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Should Reward Deficiency Syndrome (RDS) Be Considered an Umbrella Disorder for Mental Illness and Associated Genetic and Epigenetic Induced Dysregulation of Brain Reward Circuitry? J Pers Med 2022; 12:jpm12101719. [PMID: 36294858 PMCID: PMC9604605 DOI: 10.3390/jpm12101719] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 11/30/2022] Open
Abstract
Reward Deficiency Syndrome (RDS) is defined as a breakdown of reward neurotransmission that results in a wide range of addictive, compulsive, and impulsive behaviors. RDS is caused by a combination of environmental (epigenetic) influences and DNA-based (genetic) neurotransmission deficits that interfere with the normal satisfaction of human physiological drives (i.e., food, water, and sex). An essential feature of RDS is the lack of integration between perception, cognition, and emotions that occurs because of (1) significant dopaminergic surges in motivation, reward, and learning centers causing neuroplasticity in the striato-thalamic-frontal cortical loop; (2) hypo-functionality of the excitatory glutamatergic afferents from the amygdala-hippocampus complex. A large volume of literature regarding the known neurogenetic and psychological underpinnings of RDS has revealed a significant risk of dopaminergic gene polymorphic allele overlap between cohorts of depression and subsets of schizophrenia. The suggestion is that instead of alcohol, opioids, gambling disorders, etc. being endophenotypes, the true phenotype is RDS. Additionally, reward deficiency can result from depleted or hereditary hypodopaminergia, which can manifest as a variety of personality traits and mental/medical disorders that have been linked to genetic studies with dopamine-depleting alleles. The carrying of known DNA antecedents, including epigenetic insults, results in a life-long vulnerability to RDS conditions and addictive behaviors. Epigenetic repair of hypodopaminergia, the causative basis of addictive behaviors, may involve precision DNA-guided therapy achieved by combining the Genetic Addiction Risk Severity (GARS) test with a researched neutraceutical having a number of variant names, including KB220Z. This nutraceutical formulation with pro-dopamine regulatory capabilities has been studied and published in peer-reviewed journals, mostly from our laboratory. Finally, it is our opinion that RDS should be given an ICD code and deserves to be included in the DSM-VI because while the DSM features symptomology, it is equally important to feature etiological roots as portrayed in the RDS model.
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Exploring dopaminergic transmission in gambling addiction: A systematic translational review. Neurosci Biobehav Rev 2020; 119:481-511. [DOI: 10.1016/j.neubiorev.2020.09.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/16/2020] [Accepted: 09/26/2020] [Indexed: 12/15/2022]
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Das A, Pagliaroli L, Vereczkei A, Kotyuk E, Langstieh B, Demetrovics Z, Barta C. Association of GDNF and CNTNAP2 gene variants with gambling. J Behav Addict 2019; 8:471-478. [PMID: 31446765 PMCID: PMC7044627 DOI: 10.1556/2006.8.2019.40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Some form of gambling can be observed in nearly every society, as the gratification felt upon winning in uncertain conditions is universal. A culturally distinct form of gambling, associated with a traditional sporting event of archery known as "teer," is innate to the province of Meghalaya, India. The objective of this study was to find genetic variants underlying this unique form of behavioral addiction. To better understand game-based gambling, we studied genetic variants related to dopaminergic pathways and other genes previously linked to various psychological disorders. METHODS This study was carried out on a sample of 196 Indo-Aryan adults from Shillong, Meghalaya. Genotyping of glial cell line-derived neurotrophic factor (GDNF) polymorphisms was carried out using real-time PCR. We further investigated 32 single nucleotide polymorphisms located in the 3' UTR of additional genes of interest using an OpenArray® real-time PCR platform. RESULTS Case-control analysis revealed a significant association between GDNF variant rs2973033 (p = .00864, χ2 = 13.132, df = 2) and contactin-associated protein-like 2 (CNTNAP2) variant rs2530311 (p = .0448, χ2 = 13.132, df = 2) with gambling. DISCUSSION AND CONCLUSIONS Association of the GDNF gene with gambling could be attributed to its involvement in the development and survival of dopaminergic neurons. Our result is in good agreement with previous data indicating the role of GDNF in certain substance addictions. Several rare variants in the CNTNAP2 gene were also implicated in alcohol addiction in a previous study. This pilot study provides further support for the role of GDNF and CNTNAP2 in addiction behaviors.
