神经营养治疗奖励缺乏症(RDS)的神经遗传学和营养基因组学:作为分子神经生物学机制功能的临床后果。

Kenneth Blum, Marlene Oscar-Berman, Elizabeth Stuller, David Miller, John Giordano, Siobhan Morse, Lee McCormick, William B Downs, Roger L Waite, Debmalya Barh, Dennis Neal, Eric R Braverman, Raquel Lohmann, Joan Borsten, Mary Hauser, David Han, Yijun Liu, Manya Helman, Thomas Simpatico
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引用次数: 62

摘要

根据美国成瘾医学协会(ASAM)发布的成瘾新定义,众所周知,到治疗中心就诊的人涉及化学依赖或其他记录的奖励依赖行为,他们的大脑奖励回路受损。由于遗传和/或环境对奖励神经回路的负压力,它们具有低多巴胺能功能。这种损害导致了异常的渴望行为和其他行为,如物质使用障碍(SUD)。对动物和人类的神经遗传学研究表明,在大脑的奖赏区有一个明确的级联反应,导致正常的多巴胺释放。这种级联被称为“大脑奖励级联”(BRC)。由于遗传或环境影响导致的任何损伤都会导致大脑奖励部位多巴胺释放量的减少。利用营养基因组学原理的神经营养疗法已经成功地实现了BRC的操纵。经过四十多年的发展,神经营养疗法提供了重要的临床效益时,适当的利用。这是一个回顾,与一些说明性的案例历史,从一些成瘾专业人士,某些分子神经生物学机制,如果忽视可能导致临床并发症。
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Neurogenetics and Nutrigenomics of Neuro-Nutrient Therapy for Reward Deficiency Syndrome (RDS): Clinical Ramifications as a Function of Molecular Neurobiological Mechanisms.

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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