Dyskinesias (Dyskinesia)

Abnormal involuntary movements which primarily affect the extremities, trunk, or jaw that occur as a manifestation of an underlying disease process. Conditions which feature recurrent or persistent episodes of dyskinesia as a primary manifestation of disease may be referred to as dyskinesia syndromes (see MOVEMENT DISORDERS). Dyskinesias are also a relatively common manifestation of BASAL GANGLIA DISEASES.

Also Known As:

Networked: 4955 relevant articles (583 outcomes, 593 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Parkinson Disease (Parkinson's Disease)
2.	Dyskinesias (Dyskinesia)
3.	Tremor (Tremors)
4.	Parkinsonian Disorders (Parkinsonism)
5.	Dystonia (Limb Dystonia)

Experts

1.	Brotchie, Jonathan M: 58 articles (10/2015 - 02/2003)
2.	Bezard, Erwan: 53 articles (11/2015 - 11/2003)
3.	Fox, Susan H: 47 articles (11/2015 - 11/2002)
4.	Di Paolo, Thérèse: 46 articles (12/2015 - 01/2002)
5.	Jenner, Peter: 46 articles (11/2015 - 02/2002)
6.	Cenci, M Angela: 44 articles (11/2015 - 01/2002)
7.	Grégoire, Laurent: 31 articles (12/2015 - 12/2003)
8.	Johnston, Tom H: 30 articles (10/2015 - 07/2004)
9.	Li, Qin: 29 articles (11/2015 - 01/2005)
10.	Hauser, Robert A: 28 articles (01/2016 - 08/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Dyskinesias:

