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Attention-deficit-hyperactivity disorder and reward deficiency syndrome

机译:注意缺陷多动障碍和奖赏缺乏综合征

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摘要

Molecular genetic studies have identified several genes that may mediate susceptibility to attention deficit hyperactivity disorder (ADHD). A consensus of the literature suggests that when there is a dysfunction in the “brain reward cascade,” especially in the dopamine system, causing a low or hypo-dopaminergic trait, the brain may require dopamine for individuals to avoid unpleasant feelings. This high-risk genetic trait leads to multiple drug-seeking behaviors, because the drugs activate release of dopamine, which can diminish abnormal cravings. Moreover, this genetic trait is due in part to a form of a gene (DRD2 A1 allele) that prevents the expression of the normal laying down of dopamine receptors in brain reward sites. This gene, and others involved in neurophysiological processing of specific neurotransmitters, have been associated with deficient functions and predispose individuals to have a high risk for addictive, impulsive, and compulsive behavioral propensities. It has been proposed that genetic variants of dopaminergic genes and other “reward genes” are important common determinants of reward deficiency syndrome (RDS), which we hypothesize includes ADHD as a behavioral subtype. We further hypothesize that early diagnosis through genetic polymorphic identification in combination with DNA-based customized nutraceutical administration to young children may attenuate behavioral symptoms associated with ADHD. Moreover, it is concluded that dopamine and serotonin releasers might be useful therapeutic adjuncts for the treatment of other RDS behavioral subtypes, including addictions.
机译:分子遗传学研究已经确定了几种可能介导对注意力缺陷多动障碍(ADHD)的敏感性的基因。文献的共识表明,当“大脑奖励级联”功能异常时,尤其是在多巴胺系统中功能异常,导致低或低多巴胺能性状时,大脑可能需要多巴胺来避免个人的不适感。这种高风险的遗传特征会导致多种寻毒行为,因为这些药物会激活多巴胺的释放,从而减少异常的渴望。此外,这种遗传特征部分是由于某种基因(DRD2 A1等位基因)的出现所致,这种基因阻止了正常人多巴胺受体在大脑奖励部位的正常表达。该基因和其他参与特定神经递质神经生理处理的基因与功能缺陷有关,使个体容易上瘾,冲动和强迫性行为。已经提出,多巴胺能基因和其他“奖励基因”的遗传变异是奖赏缺乏综合症(RDS)的重要共同决定因素,我们假设其将ADHD列为行为亚型。我们进一步假设,通过遗传多态性鉴定结合基于DNA的定制营养食品对幼儿的早期诊断可以减轻与多动症相关的行为症状。此外,得出的结论是,多巴胺和5-羟色胺释放剂可能是治疗其他RDS行为亚型(包括成瘾)的有用治疗辅助剂。

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