Blum Kenneth, Gondré-Lewis Marjorie, Steinberg Bruce, Elman Igor, Baron David, Modestino Edward J, Badgaiyan Rajendra D, Gold Mark S
Department of Psychiatry, Boonshoft School of Medicine, Dayton VA Medical Center, Wright State University, Dayton, OH, USA.
Department of Psychiatry, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA.
J Syst Integr Neurosci. 2018 Jun;4(1). doi: 10.15761/JSIN.1000191. Epub 2018 Feb 28.
The brain regions tied to pleasure can be triggered by engaging in sex, eating tasty food, watching a movie, accomplishments at school and athletics, consuming drugs, and noble efforts to help the community, the country, and the world. It is noteworthy that research suggests that the latter type of satisfaction, supporting the community, may result in the most substantial positive effects on our immune system. However, these pathways for these effects are not understood. Berridge and Kringelbach have suggested that pleasure is mediated by well-developed mesocorticolimbic circuitry and serves adaptive functions. In affective disorders, anhedonia (lack of pleasure) or dysphoria (negative affect) can result from a breakdown of that hedonic system. Most importantly, human neuroimaging investigations indicate that surprisingly similar circuitry is activated by quite diverse pleasures, suggesting a common neural pathway shared by all rewarding stimuli and behaviors. Over many years the controversy of dopamine involvement in pleasure/reward has led to confusion in terms, such as trying to separate motivation from pure pleasure (i.e., wanting versus liking). We take the position that animal studies cannot provide real clinical information that is described by self-reports in humans. On November 23, 2017, evidence for our concerns was revealed. A brain system involved in everything from addiction to autism appears to have evolved differently in humans than in apes, as reported by a large research team in the journal . To reiterate, the new findings by Sousa et al., also suggest the importance of not over-relying on rodent and even non-human primate studies. Extrapolations, when it comes to the concept of pleasure, dopamine, and reinforcement, are not supported by these data. Human experience and study are now much more critical and important. Extrapolations from non-humans to humans may be more fiction than fact. While this statement is bold it should not at all suggest that animal date is unimportant, that is not the case. It is extremely valuable in many aspects and we must encourage the development of animal models for disease. However, we must be cautious in our interpretation of results without leaping to conclusions that may be explained by follow-up human experiments and subsequent data. We are further proposing that in terms of overcoming a never -ending battle related to the current drug epidemic, the scientific community should realize that disturbing dopamine homeostasis by taking drugs or having a system compromised by genes or other epigenetic experiences, should be treated by alternative therapeutic modalities, expressed in this article as a realistic key goal. Application of genetic addiction risk (GARS™) testing and pro-dopamine regulation (KB220) should be considered along with other promising technologies including cognitive behavioral therapy, mind fullness, brain spotting and trauma therapy. Basic scientists have worked very hard to dis-entangle pleasure from incentive salience and learning signals in brain reward circuitry, but this work may be limited to animal models and rodents. A different consideration regarding the human reward systems is required.
与愉悦感相关的脑区可通过性行为、品尝美味食物、看电影、在学校和体育方面取得成就、吸毒以及为帮助社区、国家和世界所做的高尚努力而被触发。值得注意的是,研究表明,后一种类型的满足感,即支持社区,可能会对我们的免疫系统产生最显著的积极影响。然而,这些影响的途径尚不清楚。贝里奇和克林格尔巴赫认为,愉悦感是由发育完善的中脑边缘叶回路介导的,并具有适应性功能。在情感障碍中,快感缺失(缺乏愉悦感)或烦躁不安(消极情绪)可能是由于享乐系统的崩溃所致。最重要的是,人类神经影像学研究表明,令人惊讶的是,相当多样的愉悦感会激活相似的脑回路,这表明所有奖励性刺激和行为都共享一条共同的神经通路。多年来,关于多巴胺在愉悦/奖励中的作用的争议导致了术语上的混淆,比如试图将动机与纯粹的愉悦感区分开来(即想要与喜欢)。我们的立场是,动物研究无法提供人类自我报告中所描述的真实临床信息。2017年11月23日,我们所担忧的证据被揭示出来。正如一个大型研究团队在该期刊上所报道的,一个涉及从成瘾到自闭症等所有方面的脑系统在人类和猿类中的进化似乎有所不同。重申一下,苏萨等人的新发现也表明了不过度依赖啮齿动物甚至非人类灵长类动物研究的重要性。就愉悦感、多巴胺和强化的概念而言,这些数据并不支持从动物研究进行推断。人类的经验和研究现在更加关键和重要。从非人类到人类的推断可能更多是虚构而非事实。虽然这个说法很大胆,但这绝不是说动物数据不重要,事实并非如此。它在许多方面都极其有价值,我们必须鼓励开发疾病动物模型。然而,在解释结果时我们必须谨慎,不要急于得出可能由后续人类实验和后续数据所解释的结论。我们进一步提议,就克服与当前毒品泛滥相关的这场永无休止的斗争而言,科学界应该认识到,通过吸毒或因基因或其他表观遗传经历而使系统受损从而扰乱多巴胺内稳态,应该采用替代治疗方式来治疗,在本文中这被表述为一个现实的关键目标。应该考虑应用遗传成瘾风险(GARS™)检测和促多巴胺调节(KB22)以及其他有前景的技术,包括认知行为疗法、正念、脑点图和创伤疗法。基础科学家们非常努力地在脑奖励回路中区分愉悦感与动机显著性和学习信号,但这项工作可能仅限于动物模型和啮齿动物。对于人类奖励系统需要有不同的考量。