Levodopa-induced dyskinesia in Parkinson disease: Current and evolving concepts

Paolo Calabresi, Annamaria Merola, Alfonso Fasano, Alberto J. Espay, Francesca Morgante, Aristide Merola, Luca Marsili, Susan H. Fox, Erwan Bezard, Barbara Picconi, Anthony E. Lang

Research output: Contribution to journalArticle

88 Citations (Scopus)


Levodopa-induced dyskinesia is a common complication in Parkinson disease. Pathogenic mechanisms include phasic stimulation of dopamine receptors, nonphysiological levodopa-to-dopamine conversion in serotonergic neurons, hyperactivity of corticostriatal glutamatergic transmission, and overstimulation of nicotinic acetylcholine receptors on dopamine-releasing axons. Delay in initiating levodopa is no longer recommended, as dyskinesia development is a function of disease duration rather than cumulative levodopa exposure. We review current and in-development treatments for peak-dose dyskinesia but suggest that improvements in levodopa delivery alone may reduce its future prevalence. Ann Neurol 2018;84:797–811.
Original languageEnglish
Pages (from-to)797-811
Number of pages15
JournalAnnals of Neurology
Publication statusPublished - 2018


  • Animals
  • Antiparkinson Agents
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Dyskinesia, Drug-Induced
  • Humans
  • Levodopa
  • Parkinson Disease


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