1.	Levodopa (L Dopa)FDA LinkGeneric 01/01/1997 - "The most important questions to be answered by such studies are: (1) Is the benefit derived from addon medication greater than that which could be brought about by further levodopa titration alone?, and (2) Can 'off' time be decreased and motor function improved without a proportionate increase in unwanted dyskinesia? " 10/05/2015 - "Levodopa (l-Dopa) replacement therapy remains the most common and effective treatment for PD, although it induces the complication of l-Dopa induced dyskinesia after years of use. " 08/01/2015 - "L-Dopa alone is the most effective medication available for treating the motor symptoms of PD patients, despite the greater incidence of involuntary movements. " 07/01/2012 - "Levodopa remains the most effective agent for relief of PD symptoms, but chronic levodopa therapy is associated with motor fluctuations and dyskinesias, and clinicians may therefore opt to postpone its use. " 01/01/2012 - "Furthermore, levodopa-induced dyskinesias are dramatically improved because STN stimulation permits an approximately 50% reduction in antiparkinsonian treatment. "
2.	Dopamine (Intropin)FDA LinkGeneric 03/01/2005 - "Thus, this study suggests that diminished buffering capacity for dopamine could play a role in the development of dyskinesias, and that an endogenous mechanism might exist that ameliorates dyskinesias." 01/01/2013 - "Preclinical studies in dopamine-denervated animals have contributed to the modeling of these abnormal movements, but the precise neurochemical and functional mechanisms underlying these untoward effects are still elusive. " 01/01/2011 - "Our study demonstrated that the A2ARs in the putamen were increased in the PD patients with dyskinesia, and also suggest that the A2ARs in the putamen compensate for the asymmetrical decrease of dopamine in drug-naïve PD patients and that antiparkinsonian therapy increases the A2ARs in the putamen. " 07/01/2008 - "The present study was aimed at assessing behavioral and biochemical correlates of intense or mild dyskinesia displayed by the different dopamine (DA) receptors stimulation in a rat model of PD. " 01/01/1988 - "The purpose of this study was to characterize the dopaminergic system in the mouse cerebellum and to determine whether the dyskinesia of the reeler mutant is accompanied by alterations in cerebellar and/or striatal dopamine binding. "
3.	Amantadine (Aman)FDA LinkGeneric 07/30/2007 - "The only currently available drug with an evidence-based recommendation on efficacy for dyskinesia is amantadine. " 02/01/2001 - "After 15 days with amantadine treatment all patients improved with an average 38% reduction in dyskinesias (p<0.001). " 03/01/2013 - "This study resolves 2 major issues useful for future testing of new antidyskinesia treatments: among tested scales, the UDysRS, having both subjective and objective dyskinesia ratings, is superior for detecting treatment effects; and the magnitude of the UDysRS effect size from amantadine sets a clear standard for comparison for new agents." 07/01/2012 - "This meta-analysis provides an update on the clinical trials and confirms the short-term benefits of amantadine therapy in the treatment of dyskinesia. " 01/01/2010 - "Results from the present study demonstrated that amantadine exhibited efficacious effects against dyskinesias in 60-70% of patients. "
4.	Dihydroxyphenylalanine (Dopa)IBA 01/01/2009 - "The aim of this study was to detect the presence of gene GCH-I mutation in our population in patients with dopa-responsive dystonic dyskinesia and to analyse clinical specificity of the affected. " 05/01/2015 - "Current treatment and future prospects of dopa-induced dyskinesias." 11/01/2012 - "On the other end of the spectrum of the disease course, during later stages of PD, significant clinical challenges like levo-dopa-induced dyskinesias and medication on-off phenomenon become more prevalent. " 08/01/2004 - "However, after an initial period of dramatic benefit, several limitations become apparent including, "dopa resistant" motor symptoms (postural abnormalities, freezing episodes, speech impairment), "dopa resistant" non-motor signs (autonomic dysfunction, mood and cognitive impairment, etc), and/or drug related side effects (especially psychosis, motor fluctuations, and dyskinesias). " 12/01/2001 - "Dopa-induced dyskinesia can be attenuated effectively by the direct and/or indirect effects of DBS therapy. "
5.	Bromocriptine (Parlodel)FDA LinkGeneric 01/01/1994 - "Of 22 patients who had been on bromocriptine monotherapy for 7 years (group B), 16 remained improved or remained in the same stages of Hoehn and Yahr, and no wearing-off phenomenon or dyskinesia was observed. " 09/01/1977 - "Dyskinesia, occurring during bromocriptine treatment in 9 of 11 patients, disappeared within the period of study in 6 patients after dose reduction without changes in Parkinson disability scores to placebo level. " 01/01/2008 - "Ergots (apart from bromocriptine) stimulate the DA D(1) subreceptor and increase dyskinesia. " 02/12/2007 - "Only AIMs, however, provided a specific measure of dyskinesia since rotations also were induced by bromocriptine, a drug with low dyskinesiogenic potential. " 01/01/1997 - "None of the 6 patients remaining on bromocriptine monotherapy experienced adverse reactions like the wearing-off phenomenon, dyskinesia, or the on-off phenomenon. "
