The Kenneth Blum Institute on Behavior & Neurogenetics, Austin, TX 78701, USA.
Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110, USA.
Int J Environ Res Public Health. 2022 Apr 30;19(9):5480. doi: 10.3390/ijerph19095480.
In 2021, over 100,000 people died prematurely from opioid overdoses. Neuropsychiatric and cognitive impairments are underreported comorbidities of reward dysregulation due to genetic antecedents and epigenetic insults. Recent genome-wide association studies involving millions of subjects revealed frequent comorbidity with substance use disorder (SUD) in a sizeable meta-analysis of depression. It found significant associations with the expression of NEGR1 in the hypothalamus and DRD2 in the nucleus accumbens, among others. However, despite the rise in SUD and neuropsychiatric illness, there are currently no standard objective brain assessments being performed on a routine basis. The rationale for encouraging a standard objective Brain Health Check (BHC) is to have extensive data available to treat clinical syndromes in psychiatric patients. The BHC would consist of a group of reliable, accurate, cost-effective, objective assessments involving the following domains: Memory, Attention, Neuropsychiatry, and Neurological Imaging. Utilizing primarily PUBMED, over 36 years of virtually all the computerized and written-based assessments of Memory, Attention, Psychiatric, and Neurological imaging were reviewed, and the following assessments are recommended for use in the BHC: Central Nervous System Vital Signs (Memory), Test of Variables of Attention (Attention), Millon Clinical Multiaxial Inventory III (Neuropsychiatric), and Quantitative Electroencephalogram/P300/Evoked Potential (Neurological Imaging). Finally, we suggest continuing research into incorporating a new standard BHC coupled with qEEG/P300/Evoked Potentials and genetically guided precision induction of "dopamine homeostasis" to diagnose and treat reward dysregulation to prevent the consequences of dopamine dysregulation from being epigenetically passed on to generations of our children.
2021 年，超过 10 万人因阿片类药物过量而过早死亡。由于遗传因素和表观遗传损伤，神经精神和认知障碍是奖赏调节障碍的报道较少的共病。最近涉及数百万人的全基因组关联研究在一项对抑郁症的大规模荟萃分析中发现，奖赏调节障碍与物质使用障碍（SUD）经常共病。它发现与下丘脑 NEGR1 的表达和伏隔核 DRD2 的表达等有显著关联。然而，尽管 SUD 和神经精神疾病有所增加，但目前并没有对常规进行标准的客观大脑评估。鼓励进行标准客观的大脑健康检查（BHC）的理由是为了有广泛的数据可用于治疗精神病患者的临床综合征。BHC 将包括一组可靠、准确、具有成本效益的客观评估，涉及以下领域：记忆、注意力、神经精神病学和神经影像学。主要利用 PUBMED，回顾了过去 36 年来几乎所有关于记忆、注意力、精神科和神经影像学的计算机化和书面评估，建议在 BHC 中使用以下评估：中枢神经系统生命体征（记忆）、变量测试注意力（注意力）、米伦临床多轴量表 III（神经精神病学）和定量脑电图/P300/诱发电位（神经影像学）。最后，我们建议继续研究将新的标准 BHC 与 qEEG/P300/诱发电位相结合，并结合基因指导的精确诱导“多巴胺稳态”，以诊断和治疗奖赏调节障碍，防止多巴胺调节障碍的后果通过表观遗传传递给我们的子孙后代。
