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Madigan MA, Gupta A, Bowirrat A, Baron D, Badgaiyan RD, Elman I, Dennen CA, Braverman ER, Gold MS, Blum K. Precision Behavioral Management (PBM) and Cognitive Control as a Potential Therapeutic and Prophylactic Modality for Reward Deficiency Syndrome (RDS): Is There Enough Evidence? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116395. [PMID: 35681980 PMCID: PMC9180535 DOI: 10.3390/ijerph19116395] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 12/20/2022]
Abstract
This brief commentary aims to provide an overview of the available and relatively new precision management of reward deficiencies manifested as substance and behavioral disorders. Current and future advances, concepts, and the substantial evidential basis of this potential therapeutic and prophylactic treatment modality are presented. Precision Behavioral Management (PBM), conceptualized initially as Precision Addiction Management (PAM), certainly deserves consideration as an important modality for the treatment of impaired cognitive control in reward processing as manifested in people with neurobiologically expressed Reward Deficiency Syndrome (RDS).
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Affiliation(s)
- Margaret A. Madigan
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Ashim Gupta
- Future Biologics, Lawrenceville, GA 30043, USA;
| | - Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel 40700, Israel;
| | - David Baron
- Center for Psychiatry, Medicine, & Primary Care (Office of Provost), Division of Addiction Research & Education, Western University Health Sciences, Pomona, CA 91766, USA;
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, South Texas Veteran Health Care System, Audie L. Murphy Memorial VA Hospital, Long School of Medicine, University of Texas Medical Center, San Antonio, TX 78229, USA;
| | - Igor Elman
- Center for Pain and the Brain (P.A.I.N Group), Department of Anesthesiology, Critical Care & Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Catherine A. Dennen
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Eric R. Braverman
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Kenneth Blum
- The Kenneth Blum Behavioral & Neurogenetic Institute, LLC., Austin, TX 78701, USA; (M.A.M.); (C.A.D.); (E.R.B.)
- Center for Psychiatry, Medicine, & Primary Care (Office of Provost), Division of Addiction Research & Education, Western University Health Sciences, Pomona, CA 91766, USA;
- Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, 1053 Budapest, Hungary
- Department of Psychiatry, School of Medicine, University of Vermont, Burlington, VT 05405, USA
- Department of Psychiatry, Wright State University Boonshoft School of Medicine, Dayton VA Medical Centre, Dayton, OH 45324, USA
- Correspondence:
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Zmigrod L, Robbins TW. Dopamine, Cognitive Flexibility, and IQ: Epistatic Catechol-O-MethylTransferase:DRD2 Gene-Gene Interactions Modulate Mental Rigidity. J Cogn Neurosci 2021; 34:153-179. [PMID: 34818409 DOI: 10.1162/jocn_a_01784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Cognitive flexibility has been hypothesized to be neurochemically rooted in dopamine neurotransmission. Nonetheless, underpowered sample sizes and contradictory meta-analytic findings have obscured the role of dopamine genes in cognitive flexibility and neglected potential gene-gene interactions. In this largest neurocognitive-genetic study to date (n = 1400), single nucleotide polymorphisms associated with elevated prefrontal dopamine levels (catechol-O-methyltransferase; rs4680) and diminished striatal dopamine (C957T; rs6277) were both implicated in Wisconsin Card Sorting Test performance. Crucially, however, these genetic effects were only evident in low-IQ participants, suggesting high intelligence compensates for, and eliminates, the effect of dispositional dopamine functioning on flexibility. This interaction between cognitive systems may explain and resolve previous empirical inconsistencies in highly educated participant samples. Moreover, compensatory gene-gene interactions were discovered between catechol-O-methyltransferase and DRD2, such that genotypes conferring either elevated prefrontal dopamine or diminished striatal dopamine-via heightened striatally concentrated D2 dopamine receptor availability-are sufficient for cognitive flexibility, but neither is necessary. The study has therefore revealed a form of epistatic redundancy or substitutability among dopamine systems in shaping adaptable thought and action, thus defining boundary conditions for dopaminergic effects on flexible behavior. These results inform theories of clinical disorders and psychopharmacological interventions and uncover complex fronto-striatal synergies in human flexible cognition.