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Affiliation(s)
- Arundhuti Das
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary,Department of Anthropology, Utkal University, Bhubaneswar, India,Indian Council of Medical Research, Regional Medical Research Center, Bhubaneswar, India
| | - Luca Pagliaroli
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Andrea Vereczkei
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Eszter Kotyuk
- MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Banrida Langstieh
- Department of Anthropology, North Eastern Hill University, Shillong, India
| | - Zsolt Demetrovics
- MTA-ELTE Lendület Adaptation Research Group, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary,Corresponding author: Csaba Barta, MD, PhD; Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, 37-47 Tuzolto Street, Budapest, 1094, PO Box 260, Hungary; Phone: +36 1 459 1500 ext. 60137; Fax: +36 1 266 7480; E-mail:
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Abstract
Gambling disorder is characterized by a persistent, recurrent pattern of gambling that is associated with substantial distress or impairment. The prevalence of gambling disorder has been estimated at 0.5% of the adult population in the United States, with comparable or slightly higher estimates in other countries. The aetiology of gambling disorder is complex, with implicated genetic and environmental factors. Neurobiological studies have implicated cortico-striato-limbic structures and circuits in the pathophysiology of this disorder. Individuals with gambling disorder often go unrecognized and untreated, including within clinical settings. Gambling disorder frequently co-occurs with other conditions, particularly other psychiatric disorders. Behavioural interventions, particularly cognitive-behavioural therapy but also motivational interviewing and Gamblers Anonymous, are supported in the treatment of gambling disorder. No pharmacological therapy has a formal indication for the treatment of gambling disorder, although placebo-controlled trials suggest that some medications, such as opioid-receptor antagonists, may be helpful. Given the associations with poor quality of life and suicide, improved identification, prevention, policy and treatment efforts are needed to help people with gambling disorder.
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Rumpf HJ, Petzold M, Bischof A, Bischof G. Mini-Review: Recovery without treatment in gambling disorder and problematic gambling. SUCHT 2018. [DOI: 10.1024/0939-5911/a000561] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Mini-Review: Überwindung von Glücksspielstörung und problematischem Glücksspielen ohne Behandlung Abstract. Zusammenfassung: Ziel: Eine Reihe von Studien konnte zeigen, dass im Bereich der substanzbezogenen Störungen Remissionen ohne formelle Hilfe weitverbreit sind. Weniger ist dazu im Bereich von Verhaltenssüchten bekannt. Ziel ist eine Übersicht zur Datenlage unbehandelter Remission bei Glücksspielstörungen zur Verfügung zu stellen. Methode: Es wurde eine systematische Recherche in PubMed and Web of Science durchgeführt. Nach Ausschluss von Duplikaten wurden 152 Publikationen hinsichtlich Relevanz und Einschlusskriterien geprüft. Insgesamt konnten 8 Studien für dieses Review genutzt werden. Ergebnisse: Etwa 80 % aller Remittierten – mit höheren Raten bei Männern im Vergleich zu Frauen – nutzen keine formale Hilfe. Remittierte mit Behandlung wiesen eine ausgeprägtere Schwere und mehr negative Konsequenzen auf. Die methodische Qualität der Studien weist deutliche Unterschiede auf und ist auf der einen Seite durch kleine Stichproben, Sample-Selection-Bias und wenig präzisen Erhebungsinstrumenten gekennzeichnet, während die Allgemeinbevölkerungsstudien eine sehr hohe Qualität aufweisen. Schlussfolgerung: Die Ergebnisse zeigen Ähnlichkeiten zu Befunden in Studien zu unbehandelter Remission bei substanzbezogenen Störungen auf. Die geringe Anzahl der gefundenen Studie in dieser systematischen Übersicht weisen auf eine Forschungslücke hin. Dies ist in Anbetracht dessen, dass solche Studien wertvolle Hinweise für die Prävention und Behandlung zur Vermeidung und Überwindung von Glücksspielstörungen ermöglichen, bedauerlich.
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Affiliation(s)
| | | | - Anja Bischof
- University of Lübeck, Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, Research Group S:TEP
| | - Gallus Bischof
- University of Lübeck, Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, Research Group S:TEP
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Potenza MN. Clinical neuropsychiatric considerations regarding nonsubstance or behavioral addictions. DIALOGUES IN CLINICAL NEUROSCIENCE 2018. [PMID: 29302225 PMCID: PMC5741111 DOI: 10.31887/dcns.2017.19.3/mpotenza] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Over the past several decades, non-substance-use behaviors like gambling, gaming, and sex have received greater consideration as possible foci of addictions. In this article, I will review the recent history and current status of non-substance or behavioral addictions. A main focus will involve gambling and gambling disorder, given that the latter is currently the sole non-substance addictive disorder described in the main text of the current (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Internet gaming disorder, currently in the DSM-5 section addressing conditions that may need additional research, will also be considered, as will the concept of Internet addiction. Compulsive sexual behaviors (including problematic pornography use) will be considered, particularly with respect to how behavioral addictions may be considered in the forthcoming 11th edition of the International Classification of Diseases (ICD-11).