6.	ropinirole (Requip)FDA LinkGeneric 07/01/1997 - "Ropinirole has demonstrated efficacy in two standard preclinical models of PD and has shown a very low propensity to induce dyskinesia in these studies. " 01/01/2011 - "Patients receiving ropinirole prolonged release had a significantly greater increase in amount/percentage of awake time "on"/"on" without troublesome dyskinesia during all periods assessed (including night-time and early morning), versus placebo, and higher odds for being "on" on waking. " 09/01/2000 - "Chronic administration of ropinirole for 21 days produced a statistically significant increase in motor activity compared to the initial administration, and akinesia scores, measured through rating the quality of movements, were also improved without obvious dyskinesia. " 09/01/2008 - "In addition to controlling motor symptoms, ropinirole improved both anxiety and depressive symptoms in PD patients with motor fluctuations and/or dyskinesias. " 05/01/2006 - "In the numerous clinical trials that were carried out, it would seem clear that ropinirole can be administered for years as sole early treatment for PD and that it offers a notable reduction in the appearance of dyskinesias. "
7.	ApomorphineIBA 02/01/1994 - "Apomorphine was effective in reducing the duration of diphasic dyskinesias at doses higher than the threshold doses necessary to induce an "on" phase (mean increase: 43%). " 02/01/1994 - "In two patients, apomorphine remained effective in the morning, but increased the intensity of the dyskinesias in the afternoon. " 03/01/2005 - "Animals receiving apomorphine rods showed improved motor function ('ON' state) within 1 day of implantation, and remained continually 'ON' for the duration of treatment (up to 6 months) without developing dyskinesias. " 12/01/2015 - "Our results document for the first time a disturbance of ERK1/2 signaling regulation associated with apomorphine-induced involuntary movements in a genetic mouse model of synucleinopathy. " 09/01/2015 - "Apomorphine infusion(1) is suited for patients whose 'off' periods can no longer be adequately controlled by standard oral PD treatment or for those in whom rescue doses of apomorphine injection are effective but either needed too frequently (more than 4-6 times per day), or are associated with increasing dyskinesia. "
8.	Clozapine (Clozaril)FDA LinkGeneric 07/01/1994 - "We conclude that clozapine is an effective agent for suppression of dyskinesias in PD with an effective daily dose for most patients of 100-200 mg/day." 01/01/1992 - "Clozapine also had a positive sleep effect in four patients and improved dyskinesia in one. " 03/01/1979 - "Twelve patients with abnormal involuntary movement disorders were treated with clozapine in a double-blind, placebo-controlled trial. " 03/01/1979 - "The trial use of clozapine for abnormal involuntary movement disorders." 02/01/2014 - "Clozapine-associated asterixis: case report."
9.	1- Methyl- 4- phenyl- 1,2,3,6- tetrahydropyridine (MPTP)IBA 02/01/1992 - "The MPTP monkey model remains very useful for predicting the potential of new drugs for inducing dyskinesia. " 01/01/2008 - "Recently, studies in MPTP-treated primates have suggested that a range of nondopaminerigic drugs might be useful in suppressing dyskinesia. " 01/01/2008 - "Recent studies in MPTP-treated primates have also suggested that switching from pulsatile drug delivery to CDD can be utilized to inhibit dyskinesia expression. " 04/15/2007 - "In this study of oral and intravenous MIF in N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned marmosets, a wide range of doses of MIF administered alone (0.25, 1, 2, 5, 10, 20 mg/kg orally) did not increase locomotor activity, relieve motor disability, or induce dyskinesias. " 07/01/2004 - "Relevance of the MPTP primate model in the study of dyskinesia priming mechanisms."
10.	Botulinum Toxins (Botulinum Toxin)IBA 03/01/1991 - "Botulinum toxin therapy is a safe and effective treatment for these facial dyskinesias and should be considered a viable alternative to surgical procedures." 06/01/1998 - "The purpose of this study was to determine whether antidepressant, antimania, antipsychotic, antihistamine, or antiparkinsonian drugs are associated with eyelid and facial dyskinesias; whether discontinuing such drugs results in improvement in the facial dyskinesias; and whether response to botulinum toxin treatment is influenced by such medications. " 12/01/1991 - "Natural history of treatment of facial dyskinesias with botulinum toxin: a study of 50 consecutive patients over seven years." 02/01/2016 - "This article reviews the current literature supporting the use of botulinum toxin in producing symmetric facial features and reducing unwanted, involuntary movements. " 04/01/2011 - "Treatment of intractable tardive lingual dyskinesia with botulinum toxin."

