1 6827 85 [GILLES DE LA TOURETTE'S DISEASE. SYMPTOMS, ETIOPATHOGENESIS AND THERAPEUTIC APPROACHES]. THE GILLES DE LA TOURETTE SYNDROME IS A USUALLY CHRONIC NEUROPSYCHIATRIC DISORDER WITH AN EARLY CHILDHOOD ONSET FEATURING MAINLY MOTOR AND VOCAL TICS. IT SEEMS THAT STRONG GENETIC FACTORS MAKE A MAJOR CONTRIBUTION TO THE ETIOLOGY OF THIS DISORDER, BUT THERE ARE ALSO CLUES THAT EPIGENETIC FACTORS ARE INVOLVED IN THE PATHOGENESIS OF TOURETTE'S SYNDROME, SUCH AS MATERNAL STRESS DURING PREGNANCY, BIRTH COMPLICATIONS AND HORMONAL INFLUENCES. FIRST IN LINE FOR ADEQUATE TREATMENT ARE NEUROLEPTIC COMPOUNDS OF HIGH POTENCY, BESIDES, SEVERAL OTHER PSYCHOACTIVE DRUGS HAVE SHOWN SOME THERAPEUTIC EFFECTS. LESS EVIDENT IS THE EFFICACY OF NEUROSURGICAL AND PSYCHOTHERAPEUTIC INTERVENTIONS. 1997 2 1946 29 EPIGENETIC ABNORMALITIES ASSOCIATED WITH A CHROMOSOME 18(Q21-Q22) INVERSION AND A GILLES DE LA TOURETTE SYNDROME PHENOTYPE. GILLES DE LA TOURETTE SYNDROME (GTS) IS A POTENTIALLY DEBILITATING NEUROPSYCHIATRIC DISORDER DEFINED BY THE PRESENCE OF BOTH VOCAL AND MOTOR TICS. DESPITE EVIDENCE THAT THIS AND A RELATED PHENOTYPIC SPECTRUM, INCLUDING CHRONIC TICS (CT) AND OBSESSIVE COMPULSIVE DISORDER (OCD), ARE GENETICALLY MEDIATED, NO GENE INVOLVED IN DISEASE ETIOLOGY HAS BEEN IDENTIFIED. CHROMOSOMAL ABNORMALITIES HAVE LONG BEEN PROPOSED TO PLAY A CAUSATIVE ROLE IN ISOLATED CASES OF GTS SPECTRUM PHENOMENA, BUT CONFIRMATION OF THIS HYPOTHESIS HAS YET TO BE FORTHCOMING. WE DESCRIBE AN I(18Q21.1-Q22.2) INVERSION IN A PATIENT WITH CT AND OCD. WE HAVE FINE MAPPED THE TELOMERIC ASPECT OF THE REARRANGEMENT TO WITHIN 1 MB OF A PREVIOUSLY REPORTED 18Q22 BREAKPOINT THAT COSEGREGATED IN A FAMILY WITH GTS AND RELATED PHENOTYPES. A COMPREHENSIVE CHARACTERIZATION OF THIS GENOMIC INTERVAL LED TO THE IDENTIFICATION OF TWO TRANSCRIPTS, NEITHER OF WHICH WAS FOUND TO BE STRUCTURALLY DISRUPTED. ANALYSIS OF THE EPIGENETIC CHARACTERISTICS OF THE REGION DEMONSTRATED A SIGNIFICANT INCREASE IN REPLICATION ASYNCHRONY IN THE PATIENT COMPARED TO CONTROLS, WITH THE INVERTED CHROMOSOME SHOWING DELAYED REPLICATION TIMING ACROSS AT LEAST A 500-KB INTERVAL. THESE FINDINGS ARE CONSISTENT WITH LONG-RANGE FUNCTIONAL DYSREGULATION OF ONE OR MORE GENES IN THE REGION. OUR DATA SUPPORT A LINK BETWEEN CHROMOSOMAL ABERRATIONS AND EPIGENETIC MECHANISMS IN GTS AND SUGGEST THAT THE STUDY OF THE FUNCTIONAL CONSEQUENCES OF BALANCED CHROMOSOMAL REARRANGEMENTS IS WARRANTED IN PATIENTS WITH PHENOTYPES OF INTEREST, IRRESPECTIVE OF THE FINDINGS REGARDING STRUCTURALLY DISRUPTED TRANSCRIPTS. 2003 3 5331 36 PUTTING THE PIECES TOGETHER IN GILLES DE LA TOURETTE SYNDROME: EXPLORING THE LINK BETWEEN CLINICAL OBSERVATIONS AND THE BIOLOGICAL BASIS OF DYSFUNCTION. GILLES DE LA TOURETTE SYNDROME IS A COMPLEX, IDIOPATHIC NEUROPSYCHIATRIC DISORDER WHOSE PATHOPHYSIOLOGICAL MECHANISMS HAVE YET TO BE ELUCIDATED. IT IS PHENOTYPICALLY HETEROGENEOUS AND MANIFESTS MORE OFTEN THAN NOT WITH BOTH MOTOR AND BEHAVIORAL IMPAIRMENT, ALTHOUGH TICS ARE ITS CLINICAL HALLMARK. TICS THEMSELVES PRESENT WITH A COMPLEX PROFILE AS THEY CHARACTERISTICALLY WAX AND WANE AND ARE OFTEN PRECEDED BY PREMONITORY SOMATOSENSORY SENSATIONS TO WHICH IT IS SAID A TIC IS THE RESPONSE. HIGHLY COMORBID WITH OBSESSIVE-COMPULSIVE DISORDER AND ATTENTION DEFICIT-HYPERACTIVITY DISORDER, IT IS PURPORTED TO BE AN EPIGENETIC, NEURODEVELOPMENTAL SPECTRUM DISORDER WITH A COMPLEX GENETIC PROFILE. IT HAS A CHILDHOOD ONSET, OCCURS DISPROPORTIONATELY IN MALES, AND SHOWS SPONTANEOUS SYMPTOMATIC ATTENUATION BY ADULTHOOD IN THE MAJORITY OF THOSE AFFLICTED. ALTHOUGH NOT FULLY UNDERSTOOD, ITS NEUROBIOLOGICAL BASIS IS LINKED TO DYSFUNCTION IN THE CORTICO-BASAL GANGLIA-THALAMO-CORTICAL NETWORK. TREATMENT MODALITIES FOR TOURETTE SYNDROME INCLUDE BEHAVIORAL, PHARMACOLOGICAL AND SURGICAL INTERVENTIONS, BUT THERE IS PRESENTLY NO CURE