Abstract
Background.
The strong link between dopamine and motor learning has been
well-established in the animal literature with similar findings reported
in healthy adults and the elderly.
Objective. We aimed to
conduct the first, to our knowledge, systematic review of the literature
on the evidence for the effects of dopaminergic medications or genetic
variations in dopamine transmission on motor recovery or learning after a
nonprogressive neurological injury.
Methods. A PubMed search was
conducted up until April 2018 for all English articles including
participants with nonprogressive neurological injury such as cerebral
palsy, stroke, spinal cord injury, and traumatic brain injury;
quantitative motor outcomes; and assessments of the dopaminergic system
or medications.
Results. The search yielded 237 articles, from
which we identified 26 articles meeting all inclusion/exclusion
criteria. The vast majority of articles were related to the use of
levodopa poststroke; however, several studies assessed the effects of
different medications and/or were on individuals with traumatic brain
injury, spinal cord injury or cerebral palsy.
Conclusions. The
evidence suggests that a brain injury can decrease dopamine transmission
and that levodopa may have a positive effect on motor outcomes
poststroke, although evidence is not conclusive or consistent.
Individual variations in genes related to dopamine transmission may also
influence the response to motor skill training during
neurorehabilitation and the extent to which dopaminergic medications or
interventions can augment that response. More rigorous safety and
efficacy studies of levodopa and dopaminergic medications in stroke and
particularly other neurological injuries including genetic analyses are
warranted.
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