Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 10029 New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, 10029 New York, NY, USA.
School of Pharmacy, Pharmacology Unit, University of Camerino, 62032 Camerino, Italy.
Neurosci Biobehav Rev. 2018 Feb;85:117-125. doi: 10.1016/j.neubiorev.2017.05.019. Epub 2017 May 29.
Substance use disorders continue to impose increasing medical, financial and emotional burdens on society in the form of morbidity and overdose, family disintegration, loss of employment and crime, while advances in prevention and treatment options remain limited. Importantly, not all individuals exposed to abused substances effectively develop the disease. Genetic factors play a significant role in determining addiction vulnerability and interactions between innate predisposition, environmental factors and personal experiences are also critical. Thus, understanding individual differences that contribute to the initiation of substance use as well as on long-term maladaptations driving compulsive drug use and relapse propensity is of critical importance to reduce this devastating disorder. In this paper, we discuss current topics in the field of addiction regarding individual vulnerability related to behavioral endophenotypes, neural circuits, as well as genetics and epigenetic mechanisms. Expanded knowledge of these factors is of importance to improve and personalize prevention and treatment interventions in the future.
物质使用障碍继续以发病率和过量用药、家庭破裂、失业和犯罪的形式给社会带来越来越大的医疗、经济和情感负担,而预防和治疗选择的进展仍然有限。重要的是,并非所有接触滥用物质的人都能有效地患上这种疾病。遗传因素在确定成瘾易感性方面起着重要作用,先天倾向、环境因素和个人经历之间的相互作用也至关重要。因此,了解导致物质使用开始以及长期适应不良导致强迫性药物使用和复发倾向的个体差异对于减少这种毁灭性疾病至关重要。在本文中,我们讨论了成瘾领域中与行为表型、神经回路以及遗传和表观遗传机制相关的个体易感性的当前主题。这些因素的知识扩展对于改善和个性化未来的预防和治疗干预措施很重要。