1
|
Blum K, Braverman ER, Gold MS, Dennen CA, Baron D, Thanos PK, Hanna C, Elman I, Gondre-Lewis MC, Ashford JW, Newberg A, Madigan MA, Jafari N, Zeine F, Sunder K, Giordano J, Barh D, Gupta A, Carney P, Bowirrat A, Badgaiyan RD. Addressing cortex dysregulation in youth through brain health check coaching and prophylactic brain development. INNOSC THERANOSTICS & PHARMACOLOGICAL SCIENCES 2024; 7:1472. [PMID: 38766548 PMCID: PMC11100020 DOI: 10.36922/itps.1472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
The Carter Center has estimated that the addiction crisis in the United States (US), if continues to worsen at the same rate, may cost the country approximately 16 trillion dollars by 2030. In recent years, the well-being of youth has been compromised by not only the coronavirus disease 2019 pandemic but also the alarming global opioid crisis, particularly in the US. Each year, deadly opioid drugs claim hundreds of thousands of lives, contributing to an ever-rising death toll. In addition, maternal usage of opioids and other drugs during pregnancy could compromise the neurodevelopment of children. A high rate of DNA polymorphic antecedents compounds the occurrence of epigenetic insults involving methylation of specific essential genes related to normal brain function. These genetic antecedent insults affect healthy DNA and mRNA transcription, leading to a loss of proteins required for normal brain development and function in youth. Myelination in the frontal cortex, a process known to extend until the late 20s, delays the development of proficient executive function and decision-making abilities. Understanding this delay in brain development, along with the presence of potential high-risk antecedent polymorphic variants or alleles and generational epigenetics, provides a clear rationale for embracing the Brain Research Commission's suggestion to mimic fitness programs with an adaptable brain health check (BHC). Implementing the BHC within the educational systems in the US and other countries could serve as an effective initiative for proactive therapies aimed at reducing juvenile mental health problems and eventually criminal activities, addiction, and other behaviors associated with reward deficiency syndrome.
Collapse
Affiliation(s)
- Kenneth Blum
- Division of Addiction Research and Education, Center for Sports, Exercise and Global Mental Health, Western University of Health Sciences, Pomona, California, United States of America
- The Kenneth Blum Behavioral and Neurogenetic Institute LLC, Austin, Texas, United States of America
- Faculty of Education and Psychology, Institute of Psychology, Eötvös Loránd University Budapest, Budapest, Hungary
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel
- Division of Personalized Medicine, Cross-Cultural Research and Educational Institute, San Clemente, California, United States of America
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Purba Medinipur, West Bengal, India
- Division of Personalized Recovery Science, Transplicegen Therapeutics, Llc., Austin, Tx., United of States
- Department of Psychiatry, University of Vermont, Burlington, Vermont, United States of America
- Department of Psychiatry, Boonshoft School of Medicine, Wright State University, Dayton, Ohio, United States of America
- Division of Personalized Medicine, Ketamine Clinic of South Florida, Pompano Beach, Florida, United States of America
| | - Eric R. Braverman
- The Kenneth Blum Behavioral and Neurogenetic Institute LLC, Austin, Texas, United States of America
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Catherine A. Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, Pennsylvania, United States of America
| | - David Baron
- Division of Addiction Research and Education, Center for Sports, Exercise and Global Mental Health, Western University of Health Sciences, Pomona, California, United States of America
| | - Panayotis K. Thanos
- Department of Psychology and Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Research Institute on Addictions, University of Buffalo, Buffalo, New York, United States of America
| | - Colin Hanna
- Department of Psychology and Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Research Institute on Addictions, University of Buffalo, Buffalo, New York, United States of America
| | - Igor Elman
- Cambridge Health Alliance, Harvard Medical School, Cambridge, Massachusetts, United States of America
| | - Marjorie C. Gondre-Lewis
- Department of Anatomy, Howard University School of Medicine, Washington, D.C., United States of America
| | - J. Wesson Ashford
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, United States of America
| | - Andrew Newberg
