The effect of L-dopa in Parkinson's disease as revealed by neurophysiological studies of motor and sensory functions
Expert review of neurotherapeutics, 2017•Taylor & Francis
Introduction: This review will first discuss evidence of motor and sensory abnormalities as
yielded by neurophysiological techniques in patients with PD. It will then go on to describe
the effects of L-dopa replacement on motor and sensory abnormalities in PD as assessed by
neurophysiological studies. Areas covered: We analyzed papers in English using Pubmed
with the following keywords: L-dopa, dopamine, bradykinesia, basal ganglia, kinematic
analysis, TMS, motor cortex plasticity, motor cortex excitability, somatosensory discrimination …
yielded by neurophysiological techniques in patients with PD. It will then go on to describe
the effects of L-dopa replacement on motor and sensory abnormalities in PD as assessed by
neurophysiological studies. Areas covered: We analyzed papers in English using Pubmed
with the following keywords: L-dopa, dopamine, bradykinesia, basal ganglia, kinematic
analysis, TMS, motor cortex plasticity, motor cortex excitability, somatosensory discrimination …
Abstract
Introduction: This review will first discuss evidence of motor and sensory abnormalities as yielded by neurophysiological techniques in patients with PD. It will then go on to describe the effects of L-dopa replacement on motor and sensory abnormalities in PD as assessed by neurophysiological studies.
Areas covered: We analyzed papers in English using Pubmed with the following keywords: L-dopa, dopamine, bradykinesia, basal ganglia, kinematic analysis, TMS, motor cortex plasticity, motor cortex excitability, somatosensory discrimination threshold, pain
Expert commentary: L-dopa improves the amplitude and speed of upper limb voluntary movements, but it does not restore abnormalities in the sequence effect or voluntary facial movements. L-dopa only partially normalizes changes in motor cortex excitability and plasticity and has also contrasting effects on the sensory system and on sensory-motor integration. The neurophysiological studies reviewed here show that PD is more than a hypo-dopaminergic disease, and non-dopaminergic mechanisms should also be considered.
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