Hadj Tahar A, Bézard E, Grondin R, Gross C E, Bédard P J
Unité de Recherche en Neurosciences, Centre de Recherche du CHUQ, Université Laval, Ste-Foy, Québec, Canada.
Rev Neurol (Paris). 2003 Dec;159(12):1125-42.
Involuntary movements, or dyskinesias, represent a debilitating complication of levodopa therapy for Parkinson's disease. Dyskinesia is, ultimately, experienced by the vast majority of the patients. Despite the importance of this problem, little was known about the cause of dyskinesia, a situation that has dramatically evolved in the last few years. The present review presents: 1) the current understanding of dyskinesia pathophysiology and 2) the therapeutic modalities, mainly non-dopaminergic, available or in development. We here show that the questions raised by the dyskinesia may have a clinically-driven pharmacological answer: the symptomatic treatment of dyskinesia, the prevention of the priming and the de-priming of the neural networks.
不自主运动,即运动障碍,是帕金森病左旋多巴治疗的一种致残性并发症。最终,绝大多数患者都会出现运动障碍。尽管这个问题很重要,但过去对运动障碍的病因知之甚少,不过在过去几年里这种情况有了显著变化。本综述介绍了:1)目前对运动障碍病理生理学的理解,以及2)主要是非多巴胺能的现有或正在研发的治疗方法。我们在此表明,运动障碍引发的问题可能有一个以临床为导向的药理学答案:运动障碍的对症治疗、神经网络启动和去启动的预防。