Therapies and Procedures

1.	Pallidotomy 05/15/2009 - "Then she started having opisthotonus lasting 20 seconds to an hour several times/day, but over 6 years abnormal movements are markedly improved, and not returned to pre-pallidotomy level. " 11/01/1997 - "The efficacy of surgery in the case of hemiballismus demonstrates that pallidotomy can be an effective treatment for this condition and suggests that patterned neuronal activity in the GPi is important in the mechanism of hyperkinetic disorders." 04/01/2000 - "Even when positive clinical results of GPi pallidotomy have recently been reported from several centers, the patients seem to have improved relatively little, the dyskinesias excepted, and the rate of side effects has been quite high. " 02/01/2000 - "According to Visual Analog Scale scores, unilateral pallidotomy significantly improved dyskinesias (P < 0.05) but no other symptoms. " 07/01/1999 - "After pallidotomy there was a significant reduction in the involuntary movement associated with these disorders and a more normal pattern of electromyographic activity during rest and movement. "
2.	Activities of Daily Living (ADL) 10/09/1997 - "The percent improvements at six months were as follows: off-period score for overall motor function, 28 percent (95 percent confidence interval, 19 to 38 percent), with most of the improvement in the contralateral limbs; off-period score for activities of daily living, 29 percent (95 percent confidence interval, 19 to 39 percent); on-period score for contralateral dyskinesias, 82 percent (95 percent confidence interval, 72 to 91 percent); and on-period score for ipsilateral dyskinesias, 44 percent (95 percent confidence interval, 29 to 59 percent). " 12/01/1990 - "During the course of this study, a statistically significant improvement was noted in percent "on" time, percent "on" time without dyskinesia, activity of daily living (ADL) scores during the "on" stages, and ADL, motor, and Schwab-England scores during the "off" stages. " 04/15/2010 - "Dyskinesias and ADL were significantly improved in both groups. " 10/01/2005 - "Stimulation improved cardinal features and activities of daily living (ADL) (P < 0.0001 and P < 0.02 for STN and GPi, respectively) and prolonged the 'on' time spent with good mobility without dyskinesias (P < 0.00001). " 07/01/2002 - "Three years postoperatively, GPi stimulation led to a significant improvement of dyskinesia severity (50%, P = 0.05) and activities of daily living (subscore of quality of life scale, 9%, P = 0.05). "
3.	Transplants (Transplant) 01/01/1994 - "This means that abnormal movements that could injure the autologous grafts were eliminated. " 01/01/2012 - "This mouse model will facilitate assessment of graft-induced dyskinesia with mouse-derived stem cell lines and exploration of mechanisms using transgenic mice in future studies. " 01/01/2012 - "However, the initial clinical trials lacked homogeneity of outcomes and were hindered by the development of troublesome graft-induced dyskinesias in a subgroup of patients. " 01/01/2010 - "A recent study, however, hypothesized that an important factor for the development of graft-induced dyskinesias could include the composition of the cell suspension and specifically that a high proportion of serotonergic neurons cografted in these transplants engage in nonphysiological properties such as false transmitter release. " 10/01/2007 - "Then the issues pertinent to its adoption in the clinic are discussed, including the ethical and practical problems with its use, the varied composition of VM tissue that is implanted with the graft and how this may account for some of the problems seen in the clinical trials using this tissue, especially graft-induced dyskinesia. "
4.	Deep Brain Stimulation 01/01/2015 - "Globus pallidus internus deep brain stimulation as rescue therapy for refractory dyskinesias following effective subthalamic nucleus stimulation." 03/01/2014 - "After 24 months of follow up, our observations suggest that globus pallidus deep brain stimulation, can improve motor fluctuations, dyskinesia and axial symptoms." 01/01/2014 - "The aim was to describe the prevalence and characteristics of difficult to manage dyskinesia associated with subthalamic nucleus (STN) deep brain stimulation (DBS). " 01/01/2014 - "Brittle Dyskinesia Following STN but not GPi Deep Brain Stimulation." 08/01/2013 - "Deep brain stimulation (DBS), applied to selected patients and difficult-to-manage motor fluctuations, yields substantial reductions in off time and dyskinesia. "
5.	Injections 09/01/2004 - "Thus regarding the origin of the circuits within the striatum, tracer injections performed in the dyskinesia site labelled neurons located in the posterior sensorimotor putamen, those performed in the hyperactivity and/or attention deficit labelled neurons in the laterodorsal putamen and caudate nucleus, regions corresponding to associative and anterior motor territories, while those performed in the stereotyped behaviour site labelled neurons in the ventral limbic striatum. " 01/01/1994 - "Ten patients with complicated PD involving fluctuations in mobility and dyskinesia were treated with subcutaneous APM (1 with continuous infusion and 9 with multiple injections). " 04/12/1991 - "Twenty patients were followed up for more than one year: in nine of them the interval between courses of injections, the dose being unaltered, remained the same (12-14 weeks), but thereafter the abnormal movements returned with the same severity as before treatment. " 06/01/1984 - "Injections located in or near to the subthalamic nucleus provoked involuntary movements of the contralateral limbs. " 04/20/1984 - "Evidence was obtained of functional heterogeneity between the dorsal and ventral lentiform nucleus, in that only injections into its ventral part gave rise to dyskinesia."