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Brain. 2005 Mar;128(Pt 3):559-69. 
  
Reversal of dyskinesias in an animal model of Parkinson's disease by 
continuous L-DOPA delivery using rAAV vectors.

Carlsson T, Winkler C, Burger C, Muzyczka N, Mandel RJ, Cenci A, Bjorklund A, 
Kirik D.

Wallenberg Neuroscience Center, Division of Neurobiology, Lund University, 
Lund, Sweden. [log in to unmask]

Dyskinesias are a major complication of long-term l-3,4-dihydroxyphenylalanine 
(L-DOPA) treatment in Parkinson's disease, and are believed to result from 
the intermittent and pulsatile supply of L-DOPA. Daily injections of L-DOPA 
can prime similar abnormal involuntary movements of the limb, orolingual and 
axial muscles in rats rendered parkinsonian by destruction of the 
nigrostriatal dopamine (DA) neurons. In this study we used 33 rats with 
severe nigrostriatal dopamine depletion and showed that in vivo gene transfer 
of the DA-synthetic enzymes tyrosine hydroxylase (TH) and GTP cyclohydrolase 
1 (GCH1) using recombinant adeno-associated virus vectors can provide a 
constant source of DOPA production locally in the striatum, at a level that 
is effective in reducing L-DOPA-induced dyskinesias by >85%, and reverse 
lesion-induced motor impairments. Furthermore, the abnormal expression of 
DeltaFosB, prodynorphin and preproenkephalin mRNA within the striatal 
projection neurons normally seen in dyskinetic animals was completely 
reversed by TH-GCH1 gene transfer. These findings form a strong basis for 
replacing, or supplementing, conventional systemic L-DOPA therapy by 
continuous intrastriatal DOPA using in vivo gene transfer in the treatment of 
patients with advanced Parkinson's disease.

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