Kiba da Jaraba: Tsarukan Neurobiological Overlaps. (2012) Nora Volkow

• Addiction;
• dopamine;
• kiba;
• kodin farko

Summary

Maganin ƙwayoyi da kiba sun bayyana suna raba kaddarori da yawa. Dukansu ana iya bayyana su azaman rikice-rikice wanda jin daɗin wani nau'in lada (abinci ko magani) ya zama ƙari dangane da, kuma a kan farashin wasu lada. Dukkanin kwayoyi da abinci suna da tasirin ƙarfafawa, waɗanda ke cikin ɓangaren sulhu ta hanyar ƙara haɓakar dopamine a cikin cibiyoyin lada na ƙwaƙwalwa. Dopamineararren kwatsam yana ƙaruwa, a cikin mutane masu rauni, na iya mamaye hanyoyin sarrafa gida mai kwakwalwa. Wadannan daidaito sun haifar da sha'awar fahimtar raunin ra'ayoyi tsakanin buri da kiba.

Hasashe, su ma sun haifar da wata muhawara mai zafi. A takaice, karatuttukan hoton kwakwalwar suna fara gano abubuwa na gama-gari tsakanin wadannan yanayi biyu tare da samarda wasu hanyoyin da suke mamaye kwakwalwar kwakwalwa wadanda nakasassun su zasu iya haifar da kasawa.

Sakamakon da aka haɗaka ya ba da shawarar cewa duka masu kiba da masu shan kwayoyi suna fama da rauni a cikin hanyoyin hanyoyin dopaminergic wanda ke daidaita tsarin neuronal wanda ba a haɗa shi kawai da sakamako mai ban sha'awa da kuma motsa hankali ba, har ma tare da yanayin kwastomomi, kamun kai, saurin sake motsa jiki da wayar da kai.

A gefe guda, binciken ma yana ba da bambance-bambance a tsakanin su waɗanda ke kan mahimmancin mahimmancin siginar hannu wanda ke da nasaba da sarrafawar gida. Anan, zamu mai da hankali ga abubuwan da ke tattare da ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta da ƙari.

Tarihi

Magunguna na zagi suna matsawa cikin hanyoyin neuronal wanda ke canza dalili don cinye abinci, don haka, ba abin mamaki bane cewa akwai katsewa cikin hanyoyin jijiyoyi waɗanda aka nuna a cikin asarar iko da kuma yawan ɗimbin abinci da aka gani cikin kiba da kuma yawan tilasta abinci na kwayoyi da aka gani a jaraba.

Babban abin da ke cikin waɗannan cututtuka guda biyu shine rushewar hanyoyin dopamine na kwakwalwa (DA), wanda ke daidaita martanin ɗabi'a ga motsin muhalli i. Kwayoyin halittar dopamine suna zaune a cikin tsakiyar kwakwalwa (yankin ventral tegmental ko VTA, da kuma substantia nigra pars compacta ko SN) waɗanda ke yin aikin striatal (nucleus accumbens ko NAc da dorsal striatum), limbic (amygdala da hippocampus) da yankuna cortical (prefrontal cortex, cingulate gyrus, temporal pole) kuma suna daidaita motsawa da dorewar ƙoƙarin da ake buƙata don cimma halayen da ake buƙata don rayuwa. Don cimma ayyukansa, ƙwayoyin halittar DA suna karɓar hasashen daga yankunan kwakwalwa da ke da alaƙa da martanin kai tsaye (misali hypothalamus, brainstem), ƙwaƙwalwa (hippocampus), amsawar motsin rai (amygdala), tashin hankali (thalamus) da kuma kula da fahimta (prefrontal cortex da cingulate) ta hanyar tarin masu ba da agajin gaggawa da peptides.

