1
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Bowirrat A, Elman I, Dennen CA, Gondré-Lewis MC, Cadet JL, Khalsa J, Baron D, Soni D, Gold MS, McLaughlin TJ, Bagchi D, Braverman ER, Ceccanti M, Thanos PK, Modestino EJ, Sunder K, Jafari N, Zeine F, Badgaiyan RD, Barh D, Makale M, Murphy KT, Blum K. Neurogenetics and Epigenetics of Loneliness. Psychol Res Behav Manag 2023; 16:4839-4857. [PMID: 38050640 PMCID: PMC10693768 DOI: 10.2147/prbm.s423802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
Loneliness, an established risk factor for both, mental and physical morbidity, is a mounting public health concern. However, the neurobiological mechanisms underlying loneliness-related morbidity are not yet well defined. Here we examined the role of genes and associated DNA risk polymorphic variants that are implicated in loneliness via genetic and epigenetic mechanisms and may thus point to specific therapeutic targets. Searches were conducted on PubMed, Medline, and EMBASE databases using specific Medical Subject Headings terms such as loneliness and genes, neuro- and epigenetics, addiction, affective disorders, alcohol, anti-reward, anxiety, depression, dopamine, cancer, cardiovascular, cognitive, hypodopaminergia, medical, motivation, (neuro)psychopathology, social isolation, and reward deficiency. The narrative literature review yielded recursive collections of scientific and clinical evidence, which were subsequently condensed and summarized in the following key areas: (1) Genetic Antecedents: Exploration of multiple genes mediating reward, stress, immunity and other important vital functions; (2) Genes and Mental Health: Examination of genes linked to personality traits and mental illnesses providing insights into the intricate network of interaction converging on the experience of loneliness; (3) Epigenetic Effects: Inquiry into instances of loneliness and social isolation that are driven by epigenetic methylations associated with negative childhood experiences; and (4) Neural Correlates: Analysis of loneliness-related affective states and cognitions with a focus on hypodopaminergic reward deficiency arising in the context of early life stress, eg, maternal separation, underscoring the importance of parental support early in life. Identification of the individual contributions by various (epi)genetic factors presents opportunities for the creation of innovative preventive, diagnostic, and therapeutic approaches for individuals who cope with persistent feelings of loneliness. The clinical facets and therapeutic prospects associated with the current understanding of loneliness, are discussed emphasizing the relevance of genes and DNA risk polymorphic variants in the context of loneliness-related morbidity.
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Affiliation(s)
- Abdalla Bowirrat
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, 40700, Israel
| | - Igor Elman
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, 02139, USA
| | - Catherine A Dennen
- Department of Family Medicine, Jefferson Health Northeast, Philadelphia, PA, USA
| | - Marjorie C Gondré-Lewis
- Neuropsychopharmacology Laboratory, Department of Anatomy, Howard University College of Medicine, Washington, DC, 20059, USA
| | - Jean Lud Cadet
- Molecular Neuropsychiatry Research Branch, NIH National Institute on Drug Abuse, Bethesda, MD, 20892, USA
| | - Jag Khalsa
- Department of Microbiology, Immunology and Tropical Medicine, George Washington University, School of Medicine, Washington, DC, USA
| | - David Baron
- Division of Addiction Research & Education, Center for Sports, Exercise, and Mental Health, Western University of Health Sciences, Pomona, CA, 91766, USA
| | - Diwanshu Soni
- Western University Health Sciences School of Medicine, Pomona, CA, USA
| | - Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Thomas J McLaughlin
- Division of Reward Deficiency Clinics, TranspliceGen Therapeutics, Inc, Austin, TX, USA
| | - Debasis Bagchi
- Department of Pharmaceutical Sciences, Texas Southern University College of Pharmacy, Houston, TX, USA
| | - Eric R Braverman
- Division of Clinical Neurology, The Kenneth Blum Institute of Neurogenetics & Behavior, LLC, Austin, TX, USA
| | - Mauro Ceccanti
- Alcohol Addiction Program, Latium Region Referral Center, Sapienza University of Rome, Roma, 00185, Italy
| | - Panayotis K Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Clinical Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, State University of New York at Buffalo, Buffalo, NY, 14203, USA
