title: Reward Deficiency Syndrome: Attentional/Arousal Subtypes, Limitations of Current Diagnostic Nosology, and Future Research.
abstract: We theorise that in some cases Attention Deficit Hyperactivity Disorder (ADHD) predisposes to narcolepsy and hypersomnia, and that there may be a shared pathophysiology with various addictions [Reward Deficiency Syndrome (RDS)]. Reticence to acknowledge such connections may be due to a narrow nosological framework. Additionally, we theorise that the development of narcolepsy on a baseline of ADHD/RDS leads to an additional assault on the dopaminergic reward system in such individuals. In this study, we propose to test these hypotheses by using a combination of broad genetic screening, and neuroimaging with and without pharmacological intervention, in those with pure ADHD, pure narcolepsy, and the combined ADHD-narcolepsy phenotype. Results of this proposed study may reveal a common pathophysiology of ADHD, narcolepsy and RDS, and perhaps an additional compromise to the reward system in those with combined ADHD-narcolepsy. If the evidence supports the hypothesis that indeed there is a shared pathophysiology for narcolepsy with RDS and thus its subtype ADHD, early intervention/preventative treatment amongst those with ADHD may be beneficial with the putative dopaminergic compound KB220Z™.
authors: Department of Neurology, Boston University School of Medicine, Boston, MA, USA.|Department of Neurology, Boston VA Healthcare System, Boston, MA, USA.
authors: Edward Justin
authors: EJ
authors: Modestino
authors: Department of Psychiatry & McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL,USA.|Human Integrated Services Unit University of Vermont Center for Clinical & Translational Science, Department of Psychiatry, College of Medicine, Burlington, VT, USA.|Dominion Diagnostics, LLC, North Kingstown, RI, USA.|Department of Addiction Research & Therapy, Malibu Beach Recovery Center, Malibu Beach, CA, USA.
authors: Kenneth
authors: K
authors: Blum
authors: Department of Neurology, Boston University School of Medicine, Boston, MA, USA.|Departments of Psychiatry, Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA.|Boston VA Healthcare System, Boston, MA, USA.
authors: Marlene
authors: M
authors: Oscar-Berman
authors: Departments of Psychiatry & Behavioral Sciences at the Keck, University of Southern California, School of Medicine, CA, USA.|Director of Research, Drug Enforcement Administration (DEA) Educational Foundation, Washington, D.C, USA.
authors: Mark S
authors: MS
authors: Gold
authors: Institute for Developmental Behavioral Neurology Scottsdale, AZ, USA.|Department of Speech and Hearing Sciences, Arizona State University, Tempe, AZ, USA.|Department of Neurology, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
authors: Drake D
authors: DD
authors: Duane
authors: Department of Psychiatry, St. Mary's Hospital Centre, Montreal, QC, Canada.|Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.
authors: Sarah G S
authors: SGS
authors: Sultan
authors: Departments of Neurology & Psychiatry, Boston University School of Medicine, Boston, MA, USA.|Sleep Disorders Center & Behavioral Neurology, Boston Medical Center, Boston, MA, USA.
authors: Sanford H
authors: SH
authors: Auerbach
keywords: ADHD; Genetics; Narcolepsy; Reward deficiency syndrome; fcMRI