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Affiliation(s)
- Marc N Potenza
- Department of Psychiatry, Child Study Center, the National Center on Addiction and Substance Abuse, Yale University School of Medicine and the Connecticut Mental Health Center, Connecticut, USA
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Blum K, Badgaiyan RD, Dunston GM, Baron D, Modestino EJ, McLaughlin T, Steinberg B, Gold MS, Gondré-Lewis MC. The DRD2 Taq1A A1 Allele May Magnify the Risk of Alzheimer's in Aging African-Americans. Mol Neurobiol 2018; 55:5526-5536. [PMID: 28965318 PMCID: PMC5878111 DOI: 10.1007/s12035-017-0758-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 08/27/2017] [Indexed: 12/11/2022]
Abstract
Alzheimer's disease is an irreversible, progressive brain disorder that slowly destroys cognitive skills and the ability to perform the simplest tasks. More than 5 million Americans are afflicted with Alzheimer's; a disorder which ranks third, just behind heart disease and cancer, as a cause of death for older people. With no real cure and in spite of enormous efforts worldwide, the disease remains a mystery in terms of treatment. Importantly, African-Americans are two times as likely as Whites to develop late-onset Alzheimer's disease and less likely to receive timely diagnosis and treatment. Dopamine function is linked to normal cognition and memory and carriers of the DRD2 Taq1A A1 allele have significant loss of D2 receptor density in the brain. Recent research has shown that A1 carriers have worse memory performance during long-term memory (LTM) updating, compared to non-carriers or A2-carriers. A1carriers also show less blood oxygen level-dependent (BOLD) activation in the left caudate nucleus which is important for LTM updating. This latter effect was only seen in older adults, suggesting magnification of genetic effects on brain functioning in the elderly. Moreover, the frequency of the A1 allele is 0.40 in African-Americans, with an approximate prevalence of the DRD2 A1 allele in 50% of an African-American subset of individuals. This is higher than what is found in a non-screened American population (≤ 28%) for reward deficiency syndrome (RDS) behaviors. Based on DRD2 known genetic polymorphisms, we hypothesize that the DRD2 Taq1A A1 allele magnifies the risk of Alzheimer's in aging African-Americans. Research linking this high risk for Alzheimer's in the African-American population, with DRD2/ANKK1-TaqIA polymorphism and neurocognitive deficits related to LTM, could pave the way for novel, targeted pro-dopamine homeostatic treatment.
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Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, USA
- Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California, Los Angeles, CA, USA
- Division of Applied Clinical Research & Education, Dominion Diagnostics, LLC, North Kingstown, RI, USA
- Department of Neurogenetics, Igene, LLC, Austin, TX, USA
- Division of Reward Deficiency Syndrome and Addiction Therapy, Nupathways, Inc., Innsbrook, MO, USA
- Department of Clinical Neurology, Path Foundation, New York, NY, USA
- Division of Neuroscience Based Addiction Therapy, The Shores Treatment & Recovery Center, Port Saint Lucie, FL, USA
- Eötvös Loránd University, Institute of Psychology, Budapest, Hungary
- Department of Psychiatry and Behavioral Health, Richmond University Medical Center, 355 Bard Avenue, Staten Island, NY, 10310, USA
- NeuroPsychoSocial Genomics Core, National Human Genome Center, Howard University, Washington, DC, USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry and Behavioral Health, Richmond University Medical Center, 355 Bard Avenue, Staten Island, NY, 10310, USA
| | - Georgia M Dunston
- NeuroPsychoSocial Genomics Core, National Human Genome Center, Howard University, Washington, DC, USA
| | - David Baron
- Department of Psychiatry and Behavioral Sciences, Keck Medicine University of Southern California, Los Angeles, CA, USA
| | | | | | | | - Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Marjorie C Gondré-Lewis
- NeuroPsychoSocial Genomics Core, National Human Genome Center, Howard University, Washington, DC, USA.
- Developmental Neuropsychopharmacology Laboratory, Department of Anatomy, Howard University College of Medicine, Washington, DC, USA.
- Department of Psychiatry and Behavioral Sciences, Howard University College of Medicine, Washington, DC, USA.
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