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Parkinson disease

The controversy of levodopa toxicity in Parkinson disease

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In the past two decades, there has been concern that levodopa—the gold-standard therapy for Parkinson disease (PD)—may be toxic to dopaminergic neurons. However, findings from a recent study suggest that chronic use of levodopa does not enhance progression of PD pathology. Can we make sense of this controversy?

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References

  1. Spencer, J. P. et al. Evaluation of the pro-oxidant and antioxidant actions of L-DOPA and dopamine in vitro: implications for Parkinson's disease. Free Radic. Res. 24, 95–105 (1996).

    Article  CAS  Google Scholar 

  2. Murer, M. G. et al. Chronic levodopa is not toxic for remaining dopamine neurons, but instead promotes their recovery, in rats with moderate nigrostriatal lesions. Ann. Neurol. 43, 561–575 (1998).

    Article  CAS  Google Scholar 

  3. Shin, J. Y., Park, H. J., Ahn, Y. H. & Lee, P. H. Neuroprotective effect of L-DOPA on dopaminergic neurons is comparable to pramipexole in MPTP-treated animal model of Parkinson's disease: a direct comparison study. J. Neurochem. 111, 1042–1050 (2009).

    Article  CAS  Google Scholar 

  4. Parkkinen, L. et al. Does levodopa accelerate the pathologic process in Parkinson disease brain. Neurology 77, 1420–1426 (2011).

    Article  CAS  Google Scholar 

  5. Jenner, P. Oxidative stress in Parkinson's disease. Ann. Neurol. 53 (Suppl. 3), S26–S38 (2003).

    Article  CAS  Google Scholar 

  6. Olanow, C. W., Gauger, L. L. & Cedarbaum, J. M. Temporal relationships between plasma and cerebrospinal fluid pharmacokinetics of levodopa and clinical effect in Parkinson's disease. Ann. Neurol. 29, 556–559 (1991).

    Article  CAS  Google Scholar 

  7. Fahn, S. et al. Levodopa and the progression of Parkinson's disease. N. Engl. J. Med. 351, 2498–2508 (2004).

    Article  CAS  Google Scholar 

  8. Rascol, O. et al. A five-year study of the incidence of dyskinesia in patients with early Parkinson's disease who were treated with ropinirole or levodopa. 056 Study Group. N. Engl. J. Med. 342, 1484–1491 (2000).

    Article  CAS  Google Scholar 

  9. Parkinson Study Group. Pramipexole vs levodopa as initial treatment for Parkinson disease: A randomized controlled trial. Parkinson Study Group. JAMA 284, 1931–1938 (2000).

    Article  Google Scholar 

  10. Constantinescu, R., Romer, M., McDermott, M. P., Kamp, C. & Kieburtz, K. Impact of pramipexole on the onset of levodopa-related dyskinesias. Mov. Disord. 22. 1317–1319 (2007).

    Article  Google Scholar 

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  1. Department of Neurology, University of South Florida, 12901 Bruce B. Downs Boulevard, MDC Box 55, Tampa, FL 33612, USA

    Theresa A. Zesiewicz

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  1. Theresa A. Zesiewicz
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The author declares no competing financial interests.

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Zesiewicz, T. The controversy of levodopa toxicity in Parkinson disease. Nat Rev Neurol 8, 8–10 (2012). https://doi.org/10.1038/nrneurol.2011.199

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