- Department of Integrative Medicine and Nutritional Sciences, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania, United States of America
| | - Margaret A. Madigan
- The Kenneth Blum Behavioral and Neurogenetic Institute LLC, Austin, Texas, United States of America
| | - Nicole Jafari
- Division of Personalized Medicine, Cross-Cultural Research and Educational Institute, San Clemente, California, United States of America
- Department of Human Development, California State University at Long Beach, Long Beach, California, United States of America
| | - Foojan Zeine
- Department of Human Development, California State University at Long Beach, Long Beach, California, United States of America
- Awareness Integration Institute, San Clemente, California, United States of America
| | - Keerthy Sunder
- Department of Health Science, California State University at Long Beach, Long Beach, California, United States of America
- Department of Psychiatry, University California, UC Riverside School of Medicine, Riverside, California, United States of America
| | - John Giordano
- Division of Personalized Medicine, Ketamine Clinic of South Florida, Pompano Beach, Florida, United States of America
| | - Debmayla Barh
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology, Purba Medinipur, West Bengal, India
| | - Ashim Gupta
- Future Biologics, Lawrenceville, Georgia, United States of America
| | - Paul Carney
- Division of Pediatric Neurology, University of Missouri Health Care-Columbia, Columbia, Missouri, United States of America
| | - Abdalla Bowirrat
- Department of Molecular Biology and Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, Mt. Sinai School of Medicine, New York City, New York, United States of America
| |
Collapse
|
2
|
Mide M, Mattiasson J, Norlin D, Sehlin H, Rasmusson J, Ljung S, Lindskog A, Petersson J, Saavedra F, Gordh AS. Internet-delivered therapist-assisted cognitive behavioral therapy for gambling disorder: a randomized controlled trial. Front Psychiatry 2023; 14:1243826. [PMID: 38146277 PMCID: PMC10749366 DOI: 10.3389/fpsyt.2023.1243826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/23/2023] [Indexed: 12/27/2023] Open
Abstract
Objectives Cognitive behavioral therapy (CBT) is the most promising treatment for gambling disorder (GD) but only 21% of those with problematic gambling seek treatment. CBT over the Internet might be one way to reach a larger population. The aim of this study was to assess the effectiveness of Internet-delivered CBT with therapist guidance compared to an active control treatment. Methods Using a single-blinded design, 71 treatment-seeking gamblers (18-75 years) diagnosed with GD were randomized to 8 weeks of Internet-delivered CBT guided by telephone support, or 8 weeks of Internet-delivered motivational enhancement paired with motivational interviewing via telephone (IMI). The primary outcome was gambling symptoms measured at a first face-to-face assessment, baseline (treatment start), every 2 weeks, post-treatment, and 6-month follow-up. Gambling expenditures, time spent gambling, depression, anxiety, cognitive distortions, and quality of life were assessed as secondary outcomes. Analysis was performed on the full analysis sample (n = 60), with intention-to-treat sensitivity analyses (n = 69). Results In the CBT group, 80% stayed in treatment until the final week, compared to 67% in IMI. Post-treatment and at 6-month follow-up, no differences were found between CBT and IMI for any outcome measure. An exploratory analysis of the total sample (n = 60) showed a significant effect of time during treatment on gambling symptoms (d, [95% CI] 0.52, [-1.15, 2.02]) and all secondary outcomes except the gambling diary (depression (0.89, [-1.07-2.65]); anxiety (0.69, [-1.20-2.38])); cognitive distortions (0.84, [-0.73-2.29]); quality of life (0.60, [-0.61-1.70])). Post-treatment, there were no clinical gambling symptoms in either group. Some deterioration was seen between post-treatment and 6-month follow-up on gambling symptoms (0.42, [-1.74-2.43]), depression (0.59, [-0.82-1.86]), and anxiety (0.30, [-0.99-1.48]). Additionally, it was observed that the largest reduction in gambling symptoms was between the first assessment and baseline. Conclusion Both treatments offered in this study were effective at reducing gambling symptoms. It is also possible that the process of change started before treatment, which gives promise to low-intensity interventions for GD. Additional research is needed as this approach could be both cost-effective and has the potential to reach more patients in need of treatment than is currently possible. Clinical trial registration https://www.isrctn.com/, identifier ISRCTN38692394.
