Effects of Dopamine on Motor Recovery and Training in Adults and Children With Nonprogressive Neurological Injuries: A Systematic Review

Neurorehabil Neural Repair, 2019 · DOI: 10.1177/1545968319837289 · Published: May 1, 2019

Simple Explanation

This review examines how medications or interventions that increase dopamine levels can help improve motor skills in people with neurological injuries. It also looks at how genes involved in dopamine transmission relate to individual differences in recovery or treatment response. The analysis included 26 articles focusing on the use of levodopa post-stroke, as well as studies on traumatic brain injury, spinal cord injury, and cerebral palsy. The review suggests that brain injuries can decrease dopamine transmission, and levodopa may positively affect motor outcomes post-stroke. It also notes that individual genetic variations related to dopamine transmission can influence motor skill training responses.

Study Duration

Not specified

Participants

Participants with nonprogressive neurological injury such as cerebral palsy, stroke, spinal cord injury, and traumatic brain injury

Evidence Level

Systematic Review

Key Findings

1
A brain injury can decrease dopamine transmission.
2
Levodopa may have a positive effect on motor outcomes poststroke, although evidence is not conclusive or consistent.
3
Individual variations in genes related to dopamine transmission may also influence the response to motor skill training during neurorehabilitation.

Research Summary

This systematic review examined the effects of dopaminergic medications or genetic variations in dopamine transmission on motor recovery or learning after a nonprogressive neurological injury. The review included 26 articles, with the majority focusing on levodopa poststroke, but also included studies on traumatic brain injury, spinal cord injury, or cerebral palsy. 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.

Practical Implications

Personalized Treatment

Genetic information may be important in informing individual treatment prescriptions after neurological injury.

Further Research Needed

More randomized, adequately powered, double-blind, placebo-controlled studies or rigorous pragmatic trials are needed to better understand the effects of dopaminergic drugs.

Training Strategies

Further studies are needed on training strategies that affect dopamine release, such as rewards-based training.

Study Limitations

1
Insufficient details on physical or occupational therapy in many of the included studies limit the conclusions that can be made about the effectiveness or efficacy of the medications
2
Compared with stroke, there is a dearth of human studies on the efficacy of dopaminergic medications in CP, TBI, and SCI and the level of evidence for existing studies is low.
3
Most genetic studies are examining associations that were largely done retrospectively to interpret outcomes

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