- Department of Psychology, State University of New York at Buffalo, Buffalo, NY, 14203, USA
| | | | - Keerthy Sunder
- Karma Doctors & Karma TMS, and Suder Foundation, Palm Springs, CA, USA
- Department of Medicine, University of California, Riverside School of Medicine, Riverside, CA, USA
| | - Nicole Jafari
- Department of Human Development, California State University at Long Beach, Long Beach, CA, USA
- Division of Personalized Medicine, Cross-Cultural Research and Educational Institute, San Clemente, CA, USA
| | - Foojan Zeine
- Awareness Integration Institute, San Clemente, CA, USA
- Department of Health Science, California State University at Long Beach, Long Beach, CA, USA
| | | | - Debmalya Barh
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology (IIOAB), Purba Medinipur, WB, 721172, India
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | - Milan Makale
- Department of Radiation Medicine and Applied Sciences, UC San Diego, La Jolla, CA, 92093-0819, USA
| | - Kevin T Murphy
- Department of Radiation Oncology, University of California San Diego, La Jolla, CA, USA
| | - Kenneth Blum
- Department of Molecular Biology, Adelson School of Medicine, Ariel University, Ariel, 40700, Israel
- Division of Addiction Research & Education, Center for Sports, Exercise, and Mental Health, Western University of Health Sciences, Pomona, CA, 91766, USA
- Division of Reward Deficiency Clinics, TranspliceGen Therapeutics, Inc, Austin, TX, USA
- Division of Clinical Neurology, The Kenneth Blum Institute of Neurogenetics & Behavior, LLC, Austin, TX, USA
- Department of Medicine, University of California, Riverside School of Medicine, Riverside, CA, USA
- Division of Personalized Medicine, Cross-Cultural Research and Educational Institute, San Clemente, CA, USA
- Centre for Genomics and Applied Gene Technology, Institute of Integrative Omics and Applied Biotechnology (IIOAB), Purba Medinipur, WB, 721172, India
- Department of Psychiatry, University of Vermont School of Medicine, Burlington, VA, USA
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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2
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Blum K, Gondré-Lewis MC, Modestino EJ, Lott L, Baron D, Siwicki D, McLaughlin T, Howeedy A, Krengel MH, Oscar-Berman M, Thanos PK, Elman I, Hauser M, Fried L, Bowirrat A, Badgaiyan RD. Understanding the Scientific Basis of Post-traumatic Stress Disorder (PTSD): Precision Behavioral Management Overrides Stigmatization. Mol Neurobiol 2019; 56:7836-7850. [PMID: 31124077 DOI: 10.1007/s12035-019-1600-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 04/02/2019] [Indexed: 12/20/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a severe polygenic disorder triggered by environmental factors. Many polymorphic genes, particularly the genetic determinants of hypodopaminergia (low dopamine function), associate with a predisposition to PTSD as well as substance use disorder. Support from the National Institutes of Health for neuroimaging research and molecular, genetic applied technologies has improved understanding of brain reward circuitry functions that have inspired the development of new innovative approaches to their early diagnosis and treatment of some PTSD symptomatology and addiction. This review presents psychosocial and genetic evidence that vulnerability or resilience to PTSD can theoretically be impacted by dopamine regulation. From a neuroscience perspective, dopamine is widely accepted as a major neurotransmitter. Questions about how to modulate dopamine clinically in order to treat and prevent PTSD and other types of reward deficiency disorders remain. Identification of genetic variations associated with the relevant genotype-phenotype relationships can be characterized using the Genetic Addiction Risk Score (GARS®) and psychosocial tools. Development of an advanced genetic panel is under study and will be based on a new array of genes linked to PTSD. However, for now, the recommendation is that enlistees for military duty be given the opportunity to voluntarily pre-test for risk of PTSD with GARS, before exposure to environmental triggers or upon return from deployment as part of PTSD management. Dopamine homeostasis may be achieved via customization of neuronutrient supplementation "Precision Behavioral Management" (PBM™) based on GARS test values and other pro-dopamine regulation interventions like exercise, mindfulness, biosensor tracking, and meditation.
