Proposing a “Brain Health Checkup (BHC)” as a Global Potential “Standard of Care” to Overcome Reward Dysregulation in Primary Care Medicine: Coupling Genetic Risk Testing and Induction of “Dopamine Homeostasis”

Abstract

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.

Positive Clinical Outcomes for Severe Reported Pain Using Robust Non-Addictive Home Electrotherapy—A Case-Series

“…Along with this notion, Blum’s group developed the GARS test [ 7 ], to help identify DNA gene reward risk antecedents that could help pin-point brain reward neurotransmitter deficits as well as surfeits in what has been previously termed RDS [ 8 , 9 ]. Along these lines, it is important for the scientific community to embrace the idea that there is a simple way to assess and stratify “preaddiction” (similar to RDS) by coupling the validated RDSq29, GARS and Brain-, Spine-, and Mental- Health Screening Methods as the way to early identification of people at risk [ 10 , 11 ].…”

“Preaddiction” construct and reward deficiency syndrome: genetic link via dopaminergic dysregulation

“…The heuristic value of our proposal will be determined by its ability to account for specific clinical, genetic, and therapeutic aspects of the preaddiction phenomenon. Further research is warranted to uncover the distinctive aspects of RDS in addictive-vs. other psychiatric-and medical conditions and their interactions in the comorbid states (61)(62)(63)(64). In essence, our proposal relates to the importance of early genetic testing to identify preaddiction or RDS in children (65).…”