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Striatal dopaminergic denervation and hypomimia in Parkinson's disease

We read with great interest the paper "Hypomimia in Parkinson's Disease: an axial sign responsive to levodopa" written by Ricciardi and coauthors1 . They found that Parkinson disease (PD) patients with hypomimia have more severe motor and orofacial symptoms and apathy. They also noted that an improvement in hypomimia after dopaminergic therapy, and this was associated with improvement of axial signs on multivariable analysis. Therefore, they conclude that hypomimia may be regarded as an axial sign and is mainly due to decreased central dopaminergic tone.