FOR THE DISORDER. FOR THOSE SEVERELY AFFECTED, DEEP BRAIN STIMULATION (DBS) HAS RECENTLY BECOME A VIABLE THERAPEUTIC OPTION. A KEY FACTOR TO ATTAINING OPTIMAL RESULTS FROM THIS SURGERY IS TARGET SELECTION, A TOPIC STILL UNDER DEBATE DUE TO THE COMPLEX CLINICAL PROFILE PRESENTED BY GTS PATIENTS. DEPENDING ON ITS PHENOTYPIC EXPRESSION AND THE MOST PROBLEMATIC ASPECT OF THE DISORDER FOR THE INDIVIDUAL, ONE OF THREE BRAIN REGIONS IS MOST COMMONLY CHOSEN FOR STIMULATION: THE THALAMUS, GLOBUS PALLIDUS, OR NUCLEUS ACCUMBENS. NEUROPHYSIOLOGICAL ANALYSES OF INTRA- AND POST-OPERATIVE HUMAN ELECTROPHYSIOLOGICAL RECORDINGS FROM CLINICAL DBS STUDIES SUGGEST A LINK BETWEEN TIC BEHAVIOR AND ACTIVITY IN BOTH THE THALAMUS AND GLOBUS PALLIDUS. IN PARTICULAR, CHRONIC RECORDINGS FROM THE THALAMUS HAVE SHOWN A CORRELATION BETWEEN SYMPTOMATOLOGY AND (1) SPECTRAL ACTIVITY IN GAMMA BAND POWER AND (2) THETA/GAMMA CROSS FREQUENCY COHERENCE. THESE RESULTS SUGGEST GAMMA OSCILLATIONS AND THETA/GAMMA CROSS CORRELATION DYNAMICS MAY SERVE AS BIOMARKERS FOR DYSFUNCTION. WHILE ACUTE AND CHRONIC RECORDINGS FROM HUMAN SUBJECTS UNDERGOING DBS HAVE PROVIDED BETTER INSIGHT INTO TIC GENESIS AND THE NEUROPATHOPHYSIOLOGICAL MECHANISMS UNDERLYING TOURETTE SYNDROME, THESE STUDIES ARE STILL SPARSE AND THE FIELD WOULD GREATLY BENEFIT FROM FURTHER INVESTIGATIONS. THIS REVIEW REPORTS DATA AND DISCOVERIES OF SCIENTIFIC AND CLINICAL RELEVANCE FROM A WIDE VARIETY OF METHODS AND PROVIDES UP-TO-DATE INFORMATION ABOUT OUR CURRENT UNDERSTANDING OF THE PATHOMECHANISMS UNDERLYING TOURETTE SYNDROME. IT GIVES A COMPREHENSIVE OVERVIEW OF THE CURRENT STATE OF KNOWLEDGE AND ADDRESSES OPEN QUESTIONS IN THE FIELD. 2017 4 6457 40 TIC DISORDERS: WHEN HABIT FORMING NEURAL SYSTEMS FORM HABITS OF THEIR OWN? TOURETTE SYNDROME (TS), OBSESSIVE-COMPULSIVE DISORDER (OCD) AND RELATED CONDITIONS ARE PREVALENT DISORDERS AFFECTING AS MANY AS 0.3-3% OF THE POPULATION. THEY ARE FREQUENTLY CHRONIC AND CAN BE ASSOCIATED WITH MARKED IMPAIRMENT AND DISABILITY. ALTHOUGH CLINICAL CARE HAS IMPROVED OVER THE PAST DECADE, A SIGNIFICANT NUMBER OF PATIENTS FAIL TO RESPOND ADEQUATELY OR EXPERIENCE INTOLERABLE SIDE EFFECTS. THE ETIOLOGY OF THESE DISORDERS IS UNKNOWN. COMPELLING EVIDENCE SUGGESTS THAT THE VULNERABILITY TO DEVELOP TS AND OCD IS MEDIATED BY BOTH GENETIC AND ENVIRONMENTAL FACTORS, AND THAT NEURAL SYSTEMS LOCATED IN THE BASAL GANGLIA AND FUNCTIONALLY RELATED BRAIN STRUCTURES ARE INVOLVED IN THEIR PATHOGENESIS. BASED ON EXPLICIT MODELS OF PATHOGENESIS FOR TS AND OCD AND BUILDING ON WORK ACCOMPLISHED OVER THE PAST TWO DECADES, AN ARRAY OF CLINICAL, NEUROPSYCHOLOGICAL, GENETIC, NEUROIMAGING, EPIDEMIOLOGICAL NEUROBIOLOGICAL, AND TREATMENT STUDIES HAVE BEEN COMPLETED OR ARE UNDERWAY AT THE CHILD STUDY CENTER AT YALE UNIVERSITY. A MULTIDISCIPLINARY TEAM OF INVESTIGATORS HAS JOINED FORCES TO TEST SPECIFIC HYPOTHESES THROUGH THE INTEGRATION AND TRANSLATION OF BASIC AND CLINICAL NEUROSCIENCE RESEARCH. ALL SUBJECTS HAVE BEEN STUDIED USING IDENTICAL CLINICAL, NEUROPSYCHOLOGICAL, GENETIC, NEUROBIOLOGICAL, AND PHARMACOLOGICAL TECHNIQUES. CURRENT CONCEPTUALIZATIONS OF TS HAVE BEEN SHAPED BY ADVANCES IN CLINICAL PHENOMENOLOGY, GENETICS, SYSTEMS NEUROSCIENCE AND THE EMERGING UNDERSTANDING OF THE ROLE OF THE BASAL GANGLIA IN IMPLICIT LEARNING AND HABIT FORMATION, NEUROIMMUNOLOGY AND PSYCHOPHARMACOLOGY. AN APPRECIATION OF THE PREMONITORY URGES THAT PRECEDE TICS AND TEMPORAL DYNAMICS OF TICS HAVE PROVIDED USEFUL VIEWPOINTS FROM WHICH TO REGARD THE NATURAL HISTORY OF TS. WHILE THE LONG-TERM OUTCOME OF TS CAN BE RELATIVELY BENIGN, THE PRESENCE OF COMORBID CONDITIONS SUCH AS ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD), OCD OR A MAJOR AFFECTIVE DISORDER CAN HAVE LASTING UNTOWARD CONSEQUENCES. THE IDENTIFICATION OF SUSCEPTIBILITY GENES IN TS WILL DOUBTLESS POINT IN NEW THERAPEUTIC