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Affiliation(s)
- Kenneth Blum
- Graduate School of Biomedical Sciences, Western University Health Sciences, Pomona, CA, USA. .,Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Department of Psychiatry, Boonshoft School of Medicine, Wright University, Dayton, OH, USA. .,Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA. .,Division of Neurogenetic Research & Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, USA. .,Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA. .,Division of Neuroscience & Addiction Research, Pathway Healthcare, LLC., Burmingham, AL, USA.
| | - M C Gondré-Lewis
- Department of Anatomy, Developmental Neuropsychopharmacology Laboratory, Howard University College of Medicine, Washington, DC, USA
| | - E J Modestino
- Department of Psychology, Curry College, Milton, MA, USA
| | - L Lott
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA
| | - D Baron
- Graduate School of Biomedical Sciences, Western University Health Sciences, Pomona, CA, USA
| | - D Siwicki
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA
| | - T McLaughlin
- Center for Psychiatric Medicine, Lawrence, MA, USA
| | - A Howeedy
- Division of Neurogenetic Research & Addiction Therapy, The Florida House Experience, Deerfield Beach, FL, USA
| | - M H Krengel
- Department of Neurology, Boston University School of Medicine and VA Boston Healthcare System, Boston, MA, USA
| | - M Oscar-Berman
- Department of Neurology, Boston University School of Medicine and VA Boston Healthcare System, Boston, MA, USA
| | - P K Thanos
- Behavioral Neuropharmacology & Neuroimaging Laboratory on Addiction, Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY, USA
| | - I Elman
- Department of Psychiatry, Cooper University School of Medicine, Camden, NJ, USA
| | - M Hauser
- Division of Addiction Services, Dominion Diagnostics, North Kingston, RI, USA
| | - L Fried
- Department of Precision Behavioral Management, Geneus Health, San Antonio, TX, USA.,Transformations Treatment Center, Delray Beach, FL, USA
| | - A Bowirrat
- Division of Anatomy, Biochemistry and Genetics Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - R D Badgaiyan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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3
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Blum K, Modestino EJ, Lott L, Siwicki D, Baron D, Howeedy A, Badgaiyan RD. Introducing "Precision Addiction Management (PAM ®)" as an Adjunctive Genetic Guided Therapy for Abusable Drugs in America. Open Access J Behav Sci Psychol 2018; 1:1-4. [PMID: 30662982 PMCID: PMC6335959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- K Blum
- Western University Health Sciences, Graduate School of Biomedical Sciences, USA
- Division of Addiction Services, Dominion Diagnostics, USA
- Department of Precision Addiction Management, Geneus Health, USA
- Division of Neurogenetic Research and Addiction Therapy, Department of Psychology, Curry College, USA
| | - EJ Modestino
- Department of Psychiatry, Ichan Mount Sinai School of Medicine, USA
| | - L Lott
- Department of Precision Addiction Management, Geneus Health, USA
| | - D Siwicki
- Department of Precision Addiction Management, Geneus Health, USA
| | - D Baron
- Western University Health Sciences, Graduate School of Biomedical Sciences, USA
| | - A Howeedy
- Division of Neurogenetic Research and Addiction Therapy, Department of Psychology, Curry College, USA
| | - RD Badgaiyan
- Department of Psychiatry, Ichan Mount Sinai School of Medicine, USA
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4
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Gold MS, Blum K, Febo M, Baron D, Modestino EJ, Elman I, Badgaiyan RD. Molecular role of dopamine in anhedonia linked to reward deficiency syndrome (RDS) and anti- reward systems. Front Biosci (Schol Ed) 2018; 10:309-325. [PMID: 29293435 DOI: 10.2741/s518] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Anhedonia is a condition that leads to the loss of feelings pleasure in response to natural reinforcers like food, sex, exercise, and social activities. This disorder occurs in addiction, and an array of related neuropsychiatric syndromes, including schizophrenia, depression, and Post Traumatic Stress Disorder (PTSD). Anhedonia may by due to derangements in mesolimbic dopaminergic pathways and their terminal fields (e.g., striatum, amygdala, and prefrontal cortex) that persist long after the traces of the causative drugs are eliminated (pharmacokinetically). Here we postulate that anhedonia is not a distinct entity but is rather an epiphenomenon of hypodopaminergic states and traits arising from the interaction of genetic traits and epigenetic neurobiological alterations in response to environmental influences. Moreover, dopaminergic activity is rather complex, and so it may give rise to differential pathophysiological processes such as incentive sensitization, aberrant learning and stress-like "anti-reward" phenomena. These processes may have additive, synergistic or antagonistic interactions with the concurrent reward deficiency states leading in some instances to more severe and long-lasting symptoms. Operant understanding of the neurogenetic antecedents to reward deficiency syndrome (RDS) and the elucidation of reward gene polymorphisms may provide a map for accessing an individual's genetic risk for developing Anhedonia. Prevention techniques that can restore homeostatic balance via physiological activation of dopaminergic receptors (D2/D3) may be instrumental for targeting not only anhedonia per se but also drug craving and relapse.
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Affiliation(s)
- Mark S Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Mo, USA
| | - Kenneth Blum
- Department of Psychiatry, McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA,
| | - Marcelo Febo
- Department of Psychiatry, McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, FL, USA
| | - David Baron
- Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | | | - Igor Elman
- Department of Psychiatry, Wright State University, Boonshoft School of Medicine, Dayton, OH ,USA
| | - Rajendra D Badgaiyan
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, Dayton, OH (IE)
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5
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Blum K, Thanos PK, Wang GJ, Febo M, Demetrovics Z, Modestino EJ, Braverman ER, Baron D, Badgaiyan RD, Gold MS. The Food and Drug Addiction Epidemic: Targeting Dopamine Homeostasis. Curr Pharm Des 2018; 23:6050-6061. [DOI: 10.2174/1381612823666170823101713] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 08/07/2017] [Accepted: 08/17/2017] [Indexed: 11/22/2022]
Affiliation(s)
- Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, United States
| | - Panayotis K Thanos
- Department of Psychology, University of Buffalo, the State University of New York, Buffalo, NY, United States
| | - Gene-Jack Wang
- Laboratory of Neuroimaging, National Institute of Alcohol Abuse & Alcoholism, Bethesda, MD, United States
| | - Marcelo Febo
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, United States
| | - Zsolt Demetrovics
- Institute of Psychology, Eotvos Lorand University Budapest, Budapest, Hungary
| | | | - Eric R. Braverman
- Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States
| | - David Baron
- Departments of Psychiatry & Behavioral Sciences, Keck School of Medicine of USC, Los Angeles, CA, United States
| | - Rajendra D. Badgaiyan
- Department of Psychiatry, Wright State University Boonshoft School of Medicine and Dayton VA Medical Center, Dayton, OH (IE), United States
| | - Mark S. Gold
- Department of Psychiatry, Washington University, St. Louis, MO, United States
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6
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Blum K, Gold M, Modestino EJ, Baron D, Boyett B, Siwicki D, Lott L, Podesta A, Roy AK, Hauser M, Downs BW, Badgaiyan RD. Would induction of dopamine homeostasis via coupling genetic addiction risk score (GARS®) and pro-dopamine regulation benefit benzodiazepine use disorder (BUD)? ACTA ACUST UNITED AC 2018; 4. [PMID: 31750006 PMCID: PMC6865059 DOI: 10.15761/jsin.1000196] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Prescriptions for Benzodiazepines (BZDs) have risen continually. According to national statistics, the combination of BZDs with opioids has increased since 1999. BZDs (sometimes called “benzos”) work to calm or sedate a person by raising the level of the inhibitory neurotransmitter GABA in the brain. In terms of neurochemistry, BZDs act at the GABAA receptors to inhibit excitatory neurons, reducing VTA glutaminergic drive to reduce dopamine release at the Nucleus accumbens. Benzodiazepine Use Disorder (BUD) is very difficult to treat, partly because BZDs are used to reduce anxiety which paradoxically induces hypodopaminergia. Considering this, we are proposing a paradigm shift. Instead of simply targeting chloride