Don haka, ba abin mamaki ba ne cewa masu neurotransmitters da ke da hannu a cikin halayen neman ƙwayoyi suma suna da alaƙa da shan abinci, kuma akasin haka, cewa peptides waɗanda ke daidaita shan abinci suma suna tasiri ga tasirin ƙarfafa magunguna (Tebur 1 da 2 ). Duk da haka, sabanin magungunan da ayyukansu ke haifarwa ta hanyar tasirin magunguna kai tsaye a cikin hanyar lada ta kwakwalwa ta hanyar DA (NAc da ventral pallidum), tsarin halayen cin abinci don haka martanin abinci, ana daidaita su ta hanyoyi da yawa na tsakiya da na tsakiya waɗanda ke isar da bayanai kai tsaye ko a kaikaice ga hanyar lada ta DA ta kwakwalwa tare da takamaiman rawar hypothalamus (Hoto na 1 ).

Siginar da ke kewaye sun haɗa da peptides da hormones (misali leptin, insulin, cholecystokinin ko CCK, tumor necrosis factor-α) amma kuma abubuwan gina jiki (misali sukari da lipids), waɗanda ake jigilar su ta hanyar afferents na jijiyar vagus zuwa ga hanyar tsakiya ta kaɗaici kuma kai tsaye ta hanyar masu karɓa da ke cikin hypothalamus da sauran yankuna na kwakwalwa masu zaman kansu da limbic. Waɗannan hanyoyin sigina da yawa suna tabbatar da cewa ana cin abinci lokacin da ake buƙata, koda kuwa ɗayan waɗannan hanyoyin da ba a saba amfani da su ba ya gaza. Duk da haka, tare da sake samun damar cin abinci mai daɗi, wasu mutane (duka mutane da dabbobin dakin gwaje-gwaje) na iya shawo kan hanyoyin hanawa waɗanda ke nuna gamsuwa kuma su fara cin abinci mai yawa duk da yawan abinci mai gina jiki har ma da ƙin wannan hali a yanayin mutane. Wannan rashin iko da tsarin tilasta cin abinci yana tunatar da tsarin shan magani da aka gani a cikin jaraba kuma ya haifar da bayanin kiba a matsayin nau'i na 'jarabar abinci' [1].

Tsarin bayar da lada na kwakwalwa na DA, wanda ke daidaita martanin da ake bayarwa ga muhalli, yana ƙara yiwuwar halayen da ke kunna shi (cin abinci ko shan magani) za a maimaita su lokacin da aka haɗu da mai ƙarfafawa iri ɗaya (takamaiman abinci ko magani). Rushewar da'irar lada ta DA tana da alaƙa da asarar iko da aka gani a cikin jaraba da kiba [ 2] , kodayake hanyoyin ilimin halittar jiki waɗanda ke wargaza aikin da'irar DA striatal, gami da waɗanda ke da alaƙa da lada (ventral striatum) da kuma samuwar al'ada (dorsal striatum), suna nuna bambance-bambance bayyanannu [3] . Bugu da ƙari, kame kai da shan tilas (ko na abinci ko magunguna) yana faruwa a cikin ci gaba mai girma, wanda mahallin ya rinjayi shi sosai, wanda zai iya tafiya daga cikakken iko zuwa babu iko kwata-kwata. Gaskiyar cewa mutum ɗaya zai iya yin iko mafi kyau a wasu yanayi fiye da wasu yana nuna cewa waɗannan matakai ne masu ƙarfi da sassauƙa a cikin kwakwalwa. Lokacin da waɗannan alamu (rashin iko da shan tilas) suka zama masu tsauri kuma suka tsara ɗabi'a da zaɓin mutum, duk da mummunan sakamakonsu, za a iya haifar da yanayin rashin lafiya mai kama da ra'ayin jaraba. Duk da haka, kamar yadda yawancin mutanen da ke shan ƙwayoyi ba sa shan ƙwayoyi, yawancin mutanen da ke cin abinci mai yawa suna da iko a kan abincin da suke ci a wasu lokutan amma ba a wasu lokutan ba.

