Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
J Neurol. 2010 Nov;257(Suppl 2):S268-75. doi: 10.1007/s00415-010-5719-9.
After more than 40 years of clinical use, levodopa (LD) still remains the gold standard for symptomatic efficacy in Parkinson's disease (PD). However, long-term treatment with LD is often complicated by the development of various types of motor response oscillations as well as drug-induced dyskinesias. These treatment-related motor complications evolve in approximately one-third of patients after only 2 years of LD exposure and, once established, they are difficult to treat and significantly contribute to overall disability and disease burden. Although first described soon after the introduction of LD, the pathophysiology of motor complications is still not completely understood. In fact, it is most likely that non-physiological pulsatile stimulation of dopamine receptors, which is followed by various downstream alterations, plays a key role in the development of LD-induced motor response oscillations and dyskinesias. This review outlines the various types of motor complications and will also address underlying mechanisms, treatment options, as well as impact on clinical disability and quality of life (QoL).
左旋多巴（LD）在临床应用 40 多年后，仍然是治疗帕金森病（PD）症状的金标准。然而，长期使用 LD 常常会出现各种类型的运动反应性波动以及药物诱导的运动障碍。这些与治疗相关的运动并发症在 LD 暴露仅 2 年后，大约三分之一的患者中就会出现，而且一旦出现，就很难治疗，并显著导致整体残疾和疾病负担。尽管在 LD 问世后不久就首次描述了这些运动并发症，但它们的病理生理学仍然不完全清楚。事实上，多巴胺受体的非生理性脉冲刺激，随后出现各种下游改变，很可能在 LD 诱导的运动反应性波动和运动障碍的发展中起关键作用。这篇综述概述了各种类型的运动并发症，并将讨论潜在的机制、治疗选择，以及对临床残疾和生活质量（QoL）的影响。