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Blum K, Khalsa J, Cadet JL, Baron D, Bowirrat A, Boyett B, Lott L, Brewer R, Gondré-Lewis M, Bunt G, Kazmi S, Gold MS. Cannabis-Induced Hypodopaminergic Anhedonia and Cognitive Decline in Humans: Embracing Putative Induction of Dopamine Homeostasis. Front Psychiatry 2021; 12:623403. [PMID: 33868044 PMCID: PMC8044913 DOI: 10.3389/fpsyt.2021.623403] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/05/2021] [Indexed: 02/01/2023] Open
Abstract
Over years, the regular use of cannabis has substantially increased among young adults, as indicated by the rise in cannabis use disorder (CUD), with an estimated prevalence of 8. 3% in the United States. Research shows that exposure to cannabis is associated with hypodopaminergic anhedonia (depression), cognitive decline, poor memory, inattention, impaired learning performance, reduced dopamine brain response-associated emotionality, and increased addiction severity in young adults. The addiction medicine community is increasing concern because of the high content of delta-9-tetrahydrocannabinol (THC) currently found in oral and vaping cannabis products, the cognitive effects of cannabis may become more pronounced in young adults who use these cannabis products. Preliminary research suggests that it is possible to induce 'dopamine homeostasis,' that is, restore dopamine function with dopamine upregulation with the proposed compound and normalize behavior in chronic cannabis users with cannabis-induced hypodopaminergic anhedonia (depression) and cognitive decline. This psychological, neurobiological, anatomical, genetic, and epigenetic research also could provide evidence to use for the development of an appropriate policy regarding the decriminalization of cannabis for recreational use.
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Affiliation(s)
- Kenneth Blum
- Western University Health Sciences, Pomona, CA, United States
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
- Department of Psychiatry, University of Vermont, Burlington, VT, United States
- Department of Psychiatry, Wright University Boonshoff School of Medicine, Dayton, OH, United States
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, School of Medicine, Washington, DC, United States
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, DHHS/NIH/NIDA Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - David Baron
- Western University Health Sciences, Pomona, CA, United States
| | - Abdalla Bowirrat
- Department of Neuroscience, Interdisciplinary Center (IDC), Herzliya, Israel
| | - Brent Boyett
- Bradford Health Services, Madison, AL, United States
| | - Lisa Lott
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Raymond Brewer
- Division of Nutrigenomics, Precision Translational Medicine, LLC., San Antonio, TX, United States
- Division of Nutrigenomics, Genomic Testing Center, Geneus Health, LLC., San Antonio, TX, United States
| | - Marjorie Gondré-Lewis
- Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC, United States
| | - Gregory Bunt
- Good Samaritan/Day Top Treatment Center, and NYU School of Medicine, New York, NY, United States
| | - Shan Kazmi
- College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, CA, United States
| | - Mark S. Gold
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, United States
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Foraita M, Howell T, Bennett P. Environmental influences on development of executive functions in dogs. Anim Cogn 2021; 24:655-675. [PMID: 33611642 DOI: 10.1007/s10071-021-01489-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/21/2021] [Accepted: 02/06/2021] [Indexed: 12/14/2022]
Abstract
Executive functions (EFs) are a set of cognitive processes used for effortful self-regulation of behaviour. They include inhibition, working memory, cognitive flexibility and, in some models, attention. In humans, socioeconomic factors and life experiences shape development of EFs. Domestic dogs (Canis familiaris) must often regulate their behaviour in the human environment (e.g. no jumping up on humans or chasing cats), and life experiences also probably influence the development of EFs in dogs. Research into dog cognition and behaviour has been thriving, and some methods used to explore these concepts (e.g. object-choice task, questionnaires measuring traits like distraction and aggression) are likely to be sensitive to differences in EFs, even if that is not their stated aim. Here we examine relevant studies to identify experiential factors which may influence the development of EFs in dogs living in human care. These are early experience, training, housing and stress. We conclude that the development of dogs' EFs may be negatively affected by hardships, and positively by surmountable challenges, early in life. Training methods appear important, with punishment-based methods leading to poorer dog EFs. Kennel environments seem to affect dog EFs negatively. While mild stressors might enhance the development of EFs, too much stress seems to have negative effects. Regulation of behaviour, a key outcome of EFs, is crucial for dogs' integration into human society. We should, therefore, strive to better understand how the environment shapes dogs' EFs.