Koyaya, muhawara kan ko kiba tana nuna 'ƙarin abinci' ya gaza la'akari da yanayin yanayin waɗannan rikice-rikicen guda biyu.

An kuma gabatar da shawarwari don kwatanta jarabar miyagun ƙwayoyi a matsayin cuta mai yaɗuwa [4, 5] , waɗanda ke da amfani wajen nazarin abubuwan da ke cikinta na zamantakewa, cututtuka da tattalin arziki [4, 6] amma sun haifar da ra'ayin cewa magunguna suna kama da masu yaɗuwa kuma ana iya magance jaraba ta hanyar kawar da magunguna. Abin da ya biyo baya shi ne imani cewa kawar da abinci mai daɗi zai magance 'jarabar abinci'. Amma wannan tsarin ra'ayi mai mayar da hankali kan wakilai yana tafiya ne a gaban fahimtarmu ta yanzu game da magunguna (da sauran halaye, gami da cin abinci mara kyau) a matsayin wani ɓangare na babban iyali na 'masu haifar da', tare da ikon fallasa, a ƙarƙashin yanayi mai dacewa (muhalli), raunin da ke cikin (na halitta).

A ƙarshe, wannan muhawarar ta ƙara kawo cikas ga kalmar 'jaraba', wadda ke haifar da ƙyamar da ke da alaƙa da lahani a cikin hali, don haka yana sa ya yi wuya a wuce ma'anar mummunan ma'anarta. A nan, muna ba da shawarar wani matsayi wanda ya fahimci gaskiyar cewa waɗannan cututtuka guda biyu suna da tsarin jijiyoyi waɗanda, idan aka katse su, na iya haifar da shan ƙwayoyi da kuma rasa iko a cikin ci gaba mai girma, yayin da kuma ya haɗa da hanyoyin jijiyoyi na musamman (Hoto na 2 ). Mun gabatar da muhimman shaidu, a matakai daban-daban na abubuwan da ke cikin jijiyoyi na kwakwalwa.

Babban sha'awar neman magani da shan magani yana ɗaya daga cikin alamomin jaraba. Bincike mai zurfi ya danganta irin wannan sha'awar da ƙarfi da daidaitawa a cikin kewayen kwakwalwa wanda ke da alhakin tsammani da tantance alaƙar lada da koyo waɗanda ke haifar da halaye da halaye na atomatik [7] . A gefe guda kuma, akwai matsaloli a cikin da'irori da ke da alaƙa da kame kai da yanke shawara, hulɗa da yanayi da daidaita damuwa [8] . Wannan samfurin aiki na jaraba kuma ana iya amfani da shi don fahimtar dalilin da yasa wasu mutane masu kiba ke ganin yana da wahala su daidaita yadda suke amfani da kalori da kuma kula da homeostasis na kuzari. Yana da mahimmanci a ambaci cewa muna amfani da 'kiba' don sauƙi, domin wannan nazarin girma ya haɗa da mutanen da ba su da kiba waɗanda ke fama da wasu matsalolin cin abinci (misali matsalar cin abinci mai yawa [BED] da anorexia nervosa) [9, 10] , waɗanda kuma suna iya haɗawa da rashin daidaito a cikin da'irori na lada da kame kai.