DIRECTIONS FOR TREATMENT, AS WILL THE CHARACTERIZATION OF THE PUTATIVE AUTOIMMUNE MECHANISMS ACTIVE IN SUBGROUP OF PATIENTS. CONTINUED SUCCESS IN FUNCTIONAL IN VIVO NEUROIMAGING STUDIES WILL LEAD TO THE TARGETING OF SPECIFIC BRAIN CIRCUITS FOR MORE INTENSIVE STUDY. ALTHOUGH IDEAL ANTI-TIC THERAPIES ARE NOT AVAILABLE, RECENTLY COMPLETED CLINICAL TRIALS WITH ALPHA-ADRENERGIC AGENTS AND ATYPICAL NEUROLEPTICS ARE ENCOURAGING. GIVEN THESE DEVELOPMENTS, TS CAN BE CONSIDERED A MODEL DISORDER TO STUDY THE DYNAMIC INTERPLAY OF GENETIC VULNERABILITIES, EPIGENETIC EVENTS, AND NEUROBIOLOGICAL SYSTEMS ACTIVE DURING EARLY BRAIN DEVELOPMENT. IT IS LIKELY THAT THE RESEARCH PARADIGMS UTILIZED IN THESE STUDIES AND MANY OF THE EMPIRICAL FINDINGS RESULTING FROM THEM, WILL BE RELEVANT TO OTHER DISORDERS OF CHILDHOOD ONSET AND TO OUR UNDERSTANDING OF NORMAL DEVELOPMENT. 2001 5 4491 22 MONOSOMY 7 MYELOPROLIFERATIVE DISEASE IN CHILDREN WITH NEUROFIBROMATOSIS, TYPE 1: EPIDEMIOLOGY AND MOLECULAR ANALYSIS. LOSS OF CONSTITUTIONAL HETEROZYGOSITY IS A COMMON MOLECULAR FEATURE OF CANCERS IN WHICH INACTIVATION OF ONE OR MORE TUMOR SUPPRESSOR GENES IS THOUGHT TO CONTRIBUTE TO TUMORIGENESIS. RECENT EVIDENCE SUGGESTS THAT THE GENE RESPONSIBLE FOR NEUROFIBROMATOSIS, TYPE 1 (NF-1), BELONGS TO THIS CLASS OF HERITABLE CANCER GENES. CHILDREN WITH NF-1 SHOW AN INCREASED INCIDENCE OF MYELOID LEUKEMIA, INCLUDING JUVENILE CHRONIC MYELOGENOUS LEUKEMIA (JCML) AND, PERHAPS, THE MYELOPROLIFERATIVE SYNDROME (MPS) ASSOCIATED WITH BONE MARROW MONOSOMY 7 (MO 7). WE HAVE INVESTIGATED FIVE CHILDREN WITH MO 7: THREE WITH NF-1 AND TWO OTHERS WITH SUGGESTIVE EVIDENCE OF NF-1. SOUTHERN BLOTTING EXPERIMENTS PERFORMED IN FOUR PATIENTS SHOWED NO LOSS OF HETEROZYGOSITY IN BONE MARROW SPECIMENS USING PROBES LINKED TO THE NF-1 LOCUS ON THE LONG ARM OF CHROMOSOME 17. BOTH OF OUR PATIENTS WITH FAMILIAL NF-1 INHERITED THE DISEASE FROM THEIR MOTHERS, AS DID 14 OF 19 OTHER CASES OF MYELOID LEUKEMIA IN CHILDREN WITH FAMILIAL NF-1. SEVENTEEN OF THESE 21 CHILDREN WERE BOYS. MYELOID LEUKEMIA DEVELOPED IN 12 BOYS AND FOUR GIRLS WHO INHERITED NF-1 FROM THEIR MOTHERS, AND IN FIVE BOYS WHO INHERITED THE DISEASE FROM THEIR FATHERS. FATHER-TO-DAUGHTER TRANSMISSION WAS NOT OBSERVED. TAKEN TOGETHER, THE PRESENCE OF CHROMOSOME 7 DELETIONS IN THE LEUKEMIAS OF CHILDREN WITH NF-1, A PATTERN OF INHERITANCE FAVORING MATERNAL TRANSMISSION OF NF-1, AND THE MARKED PREDILECTION FOR BOYS TO DEVELOP JCML AND MO 7 SUGGEST A MULTISTEP MECHANISM OF ONCOGENESIS IN WHICH EPIGENETIC FACTORS MIGHT PLAY A ROLE. FURTHER INVESTIGATION IS REQUIRED TO DETERMINE IF THE NF-1 GENES IN THE LEUKEMIC BONE MARROWS OF THESE PATIENTS HAVE ACQUIRED POINT MUTATIONS OR SMALL DELETIONS. 1992 6 2209 18 EPIGENETIC MODIFICATIONS AND OBSESSIVE-COMPULSIVE DISORDER: WHAT DO WE KNOW? OBSESSIVE-COMPULSIVE DISORDER (OCD) IS A CHRONIC, SEVERE DISABLING NEUROPSYCHIATRIC DISORDER WHOSE PATHOPHYSIOLOGY IS NOT YET WELL DEFINED. GENERALLY, THE SYMPTOM ONSET OCCURS DURING PRE-ADULT LIFE AND AFFECTS SUBJECTS IN DIFFERENT LIFE ASPECTS, INCLUDING PROFESSIONAL AND SOCIAL RELATIONSHIPS. ALTHOUGH ROBUST EVIDENCE INDICATES THE PRESENCE OF GENETIC FACTORS IN THE ETIOPATHOLOGY OF OCD, THE ENTIRELY MECHANISMS ARE NOT TOTALLY CLARIFIED. THUS, THE POSSIBLE INTERACTIONS BETWEEN GENES AND ENVIRONMENTAL RISK FACTORS MEDIATED BY EPIGENETIC MECHANISMS SHOULD BE SOUGHT. THEREFORE, WE PROVIDE A REVIEW OF GENETIC AND EPIGENETIC MECHANISMS RELATED TO OCD WITH A DEEP FOCUS ON THE REGULATION OF CRITICAL GENES OF THE CENTRAL NERVOUS SYSTEM SEEKING POSSIBLE POTENTIAL BIOMARKERS. 