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Affiliation(s)
- Maike Foraita
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Tiffani Howell
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Pauleen Bennett
- Anthrozoology Research Group, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Elton A, Allen JH, Yorke M, Khan F, Lin Q, Boettiger CA. High Trait Attention Promotes Resilience and Reduces Binge Drinking Among College Students With a Family History of Alcohol Use Disorder. Front Psychiatry 2021; 12:672863. [PMID: 34054623 PMCID: PMC8155514 DOI: 10.3389/fpsyt.2021.672863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/15/2021] [Indexed: 01/02/2023] Open
Abstract
Binge patterns of alcohol use among post-high school emerging adults are associated with both immediate negative consequences and increased risk of long-term drinking problems, particularly among individuals with a family history (FH) of alcohol use disorder (AUD). Therefore, the developmental time period of emerging adulthood, paired with the high-risk environment of college campuses, represents an important target for interventions. Attentional ability has recently emerged as a mediator of resilience to stress-related psychopathology and offers a potential neurocognitive target for interventions. We tested the hypothesis that attentional ability promotes resilience to binge drinking in a sample of 464 college students with (n = 221) or without (n = 243) familial risk for AUD. Two-way analyses of covariance (ANCOVA) tested effects of FH and self-reported binge drinking on attention scores from the Barratt Impulsiveness Scale (BIS). In addition, mediation analyses tested whether BIS attention scores mediated the relationship between Conner-Davidson Resilience Scale scores and binge drinking. ANCOVA results indicated a significant FH-by-binge drinking interaction (p = 0.008) in which FH positive subjects who did not binge drink had the fewest attention problems, consistent with a marker of resilience. Furthermore, BIS attention scores significantly mediated the effect of Conner-Davidson Resilience Scale scores on binge drinking, with stronger effects in FH positive subjects (p < 0.001) than FH negative subjects (p = 0.49). The findings suggest that attention promotes resilience to binge drinking in individuals with familial risk for AUD. Interventions targeting attentional ability in this high-risk population, particularly FH positive individuals with attention deficits, may serve to reduce binge drinking and its consequences.
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Affiliation(s)
- Amanda Elton
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - J Hunter Allen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Mya Yorke
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Farhan Khan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Qiaosen Lin
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Charlotte A Boettiger
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Bowles Center for Alcohol Studies, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Najafi H, Hosseini SM, Tavallaie M, Soltani BM. A Predicted Molecular Model for Development of Human Intelligence. NEUROCHEM J+ 2018. [DOI: 10.1134/s1819712418030091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Vitali M, Napolitano C, Berman MO, Minuto SF, Battagliese G, Attilia ML, Braverman ER, Romeo M, Blum K, Ceccanti M. Neurophysiological Measures and Alcohol Use Disorder (AUD): Hypothesizing Links between Clinical Severity Index and Molecular Neurobiological Patterns. ACTA ACUST UNITED AC 2016; 5. [PMID: 28090374 PMCID: PMC5231399 DOI: 10.4172/2155-6105.1000181] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Background In 1987, Cloninger proposed a clinical description and classification of different personality traits genetically defined and independent from each other. Moreover, he elaborated a specific test the TCI to investigate these traits/states. The study of craving in Alcohol Use Disorder (AUD) assumed a greater significance, since ever more data seems to suggest a direct correlation between high levels of craving and a higher risk of relapse in alcoholics. Thus, our study aim is to explore the possible correlations among TCI linked molecular neurobiological pattern (s), craving and alcohol addiction severity measures in a sample of Italian alcoholics. Materials and Methods 191 alcoholics were recruited in a Day Hospital (DH) setting at the Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome. After 7 days detoxification treatment a psychodiagnostic protocol was administered, including TCI, VAS-C, ASI and SADQ. All patients signed an Institutional Review Board (IRB) approved informed consent. Results Principally, we detected a significant positive correlation between HA-scale scores and the VAS scale: increasing in HA-scale corresponds to an increase in craving perception for both intensity (r=0.310; p ≤ 0.001) and frequency (r=0.246; p ≤ 0.001). Moreover, perception of dependence severity, measured with SADQ was also found to be significantly associated positively to both HA-scale (r=0.246; p ≤ 0.001) and NS-scale (r=0.224; p ≤ 0.01). While, for character scales, Persistence (r=−0.195; p=.008) and Self-directedness (r=−0.294; p ≤ 0.001) was negatively associated with ASI linked to alcohol problems. Self-directedness was also negatively correlated with ASI linked to family and social problems (r=−0.349; p ≤ 0.001), employment and support problems (r=−0.220; p=0.003) and psychiatric problems (r=−0.358; p ≤ 0.001). Cooperativeness was a negative correlate with Legal Problems (r=−0.173; p=0.019). and Self-Transcendence was positive correlated with Medical Problems (r=0.276; p ≤ 0.001) Conclusions In view of recent addiction neurobiological theories, such as the “Reward Deficiency Syndrome (RDS)” and the Koob model, our data could suggest that our cohort of patients could possibly be in a particular stage of the course of their addiction history. Thus, if our hypothesis will be confirmed, the TCI-based assessment of alcoholics would allow an optimization of the treatment. Clinicians understanding these newer concepts will be able to translate this information to their patients and potentially enhance clinical outcome (s), because it could suggest a functional hypothesis of neurotransmitter circuits that helps to frame the patient in his/her history of addiction.
