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奖赏缺乏综合征:行为障碍的遗传学方面

Reward deficiency syndrome: genetic aspects of behavioral disorders.

作者信息

Comings D E, Blum K

机构信息

Department of Medical Genetics, City of Hope Medical Center, Duarte, CA 91010, USA.

出版信息

Prog Brain Res. 2000;126:325-41. doi: 10.1016/S0079-6123(00)26022-6.

Abstract

The dopaminergic and opioidergic reward pathways of the brain are critical for survival since they provide the pleasure drives for eating, love and reproduction; these are called 'natural rewards' and involve the release of dopamine in the nucleus accumbens and frontal lobes. However, the same release of dopamine and production of sensations of pleasure can be produced by 'unnatural rewards' such as alcohol, cocaine, methamphetamine, heroin, nicotine, marijuana, and other drugs, and by compulsive activities such as gambling, eating, and sex, and by risk taking behaviors. Since only a minority of individuals become addicted to these compounds or behaviors, it is reasonable to ask what factors distinguish those who do become addicted from those who do not. It has usually been assumed that these behaviors are entirely voluntary and that environmental factors play the major role; however, since all of these behaviors have a significant genetic component, the presence of one or more variant genes presumably act as risk factors for these behaviors. Since the primary neurotransmitter of the reward pathway is dopamine, genes for dopamine synthesis, degradation, receptors, and transporters are reasonable candidates. However, serotonin, norepinephrine, GABA, opioid, and cannabinoid neurons all modify dopamine metabolism and dopamine neurons. We have proposed that defects in various combinations of the genes for these neurotransmitters result in a Reward Deficiency Syndrome (RDS) and that such individuals are at risk for abuse of the unnatural rewards. Because of its importance, the gene for the [figure: see text] dopamine D2 receptor was a major candidate gene. Studies in the past decade have shown that in various subject groups the Taq I A1 allele of the DRD2 gene is associated with alcoholism, drug abuse, smoking, obesity, compulsive gambling, and several personality traits. A range of other dopamine, opioid, cannabinoid, norepinephrine, and related genes have since been added to the list. Like other behavioral disorders, these are polygenically inherited and each gene accounts for only a small per cent of the variance. Techniques such as the Multivariate Analysis of Associations, which simultaneously examine the contribution of multiple genes, hold promise for understanding the genetic make up of polygenic disorders.

摘要

大脑中的多巴胺能和阿片样物质奖赏通路对生存至关重要,因为它们为饮食、爱情和繁殖提供愉悦驱动力;这些被称为“自然奖赏”,涉及伏隔核和额叶中多巴胺的释放。然而,“非自然奖赏”,如酒精、可卡因、甲基苯丙胺、海洛因、尼古丁、大麻及其他毒品,以及强迫性活动,如赌博、饮食和性行为,还有冒险行为,也能产生相同的多巴胺释放和愉悦感。由于只有少数个体对这些化合物或行为上瘾,所以很有必要问一问,哪些因素区分了那些会上瘾的人和不会上瘾的人。通常认为这些行为完全是自愿的,环境因素起主要作用;然而,由于所有这些行为都有显著的遗传成分,一个或多个变异基因的存在大概是这些行为的风险因素。由于奖赏通路的主要神经递质是多巴胺,多巴胺合成、降解、受体和转运体的基因是合理的候选基因。然而,血清素、去甲肾上腺素、γ-氨基丁酸、阿片样物质和大麻素神经元都会改变多巴胺代谢和多巴胺神经元。我们提出,这些神经递质基因的各种组合缺陷会导致奖赏缺乏综合征(RDS),这类个体有滥用非自然奖赏的风险。由于其重要性,[图:见正文]多巴胺D2受体基因是一个主要的候选基因。过去十年的研究表明,在不同的受试者群体中,DRD2基因的Taq I A1等位基因与酗酒、药物滥用、吸烟、肥胖、强迫性赌博以及几种人格特质有关。此后,一系列其他多巴胺、阿片样物质、大麻素、去甲肾上腺素及相关基因也被列入其中。与其他行为障碍一样,这些是多基因遗传的,每个基因仅占变异的一小部分。诸如多变量关联分析等技术,可同时检测多个基因的贡献,有望用于理解多基因疾病的基因组成。

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