2023 7 2105 23 EPIGENETIC EVIDENCE FOR INVOLVEMENT OF THE OXYTOCIN RECEPTOR GENE IN OBSESSIVE-COMPULSIVE DISORDER. BACKGROUND: OBSESSIVE-COMPULSIVE DISORDER (OCD) IS A CHRONIC NEURODEVELOPMENTAL DISORDER THAT AFFECTS UP TO 3% OF THE GENERAL POPULATION. ALTHOUGH EPIGENETIC MECHANISMS PLAY A ROLE IN NEURODEVELOPMENT DISORDERS, EPIGENETIC PATHWAYS ASSOCIATED WITH OCD HAVE RARELY BEEN INVESTIGATED. OXYTOCIN IS A NEUROPEPTIDE INVOLVED IN NEUROBEHAVIORAL FUNCTIONS. OXYTOCIN HAS BEEN SHOWN TO BE ASSOCIATED WITH THE REGULATION OF COMPLEX SOCIO-COGNITIVE PROCESSES SUCH AS ATTACHMENT, SOCIAL EXPLORATION, AND SOCIAL RECOGNITION, AS WELL AS ANXIETY AND OTHER STRESS-RELATED BEHAVIORS. OXYTOCIN HAS ALSO BEEN LINKED TO THE PATHOPHYSIOLOGY OF OCD, ALBEIT INCONSISTENTLY. THE AIM OF THIS STUDY WAS TO INVESTIGATE METHYLATION IN TWO TARGETS SEQUENCES LOCATED IN THE EXON III OF THE OXYTOCIN RECEPTOR GENE (OXTR), IN OCD PATIENTS AND HEALTHY CONTROLS. WE USED BISULFITE SEQUENCING TO QUANTIFY DNA METHYLATION IN PERIPHERAL BLOOD SAMPLES COLLECTED FROM 42 OCD PATIENTS AND 31 HEALTHY CONTROLS. RESULTS: WE FOUND THAT THE LEVEL OF METHYLATION OF THE CYTOSINE-PHOSPHATE-GUANINE SITES IN TWO TARGETS SEQUENCES ANALYZED WAS GREATER IN THE OCD PATIENTS THAN IN THE CONTROLS. THE HIGHER METHYLATION IN THE OCD PATIENTS CORRELATED WITH OCD SEVERITY. WE MEASURED DNA METHYLATION IN THE PERIPHERAL BLOOD, WHICH PREVENTED US FROM DRAWING ANY CONCLUSIONS ABOUT PROCESSES IN THE CENTRAL NERVOUS SYSTEM. CONCLUSION: TO OUR KNOWLEDGE, THIS IS THE FIRST STUDY INVESTIGATING DNA METHYLATION OF THE OXTR IN OCD. FURTHER STUDIES ARE NEEDED TO EVALUATE THE ROLES THAT DNA METHYLATION AND OXYTOCIN PLAY IN OCD. 2016 8 6266 16 THE NEUROBIOLOGY OF SUICIDE. THE STRESS-DIATHESIS MODEL POSITS THAT SUICIDE IS THE RESULT OF AN INTERACTION BETWEEN STATE-DEPENDENT (ENVIRONMENTAL) STRESSORS AND A TRAIT-LIKE DIATHESIS OR SUSCEPTIBILITY TO SUICIDAL BEHAVIOUR, INDEPENDENT OF PSYCHIATRIC DISORDERS. FINDINGS FROM POST-MORTEM STUDIES OF THE BRAIN AND FROM GENOMIC AND IN-VIVO NEUROIMAGING STUDIES INDICATE A BIOLOGICAL BASIS FOR THIS DIATHESIS, INDICATING THE IMPORTANCE OF NEUROBIOLOGICAL SCREENING AND INTERVENTIONS, IN ADDITION TO COGNITIVE AND MOOD INTERVENTIONS, IN THE PREVENTION OF SUICIDE. EARLY-LIFE ADVERSITY AND EPIGENETIC MECHANISMS MIGHT EXPLAIN SOME OF THE LINK BETWEEN SUICIDE RISK AND BRAIN CIRCUITRY AND NEUROCHEMISTRY ABNORMALITIES. RESULTS FROM A RANGE OF STUDIES USING DIVERSE DESIGNS AND POST-MORTEM AND IN-VIVO TECHNIQUES SHOW IMPAIRMENTS OF THE SEROTONIN NEUROTRANSMITTER SYSTEM AND THE HYPOTHALAMIC-PITUITARY-ADRENAL AXIS STRESS-RESPONSE SYSTEM IN THE DIATHESIS FOR SUICIDAL BEHAVIOUR. THESE IMPAIRMENTS MANIFEST AS IMPAIRED COGNITIVE CONTROL OF MOOD, PESSIMISM, REACTIVE AGGRESSIVE TRAITS, IMPAIRED PROBLEM SOLVING, OVER-REACTIVITY TO NEGATIVE SOCIAL SIGNS, EXCESSIVE EMOTIONAL PAIN, AND SUICIDAL IDEATION, LEADING TO SUICIDAL BEHAVIOUR. BIOMARKERS RELATED TO THE DIATHESIS MIGHT HELP TO INFORM RISK-ASSESSMENT PROCEDURES AND TREATMENT CHOICE IN THE PREVENTION OF SUICIDE. 2014 9 6917 17 [WHOSE BORDERLINE IS IT? HYPOTHESIZED ETIOLOGIES OF BORDERLINE PERSONALITY]. BORDERLINE PERSONALITY IS A WELL KNOWN CONCEPT IN PSYCHIATRIC LITERATURE, HOWEVER, NOT FULLY UNDERSTOOD AS TO ITS VERY NATURE. THIS ARTICLE PRESENTS A SHORT REVIEW OF HYPOTHESIZED ETIOLOGIES OF THE BORDERLINE PERSONALITY, STARTING WITH SO CALLED TRADITIONAL THEORIES, NAMELY, BORDERLINE PERSONALITY AS A CONSOLIDATED PERSONALITY ORGANIZATION, IN WHICH THE PATIENT PATHOLOGICALLY DEALS WITH HIS OR HER INNER AGGRESSION, OR WITH AN ENDURING DEVELOPMENTAL FAILURE. MORE MODERN HYPOTHESES FOCUS ON POSSIBLE CHILDHOOD SEXUAL ABUSE AS THE ORIGIN OF THE BORDERLINE, VIEWING THE ADULT PERSONALITY AS A CHRONIC, UNRESOLVED, POST-TRAUMATIC DISORDER. ADDITIONALLY, A NEURO-EPIGENETIC VIEW HYPOTHESIZED THAT A UNIQUE CONGENITAL NEUROLOGICAL STRUCTURE INTERACTS WITH CONSEQUENTIAL EVENTS IN EARLY CHILDHOOD TO CREATE THE BORDERLINE PERSONALITY. 