Juyin halittar halayen cin abinci ya samo asali ne daga buƙatar cimma yanayin kuzarin da ake buƙata don rayuwa kuma an tsara shi ta hanyar hanyoyin tsari masu rikitarwa waɗanda suka haɗa da tsarin tsakiya (misali hypothalamus) da na gefe (misali ciki, hanyar ciki, ƙwayar kitse). Yawancin bambance-bambancen da ke tsakanin jaraba da cututtukan kiba suna tasowa ne daga rashin aiki a wannan matakin tsari, wato, yanayin kuzarin kuzari. Amma halayen ciyarwa kuma suna da tasiri ta hanyar wani tsari na tsari wanda ya haɗa da sarrafa lada ta hanyar siginar DA da ikonta na daidaita abubuwan da ke haifar da abinci wanda hakan zai haifar da sha'awar abincin da ke da alaƙa. Bincike yana gano babban matakin sadarwa tsakanin waɗannan hanyoyin tsari guda biyu, ta yadda layin da ke tsakanin homeostatic da hedonic control of equipment ke ƙara duhu (Tebur 1 da 2 ). Kyakkyawan misali shine sabon shaidar kwayoyin halitta, magunguna da kuma hoton jijiyoyi da ke nuna tasirin kai tsaye na wasu kwayoyin halittar peptide (misali peptide YY [PYY], ghrelin da leptin) akan yankuna da aka daidaita da DA, gami da waɗanda ke da hannu a cikin lada (VTA, NAc da ventral pallidum), ikon sarrafa kai (prefrontal cortices), interoception (cingulate, insula), motsin rai (amygdala), halaye da ayyuka (dorsal striatum) da ƙwaƙwalwar ilmantarwa (hippocampus) [11].

Dopamine a cibiyar cibiyoyin sadarwar kwakwalwa wanda ke tallata farfadowa ga mahallin muhalli

Kusan kowace tsari mai rikitarwa ya dogara ne akan hanyar sadarwa mai tsari sosai wacce ke daidaita daidaito tsakanin inganci, ƙarfi da kuma iya canzawa. An lura cewa nazarin raunin da ake iya faɗi na irin waɗannan hanyoyin sadarwa yana ba da wasu daga cikin mafi kyawun hanyoyin fahimtar cutar [12] . A mafi yawan lokuta, waɗannan hanyoyin sadarwa an tsara su a cikin tsarin gini mai layi wanda galibi ana kiransa 'ƙulli mai baka' [12] , inda magudanar kunkuntar shigarwar da yawa ke haɗuwa zuwa ƙaramin adadin hanyoyin kafin sake fitarwa zuwa nau'ikan fitarwa daban-daban . Halayen cin abinci suna gabatar da babban misali na wannan tsarin inda hypothalamus ke ƙarƙashin 'ƙulli' na ƙulli mai metabolism (Hoto na 3 a) kuma hanyoyin DA suna ƙarƙashin 'ƙulli' don amsawa ga abubuwan da ke haifar da waje (gami da magunguna da abinci) da siginar ciki (gami da siginar hypothalamic da hormones kamar leptin da insulin; Hoto na 3 b). Ganin cewa ƙwayoyin halittar DA na tsakiya (VTA da SN) suna tsara halayen da suka dace ga tarin abubuwan da ke haifar da abubuwa na waje da na ciki, suna wakiltar wani muhimmin 'ƙulli' wanda rauninsa ke da alaƙa da rashin aiki ga yawancin abubuwan da aka samar, gami da ladan magani da abinci.

Matsayin dopamine a cikin babban sakamako ga magunguna da abinci

Magungunan cin zarafi suna aiki akan lada da hanyoyin taimako ta hanyoyi daban-daban; duk da haka, duk suna haifar da ƙaruwa mai ƙarfi na DA a cikin NAc. Abin sha'awa, shaidu suna tarawa cewa martanin dopaminergic iri ɗaya suna da alaƙa da ladan abinci kuma waɗannan hanyoyin suna iya taka rawa wajen yawan cin abinci da kiba. An san cewa wasu abinci, musamman waɗanda ke da wadataccen sukari da mai, suna da lada mai ƙarfi [13] kuma suna iya haifar da halaye masu kama da jaraba a cikin dabbobin dakin gwaje-gwaje [14, 15] . Duk da haka, martanin abinci ga mutane, ya fi rikitarwa, kuma ba wai kawai yana tasiri ta hanyar dandanonsa ba har ma da samuwarsa (tsarin ƙuntatawa da cin abinci fiye da kima, wanda aka sani da yanayin cin abinci [16] ), kyawun gani, tattalin arziki da ƙarfafawa (watau, tayin 'babban girma', haɗin soda), ayyukan zamantakewa don cin abinci, madadin ƙarfafawa da tallace-tallace [17].

