title: Lifetime experiences, the brain and personalized medicine: an integrative perspective.
abstract: The aim of personalized medicine is to base medical prevention and therapy on the unique health and disease susceptibility profile of each individual. Starting from this idea, we briefly discuss the meaning of the word 'personalized' before analyzing the practical content of personalized healthcare. From a medical perspective, knowledge of a person encompasses both biological and biographical perspectives. The latter includes significant events and experiences throughout the person's lifespan, from conception to the present, in which epigenetic influences play an important role. In practice, we believe personalized medicine should emphasize the development and maintenance of a healthy nervous system. The neurobiological processes involved here depend heavily on the psychosocial environment, in particular the presence of responsible, caring adults and integration in a reasonably fair society. A healthy brain subsequently promotes good health throughout life, both through direct, favorable influences on the body's intrinsic biological pathways, and indirectly by enabling the person to engage in supportive relationships, make wise decisions and take good care of him/herself. From a public health perspective, we conclude that hi-tech personalized medicine based on detailed bio-molecular mapping, monitoring and tailored drug interventions holds promise only as part of a wider, socio-culturally informed approach to the person.
authors.affiliation: Laboratory of Neuroendocrinology, The Rockefeller University, New York, NY 10065, USA. mcewen@rockefeller.edu
authors.forename: Bruce S
authors.initials: BS
authors.lastname: McEwen
authors.forename: Linn
authors.initials: L
authors.lastname: Getz
mesh_terms: D000223:Adaptation, Psychological; D000818:Animals; D001921:Brain / Q000503:physiopathology*; D002755:Choice Behavior; D002908:Chronic Disease; D058245:Cognitive Reserve; D044127:Epigenesis, Genetic; D057890:Epigenomics; D015444:Exercise; D059647:Gene-Environment Interaction; D015438:Health Behavior; D006624:Hippocampus / Q000503:physiopathology; D006801:Humans; D008016:Life Change Events; D008603:Mental Health; D009473:Neuronal Plasticity; D057285:Precision Medicine / Q000379:methods / Q000639:trends*; D011322:Primary Prevention; D011603:Psychophysiology; D020377:Self Efficacy; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000235:genetics; D013312:Stress, Physiological / Q000235:genetics*; D013315:Stress, Psychological / Q000235:genetics*