channel direct GABAA receptors for replacement or substitution therapy, we propose the induction of dopamine homeostasis. Our rationale is supported by the well-established notion that the root cause of drug and non-drug addictions (i.e. Reward Deficiency Syndrome [RDS]), at least in adults, involve dopaminergic dysfunction and heightened stress. This proposition involves coupling the Genetic Addiction Risk Score (GARS) with a subsequent polymorphic matched genetic customized Pro-Dopamine Regulator known as KB220ZPBM (Precision Behavioral Management). Induction of dopamine homeostasis will be clinically beneficial in attempts to combat BUD for at least three reasons: 1) During detoxification of alcoholism, the potential induction of dopamine regulation reduces the need for BZDs; 2) A major reason for BZD abuse is because people want to achieve stress reduction and subsequently, the potential induction of dopamine regulation acts as an anti-stress factor; and 3) BUD and OUD are known to reduce resting state functional connectivity, and as such, potential induction of dopamine regulation enhances resting state functional connectivity. Future randomized placebo-controlled studies will investigate this forward thinking proposed novel modality.
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Affiliation(s)
- K Blum
- Western University Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA.,Division of Nutrigenomics, Geneus Health, LLC., San Antonio, TX, USA.,Division of Neuroscience & Addiction Research, Pathway Healthcare, LLc., Birmingham, AL, USA.,Division of Addiction Services, Dominion Diagnostics, LLC. North Kingstown, RI, USA.,Division of Nutrigenomic Research, Victory Nutrition International, Lederach, PA, USA
| | - M Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Mo, USA
| | - E J Modestino
- Department of Psychology, Curry College, Milton, MA, USA
| | - D Baron
- Western University Health Sciences, Graduate School of Biomedical Sciences, Pomona, CA, USA.,Division of Nutrigenomics, Geneus Health, LLC., San Antonio, TX, USA
| | - B Boyett
- Division of Neuroscience & Addiction Research, Pathway Healthcare, LLc., Birmingham, AL, USA
| | - D Siwicki
- Division of Nutrigenomics, Geneus Health, LLC., San Antonio, TX, USA
| | - L Lott
- Division of Nutrigenomics, Geneus Health, LLC., San Antonio, TX, USA
| | - A Podesta
- Department of psychiatry, Tulane University School of Medicine, New Orleans, LA, USA
| | - A K Roy
- Department of psychiatry, Tulane University School of Medicine, New Orleans, LA, USA
| | - M Hauser
- Division of Addiction Services, Dominion Diagnostics, LLC. North Kingstown, RI, USA
| | - B W Downs
- Division of Nutrigenomic Research, Victory Nutrition International, Lederach, PA, USA
| | - R D Badgaiyan
- Department of Psychiatry, Veterans Administration Hospital at San Antonio, San Antonio, TX, USA
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7
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Modestino EJ. Hoehn and Yahr staging of Parkinson rsquo s disease in relation to neuropsychological measures. FRONT BIOSCI-LANDMRK 2018; 23:1370-1379. [DOI: 10.2741/4649] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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8
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O'Toole P, Modestino EJ. Alice in Wonderland Syndrome: A real life version of Lewis Carroll's novel. Brain Dev 2017; 39:470-474. [PMID: 28189272 DOI: 10.1016/j.braindev.2017.01.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 11/26/2022]
Abstract
Alice in Wonderland Syndrome was originally coined by Dr. John Todd in 1955. The syndrome is named after the sensations experienced by the character Alice in Lewis Carroll's novel Alice's Adventures in Wonderland. Alice in Wonderland Syndrome consists of metamorphopsia (seeing something in a distorted fashion), bizarre distortions of their body image, and bizarre perceptual distortions of form, size, movement or color. Additionally, patients with Alice in Wonderland Syndrome can experience auditory hallucinations and changes in their perception of time. Currently, there is no known specific cause of Alice in Wonderland Syndrome. However, theories point to infections such as the Epstein-Barr virus, medications such as topiramate and associated migraines. Neuroimaging studies have revealed brain regions involved with the manifestation of symptoms. These include the temporo-parietal junction within the temporal lobe and the visual pathway, specifically the occipital lobe. There are no current treatments for Alice in Wonderland Syndrome. Further research is needed to find better treatments for Alice in Wonderland Syndrome and to elucidate the exact cause or causes of Alice in Wonderland Syndrome.
