Dystonia and Parkinson’s disease: What is the relationship?

Dystonia and Parkinson’s disease: What is the relationship?

Publication date: May 09, 2019

Dystonia and Parkinson’s disease are closely linked disorders sharing many pathophysiological overlaps. Dystonia can be seen in 30% or more of the patients suffering with PD and sometimes can precede the overt parkinsonism. The response of early dystonia to the introduction of dopamine replacement therapy (levodopa, dopamine agonists) is variable; dystonia commonly occurs in PD patients following levodopa initiation. Similarly, parkinsonism is commonly seen in patients with mutations in various DYT genes including those involved in the dopamine synthesis pathway. Pharmacological blockade of dopamine receptors can cause both tardive dystonia and parkinsonism and these movement disorders syndromes can occur in many other neurodegenerative, genetic, toxic and metabolic diseases. Pallidotomy in the past and currently deep brain stimulation largely involving the GPi are effective treatment options for both dystonia and parkinsonism. However, the physiological mechanisms underlying the response of these two different movement disorder syndromes are poorly understood.. Interestingly, DBS for PD can cause dystonia such as blepharospasm and bilateral pallidal DBS for dystonia can result in features of parkinsonism. Advances in our understanding of these responses may provide better explanations for the relationship between dystonia and Parkinson’s disease.

Shetty, A.S., Bhatia, K.P., and Lang, A.E. Dystonia and Parkinson’s disease: What is the relationship? 20751. 2019 Neurobiol Dis.

Concepts Keywords
Blepharospasm Parkinson’s disease
Blockade Congenital disorders
DBS Tardive
Deep Brain Stimulation Tyrosine hydroxylase
Dopamine Movement disorders
Dopamine Agonists Parkinsonism
Dystonia Dystonia
Genetic Geriatrics
Levodopa Neurological disorders
Metabolic Diseases Medicine
Movement Disorder Organ systems
Movement Disorders Nervous system
Neurodegenerative Movement disorder syndromes
Pallidal Deep brain stimulation
Parkinson DBS dystonia blepharospasm
Parkinsonism Overt parkinsonism
Pathophysiological Early dystonia


Type Source Name
drug DRUGBANK Tropicamide
disease DOID blepharospasm
disease MESH blepharospasm
disease MESH metabolic diseases
disease MESH syndromes
disease MESH movement disorders
disease MESH tardive dystonia
pathway BSID Dopamine receptors
drug DRUGBANK Levodopa
drug DRUGBANK Dopamine
disease MESH suffering
disease DOID Dystonia

Original Article

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