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What is the pathogenesis of Tardive Dyskinesia?
Because medications that cause Tardive Dyskinesia block the dopamine receptors, dysfunction of striatal dopaminergic systems has been implicated in the pathogenesis.
However, the mechanism of production of Tardive Dyskinesia is still not understood.
Clinical and experimental evidence suggests that Tardive Dyskinesia and levodopa-induced dyskinesias share a common pathogenetic mechanism.
These studies suggest that Tardive Dyskinesia ultimately results from disruption of the lateral pallidal–subthalamic GABAergic projection, leading to inhibition of the STN.
Recent evidence supports the notion that dopamine receptor-blocking drugs exert a neurotoxic effect, resulting in neuronal damage.
There is no explanation, however, for the diversity of movement disorders in Tardive Dyskinesia.
The relatively specific pharmacologic profile of each of these dyskinesias suggests that different mechanisms are involved in their generation.
Sources
Wijemanne S, Jankovic J: Stereotypy. In Falup-Pecurariu C, Ferreira J, Martinez-Martin P, Chaudhuri KR (eds): Movement disorders. New York: Springer, 2016.
Waln O, Jankovic J: An update on tardive dyskinesia: from phenomenology to treatment. Tremor Other Hyperkinet Mov (N Y) 3, 2013.