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Affiliation(s)
- Patrick O'Toole
- Department of Neurology, Boston University School of Medicine, Boston, United States.
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9
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Modestino EJ, Blum K, Oscar-Berman M, Gold MS, Duane DD, Sultan SG, Auerbach SH. Reward Deficiency Syndrome: Attentional/Arousal Subtypes, Limitations of Current Diagnostic Nosology, and Future Research. J Reward Defic Syndr 2015; 1:6-9. [PMID: 26306327 PMCID: PMC4545661 DOI: 10.17756/jrds.2015-002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
We theorise that in some cases Attention Deficit Hyperactivity Disorder (ADHD) predisposes to narcolepsy and hypersomnia, and that there may be a shared pathophysiology with various addictions [Reward Deficiency Syndrome (RDS)]. Reticence to acknowledge such connections may be due to a narrow nosological framework. Additionally, we theorise that the development of narcolepsy on a baseline of ADHD/RDS leads to an additional assault on the dopaminergic reward system in such individuals. In this study, we propose to test these hypotheses by using a combination of broad genetic screening, and neuroimaging with and without pharmacological intervention, in those with pure ADHD, pure narcolepsy, and the combined ADHD-narcolepsy phenotype. Results of this proposed study may reveal a common pathophysiology of ADHD, narcolepsy and RDS, and perhaps an additional compromise to the reward system in those with combined ADHD-narcolepsy. If the evidence supports the hypothesis that indeed there is a shared pathophysiology for narcolepsy with RDS and thus its subtype ADHD, early intervention/preventative treatment amongst those with ADHD may be beneficial with the putative dopaminergic compound KB220Z™.
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Affiliation(s)
- Edward Justin Modestino
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Neurology, Boston VA Healthcare System, Boston, MA, USA
| | - Kenneth Blum
- Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL,USA
- Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, Department of Psychiatry, College of Medicine, Burlington, VT, USA
- Dominion Diagnostics, LLC, North Kingstown, RI, USA
- Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA
| | - Marlene Oscar-Berman
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Departments of Psychiatry, Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA
- Boston VA Healthcare System, Boston, MA, USA
| | - Mark S. Gold
- Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA
- Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA
| | - Drake D. Duane
- Institute for Developmental Behavioral Neurology Scottsdale, AZ, USA
- Department of Speech and Hearing Sciences, Arizona State University, Tempe, AZ, USA
- Department of Neurology, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
| | - Sarah G.S. Sultan
- Department of Psychiatry, St. Mary's Hospital Centre, Montreal, QC, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sanford H. Auerbach
- Departments of Neurology & Psychiatry, Boston University School of Medicine, Boston, MA, USA
- Sleep Disorders Center & Behavioral Neurology, Boston Medical Center, Boston, MA, USA
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10
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Abstract
Functional magnetic resonance imaging (fMRI), which is a technique useful for non-invasive mapping of brain function, is well suited for studying the visual system. This review highlights current clinical applications and research studies involving patients with visual deficits. Relevant reports regarding the investigation of the brain's role in visual processing and some newer fMRI techniques are also reviewed. Functional magnetic resonance imaging has been used for presurgical mapping of visual cortex in patients with brain lesions and for studying patients with amblyopia, optic neuritis, and residual vision in homonymous hemianopia. Retinotopic borders, motion processing, and visual attention have been the topics of several fMRI studies. These reports suggest that fMRI can be useful in clinical and research studies in patients with visual deficits.
