Dopaminergic Homeostatic Therapy (DHT) as a Putative Anti-Addiction Seeking Intervention and Early Identification of Genetic Preaddiction with Genetic Addiction Risk Severity (GARS) Screening.

In spite of the ongoing exquisite work of a multitude of researchers worldwide including governmental institutions like the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and for example in the United States the FDA Medication Assisted Therapy (MAT) embracing Opioid Replacement Therapy (ORT) in 2022, 111,000 people prematurely died from opioid induced overdose. It is estimated that if treatment stays as usual by 2025 the death rate will increase to 165,00.Therefore, we are encouraging the scientific and clinical community to at least consider our "out of the box" thinking whereby we are proposing a new paradigm shift involving the " dopaminergic homeostatic modeling approach and Genetic screening to early identify preaddiction.

Theorizing The Role of Gama Type Endorphins in Schizophrenia and Alcoholism: Promoting Genetic Testing and Attempts at Inducing "Dopamine Homeostasis".

We examine the relationship between substance use disorder (SUD) and schizophrenia, emphasizing the role of dopaminergic neurotransmission and genetic predispositions within the context of Reward Deficiency Syndrome (RDS). Our hypothesis posits that a deficiency in gamma-type endorphins leads to persistent hyperdopaminergic activity, amplifying schizophrenia-related symptoms such as hallucinations. Thus, alcohol use may function as a physiological self-healing mechanism by increasing gamma-endorphin levels, thereby mitigating dopaminergic hyperactivity.

Is It Scientifically Possible To 'Cure" Reward Deficiency Syndrome (RDS) Via Transplice Molecular Genetic Technology?

In 1995, Kenneth Blum coined the term "Reward Deficiency Syndrome'(RDS) to provide the mental health field with an umbrella term expressing a dissatisfaction of everyday experiences due to a dysregulation of dopaminergic dysregulation especially the DRD2 Taq A1 polymorphism presenting with up to a 40% reduction of D2 receptors in brain tissue with two copies. While the concept of RDS as the actual real umbrella of all mental illness unlike the current DSM-V (the brain is not carved out as portrayed by this important psychiatric manual) awaits further intensive research. In fact, Steven Hyman (former director of NIMH) suggests otherwise and has urged for research related to etiological causes instead to help explain the failings of mental health.

Exploring dopamine as the master regulator of brain circuitry and mental health genome.

Artificially increasing dopamine transmission is the common mechanism by which substances with addictive potential lead to addiction. A key area of research in neurobiology is the role of dopamine. Significant advancements have been made in uncovering the intracellular signaling pathways that mediate both dopamine's immediate effects and its long-term influence on brain function.

A GWAS Meta-meta-analysis and In-depth Silico Pharmacogenomic Investigations in Identification of APOE and Other Genes Associated with Pain, Anti-inflammatory, and Immunomodulating Agents in Opioid Use Disorder (OUD) Derived from 14.91 M Subjects.

This study aimed to integrate genome-wide association studies (GWAS) with pharmacogenomics data to develop personalized pain and inflammatory therapeutics. Despite recent developments in the clinical utilities of pharmacogenomics, it needs more investigations for uncovering the complicated mechanisms of drugs from a genetic standpoint. The research addresses the increasing misuse of opioids during recovery, emphasizing personalized interventions for opioid use disorder (OUD).

Opioid-Induced Hyperalgesia and Inflammaging in the Management of Spine Pain: The Case for Genetically Directed Dopamine Homeostasis.

Background: The management of spine-related pain with narcotics, both before and after surgery, poses major challenges, including drug diversion, limited effectiveness, and worsening of pain symptoms over time. Chronic opioid use is associated with hypodopaminergia-induced hyperalgesia, whereby dopamine depletion increases pain sensitivity. Patients with inherently low dopaminergic function are particularly predisposed to hyperalgesia and reduced pain tolerance.

Exercise Leads to Brain Glucose Metabolism Activation, Increased Dopamine D1 Receptor Levels and is Negatively Correlated with Social Behavior.

