Nigrostriatal system plasticity in Parkinson's disease: Effect of dopaminergic denervation and treatment

Clinical studies suggest chat the appearance of levodopa-induced dyskinesia s may be partly related to changes in the dopaminergic system. This article reviews data on biochemical and morphological changes induced by treatment , the lesion, or both, in dopaminergic neurons themselves, postsynaptic str iatal tissue, and afferent fibers to dopaminergic neurons in the substantia nigra. Recent studies on dopaminergic neurons suggest that levodopa therap y can induce sprouting of surviving dopaminergic neurons at their terminals in the striatum. At the postsynaptic level, treatment may trigger inductio n of D3 dopamine receptors and internalization of D1 receptors. Furthermore , dopaminergic denervation has been shown to be involved in plastic changes in the striatum associated with hyperactivity of glutamatergic fibers maki ng synapses with the head of the spines of gamma-aminobutyric acidergic neu rons. At the level of the dendrites of dopaminergic neurons, plasticity of excitatory cholinergic afferent fibers targeting dopaminergic neurons and a n involution of noncholinergic afferent fibers have been observed. Taken to gether, these data suggest that dopaminergic denervation and treatment indu ce profound plastic changes in the nigrostriatal system. Whether such chang es participate in side-effects of treatment and, in particular, the appeara nce of dyskinesias remains to be determined.