2008 10 4632 19 NEUROIMAGING GENETIC APPROACHES TO POSTTRAUMATIC STRESS DISORDER. NEUROIMAGING GENETIC STUDIES THAT ASSOCIATE GENETIC AND EPIGENETIC VARIATION WITH NEURAL ACTIVITY OR STRUCTURE PROVIDE AN OPPORTUNITY TO LINK GENES TO PSYCHIATRIC DISORDERS, OFTEN BEFORE PSYCHOPATHOLOGY IS DISCERNABLE IN BEHAVIOR. HERE WE REVIEW NEUROIMAGING GENETICS STUDIES WITH PARTICIPANTS WHO HAVE POSTTRAUMATIC STRESS DISORDER (PTSD). RESULTS SHOW THAT GENES RELATED TO THE PHYSIOLOGICAL STRESS RESPONSE (E.G., GLUCOCORTICOID RECEPTOR AND ACTIVITY, NEUROENDOCRINE RELEASE), LEARNING AND MEMORY (E.G., PLASTICITY), MOOD, AND PAIN PERCEPTION ARE TIED TO NEURAL INTERMEDIATE PHENOTYPES ASSOCIATED WITH PTSD. THESE GENES ARE ASSOCIATED WITH AND SOMETIMES PREDICT NEURAL STRUCTURE AND FUNCTION IN AREAS INVOLVED IN ATTENTION, EXECUTIVE FUNCTION, MEMORY, DECISION-MAKING, EMOTION REGULATION, SALIENCE OF POTENTIAL THREATS, AND PAIN PERCEPTION. EVIDENCE SUGGESTS THESE RISK POLYMORPHISMS AND NEURAL INTERMEDIATE PHENOTYPES ARE VULNERABILITIES TOWARD DEVELOPING PTSD IN THE AFTERMATH OF TRAUMA, OR VULNERABILITIES TOWARD PARTICULAR SYMPTOMS ONCE PTSD HAS DEVELOPED. WORK DISTINGUISHING BETWEEN THE RE-EXPERIENCING AND DISSOCIATIVE SUB-TYPES OF PTSD, AND EXAMINING OTHER PTSD SYMPTOM CLUSTERS IN ADDITION TO THE RE-EXPERIENCING AND HYPERAROUSAL SYMPTOMS, WILL FURTHER CLARIFY NEUROBIOLOGICAL MECHANISMS AND INCONSISTENT FINDINGS. FURTHERMORE, AN EXCITING POSSIBILITY IS THAT GENETIC ASSOCIATIONS WITH PTSD MAY EVENTUALLY BE UNDERSTOOD THROUGH DIFFERENTIAL INTERMEDIATE PHENOTYPES OF NEURAL CIRCUIT STRUCTURE AND FUNCTION, POSSIBLY UNDERLYING THE DIFFERENT SYMPTOM CLUSTERS SEEN WITHIN PTSD. 2016 11 1050 24 CLINICAL FEATURES ASSOCIATED TO REFRACTORY OBSESSIVE-COMPULSIVE DISORDER. SOME PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER (OCD) EXHIBIT AN UNSATISFACTORY REDUCTION IN SYMPTOM SEVERITY DESPITE BEING TREATED WITH ALL THE AVAILABLE THERAPEUTIC ALTERNATIVES. THE CLINICAL VARIABLES ASSOCIATED WITH TREATMENT-REFRACTORINESS IN OCD ARE INCONSISTENTLY DESCRIBED IN THE LITERATURE. METHODS: TO INVESTIGATE FACTORS ASSOCIATED WITH TREATMENT-REFRACTORINESS OF PATIENTS WITH OCD, WE CONDUCTED A CASE-CONTROL STUDY, COMPARING 23 PATIENTS WITH TREATMENT-REFRACTORY OCD TO 26 PATIENTS WITH TREATMENT-RESPONDING OCD. RESULTS: THE FACTORS ASSOCIATED WITH REFRACTORINESS OF OCD WERE HIGHER SEVERITY OF SYMPTOMS SINCE THE ONSET OF OCD (P<0.001), CHRONIC COURSE (P=0.003), LACK OF A PARTNER (P=0.037), UNEMPLOYMENT (P=0.025), LOW ECONOMIC STATUS (P=0.015), PRESENCE OF OBSESSIVE-COMPULSIVE SYMPTOMS OF SEXUAL/RELIGIOUS CONTENT (P=0.043), AND HIGHER SCORES ON FAMILY ACCOMMODATION (P<0.001). ONLY THE THREE LATTER VARIABLES REMAINED SIGNIFICANTLY ASSOCIATED WITH TREATMENT-REFRACTORINESS AFTER REGRESSION ANALYSES. LIMITATIONS: SMALL SAMPLE SIZE, THE BIASES AND DRAWBACKS INHERENT TO A CASE-CONTROL STUDY, AND THE INCLUSION CRITERIA USED TO DEFINE THE STUDY GROUPS MAY HAVE LIMITED THE GENERALISATION OF THE RESULTS. CONCLUSION: A MAJOR STRENGTH OF THIS STUDY IS THE SYSTEMATIC AND STRUCTURED EVALUATION OF A VAST ARRAY OF VARIABLES RELATED TO THE CLINICAL EXPRESSION OF OCD, INCLUDING EPIGENETIC FACTORS AND RATINGS DERIVED FROM INSTRUMENTS EVALUATING FAMILY ACCOMMODATION. THE PRESENCE OF SEXUAL/RELIGIOUS SYMPTOMS, LOW ECONOMIC STATUS AND HIGH MODIFICATION ON FAMILY FUNCTION DUE TO OCD WERE INDEPENDENTLY ASSOCIATED WITH TREATMENT-REFRACTORINESS. FUTURE LONGITUDINAL STUDIES ARE WARRANTED TO VERIFY IF THESE VARIABLES REPRESENT PREDICTIVE FACTORS OF TREATMENT NON-RESPONSE. 