The Possible Role of Anti-Epileptic Drugs (AEDS) in Treating Levodopa Induced Dyskinesia (LID) | BiomedgridJournal: American Journal of Biomedical Science & Research (Vol.6, No. 4)
Publication Date: 2019-11-26
Authors : Mohamed Khateb;
Page : 348-351
Keywords : Levodopa-induced dyskinesia; Parkinson’s diseases; Anti-epileptic drugs; Motor cortex; Basal ganglia;
Parkinson's disease (PD) is a common neurodegenerative disease with a lifetime risk of 1-2%. It primarily affects the basal ganglia system (BG). Disruption of motor functions is one of the main clinical manifestations of PD. The main treatments of PD are L-dopa and dopamine receptor agonists. However, they are usually accompanied with dyskinesia (L-dopa induced dyskinesia or LID) which is common and very difficult to treat causing a significant decrease in patient's quality of life. The exact mechanism beyond LID is largely unclear. A leading theory, based on the classical basal ganglia-cortical loop model, claimed that LID might be the result of dis-inhibition of the motor cortex (mainly the supplementary motor cortex or SMA) because of hypoactivity of GPi. At the cellular level, mechanisms involving pulsatile stimulation of dopamine receptors, dysregulation of genes and proteins in neurons resulting in changes in neural discharge patterns between BG and cortex were reported. Here, we are exploring the possible effects of anti-epileptic drugs (AED) in improving LID. AED are widely used agents mainly for controlling seizure disorders. Moreover, they have been used for other neurological and psychiatrial disorders. Part of the AED were investigated in PD patients with LID. Despite the lack of multiple wide prospective double-blind placebo-controlled trials, the current evidences provide possible positive effects in alleviating LID for at least part of AED such as Levetiracetam and others. We believe future clinical as well as pre-clinical research is recommended for properly investigating the effects of other AED in treating LID.
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