Differential effects of dopaminergic therapies on dorsal and ventral striatum in XXXX : implications for cognitive function.

@entity935 @entity73 @entity191
@entity73 are a feature of @entity191 ( @entity191 ). Unlike motor symptoms that are clearly improved by dopaminergic therapy, the effect of @entity935 replacement on cognition seems paradoxical. Some cognitive functions are improved whereas others are unaltered or even hindered. Our aim was to understand the effect of @entity935 replacement therapy on various aspects of cognition. Whereas dorsal striatum receives @entity935 input from the substantia nigra (SN), ventral striatum is innervated by @entity935 -producing cells in the ventral tegmental area (VTA). In @entity191 , degeneration of SN is substantially greater than cell loss in VTA and hence @entity935 -deficiency is significantly greater in dorsal compared to ventral striatum. We suggest that @entity935 supplementation improves functions mediated by dorsal striatum and impairs, or heightens to a pathological degree, operations ascribed to ventral striatum. We consider the extant literature in light of this principle. We also survey the effect of @entity935 replacement on functional neuroimaging in @entity191 relating the findings to this framework. This paper highlights the fact that currently, titration of therapy in @entity191 is geared to optimizing dorsal striatum-mediated motor symptoms, at the expense of ventral striatum operations. Increased awareness of contrasting effects of @entity935 replacement on dorsal versus ventral striatum functions will lead clinicians to survey a broader range of symptoms in determining optimal therapy, taking into account both those aspects of cognition that will be helped versus those that will be hindered by dopaminergic treatment.