2006 12 6278 28 THE PATHWAYS BETWEEN CORTISOL-RELATED REGULATION GENES AND PTSD PSYCHOTHERAPY. POST-TRAUMATIC STRESS DISORDER (PTSD) ONLY DEVELOPS AFTER EXPOSURE TO A TRAUMATIC EVENT IN SOME INDIVIDUALS. PTSD CAN BE CHRONIC AND DEBILITATING, AND IS ASSOCIATED WITH CO-MORBIDITIES SUCH AS DEPRESSION, SUBSTANCE USE, AND CARDIOMETABOLIC DISORDERS. ONE OF THE MOST IMPORTANT PATHOPHYSIOLOGICAL MECHANISMS UNDERLYING THE DEVELOPMENT OF PTSD AND ITS SUBSEQUENT MAINTENANCE IS A DYSFUNCTIONAL HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS. THE CORTICOTROPHIN-RELEASING HORMONE, CORTISOL, GLUCOCORTICOID RECEPTOR (GR), AND THEIR RESPECTIVE GENES ARE SOME OF THE MEDIATORS OF PTSD'S PATHOPHYSIOLOGY. SEVERAL TREATMENTS ARE AVAILABLE, INCLUDING MEDICATION AND PSYCHOTHERAPIES, ALTHOUGH THEIR SUCCESS RATE IS LIMITED. SOME PHARMACOLOGICAL THERAPIES BASED ON THE HPA AXIS ARE CURRENTLY BEING TESTED IN CLINICAL TRIALS AND CHANGES IN HPA AXIS BIOMARKERS HAVE BEEN FOUND TO OCCUR IN RESPONSE NOT ONLY TO PHARMACOLOGICAL TREATMENTS, BUT ALSO TO PSYCHOTHERAPY-INCLUDING THE EPIGENETIC MODIFICATION OF THE GR GENE. PSYCHOTHERAPIES ARE CONSIDERED TO BE THE FIRST LINE TREATMENTS FOR PTSD IN SOME GUIDELINES, EVEN THOUGH THEY ARE EFFECTIVE FOR SOME, BUT NOT FOR ALL PATIENTS WITH PTSD. THIS REVIEW AIMS TO ADDRESS HOW KNOWLEDGE OF THE HPA AXIS-RELATED GENETIC MAKEUP CAN INFORM AND PREDICT THE OUTCOMES OF PSYCHOTHERAPEUTIC TREATMENTS. 2020 13 1722 24 DYSREGULATION OF BRAIN DOPAMINE SYSTEMS IN MAJOR DEPRESSIVE DISORDER. MAJOR DEPRESSIVE DISORDER (MDD OR DEPRESSION) IS A DEBILITATING NEUROPSYCHIATRIC SYNDROME WITH GENETIC, EPIGENETIC, AND ENVIRONMENTAL CONTRIBUTIONS. DEPRESSION IS ONE OF THE LARGEST CONTRIBUTORS TO CHRONIC DISEASE BURDEN; IT AFFECTS MORE THAN ONE IN SIX INDIVIDUALS IN THE UNITED STATES. A WIDE ARRAY OF CELLULAR AND MOLECULAR MODIFICATIONS DISTRIBUTED ACROSS A VARIETY OF NEURONAL PROCESSES AND CIRCUITS UNDERLIE THE PATHOPHYSIOLOGY OF DEPRESSION-NO ESTABLISHED MECHANISM CAN EXPLAIN ALL ASPECTS OF THE DISEASE. MDD SUFFERS FROM A VAST TREATMENT GAP WORLDWIDE, AND LARGE NUMBERS OF INDIVIDUALS WHO REQUIRE TREATMENT DO NOT RECEIVE ADEQUATE CARE. THIS MINI-REVIEW FOCUSES ON DYSREGULATION OF BRAIN DOPAMINE (DA) SYSTEMS IN THE PATHOPHYSIOLOGY OF MDD AND DESCRIBING NEW CELLULAR TARGETS FOR POTENTIAL MEDICATION DEVELOPMENT FOCUSED ON DA-MODULATED MICRO-CIRCUITS. WE ALSO EXPLORE HOW NEURODEVELOPMENTAL FACTORS MAY MODIFY RISK FOR LATER EMERGENCE OF MDD, POSSIBLY THROUGH DOPAMINERGIC SUBSTRATES IN THE BRAIN. 2021 14 5310 20 PSYCHOBIOLOGY AND MOLECULAR GENETICS OF RESILIENCE. EVERY INDIVIDUAL EXPERIENCES STRESSFUL LIFE EVENTS. IN SOME CASES ACUTE OR CHRONIC STRESS LEADS TO DEPRESSION AND OTHER PSYCHIATRIC DISORDERS, BUT MOST PEOPLE ARE RESILIENT TO SUCH EFFECTS. RECENT RESEARCH HAS BEGUN TO IDENTIFY THE ENVIRONMENTAL, GENETIC, EPIGENETIC AND NEURAL MECHANISMS THAT UNDERLIE RESILIENCE, AND HAS SHOWN THAT RESILIENCE IS MEDIATED BY ADAPTIVE CHANGES IN SEVERAL NEURAL CIRCUITS INVOLVING NUMEROUS NEUROTRANSMITTER AND MOLECULAR PATHWAYS. THESE CHANGES SHAPE THE FUNCTIONING OF THE NEURAL CIRCUITS THAT REGULATE REWARD, FEAR, EMOTION REACTIVITY AND SOCIAL BEHAVIOUR, WHICH TOGETHER ARE THOUGHT TO MEDIATE SUCCESSFUL COPING WITH STRESS. 2009 15 4848 22 OPIOID-INDUCED STRUCTURAL AND FUNCTIONAL PLASTICITY OF MEDIUM-SPINY NEURONS IN THE NUCLEUS ACCUMBENS. OPIOID USE DISORDER (OUD) IS A CHRONIC RELAPSING CLINICAL CONDITION WITH TREMENDOUS MORBIDITY AND MORTALITY THAT FREQUENTLY PERSISTS, DESPITE TREATMENT, DUE TO AN INDIVIDUAL'S UNDERLYING PSYCHOLOGICAL, NEUROBIOLOGICAL, AND GENETIC VULNERABILITIES. EVIDENCE SUGGESTS THAT THESE VULNERABILITIES MAY HAVE NEUROCHEMICAL, CELLULAR, AND MOLECULAR BASES. KEY NEUROPLASTIC EVENTS WITHIN THE MESOCORTICOLIMBIC SYSTEM THAT EMERGE THROUGH CHRONIC EXPOSURE TO OPIOIDS MAY HAVE A DETERMINATIVE INFLUENCE ON BEHAVIORAL SYMPTOMS ASSOCIATED WITH OUD. IN PARTICULAR, STRUCTURAL AND FUNCTIONAL ALTERATIONS IN THE DENDRITIC SPINES OF MEDIUM SPINY NEURONS (MSNS) WITHIN THE NUCLEUS ACCUMBENS (NAC) AND ITS DOPAMINERGIC PROJECTIONS FROM THE VENTRAL TEGMENTAL AREA (VTA) ARE BELIEVED TO FACILITATE THESE BEHAVIORAL SEQUELAE. ADDITIONALLY, GLUTAMATERGIC NEURONS FROM THE PREFRONTAL CORTEX, THE BASOLATERAL AMYGDALA, THE HIPPOCAMPUS, AND