Background: Exercise enhances overall health, playing an important role in protecting against diseases that impact brain function. Studies show that physical activity influences several key biological processes, including dopamine signaling, brain glucose metabolism (BGluM), and social behavior.

Methods: Male sedentary and chronic exercise rats were examined for dopamine signaling and social behavior.

ISASS Recommendations and Coverage Criteria for Bone-Anchored Annular Defect Closure Following Lumbar Discectomy: Coverage Indications, Limitations, and/or Medical Necessity-An ISASS 2025 Policy Update on the Use of Bone-Anchored Annular Closure to Prevent Reherniation in High-Risk Lumbar Discectomy Patients.

Patients with symptomatic lumbar disc herniation with radiculopathy where there is a large residual annular defect following discectomy are at greater risk of reherniation with symptom recurrence and revision surgery. These patients may benefit from primary annular repair. In 2019, the International Society for the Advancement of Spine Surgery published clinical guidelines supporting the use of bone-anchored annular closure in patients with large annular defects who are at greater risk for recurrent disc herniation.

Patient Perspectives on Awake Transforaminal Endoscopic Decompression Surgery Outcomes.

Background: This study aims to evaluate patient perceptions of the outcomes following awake transforaminal endoscopic lumbar decompression surgery for treating degenerative spine diseases.

Methods: Over a 1-year period from 2022 to 2023, awake transforaminal endoscopic spine surgeries were performed on 183 patients using local anesthesia and sedation, allowing patients to communicate with the surgical team throughout the procedure. A follow-up app-based survey was sent to these patients to assess their perceptions and outcomes related to the surgery.

A Comprehensive 4-Layered In Silico Pharmacogenomics Analysis of the Genetic Addiction Risk Severity (GARS) Test: Strong Genetic Evidence Supporting GARS as a Novel Personalized Pre-Addiction Assessment Tool in the Opioid Crisis Era.

Background: Overdose involving opioids is the black heart of the addiction crisis. "Pre-addiction," as an encouraging concept by NIDA and NIAAA, seems best captured with the construct of dopamine dysregulation. Referring to the abundant publications on "Reward Deficiency Syndrome" (RDS), Genetic Addiction Risk Score (GARS) test, RDSQ29, and KB220, Pre-addiction can be referred to as "reward dysregulation" as a suitable suggestion.

Genetic and Regulatory Mechanisms of Comorbidity of Anxiety, Depression and ADHD: A GWAS Meta-Meta-Analysis Through the Lens of a System Biological and Pharmacogenomic Perspective in 18.5 M Subjects.

In the United States, approximately 1 in 5 children experience comorbidities with mental illness, including depression and anxiety, which lead to poor general health outcomes. Adolescents with substance use disorders exhibit high rates of co-occurring mental illness, with over 60% meeting diagnostic criteria for another psychiatric condition in community-based treatment programs. Comorbidities are influenced by both genetic (DNA antecedents) and environmental (epigenetic) factors.

EEG-Spectra-Guided Personalized rTMS in PTSD with Co-occurring Psychiatric Disorders: A Case Series.

Personalized repetitive Transcranial Magnetic Stimulation (PrTMS) offers an individualized approach to neuromodulation through customized treatment protocols. This case series aims to explore therapeutic outcomes of PrTMS in two patients with post-traumatic stress disorder (PTSD), based on standardized rating scale scores and spectral EEG-guided alpha brainwave activity optimization. Participants diagnosed with PTSD received PrTMS treatments informed by quantitative rating scales and weekly spectral EEG measurements.

Comparative perioperative narcotic use in tlif patients: Spinal versus general anesthesia in a retrospective cohort study of 180 cases in hospital and ambulatory settings.

Objectives: To implement an integrated anesthesia and surgery protocol of improved postoperative pain control to facilitate transitioning of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) from a hospital to an ambulatory surgery center setting by lowering postoperative (in-facility) narcotic consumption and length of stay (LOS) transitioning from general to awake spinal anesthesia.