Abincin da ke da yawan kalori zai iya haɓaka cin abinci fiye da kima (watau cin abinci wanda ba a haɗa shi da buƙatun kuzari ba) kuma ya haifar da alaƙar da aka koya tsakanin abin ƙarfafawa da lada (sharaɗi). A cikin ma'anar juyin halitta, wannan siffa ta abinci mai daɗi a da tana da amfani a cikin muhalli inda tushen abinci yake da ƙaranci da/ko kuma ba a iya dogara da shi ba saboda yana tabbatar da cewa ana cin abinci lokacin da ake da shi, yana ba da damar adana kuzari a cikin jiki (a matsayin mai) don amfani a nan gaba . Duk da haka, a cikin al'ummomi kamar namu, inda abinci yake da yawa kuma ko'ina, wannan daidaitawa ya zama babban alhaki mai haɗari.

Yawancin masu ba da magani, ciki har da DA, cannabinoids, opioids, gamma-aminobutyric acid (GABA) da serotonin, da kuma homon da neuropeptides da ke cikin tsarin cin abinci na gida, irin su insulin, orexin, leptin, ghrelin, PYY, glucagon-like peptide -1 (GLP-1) suna da hannu cikin tasirin sakamako na abinci da ƙwayoyi (Tables 1 da kuma 2) [18-21]. Daga cikin waɗannan, DA DA an yi bincike sosai kuma shine mafi kyawun ƙwarewa. Gwaje-gwaje a cikin ƙwayoyin wuta sun nuna cewa, lokacin da aka fara bayyanuwa da sakamako na abinci, harbi DA neurons a cikin VTA yana ƙaruwa tare da haifar da karuwa a cikin Sakin NA a NAc [22]. TAnan ne kuma tabbataccen shaida cewa siginar sigari wanda ke canza kayan abincin suna aiwatar da ayyukansu a bangare ta siginar hypothalamic zuwa VTA amma kuma sakamakon tasirin su kai tsaye akan hanyoyin VTA DA meso-accumbens da meso-limbic way.. Pereides / Orexigenic peptides suna haɓaka ayyukan ƙwayoyin VTA DA kuma haɓaka DA saki a cikin NAc (babban maƙasudin VTA DA neurons) lokacin da aka fallasa su da ƙwaƙwalwar abinci, yayin da anorexigenic waɗanda ke hana DA harbewa da rage DA sakiwa [23]. Haka kuma, neurons a cikin VTA da / ko NAc sun bayyana GLP-1 [24, 25], ghrelin [26, 27], leptin [28, 29], insulin [30], orexin [31] da masu karɓar melanocortin [32]. Sabili da haka, ba abin mamaki bane cewa yawancin karatun suna bayar da rahoto cewa waɗannan hormone / peptides na iya canza tasirin sakamakon kwayoyi na zagi (Tebur 1), wanda kuma yayi daidai da binciken da aka samu na martani game da ladan magunguna a sifofin dabbobi masu kiba [33, 34]. Nin mutane, an sami rahotannin alaƙar rashin daidaituwa tsakanin ƙirar jiki (BMI) da kuma amfani da miyagun ƙwayoyi na kwanan nan [35] da kuma haɗin gwiwa tsakanin kiba da ƙaramar haɗari don rikicewar amfani da abubuwa [36]. Lallai, mutane masu kiba suna nuna ƙarancin sinadarin nicotine [37] da zagin marijuana [38] fiye da mutane masu kiba. Haka kuma, abubuwanda ake juyawa wadanda ke rage BMI da rage matakan plasma na insulin da leptin suna kara azanci game da magungunan psychostimulant [39]. Wannan ya yi daidai da daidaitaccen bayani [40] da asibiti [41] nazarin da ke nuna ƙungiyoyi masu ƙarfi tsakanin canje-canje a cikin kwayoyin hormonendocrine (misali insulin, leptin, ghrelin) ya haifar da ƙuntatawa na abinci da siginar kwakwalwa DA waɗanda aka ba da rahoto na kwanan nan game da dangantaka tsakanin halayen jaraba da halayyar cin abinci mai cutarwa bayan tiyata na bariatric. [42, 43]. Gabaɗaya, waɗannan sakamakon suna ba da shawarar cewa yiwuwar abinci da kwayoyi na iya yin gasa tare da hanyoyin sakamako.

