Parkinson's disease progression can increase levodopa dosing frequency and affect cognitive circuits where levodopa is less effective.

“there are several points one is that it you know the because those cells are not storing it as well they're you know you're having to dose more frequently so that's a cell dysfunction problem and then secondarily um there are other circuits cognitive circuits as an example that are getting affected and we know cognition plays a big role in my ability to move safely through space and so that's going to be a big contributor and l-dopa does not do as much um it's not as effective for cognitive function”