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Affiliation(s)
- Mario Vitali
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Carmen Napolitano
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Marlene Oscar Berman
- Department of Psychiatry and Neurology, Boston University School of Medicine and Veterans Administration System, Boston, Massachusetts, USA
| | | | - Gemma Battagliese
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Maria Luisa Attilia
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Eric R Braverman
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA; Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA
| | - Marina Romeo
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
| | - Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, USA; Department of Clinical Neurology, Path Foundation, NY, New York, New York, USA; Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, California, USA; Department of Psychiatry & Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, Vermont, USA; Department of Nutrigenomics, RD Solutions, LLC, La Jolla, California, USA; Department of Personalized Medicine, IGENE, LLC, Austin, Texas, USA; Dominion Diagnostics, LLC, North Kingstown, Rhode Island, USA; Basic & Clinical Research Center, Victory Nutrition, LLC., Austin, Texas, USA
| | - Mauro Ceccanti
- Alcohol Addiction Program Latium Region Referral Center, Sapienza University of Rome
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Martelle SE, Raffield LM, Palmer ND, Cox AJ, Freedman BI, Hugenschmidt CE, Williamson JD, Bowden DW. Dopamine pathway gene variants may modulate cognitive performance in the DHS - Mind Study. Brain Behav 2016; 6:e00446. [PMID: 27066308 PMCID: PMC4797918 DOI: 10.1002/brb3.446] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 01/04/2016] [Accepted: 01/11/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is an established association between type 2 diabetes and accelerated cognitive decline. The exact mechanism linking type 2 diabetes and reduced cognitive function is less clear. The monoamine system, which is extensively involved in cognition, can be altered by type 2 diabetes status. Thus, this study hypothesized that sequence variants in genes linked to dopamine metabolism and associated pathways are associated with cognitive function as assessed by the Digit Symbol Substitution Task, the Modified Mini-Mental State Examination, the Stroop Task, the Rey Auditory-Verbal Learning Task, and the Controlled Oral Word Association Task for Phonemic and Semantic Fluency in the Diabetes Heart Study, a type 2 diabetes-enriched familial cohort (n = 893). METHODS To determine the effects of candidate variants on cognitive performance, genetic association analyses were performed on the well-documented variable number tandem repeat located in the 3' untranslated region of the dopamine transporter, as well as on single-nucleotide polymorphisms covering genes in the dopaminergic pathway, the insulin signaling pathway, and the convergence of both. Next, polymorphisms in loci of interest with strong evidence for involvement in dopamine processing were extracted from genetic datasets available in a subset of the cohort (n = 572) derived from Affymetrix(®) Genome-Wide Human SNP Array 5.0 and 1000 Genomes imputation from this array. RESULTS The candidate gene analysis revealed one variant from the DOPA decarboxylase gene, rs10499695, to be associated with poorer performance on a subset of Rey Auditory-Verbal Learning Task measuring retroactive interference (P = 0.001, β = -0.45). Secondary analysis of genome-wide and imputed data uncovered another DOPA decarboxylase variant, rs62445903, also associated with retroactive interference (P = 7.21 × 10(-7), β = 0.3). These data suggest a role for dopaminergic genes, specifically a gene involved in regulation of dopamine synthesis, in cognitive performance in type 2 diabetes.
