Treatment-related dyskinesias are the major limitation of dopamine replacem
ent therapies such as levodopa in Parkinson's disease (PD). Recent studies
in parkinsonian, nonhuman primates have highlighted abnormalities in neural
functioning that might underlie the generation of dyskinetic symptoms in p
atients with PD who have received prolonged dopaminergic therapy. This arti
cle reviews studies on metabolic activity in subregions of the basal gangli
a which suggest that profound abnormalities in basal ganglia output may und
erlie levodopa-induced dyskinesia. Such abnormalities may result from chang
es within basal ganglia circuitry and may include either overt changes in a
verage firing rate or modulation of the pattern of cell-cell communication
within subregions of the basal ganglia circuitry. An appreciation of abnorm
alities in the mechanisms responsible for modulating synaptic transmission
in the basal ganglia may suggest novel therapeutic approaches to the proble
m of dyskinesia.