Morning akinesia in Parkinson's disease: challenges and solutions

Abstract

Motor complications of Parkinson's disease (PD) have been reported to occur after a few years of treatment with levodopa (L-dopa). Morning akinesia is a delayed ON of the first L-dopa daily dose, occurring in almost 60% of patients on dopaminergic treatment. This is primarily a motor symptom, but has been recently recognized as being correlated with nonmotor fluctuations. Sleep disorders and gastrointestinal dysfunction might be the underlying mechanisms. Over the past 30 years, several pharmacological and nonpharmacological approaches have been investigated.