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
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).
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).
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).
Parkkinen, L. et al. Does levodopa accelerate the pathologic process in Parkinson disease brain. Neurology 77, 1420–1426 (2011).
Jenner, P. Oxidative stress in Parkinson's disease. Ann. Neurol. 53 (Suppl. 3), S26–S38 (2003).
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).
Fahn, S. et al. Levodopa and the progression of Parkinson's disease. N. Engl. J. Med. 351, 2498–2508 (2004).
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).
Parkinson Study Group. Pramipexole vs levodopa as initial treatment for Parkinson disease: A randomized controlled trial. Parkinson Study Group. JAMA 284, 1931–1938 (2000).
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).
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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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DOI: https://doi.org/10.1038/nrneurol.2011.199
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