Executive function in striatal disorders

Abstract

The striatum, part of the basal ganglia complex, has close anatomical and functional ties with the prefrontal and sensorimotor cortices being critical not only for movement planning but also for instrumental behavior (either goal-directed actions or habit formation), decision-making, working memory, learning, and reward. Conditions affecting the striatum, including not only movement disorders such as Parkinson’s and Huntington’s disease but also psychiatric conditions such as major depression and obsessive compulsive disorders and external factors such as chronic stress exposure, affect information processing in corticobasal ganglia loops and are associated with different aspects of executive dysfunction. Treatment of these conditions, particularly using dopaminergic agents, can partly revert such impairments but can also further aggravate the disbalance in modulatory pathways being also the cause for dysfunction. Executive dysfunction should be recognized as part of the clinical manifestations of striatal disorders and addressed adequately to promote patient’s well-being and autonomy.