Single photon emission tomography with the ligand [123I]-IBZM was used to image central dopamine D2 receptors in Parkinson's disease patients. The aim was to assess striatal receptor densities in relation to response to L-Dopa therapy. In the parkinsonian patients group who were untreated until SPET study and in the group of patients with a sustained response to chronic L-Dopa, striatal [123I]-IBZM uptake did not differ significantly from mean values of the control group. On the contrary, significantly diminished uptake of [123I]-IBZM was found in the basal ganglia regions of the group of patients who developed a complicated/fluctuating response to chronic L-Dopa treatment. Our results indicate that striatal D2 receptor alterations in Parkinson's disease may contribute to the altered response to L-Dopa.