We now know that motor complications are not so much a reflection of the inherent properties of levodopa, but rather are related to the way in which they are administered.
Evidence from preclinical and clinical studies indicates that pulsatile stimulation of striatal dopamine receptors is a key factor in the development of levodopa-associated motor complications. Therefore, in the de novo person, it is believed that providing a more continuous dopaminergic stimulation from the start of anti-Parkinson therapy may prevent priming for motor fluctuations and dyskinesia.
Chronic levodopa treatment in people with Parkinson’s frequently results in the development of motor complications, including dyskinesia and motor fluctuations. These complications are associated with discontinuous stimulation of dopamine receptors induced by intermittent oral doses of levodopa.
