The role of dopaminergic signalling from physiology to neuroprotection in acute and chronic disorders

The dopaminergic system plays a central role in neuromodulation, involving motor control, reward, and cognition, and exerting its effects through five G protein-coupled receptors (DRD1-DRD5) with distinct tissue distributions and signalling mechanisms. While dopaminergic alterations are known to be associated to neuropsychiatric and movement disorders such as schizophrenia, Parkinson's disease, and Huntington's disease, growing evidence highlights a broader role in neurological and neurodegenerative conditions. This review explores the dopaminergic system's pathophysiological involvement in acute and chronic diseases such as stroke, spinal cord (SCI), traumatic brain (TBI) injury, and amyotrophic lateral sclerosis (ALS). Beyond characterizing its dysfunction, we aim to examine how this disrupted signalling contributes to the neurodegeneration underlying the neurological and neurodegenerative disorders discussed here, along with the associated pathophysiological factors of inflammation and altered plasticity. We further discuss emerging data supporting the potential of dopamine-based interventions not only to modulate disease mechanisms, but also to confer neuroprotection and reduce tissue damage in both acute and progressive neurodegeneration, while also considering sex-related dopamine alterations. By integrating findings across diverse conditions, we underscore the importance of advancing dopaminergic research beyond classical disease models into novel therapeutic territory.