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Reward Deficiency Syndrome (RDS) is an umbrella term for all drug and nondrug addictive behaviors, due to a dopamine deficiency, “hypodopaminergia.” There is an opioid-overdose epidemic in the USA, which may result in or worsen RDS. A paradigm shift is needed to combat a system that is not working. This shift involves the recognition of dopamine homeostasis as the ultimate treatment of RDS via precision, genetically guided KB220 variants, called Precision Behavioral Management (PBM). Recognition of RDS as an endophenotype and an umbrella term in the future DSM 6, following the Research Domain Criteria (RDoC), would assist in shifting this paradigm.
Gene-Jack Wang, Department of Psychiatry Mount Sinai School of Medicine New York, NY, USA and Medical Department Brookhaven National Laboratory Upton, NY, USA,
Nora D. Volkow, National institute of Drug Abuse and National Institute of Alcohol Abuse and Alcoholism Bethesda, MD, USA,
Joanna S. Fowler, Department of Psychiatry Mount Sinai School of Medicine New York, NY, USA and Medical Department Brookhaven National Laboratory Upton, NY, USA,
Panayotis K. Thanos, National institute of Drug Abuse and National Institute of Alcohol Abuse and Alcoholism Bethesda, MD, USA
Functional neuroimaging techniques have been used to assess the link between intake of food ingredients (i.e. glucose) and changes in hypothalamus, and to compare responses in lean and obese individuals. Several functional magnetic resonance imaging (fMRI) studies reported transient changes of the blood oxygen level dependent (BOLD) signals in the hypothalamus after administration of glucose in rats and humans. Many peripheral metabolic signals directly or indirectly interact with brain dopamine (DA) pathways. This chapter discusses the relation of DA in brain regions during sensory perception of food. These regions include insular cortex, somatosensory cortex, orbitofrontal cortex (OFC), and amygdala. These brain imaging studies have the potential to facilitate the understanding of mechanisms underlying obesity and overeating behaviors and provide scientific bases for the assessment of the efficacy of drug treatments and for the development of novel pharmacological approaches.
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