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Affiliation(s)
- A Miki
- Division of Neuro-Ophthalmology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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11
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Miki A, Liu GT, Englander SA, Raz J, van Erp TG, Modestino EJ, Liu CJ, Haselgrove JC. Reproducibility of visual activation during checkerboard stimulation in functional magnetic resonance imaging at 4 Tesla. Jpn J Ophthalmol 2001; 45:151-5. [PMID: 11313046 DOI: 10.1016/s0021-5155(00)00352-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the reproducibility of visual activation by checkerboard stimulation, we used functional magnetic resonance imaging (fMRI) at 4 Tesla (T). METHODS Four subjects were studied with fMRI at 4 T during checkerboard visual stimulation. The functional images were realigned and spatially normalized to the standard brain. For each subject, statistical parametric maps were made for each study, and the reproducibility was determined based on the number of supra-threshold voxels (Z > 3.5, 4.5, and 5.5). RESULTS The mean ratio for the number of supra-threshold (Z > 4.5) voxels was 0.75, and the mean ratio for the overlapping voxels was 0.61. Restricting the region of interest within the posterior half of the brain improved reproducibility values at the low threshold (Z > 3.5), but did not improve the values at the higher thresholds. CONCLUSIONS Despite the fact that more than half of the supra-threshold voxels were found to be active for the repeated scans, visual activation with checkerboard stimulation seems to be less reproducible than that by flash stimulation.
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Affiliation(s)
- A Miki
- Department of Neurology, Division of Neuro-ophthalmology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Miki A, Liu GT, Raz J, Englander SA, Bonhomme GR, Aleman DO, Modestino EJ, Liu CS, Haselgrove JC. Visual activation in functional magnetic resonance imaging at very high field (4 Tesla). J Neuroophthalmol 2001; 21:8-11. [PMID: 11315986 DOI: 10.1097/00041327-200103000-00002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Functional magnetic resonance imaging (fMRI) at very high field strengths provides functional brain mapping with the enhanced signal to noise ratio and the larger blood oxygenation level-dependent (BOLD) effect. We report activated areas in the standard space detected by fMRI at 4 Tesla (T) during simple visual stimulation. MATERIALS AND METHODS Twelve healthy young subjects were scanned using a 4 T scanner during binocular flashing visual stimulation. Functional images were realigned to the first scan and then spatially normalized. Individual and group data analyses were performed to identify areas of visual activation. RESULTS Activation of the bilateral primary visual cortex (V1/V2) was observed along the entire calcarine fissure in all subjects. The activated area extended to the extrastriate cortex in all subjects. Activation of the bilateral lateral geniculate nucleus (LGN) was detected in all subjects. The group data showed activation of the bilateral primary visual cortex and the bilateral lateral geniculate nucleus. CONCLUSIONS Robust activation of the vision-related areas was successfully obtained in all subjects using a 4 T magnetic resonance scanner. These results suggest that fMRI at very high field strengths may be effective in showing visual system physiology, and that it can be a promising method to assess visual function of human subjects.
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Affiliation(s)
- A Miki
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.
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