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Affiliation(s)
- Susan E Martelle
- Department of Physiology and Pharmacology Wake Forest School of Medicine Winston - Salem North Carolina; Center for Genomics and Personalized Medicine Research Wake Forest School of Medicine Winston - Salem North Carolina
| | - Laura M Raffield
- Center for Genomics and Personalized Medicine Research Wake Forest School of Medicine Winston - Salem North Carolina
| | - Nichole D Palmer
- Center for Genomics and Personalized Medicine Research Wake Forest School of Medicine Winston - Salem North Carolina
| | - Amanda J Cox
- Molecular Basis of Disease Griffith University Southport Brisbane Queensland Australia
| | - Barry I Freedman
- Department of Internal Medicine, Nephrology Wake Forest School of Medicine Winston - Salem North Carolina
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Gerontology and Geriatric Medicine Wake Forest School of Medicine Winston - Salem North Carolina
| | - Jeff D Williamson
- Department of Internal Medicine, Gerontology and Geriatric Medicine Wake Forest School of Medicine Winston - Salem North Carolina
| | - Don W Bowden
- Center for Genomics and Personalized Medicine Research Wake Forest School of Medicine Winston - Salem North Carolina
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Richards JS, Arias Vásquez A, von Rhein D, van der Meer D, Franke B, Hoekstra PJ, Heslenfeld DJ, Oosterlaan J, Faraone SV, Buitelaar JK, Hartman CA. Adolescent behavioral and neural reward sensitivity: a test of the differential susceptibility theory. Transl Psychiatry 2016; 6:e771. [PMID: 27045841 PMCID: PMC4872395 DOI: 10.1038/tp.2016.37] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 12/27/2022] Open
Abstract
Little is known about the causes of individual differences in reward sensitivity. We investigated gene-environment interactions (GxE) on behavioral and neural measures of reward sensitivity, in light of the differential susceptibility theory. This theory states that individuals carrying plasticity gene variants will be more disadvantaged in negative, but more advantaged in positive environments. Reward responses were assessed during a monetary incentive delay task in 178 participants with and 265 without attention-deficit/hyperactivity disorder (ADHD), from N=261 families. We examined interactions between variants in candidate plasticity genes (DAT1, 5-HTT and DRD4) and social environments (maternal expressed emotion and peer affiliation). HTTLPR short allele carriers showed the least reward speeding when exposed to high positive peer affiliation, but the most when faced with low positive peer affiliation or low maternal warmth. DAT1 10-repeat homozygotes displayed similar GxE patterns toward maternal warmth on general task performance. At the neural level, DRD4 7-repeat carriers showed the least striatal activation during reward anticipation when exposed to high maternal warmth, but the most when exposed to low warmth. Findings were independent of ADHD severity. Our results partially confirm the differential susceptibility theory and indicate the importance of positive social environments in reward sensitivity and general task performance for persons with specific genotypes.
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Affiliation(s)
- J S Richards
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatry University Centre, Reinier Postlaan 12, 6525 GC Nijmegen, The Netherlands. E-mail:
| | - A Arias Vásquez
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D von Rhein
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D van der Meer
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - B Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P J Hoekstra
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D J Heslenfeld
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - J Oosterlaan
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - S V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - J K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - C A Hartman
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Blum K, Thompson B, Demotrovics Z, Femino J, Giordano J, Oscar-Berman M, Teitelbaum S, Smith DE, Roy AK, Agan G, Fratantonio J, Badgaiyan RD, Gold MS. The Molecular Neurobiology of Twelve Steps Program & Fellowship: Connecting the Dots for Recovery. JOURNAL OF REWARD DEFICIENCY SYNDROME 2015; 1:46-64. [PMID: 26306329 PMCID: PMC4545669 DOI: 10.17756/jrds.2015-008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
There are some who suggest that alcoholism and drug abuse are not diseases at all and that they are not consequences of a brain disorder as espoused recently by the American Society of Addiction Medicine (ASAM). Some would argue that addicts can quit on their own and moderate their alcohol and drug intake. When they present to a treatment program or enter the 12 Step Program & Fellowship, many addicts finally achieve complete abstinence. However, when controlled drinking fails, there may be successful alternatives that fit particular groups of individuals. In this expert opinion, we attempt to identify personal differences in recovery, by clarifying the molecular neurobiological basis of each step of the 12 Step Program. We explore the impact that the molecular neurobiological basis of the 12 steps can have on Reward Deficiency Syndrome (RDS) despite addiction risk gene polymorphisms. This exploration has already been accomplished in part by Blum and others in a 2013 Springer Neuroscience Brief. The purpose of this expert opinion is to briefly, outline the molecular neurobiological and genetic links, especially as they relate to the role of epigenetic changes that are possible in individuals who regularly attend AA meetings. It begs the question as to whether "12 steps programs and fellowship" does induce neuroplasticity and continued dopamine D2 receptor proliferation despite carrying hypodopaminergic type polymorphisms such as DRD2 A1 allele. "Like-minded" doctors of ASAM are cognizant that patients in treatment without the "psycho-social-spiritual trio," may not be obtaining the important benefits afforded by adopting 12-step doctrines. Are we better off with coupling medical assisted treatment (MAT) that favors combining dopamine agonist modalities (DAM) as possible histone-deacetylase activators with the 12 steps followed by a program that embraces either one or the other? While there are many unanswered questions, at least we have reached a time when "science meets recovery," and in doing so, can further redeem joy in recovery.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- IGENE, LLC., Austin, TX, USA
- RDSolutions, Del Mar, CA, USA
- National Institute for Holistic Medicine, North Miami Beach, FL, USA
| | - Benjamin Thompson
