Servicio de Neurología, Hospital Gregorio Marañón, Madrid, Spain
The Role of Pulsatile Versus Continuous Dopamine Receptor Stimulation for Functional Recovery in Parkinson's Disease
Article first published online: 7 APR 2006
European Journal of Neuroscience
Volume 6, Issue 6, pages 889–897, June 1994
How to Cite
Obeso, J. A., Grandas, F., Herrero, M. T. and Horowski, R. (1994), REVIEW. European Journal of Neuroscience, 6: 889–897. doi: 10.1111/j.1460-9568.1994.tb00584.x
- Issue published online: 7 APR 2006
- Article first published online: 7 APR 2006
- Received 29 September 1993, revised 20 December 1993, accepted 21 January 1994.
- Parkinson's disease;
- receptor stimulation;
- continuous and intermittent dopaminergic stimulation
More effective measures to control and replace the dopaminergic deficit of Parkinson's disease are being actively sought. One basic problem is how the striatal dopamine loss should be replaced in order to mimic most accurately the physiological state. Animal electrophysiology indicates that the dopaminergic nigrostriatal pathway has a dual tonic and phasic action. Intermittent dopaminergic stimulation is associated with behavioural hyposensitivity both in animal models and in patients with Parkinson's disease. Continuous dopaminergic stimulation provides a tonic background and improves some clinical problems but is also associated with tolerance. None of the available pharmacological approaches can restore the dopamine deficiency of Parkinson's disease to physiological levels. Continuous dopaminergic stimulation for <24 h, associated with small doses of levodopa or a short-acting dopamine agonist, appears to be the best, albeit imperfect, therapeutic approach until other, more efficacious remedies are developed.