THE THALAMUS PROJECT TO THESE SAME MSNS, PROVIDING AN ENRICHED TARGET FOR SYNAPTIC PLASTICITY. HERE, WE REVIEW LITERATURE RELATED TO NEUROADAPTATIONS IN NAC MSNS FROM DOPAMINERGIC AND GLUTAMATERGIC PATHWAYS IN OUD. WE ALSO DESCRIBE NEW FINDINGS RELATED TO TRANSCRIPTIONAL, EPIGENETIC, AND MOLECULAR MECHANISMS IN MSN PLASTICITY IN THE DIFFERENT STAGES OF OUD. 2021 16 6577 25 TREATMENT STRATEGIES FOR COMPLEX BEHAVIORAL INSOMNIA IN CHILDREN WITH NEURODEVELOPMENTAL DISORDERS. PURPOSE OF REVIEW: THIS REVIEW DESCRIBES RECENT RESEARCH IN PEDIATRIC BEHAVIORAL INSOMNIAS IN NEURODEVELOPMENTAL DISORDERS AND THEIR TREATMENT. RECENT FINDINGS: INSOMNIA IN CHILDREN WITH AUTISM SPECTRUM DISORDER (ASD) AND OTHER NEURODEVELOPMENTAL DISORDERS (NDDS) IS TYPICALLY COMPLEX, CHRONIC, AND DIFFICULT TO ADEQUATELY CONTROL. ABNORMALITIES IN GENETIC AND/OR EPIGENETIC REGULATION OF SLEEP/WAKEFULNESS AND ITS TIMING PREDISPOSE PATIENTS WITH NDD TO INSOMNIA, ALTHOUGH POOR SLEEP HYGIENE, MALADAPTIVE ASSOCIATIONS, AND LIMIT-SETTING ARE LIKELY TO CONTRIBUTE. PARENTS ARE AGENTS FOR CHANGE IN PROBLEMATIC SLEEP BEHAVIORS IN PATIENTS WITH NDD. WE REVIEW THE BENEFITS OF BEHAVIORAL THERAPIES AND MELATONIN TO TREAT SLEEP PROBLEMS IN CHILDREN WITH NDD. PROBLEMATIC SLEEP IS SO PREVALENT IN SOME NEURODEVELOPMENTAL SYNDROMES (RETT, ANGELMAN, WILLIAMS, AND SMITH-MAGENIS) THAT IT IS PART OF THEIR DIAGNOSTIC CRITERIA. SUMMARY: CHILDREN AND ADOLESCENTS WITH NEUROLOGICAL DISORDERS FREQUENTLY HAVE COMPLEX SLEEP DISORDERS THAT REQUIRE TREATMENT. UNDERSTANDING THE BASIC PATHOLOGY AND TREATMENT STRATEGIES PROVIDES AN OPPORTUNITY TO IMPROVE WELL BEING AND QUALITY OF LIFE IN THOSE AFFECTED BY NDD AND THEIR FAMILIES. 2013 17 4525 21 MULTIFACTORIAL CAUSES OF PARANOID SCHIZOPHRENIA WITH AUDITORY-VISUAL HALLUCINATIONS IN A 31-YEAR-OLD MALE WITH HISTORY OF TRAUMATIC BRAIN INJURY AND SUBSTANCE ABUSE. SCHIZOPHRENIA IS A CHRONIC PSYCHIATRIC DISORDER THAT CLASSICALLY PRESENTS WITH DISTORTIONS OF THOUGHT, BEHAVIOR, AND PERCEPTIONS THAT ARE OFTEN MISDIAGNOSED. ONE DIFFICULTY IN DIAGNOSING SCHIZOPHRENIA IS DUE TO ITS PHENOTYPICALLY HETEROGENEOUS CONDITION THAT CAN BE PRECIPITATED BY A COMBINATION OF GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS. THE PREVALENCE OF SCHIZOPHRENIA IS ROUGHLY 1%, BUT IT IS OFTEN MISDIAGNOSED. POSSIBLE DIFFERENTIAL DIAGNOSES INCLUDE DEPRESSION OR BIPOLAR DISORDER WITH PSYCHOSIS, PSYCHOSIS DUE TO A MEDICAL CONDITION, SCHIZOTYPAL AND SCHIZOID PERSONALITY DISORDERS, AND NEUROCOGNITIVE DISORDERS. IN THIS CASE REPORT, A 31-YEAR-OLD MALE PRESENTS WITH THOUGHTS OF SUICIDE FOLLOWING A RECENT EXACERBATION OF HIS HALLUCINATIONS. ON PRESENTATION, THE PATIENT PRESENTED WITH A HISTORICAL DIAGNOSIS OF "PARANOID SCHIZOPHRENIA" AS WELL AS A HISTORY OF TRAUMATIC BRAIN INJURY (TBI), POLY-SUBSTANCE USE DISORDER, AND A FAMILY HISTORY OF SCHIZOPHRENIA. THIS CASE SERVES TO HIGHLIGHT THE DIFFICULTIES OF MAKING AN ACCURATE DIAGNOSIS AND PROVIDING EVIDENCED-BASED TREATMENT. 2022 18 6375 27 THE ROLE OF NEURO-IMMUNE INTERACTION IN CHRONIC PAIN CONDITIONS; FUNCTIONAL SOMATIC SYNDROME, NEUROGENIC INFLAMMATION, AND PERIPHERAL NEUROPATHY. FUNCTIONAL SOMATIC SYNDROMES ARE INCREASINGLY DIAGNOSED IN CHRONICALLY ILL PATIENTS PRESENTING WITH AN ARRAY OF SYMPTOMS NOT ATTRIBUTED TO PHYSICAL AILMENTS. CONDITIONS SUCH AS CHRONIC FATIGUE SYNDROME, FIBROMYALGIA SYNDROME, OR IRRITABLE BOWEL SYNDROME ARE COMMON DISORDERS THAT BELONG IN THIS BROAD CATEGORY. SUCH SYNDROMES ARE CHARACTERISED BY THE PRESENCE OF ONE OR MULTIPLE CHRONIC SYMPTOMS INCLUDING WIDESPREAD MUSCULOSKELETAL PAIN, FATIGUE, SLEEP DISORDERS, AND ABDOMINAL PAIN, AMONGST OTHER ISSUES. SYMPTOMS ARE BELIEVED TO RELATE TO A COMPLEX INTERACTION OF BIOLOGICAL AND PSYCHOSOCIAL FACTORS, WHERE A DEFINITE AETIOLOGY HAS NOT BEEN ESTABLISHED. THEORIES SUGGEST CAUSATIVE PATHWAYS BETWEEN THE IMMUNE AND NERVOUS SYSTEMS OF AFFECTED INDIVIDUALS WITH SEVERAL RISK FACTORS IDENTIFIED IN PATIENTS PRESENTING WITH ONE OR MORE FUNCTIONAL SYNDROMES. RISK FACTORS INCLUDING STRESS AND CHILDHOOD TRAUMA ARE NOW RECOGNISED AS IMPORTANT CONTRIBUTORS TO CHRONIC PAIN CONDITIONS. EMOTIONAL, PHYSICAL, AND SEXUAL ABUSE DURING CHILDHOOD IS CONSIDERED A SEVERE STRESSOR HAVING A HIGH PREVALENCE IN FUNCTIONAL SOMATIC SYNDROME SUFFERS. SUCH TRAUMA PERMANENTLY ALTERS THE BIOLOGICAL STRESS RESPONSE OF THE SUFFERS LEADING TO NEUROEXCITATORY AND OTHER NERVE ISSUES ASSOCIATED WITH CHRONIC PAIN IN ADULTS. TRAUMATIC AND CHRONIC STRESS RESULTS IN EPIGENETIC CHANGES IN STRESS RESPONSE GENES, WHICH ULTIMATELY LEADS TO DYSREGULATION OF THE HYPOTHALAMIC-PITUITARY AXIS, THE AUTONOMIC NERVOUS SYSTEM, AND THE IMMUNE SYSTEM MANIFESTING IN A BROAD ARRAY OF SYMPTOMS. IMPORTANTLY, THESE SYSTEMS ARE KNOWN TO BE DYSREGULATED IN PATIENTS SUFFERING FROM FUNCTIONAL SOMATIC SYNDROME. FUNCTIONAL SOMATIC SYNDROMES ARE ALSO HIGHLY PREVALENT CO-MORBIDITIES OF PSYCHIATRIC CONDITIONS, MOOD DISORDERS, AND ANXIETY. CONSEQUENTLY, THIS REVIEW AIMS TO PROVIDE INSIGHT INTO THE ROLE OF THE NERVOUS SYSTEM AND IMMUNE SYSTEM IN CHRONIC PAIN DISORDERS ASSOCIATED WITH THE MUSCULOSKELETAL SYSTEM, AND CENTRAL AND PERIPHERAL NERVOUS SYSTEMS. 2022 19 4622 16 NEUROBIOLOGICAL DEVELOPMENT IN THE CONTEXT OF CHILDHOOD TRAUMA. NEUROBIOLOGICAL SYSTEMS MAY BE PARTICULARLY SUSCEPTIBLE TO DELETERIOUS IMPACT OF CHILDHOOD TRAUMA, AND THE IMPACT OF CHILDHOOD TRAUMA ON DEVELOPMENT AND SUBSEQUENT FUNCTIONAL OUTCOMES ACROSS THE LIFESPAN HAS BEEN WELL-DOCUMENTED. THE CURRENT REVIEW ADDRESSES THE NEUROBIOLOGICAL IMPACT OF EXPOSURE TO INTERPERSONAL TRAUMA IN CHILDHOOD IN THE CONTEXT OF EXECUTIVE FUNCTION, EMOTION REGULATION, AND DISSOCIATION/INTEROCEPTIVE AWARENESS. SUBSEQUENT RISK FOR PTSD AND DEPRESSION IS ALSO DISCUSSED. THE PATHWAY OF RISK FROM CHILDHOOD TRAUMA TO THESE COGNITIVE, EMOTIONAL, AND PSYCHIATRIC OUTCOMES IS ADDRESSED IN TERMS OF POTENTIAL STRUCTURAL AND FUNCTIONAL ALTERATIONS WITHIN THE HIPPOCAMPUS, PREFRONTAL CORTEX, AND AMYGDALA RESULTING FROM CHRONIC OR REPEATED ACTIVATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS AND ITS INTERACTION WITH AND INFLUENCE ON GENETIC AND EPIGENETIC PROCESSES DURING SENSITIVE PERIODS OF DEVELOPMENT. IMPLICATIONS FOR PRACTICE ARE DISCUSSED. 2017 20 1179 21 CONVERGENCE AND DIVERGENCE IN THE ETIOLOGY OF MYELIN IMPAIRMENT IN PSYCHIATRIC DISORDERS AND DRUG ADDICTION. IMPAIRMENT OF OLIGODENDROGLIA (OL)-DEPENDENT MYELINATION IN THE CENTRAL NERVOUS SYSTEM (CNS) IS A REMARKABLE PARALLEL RECENTLY IDENTIFIED IN MAJOR PSYCHIATRIC DISORDERS AND CHRONIC DRUG ABUSE. NEUROIMAGING AND NEUROPATHOLOGICAL STUDIES REVEALED MYELIN DEFECTS AND MICROARRAY-PROFILING ANALYSIS DEMONSTRATED ABERRANT EXPRESSION OF MYELIN-RELATED GENES IN SCHIZOPHRENIA (SZ), BIPOLAR DISORDER (BD), MAJOR DEPRESSIVE DISORDER (MDD) AND COCAINE ADDICTION. HOWEVER, THE ETIOLOGY UNDERLYING MYELIN IMPAIRMENT IN THESE CLINICALLY DISTINCT SUBJECTS REMAINS ELUSIVE. THIS ARTICLE REVIEWS MYELIN IMPAIRMENT IN LINE WITH DOPAMINERGIC DYSFUNCTION, A PRIME NEUROPATHOPHYSIOLOGICAL TRAIT SHARED IN PSYCHIATRIC DISORDERS AND DRUG ABUSE, AS WELL AS THE GENETIC AND EPIGENETIC ALTERATIONS ASSOCIATED WITH THESE DISEASES. THE CURRENT FINDINGS SUPPORT THE HYPOTHESIS THAT ABERRANT DOPAMINE (DA) ACTION ON OLS IS A COMMON PATHOLOGIC MECHANISM FOR MYELIN IMPAIRMENT IN THE AFOREMENTIONED MENTAL MORBIDITIES, WHEREAS INHERITED GENETIC VARIATIONS THAT SPECIFICALLY AFFECT OL DEVELOPMENT AND MYELINOGENESIS MAY FURTHER INCREASE MYELIN VULNERABILITY IN PSYCHIATRIC DISORDERS. IMPORTANTLY, OL DEFECT IS NOT ONLY A PATHOLOGICAL CONSEQUENCE BUT ALSO A CAUSATIVE FACTOR FOR DOPAMINERGIC DYSFUNCTION. HENCE, MYELIN IMPAIRMENT IS A KEY FACTOR IN THE PATHOGENIC LOOP OF PSYCHIATRIC DISEASES AND DRUG ADDICTION. 2008