Methods: A retrospective cohort study of 180 patients who received awake or general anesthesia (GA) MI-TLIF from 2017 to 2023.

Results: Among 180 MI-TLIF patients, 101 (56 %) received awake protocol and 79 (44 %) received general anesthesia.

Endoscopic transfacet Decompression for Severe Lumbar Spinal Stenosis: A Technical Note, Illustrative Clinical Series, and Surgeon Survey Regarding Post-Decompression Instability.

: Lumbar spinal stenosis (LSS) remains a predominant cause of debilitating back and leg pain, affecting many aging populations. Traditional decompression surgeries can be invasive and pose significant risks and recovery time. This study elucidates the techniques and preliminary outcomes of endoscopic transfacet decompression in treating severe LSS.

Complex NADASE Infusions Improve Clinical Outcome in Substance Use Disorder: Descriptive Annotation in Fifty Cases.

Background: The present study relates to a method to treat and detoxify patients with substance use disorder (SUD) utilizing a series of nicotinamide adenine dinucleotide (NAD+) and enkephalinase infusions (NADASE) in subjects attending chemical dependency programs.

Objective: The primary objective of the current investigation is to provide some additional clinical evidence to show that NAD+ other amino acids including d-phenylalanine, glycine and ananylglutamine dipeptide and Myer's cocktail (B complex) infusions significantly attenuates substance craving behavior and concomitant psychiatric burden sequalae in poly-drug abusers attending both in-patient and out-patient level of care in a number of chemical dependency programs in orange country.

Methods: At symmetry approximately 1,000 now performed approximately 1,000 infusions on 900 patients without any serious side effects pointing to the safety of this procedure.

EPIC Technique Spinal Procedure Improves Ocular Motion and Dizziness by Resolving Cranial Nerve VI Palsy.

Unlabelled: This case study demonstrates that craniocervical spinal alignment with the EPIC technique spinal procedure appears to have a potential positive impact on ocular function. This paper will report the case of a patient with cranial nerve VI palsy and dizziness, and the clinical improvements following treatment with the soundwave technology of the EPIC technique spinal procedure [1].

Objective: To report the case of a patient with cranial nerve VI (CN VI) palsy and the clinical changes that occurred after receiving treatment using the EPIC (Evolutionary Percussion Instrument Corrections) technique spinal procedure.

Key Takeaways From the ISASS Webinar Series on Current and Emerging Techniques in Endoscopic Spine Surgery | Part 2: Polytomous Rasch Analysis of Learning Curve and Surgeon Endorsement of Biportal, Interlaminar, and Transforaminal Endoscopic Stenosis Decompression, Discectomy, and Laminectomy in Combination With Interspinous Process Spacers.

Background: The International Society for the Advancement of Spine Surgery hosted the second of a series of 4 webinars on endoscopic spine surgery techniques. The second webinar focused on the application of unilateral biportal endoscopy for discectomy and laminectomy in combination with interbody fusion and interspinous process spacers. This series was intended to identify current trends with contemporary modern endoscopic spine surgery techniques.

Key Takeaways From ISASS Webinar Series on Endoscopic Spine Surgery Techniques | Part 4: Advancing the Curve on Surgeons' Experience With Complex Lumbar Revision Scenarios, Grades 1 to 3 Spondylolytic Spondylolisthesis, Cervical Foraminotomy, and Cervical Spondylotic Myelopathy.

Background: The fourth webinar in a 4-part series hosted by the International Society for the Advancement of Spine Surgery explored contemporary endoscopic spine surgery techniques. This session covered complex revision strategies, endoscopic management of grades 1-3 spondylolytic spondylolisthesis, cervical foraminotomy, and decompression techniques for cervical spondylotic myelopathy (CSM).

Objective: The aim was to assess surgeon endorsement of the discussed endoscopic spine surgery techniques both before and after the webinar using polytomous Rasch analysis.