- Behavioral Neuroscience Program, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Zsolt Demotrovics
- Eötvös Loránd University, Institute of Psychology, Budapest, Hungary
| | - John Femino
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- Meadows Edge Recovery Center, North Kingstown, RI, USA
| | - John Giordano
- National Institute for Holistic Medicine, North Miami Beach, FL, USA
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy & Neurobiology, Boston University School of Medicine, and Boston VA Healthcare System, Boston, MA, USA
| | - Scott Teitelbaum
- Department of Psychiatry, School of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - David E. Smith
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
- Institute of Health & Aging, University of California at San Francisco, San Francisco, CA, USA
| | | | - Gozde Agan
- Dominion Diagnostics, Inc., North Kingstown, RI, USA
| | | | - Rajendra D. Badgaiyan
- Department of Psychiatry, University of Minnesota College of Medicine, Minneapolis, MN, USA
| | - Mark S. Gold
- Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA
- Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA
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11
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Zheng JO, Yu L, Huang DH, Cao XL, Chen ZR, Ye W. Reduced self-regulation of cerebrum contributes to executive impairment in patients with temporal lobe epilepsy. Int J Clin Exp Med 2015; 8:9610-9619. [PMID: 26309635 PMCID: PMC4538127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/28/2015] [Indexed: 06/04/2023]
Abstract
The aim of this study was to investigate the role of self-regulation of cerebrum in the executive impairment. 22 subjects were enrolled were assessed by a neuropsychological test of executive function using attentional networks test and the cerebral activity was evaluated by functional magnetic resonance imaging. The patients with TLE had a longer reaction time than controls (P < 0.05). Moreover, the healthy controls showed more right hemisphere lateralized activation in incongruent tasks. Finally, both positively and negatively correlated cerebral areas were found in the healthy controls but only negatively correlated cerebral areas were found in the TLE patients. Reduced cerebral lead to areas and lack of activation of right midline positively self-regulatory cerebral areas may executive impairment in TLE patients.
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Affiliation(s)
- Jin-Ou Zheng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, China
| | - Lu Yu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, China
| | - Dong-Hong Huang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, China
| | - Xiao-Li Cao
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, China
| | - Zi-Rong Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, China
| | - Wei Ye
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical UniversityNanning, Guangxi 530021, China
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12
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Blum K, Thanos PK, Badgaiyan RD, Febo M, Oscar-Berman M, Fratantonio J, Demotrovics Z, Gold MS. Neurogenetics and gene therapy for reward deficiency syndrome: are we going to the Promised Land? Expert Opin Biol Ther 2015; 15:973-85. [PMID: 25974314 DOI: 10.1517/14712598.2015.1045871] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Addiction is a substantial health issue with limited treatment options approved by the FDA and as such currently available. The advent of neuroimaging techniques that link neurochemical and neurogenetic mechanisms to the reward circuitry brain function provides a framework for potential genomic-based therapies. AREAS COVERED Through candidate and genome-wide association studies approaches, many gene polymorphisms and clusters have been implicated in drug, food and behavioral dependence linked by the common rubric reward deficiency syndrome (RDS). The results of selective studies that include the role of epigenetics, noncoding micro RNAs in RDS behaviors especially drug abuse involving alcohol, opioids, cocaine, nicotine, pain and feeding are reviewed in this article. New targets for addiction treatment and relapse prevention, treatment alternatives such as gene therapy in animal models, and pharmacogenomics and nutrigenomics methods to manipulate transcription and gene expression are explored. EXPERT OPINION The recognition of the clinical benefit of early genetic testing to determine addiction risk stratification and dopaminergic agonistic, rather than antagonistic therapies are potentially the genomic-based wave of the future. In addition, further development, especially in gene transfer work and viral vector identification, could make gene therapy for RDS a possibility in the future.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine , Gainesville, FL , USA
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13
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The neural and genetic basis of executive function: attention, cognitive flexibility, and response inhibition. Pharmacol Biochem Behav 2013; 123:45-54. [PMID: 23978501 DOI: 10.1016/j.pbb.2013.08.007] [Citation(s) in RCA: 257] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 07/28/2013] [Accepted: 08/14/2013] [Indexed: 12/11/2022]
Abstract
Executive function is a collection of cognitive processes essential for higher order mental function. Processes involved in executive function include, but are not limited to, working memory, attention, cognitive flexibility, and impulse control. These complex behaviors are largely mediated by prefrontal cortical function but are modulated by dopaminergic, noradrenergic, serotonergic, and cholinergic input. The ability of these neurotransmitter systems to modulate executive function allows for adaptation in cognitive behavior in response to changes in the environment. Because of the important role these neurotransmitter systems play in regulating executive function, changes in these systems can also have a grave impact on executive function. In addition, polymorphisms in genes associated with these neurotransmitters are associated with phenotypic differences in executive function. Understanding how these naturally occurring polymorphisms contribute to different executive function phenotypes will advance basic knowledge of cognition and potentially further understanding and treatment of mental illness that involve changes in executive function. In this review, we will examine the influence of dopamine, norepinephrine, serotonin, and acetylcholine on the following measures of executive function: attention, cognitive flexibility, and impulse control. We will also review the effects of polymorphisms in genes associated with these neurotransmitter systems on these measures of executive function.
