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THE JOURNAL OF SCHOOL AND UNIVERSITY MEDICINE - Volume 9, Issue 3, July-September 2022

Pages: 24-27
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Author: Nicoleta Tohanean, Laura Grosu, Andreea Dit-Filipas, Lacramioara Perju-Dumbrava

Category: Medical


BACKGROUND AND AIM: Parkinson’s disease (PD) was initially seen as a neurodegenerative process of the basal ganglia but clinical and pathological evidence revealed its strong systemic as well as peripheral nervous system involvement. The current review aims to present the recent data in the association of polyneuropathy (PN) and PD.

METHODS: We performed a systematic literature search in the most important international databases. We report the results of most recent studies in a narrative way.

RESULTS: Several recent studies have shown the presence of PN as a small fiber disease in the early stages of PD. Also there seems to be a link between acquired axonal neuropathy and chronic Levo-Dopa intake. We present the possible pathogenesis of this association, also a summary of the evaluation of PN in PD patients and the main management approaches.

CONCLUSION: The association of PN in PD patients is an important phenomenon that significantly decreases their quality of life, underlining the value of clinical and paraclinical assessment the all stages of the disease

Keywords: Parkinson’s disease, polyneuropathy, Levo-Dopa, skin biopsy, corneal confocal microscopy.

DOI: 10.51546/JSUM.2022.9304



  1. Comi C, Magistrelli L, Oggioni GD, Carecchio M, Fleetwood T, Cantello R. Parkinsonism and Related Disorders Peripheral nervous system involvement in Parkinson’s disease: Evidence and controversies. Park Relat Disord [Internet]. 2014;20(12):1329–34. Available from:
  2. Cossu G, Melis M. Parkinsonism and Related Disorders The peripheral nerve involvement in Parkinson Disease: A multifaceted phenomenon. Park Relat Disord [Internet]. 2016;25:17–20. Available from:
  3. Ceravolo R, Cossu G, Bandettini M, Santoro L, Barone P, Zibetti M, et al. Neuropathy and Levodopa in Parkinson ’ s Disease: Evidence From a Multicenter Study. 2013;28(10):1391–7
  4. Zis P, Grünewald RA, Kallol R, Hadjivassiliou M. Journal of the Neurological Sciences Peripheral neuropathy in idiopathic Parkinson ’ s disease: A systematic review. J Neurol Sci [Internet]. 2017; 378:204–9. Available from:
  5. Podgorny PJ, Suchowersky O, Romanchuk KG, Feasby TE. Parkinsonism and Related Disorders Evidence for small fi ber neuropathy in early Parkinson ’ s disease. Park Relat Disord [Internet]. 2016;28:94–9. Available from:
  6. Nolano M, Iodice R, Stancanelli A, Caporaso G, Califano F, Lanzillo B, et al. Loss of cutaneous large and small fibers in naive and L-dopa – treated PD patients. 2017 ;89:1–9
  7. Araújo DF De, Pinto A, Neto DM, Sérgio Í, Oliveira C, Brito BS. Small (autonomic) and large fiber neuropathy in Parkinson disease and parkinsonism. BMC Neurol [Internet]. 2016;1–7. Available from:
  8. Rajabally YA, Martey J. Neuropathy in Parkinson disease Prevalence and determinants. 2011;1947–51
  9. Toth C, Brown MS, Furtado S, Suchowersky O, Zochodne D. Neuropathy as a Potential Complication of Levodopa Use in Parkinson ’ s Disease. 2008;23(13):1850–9.
  10. Mancini F, Comi C, Oggioni GD, Pacchetti C, Calandrella D, Moja MC, et al. Parkinsonism and Related Disorders Prevalence and features of peripheral neuropathy in Parkinson’s disease patients under different therapeutic regimens. Park Relat Disord [Internet]. 2014;20(1):27–31. Available from:
  11. Szadejko K, Dziewiatowski K, Szabat K, Robowski P, Sitek E. Journal of the Neurological Sciences Polyneuropathy in levodopa-treated Parkinson’s patients. 2016;371:36–41
  12. Kass-iliyya L, Javed S, Gosal D, Kobylecki C, Marshall A, Petropoulos IN, et al. Parkinsonism and Related Disorders Small fi ber neuropathy in Parkinson’s disease: A clinical , pathological and corneal confocal microscopy study. Park Relat Disord [Internet]. 2015;21(12):1454–60. Available from:
  13. Commentaries S. Peripheral synuclein tissue markers: a step closer to Parkinson’s disease diagnosis. 2018;(March):2120–2
  14. Cossu G, Ceravolo R, Zibetti M, Arca R, Ricchi V, Paribello A, et al. Parkinsonism and Related Disorders Levodopa and neuropathy risk in patients with Parkinson disease: Effect of COMT inhibition. Park Relat Disord [Internet]. 2016;27(September 2014):81–4. Available from:
  15. Kocer B, Guven H, Comoglu SS. Homocysteine Levels in Parkinson’s Disease: Is Entacapone Effective? 2016;2016
  16. Müller T, Laar T Van, Cornblath DR, Odin P, Klostermann F, Grandas FJ, et al. Parkinsonism and Related Disorders Peripheral neuropathy in Parkinson’s disease: Levodopa exposure and implications for duodenal delivery [ Universally Available ]. Park Relat Disord [Internet]. 2013;19(5):501–7. Available from: