Basal Ganglia Pathophysiology Unit, Dept. Experimental Medical Science, Lund University, Sweden.
CNS Neurol Disord Drug Targets. 2011 Sep 1;10(6):670-84. doi: 10.2174/187152711797247885.
Dyskinesia and motor fluctuations affect up to 90% of patients with Parkinson's disease (PD) within ten years of L-DOPA pharmacotherapy, and represent a major challenge to a successful clinical management of this disorder. There are currently two main treatment options for these complications, namely, deep brain electrical stimulation or continuous infusion of dopaminergic agents. The latter is achieved using either subcutaneous apomorphine infusion or enteric L-DOPA delivery. Some patients also benefit from the antidyskinetic effect of amantadine as an adjunct to L-DOPA treatment. Ongoing research in animal models of PD aims at discovering additional, novel treatment options that can either prevent or reverse dyskinesia and motor fluctuations. Alternative methods of continuous L-DOPA delivery (including gene therapy), and pharmacological agents that target nondopaminergic receptor systems are currently under intense experimental scrutiny. Because clinical response profiles show large individual variation in PD, an increased number of treatment options for dyskinesia and motor fluctuations will eventually allow for antiparkinsonian and antidyskinetic therapies to be tailor-made to the needs of different patients and/or PD subtypes.
运动障碍和运动波动在左旋多巴药物治疗的 10 年内影响高达 90%的帕金森病（PD）患者，是成功治疗这种疾病的主要挑战。目前，针对这些并发症有两种主要的治疗选择，即深部脑电刺激或多巴胺能药物的持续输注。后者通过皮下给予阿朴吗啡输注或肠内给予左旋多巴来实现。一些患者还受益于金刚烷胺作为左旋多巴治疗的辅助药物的抗运动障碍作用。正在进行的 PD 动物模型研究旨在发现其他新的治疗选择，以预防或逆转运动障碍和运动波动。目前正在对连续左旋多巴输送的替代方法（包括基因治疗）和针对非多巴胺能受体系统的药物进行深入的实验研究。由于 PD 患者的临床反应谱存在很大的个体差异，因此运动障碍和运动波动的治疗选择增加最终将允许根据不同患者和/或 PD 亚型的需求来定制抗帕金森病和抗运动障碍治疗。
