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INNOSC Theranostics and
Pharmacological Sciences Youth brain health check and dysregulation

impairments are underreported comorbidities of reward educational and therapeutic environment for students
dysregulation due to genetic antecedents and epigenetic following SUD treatment. According to Weimer et al.,
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insults. Recent genome-wide association studies involving most students served by RHSs have concurrent mental
millions of subjects revealed frequent comorbidity with health disorders and are at risk for school failure, dropout,
SUD in a sizeable meta-analysis of depression. Significant and substance use relapse. Fairly recently, RHS student
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associations were identified between the expression of high school graduation rates were 21 – 25 percentage points
NEGR1 in the hypothalamus and DRD2 in the NAc, higher compared to students not attending RHS. This
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among other genetic factors. However, despite the rise finding was statistically significant, albeit with limitations
in SUD and neuropsychiatric illness, especially in youth, related to non-randomized design, selection bias in the
routine standard objective assessments of brain function study conditions, and uncertainty in calculating school
remain absent. costs. In another study by Tanner-Smith et al., students
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The importance of exercise programs in the global attending RHS exhibited less frequent delinquent behavior
educational system was emphasized in 2020 by the release while intoxicated and fewer days of substance use after
of updated global guidelines by the WHO on physical discharge from SUD treatment than students attending
activity and sedentary behavior for children, adolescents, non-RHS. Therefore, we propose RHS students as suitable
adults, older adults, sub-populations such as pregnant and candidates to test out the utilization of the BHC.
postpartum women, and those living with chronic conditions The proposed BHC comprises a set of reliable, accurate,
or disabilities. According to Chaput et al., increased and and cost-effective objective assessments involving the
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higher intensities of physical activity, as well as a diversity of following domains: (i) episodic and general memory;
physical activity (i.e., aerobic, muscle, and bone strengthening (ii) processing speed; (iii) attention; (iv) neuropsychiatry;
activities), are associated with improved health outcomes and (iv) neurological imaging. After a review of over
(primarily intermediate outcomes), as supported by various 36 years of computerized and written assessments primarily
systematic reviews. Similarly, Thanos’s group reported from PUBMED of memory, attention, psychiatric, and
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that exercised rats had 18% and 21% lower dopamine D1R- neurological imaging, the following recommendations
like binding levels than sedentary rats within the olfactory have been selected for inclusion in the BHC: (i) MemTrax
tubercle and NAc shell, respectively. In addition, there was (episodic memory and processing speed); (ii) CNS vital
greater dopamine D2R-like binding in the NAc core (24%) signs (general and remote memory); (iii) test of variables
and shell (25%) of exercised rats compared with sedentary of attention (attention); (iv) millon clinical multiaxial
rats. These observations support the hypothesis that aerobic inventory III (neuropsychiatric); and (v) quantitative
exercise results in changes in the mesolimbic pathway that electroencephalogram/P300/evoked potential (neurological
could mediate exercise-induced attenuation of drug-seeking imaging). Continued research aims to simplify the BHC by
behavior. The role of exercise, especially in the educational including qEEG/P300/evoked potentials and genetically
system, may have potential benefits for assisting school-age guided precision induction of “dopamine homeostasis.”
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children with a positive family history of SUD, for example, This approach allows the assessment and treatment of reward
through formal fitness programs. 80 deficiency and helps prevent dopamine dysregulation from
We propose that integrating existing education-based being epigenetically transmitted to future generations.
fitness programs with a standard BHC could synergistically During adolescence, developmental changes in the
not only improve the health of individuals but could also neural circuitry of reward processing, motivation, cognitive
facilitate early identification of cognitive impairments. For control, and stress may contribute to vulnerability to
early identification of cognitive abilities, DNA analysis increased engagement in substance use and nonsubstance
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through genetic testing, such as the GARS test, could addictive behaviors. It has been suggested that the
provide important information, reflecting students’ brain adolescent’s liability for addictions involves changes in
neurotransmitter function at a genetic level. 19,21,78,80,81 the function and structure of the midbrain dopaminergic
The rationale for encouraging a standard objective BHC system, genetic antecedents, and epigenetic insults such as
is to acquire an extensive dataset to treat clinical syndromes stress-induced neuroplasticity, contributing to imbalances
in psychiatric patients and high-risk populations. While we between cognitive control and reward response.
advocate for implementing a generalized BHC across all Potenzas’ group suggests that leveraging genetics,
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K1–K12 students, its importance is especially pronounced epigenetics, and intermediate phenotypes/endophenotypes
for high-risk children attending “recovery high school may help identify children and adolescents at risk. Once
(RHS).” Spearheaded by one of us (AJF) and others is the identified, it is crucial for these individuals to participate
needed development of RHSs that provide a supportive in a guidance program, essentially brain health coaching

Volume 7 Issue 2 (2024) 7 doi: 10.36922/itps.1472