Collapse
Affiliation(s)
- Mikael Mide
- Department of Addiction Medicine, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jessica Mattiasson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - David Norlin
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helena Sehlin
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Josefine Rasmusson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sofia Ljung
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Amanda Lindskog
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jonna Petersson
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Fanny Saavedra
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Söderpalm Gordh
- Department of Addiction Medicine, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Addiction and Dependency, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
3
|
Baenas I, Solé-Morata N, Granero R, Fernández-Aranda F, Pujadas M, Mora-Maltas B, Lucas I, Gómez-Peña M, Moragas L, del Pino-Gutiérrez A, Tapia J, de la Torre R, Potenza MN, Jiménez-Murcia S. Anandamide and 2-arachidonoylglycerol baseline plasma concentrations and their clinical correlate in gambling disorder. Eur Psychiatry 2023; 66:e97. [PMID: 37937379 PMCID: PMC10755577 DOI: 10.1192/j.eurpsy.2023.2460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 11/09/2023] Open
Abstract
INTRODUCTION Different components of the endocannabinoid (eCB) system such as their most well-known endogenous ligands, anandamide (AEA) and 2-arachidonoylglycerol (2-AG), have been implicated in brain reward pathways. While shared neurobiological substrates have been described among addiction-related disorders, information regarding the role of this system in behavioral addictions such as gambling disorder (GD) is scarce. AIMS Fasting plasma concentrations of AEA and 2-AG were analyzed in individuals with GD at baseline, compared with healthy control subjects (HC). Through structural equation modeling, we evaluated associations between endocannabinoids and GD severity, exploring the potentially mediating role of clinical and neuropsychological variables. METHODS The sample included 166 adult outpatients with GD (95.8% male, mean age 39 years old) and 41 HC. Peripheral blood samples were collected after overnight fasting to assess AEA and 2-AG concentrations (ng/ml). Clinical (i.e., general psychopathology, emotion regulation, impulsivity, personality) and neuropsychological variables were evaluated through a semi-structured clinical interview and psychometric assessments. RESULTS Plasma AEA concentrations were higher in patients with GD compared with HC (p = .002), without differences in 2-AG. AEA and 2-AG concentrations were related to GD severity, with novelty-seeking mediating relationships. CONCLUSIONS This study points to differences in fasting plasma concentrations of endocannabinoids between individuals with GD and HC. In the clinical group, the pathway defined by the association between the concentrations of endocannabinoids and novelty-seeking predicted GD severity. Although exploratory, these results could contribute to the identification of potential endophenotypic features that help optimize personalized approaches to prevent and treat GD.
Collapse
Affiliation(s)
- Isabel Baenas
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Doctoral Program in Medicine and Translational Research, University of Barcelona, Barcelona, Spain
| | - Neus Solé-Morata
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Roser Granero
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Mitona Pujadas
- Integrative Pharmacology and Systems Neuroscience Research Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Bernat Mora-Maltas
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Doctoral Program in Medicine and Translational Research, University of Barcelona, Barcelona, Spain
| | - Ignacio Lucas
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Mónica Gómez-Peña
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Laura Moragas
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
| | - Amparo del Pino-Gutiérrez
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Javier Tapia
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Doctoral Program in Medicine and Translational Research, University of Barcelona, Barcelona, Spain
| | - Rafael de la Torre
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona Spain
- Integrative Pharmacology and Systems Neuroscience Research Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (CEXS-UPF), Barcelona, Spain
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Child Study Center, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Department of Neuroscience, Yale University, New Haven, CT, USA
| | - Susana Jiménez-Murcia
- Department of Clinical Psychology, Bellvitge University Hospital, Barcelona, Spain
- CIBER Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III, Barcelona Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neuroscience Program, Bellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| |
Collapse
|