalamic nucleus.

Authors+Show Affiliations

Department of Neurology, University Medical Centre, Zaloška 2, SI-1000 Ljubljana, Slovenia. zvezdan.pirtosek@kclj.si

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21448103

Citation

Pirtošek, Zvezdan. "Myths and Realities of Continuous Dopaminergic Stimulation." Psychiatria Danubina, vol. 23, no. 1, 2011, pp. 80-3.
Pirtošek Z. Myths and realities of continuous dopaminergic stimulation. Psychiatr Danub. 2011;23(1):80-3.
Pirtošek, Z. (2011). Myths and realities of continuous dopaminergic stimulation. Psychiatria Danubina, 23(1), 80-3.
Pirtošek Z. Myths and Realities of Continuous Dopaminergic Stimulation. Psychiatr Danub. 2011;23(1):80-3. PubMed PMID: 21448103.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Myths and realities of continuous dopaminergic stimulation. A1 - Pirtošek,Zvezdan, PY - 2011/3/31/entrez PY - 2011/3/31/pubmed PY - 2011/6/3/medline SP - 80 EP - 3 JF - Psychiatria Danubina JO - Psychiatr Danub VL - 23 IS - 1 N2 - Motor fluctuations and dyskinesia in later stages of Parkinson's disease (PD) are caused by pharmacokinetic as well as pharmacodynamic factors, intermittent dopaminergic stimulation being one of the most important. In the healthy brain, dopamine neurons in the substantia nigra pars compacta fire tonically at a steady rate of about 4 cycles/second. In later stages of PD, steady firing is replaced by pulsatile stimulation which causes molecular and physiologic changes in the basal ganglia. Continuous dopaminergic stimulation has been shown to dramatically improve motor fluctuations and dyskinesia by modifications of oral treatment (dopamine agonists, smaller, more frequent levodopa doses, controlled-release formulation of levodopa, addition of agents that slow down the catabolism of dopamine, such as inhibitors of catechol-O-methyl transferase and monoamine oxidase), transdermal delivery (rotigotine), infusion therapies (intravenous levodopa, subcutaneous application of apomorphine and lisuride, duodenal infusion of levodopa) and deep brain stimulation of the subthalamic nucleus. SN - 0353-5053 UR - https://www.unboundmedicine.com/medline/citation/21448103/Myths_and_realities_of_continuous_dopaminergic_stimulation_ L2 - http://www.psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol23_no1/dnb_vol23_no1_80.pdf DB - PRIME DP - Unbound Medicine ER -