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14
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Hill E, Han D, Dumouchel P, Dehak N, Quatieri T, Moehs C, Oscar-Berman M, Giordano J, Simpatico T, Blum K. Long term Suboxone™ emotional reactivity as measured by automatic detection in speech. PLoS One 2013; 8:e69043. [PMID: 23874860 PMCID: PMC3706486 DOI: 10.1371/journal.pone.0069043] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 05/19/2013] [Indexed: 11/19/2022] Open
Abstract
Addictions to illicit drugs are among the nation's most critical public health and societal problems. The current opioid prescription epidemic and the need for buprenorphine/naloxone (Suboxone®; SUBX) as an opioid maintenance substance, and its growing street diversion provided impetus to determine affective states ("true ground emotionality") in long-term SUBX patients. Toward the goal of effective monitoring, we utilized emotion-detection in speech as a measure of "true" emotionality in 36 SUBX patients compared to 44 individuals from the general population (GP) and 33 members of Alcoholics Anonymous (AA). Other less objective studies have investigated emotional reactivity of heroin, methadone and opioid abstinent patients. These studies indicate that current opioid users have abnormal emotional experience, characterized by heightened response to unpleasant stimuli and blunted response to pleasant stimuli. However, this is the first study to our knowledge to evaluate "true ground" emotionality in long-term buprenorphine/naloxone combination (Suboxone™). We found in long-term SUBX patients a significantly flat affect (p<0.01), and they had less self-awareness of being happy, sad, and anxious compared to both the GP and AA groups. We caution definitive interpretation of these seemingly important results until we compare the emotional reactivity of an opioid abstinent control using automatic detection in speech. These findings encourage continued research strategies in SUBX patients to target the specific brain regions responsible for relapse prevention of opioid addiction.
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Affiliation(s)
- Edward Hill
- Department of Software and Information Technology Engineering, École de Technologie Supérieure - Université du Québec, Montréal, Québec, Canada
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Pierre Dumouchel
- Department of Software and Information Technology Engineering, École de Technologie Supérieure - Université du Québec, Montréal, Québec, Canada
| | - Najim Dehak
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Thomas Quatieri
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, Massachusetts, United States of America
| | - Charles Moehs
- Occupational Medicine Associates, Watertown, New York, United States of America
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy and Neurobiology, Boston University School of Medicine, and Boston Veteran Affaires Healthcare System, Boston, Massachusetts, United States of America
| | - John Giordano
- G & G Holistic Health Care Services, LLC., North Miami Beach, Florida, United States of America
| | - Thomas Simpatico
- Global Integrated Services Unit University of Vermont Center for Clinical and Translational Science, College of Medicine, Burlington, Vermont, United States of America
| | - Kenneth Blum
- G & G Holistic Health Care Services, LLC., North Miami Beach, Florida, United States of America
- Global Integrated Services Unit University of Vermont Center for Clinical and Translational Science, College of Medicine, Burlington, Vermont, United States of America
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, United States of America
- Dominion Diagnostics, LLC, North Kingstown, Rhode Island, United States of America
- Department of Clinical Neurology, Path Foundation New York, New York, United States of America
- Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu Beach, California, United States of America
- Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India
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15
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Kushner S, Han D, Oscar-Berman M, William Downs B, Madigan MA, Giordano J, Beley T, Jones S, Barh D, Simpatico T, Dushaj K, Lohmann R, Braverman ER, Schoenthaler S, Ellison D, Blum K. Declinol, a Complex Containing Kudzu, Bitter Herbs (Gentian, Tangerine Peel) and Bupleurum, Significantly Reduced Alcohol Use Disorders Identification Test (AUDIT) Scores in Moderate to Heavy Drinkers: A Pilot Study. ACTA ACUST UNITED AC 2013; 4. [PMID: 24273684 DOI: 10.4172/2155-6105.1000153] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
