Figure 13.4. Neurotransmitters involved in the control of the striatum. Aden.= adenosine; A2A=adenosine type 2A receptor; M1=muscarinic type 1 receptor;
symptoms. In support of this view, there is clinical evidence that the nonspecific adenosine antagonist theophylline augments the effects of L-dopa in the treatment of parkinsonian symptoms. Figure 13.4 summarizes the inter-relationships between these neurotransmitters in the striatum.
In SUMMARY, the Parkinsonian syndromes all show a marked degeneration of the nigrostriatal dopaminergic system which Hornykiewicz has designated the ''striatal dopaminergic deficiency syndromes''. Nevertheless, other neurotransmitter systems, such as those involving the cortical noradrenergic, serotonergic, cholinergic and somatostatin-containing neurons have also been shown to be defective. Such systems may be responsible for the intellectual and cognitive deterioration which frequently occurs in the advanced stage of the disease.
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