In patients with Parkinson disease (PD), the motor response to dopamine replacement therapy comprises an acute improvement in motor function, followed by the 'long-duration response' (LDR), in which motor improvements develop over weeks. Kang and colleagues review evidence to suggest that the LDR involves dopamine-dependent changes in corticostriatal plasticity, and discuss the implications of this framework for clinical management of PD. The authors argue that aberrant plasticity contributes to motor fluctuations during chronic dopamine replacement, and could be a novel therapeutic target for patients with PD or other basal ganglia disorders.
- Xiaoxi Zhuang
- Pietro Mazzoni
- Un Jung Kang