Blum Kenneth, Oscar-Berman Marlene, Stuller Elizabeth, Miller David, Giordano John, Morse Siobhan, McCormick Lee, Downs William B, Waite Roger L, Barh Debmalya, Neal Dennis, Braverman Eric R, Lohmann Raquel, Borsten Joan, Hauser Mary, Han David, Liu Yijun, Helman Manya, Simpatico Thomas
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.
J Addict Res Ther. 2012 Nov 27;3(5):139. doi: 10.4172/2155-6105.1000139.
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.
根据美国成瘾医学协会(ASAM)发布的成瘾新定义,众所周知,前往治疗中心接受化学物质依赖或其他有记录的奖励依赖行为治疗的个体,其大脑奖励回路受损。由于奖励神经回路受到遗传和/或环境负面压力,他们存在多巴胺能功能减退。这种损伤会导致异常的渴望行为以及其他行为,如物质使用障碍(SUD)。对动物和人类的神经遗传学研究表明,大脑奖励部位存在一个明确的级联反应,可导致多巴胺正常释放。这个级联反应被称为“大脑奖励级联”(BRC)。由于遗传或环境对该级联反应的任何影响而导致的损伤,都会使大脑奖励部位的多巴胺释放量减少。利用营养基因组学原理的神经营养疗法已成功实现对BRC的调控。经过四十多年的发展,神经营养疗法在合理应用时已带来重要的临床益处。本文结合多位成瘾专业人士的一些典型病例,对某些分子神经生物学机制进行综述,这些机制若被忽视可能会导致临床并发症。