It is well established that inherited human aldehyde dehydrogenase 2 (ALDH-2) deficiency reduces the risk for alcoholism. Kudzu plants and extracts have been used for 1,000 years in traditional Chinese medicine to treat alcoholism. Kudzu contains daidzin, which inhibits ALDH-2 and suppresses heavy drinking in rodents. Decreased drinking due to ALDH-2 inhibition is attributed to aversive properties of acetaldehyde accumulated during alcohol consumption. However not all of the anti-alcohol properties of diadzin are due to inhibition of ALDH-2. This is in agreement with our earlier work showing significant interaction effects of both pyrozole (ALDH-2 inhibitor) and methyl-pyrozole (non-inhibitor) and ethanol's depressant effects. Moreover, it has been suggested that selective ALDH 2 inhibitors reduce craving for alcohol by increasing dopamine in the nucleus accumbens (NAc). In addition there is significant evidence related to the role of the genetics of bitter receptors (TAS2R) and its stimulation as an aversive mechanism against alcohol intake. The inclusion of bitters such as Gentian & Tangerine Peel in Declinol provides stimulation of gut TAS2R receptors which is potentially synergistic with the effects of Kudzu. Finally the addition of Radix Bupleuri in the Declinol formula may have some protective benefits not only in terms of ethanol induced liver toxicity but neurochemical actions involving endorphins, dopamine and epinephrine. With this information as a rationale, we report herein that this combination significantly reduced Alcohol Use Disorders Identification Test (AUDIT) scores administered to ten heavy drinkers (M=8, F=2; 43.2 ± 14.6 years) attending a recovery program. Specifically, from the pre-post comparison of the AUD scores, it was found that the score of every participant decreased after the intervention which ranged from 1 to 31. The decrease in the scores was found to be statistically significant with the p-value of 0.00298 (two-sided paired test; p-value = 0.00149 for one-sided test). Albeit this being a small pilot, we are encouraged about these significant results, and caution any interpretation until larger controlled studies are executed.
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Affiliation(s)
- Steven Kushner
- Department of Nutritional Science, ALM Research & Development, Inc., Tampa, FL, USA
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16
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Blum K, Oscar-Berman M, Stuller E, Miller D, Giordano J, Morse S, McCormick L, Downs WB, Waite RL, Barh D, Neal D, Braverman ER, Lohmann R, Borsten J, Hauser M, Han D, Liu Y, Helman M, Simpatico T. Neurogenetics and Nutrigenomics of Neuro-Nutrient Therapy for Reward Deficiency Syndrome (RDS): Clinical Ramifications as a Function of Molecular Neurobiological Mechanisms. ACTA ACUST UNITED AC 2013; 3:139. [PMID: 23926462 DOI: 10.4172/2155-6105.1000139] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In accord with the new definition of addiction published by American Society of Addiction Medicine (ASAM) it is well-known that individuals who present to a treatment center involved in chemical dependency or other documented reward dependence behaviors have impaired brain reward circuitry. They have hypodopaminergic function due to genetic and/or environmental negative pressures upon the reward neuro-circuitry. This impairment leads to aberrant craving behavior and other behaviors such as Substance Use Disorder (SUD). Neurogenetic research in both animal and humans revealed that there is a well-defined cascade in the reward site of the brain that leads to normal dopamine release. This cascade has been termed the "Brain Reward Cascade" (BRC). Any impairment due to either genetics or environmental influences on this cascade will result in a reduced amount of dopamine release in the brain reward site. Manipulation of the BRC has been successfully achieved with neuro-nutrient therapy utilizing nutrigenomic principles. After over four decades of development, neuro-nutrient therapy has provided important clinical benefits when appropriately utilized. This is a review, with some illustrative case histories from a number of addiction professionals, of certain molecular neurobiological mechanisms which if ignored may lead to clinical complications.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry, University of Florida, McKnight Brain Institute, Gainesville, Fl, 100183, USA ; Department of Nutrigenomic, LifeGen, Inc. San Diego, CA, 92101, USA ; Department of Holistic Medicine, G&G Holistic Addiction Treatment Center, North Miami Beach, Fl, 33162, USA ; Center for Genomics and Applied Gene Technology, Institute of Integrative Omics and applied Biotechnology (IIOAB), Nonakuri, Purbe Medinpur, West Bengal, 721172, India ; Path Foundation NY, New York, 10001, New York USA ; Malibu Beach Recovery Center, Malibu Beach, California, 9026, USA ; Dominion Diagnostics, North Kingstown Rhode Island, 02852, USA ; Global Integrated Services Unit University of Vermont Center for Clinical & Translational Science, College of Medicine, Burlington, VT, USA
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