Nazarin hoton kwakwalwa ya fara bayar da muhimman alamu game da irin wannan zagayen aiki mai kama da juna. Misali, a cikin mutane masu lafiya, masu nauyin nauyi na yau da kullun, shan abinci mai daɗi yana fitar da DA a cikin yanayin narkewa gwargwadon ƙimar jin daɗin abinci [44] , yayin da abubuwan da ke motsa abinci ke kunna sassan kwakwalwa waɗanda ke cikin yanayin lada na kwakwalwa [45] . An kuma ruwaito kwanan nan, cewa masu sa kai na ɗan adam masu lafiya suna nuna ƙarfin kunnawar tashin hankali bayan karɓar milkshake, kuma yawan shan ice cream yana rage martanin tashin hankali [46] . Wasu nazarin hoto sun kuma nuna cewa, daidai da binciken da aka yi a cikin dabbobin dakin gwaje-gwaje, peptides na anorexigenic (misali insulin, leptin, PYY) suna rage saurin tsarin lada na kwakwalwa ga lada na abinci, yayin da na orexigenic (misali ghrelin) ke ƙaruwa da shi (duba bita [47] ).

Duk da haka, kamar yadda yake ga magunguna da jaraba, ƙaruwar da abinci ke haifarwa a cikin striatal DA kaɗai ba zai iya bayyana bambanci tsakanin cin abinci na yau da kullun da yawan shan abinci mai ƙarfi ba tunda waɗannan martanin suna nan a cikin mutane masu lafiya waɗanda ba sa cin abinci mai yawa . Don haka, daidaitawar da ke ƙasa na iya haifar da rashin iko akan shan abinci kamar yadda yake ga shan magani.

Sauyawa zuwa amfani mai tilastawa

Matsayin Dopamine a cikin ƙarfafawa ya fi rikitarwa fiye da kawai ƙirƙirar jin daɗin hedonic. Musamman ma, abubuwan da ke haifar da ƙaruwa cikin sauri da babba a cikin DA suna haifar da martanin da aka tsara kuma suna haifar da ƙarfafawa don samun su [48] . Wannan yana da mahimmanci saboda, godiya ga yanayin kwantar da hankali, abubuwan da ke da tsaka tsaki waɗanda ke da alaƙa da mai ƙarfafawa (ko na halitta ko mai ƙarfafa magani) suna samun ikon da kansu don ƙara DA a cikin yanayin tashin hankali (gami da NAc) don tsammanin lada, don haka suna haifar da ƙarfi mai ƙarfi don aiwatarwa da kuma ci gaba da halayen da ake buƙata don neman maganin ko neman abincin [48] . Don haka, da zarar yanayin kwantar da hankali ya faru, alamun DA suna aiki azaman hasashen lada [49] , suna ƙarfafa dabbar don yin halayyar da za ta haifar da cin ladar da ake tsammani (magani ko abinci). Daga nazarin asibiti, akwai kuma shaidar sauyawa a hankali a cikin ƙaruwar DA daga NAc zuwa yanayin tashin hankali na dorsal, wanda ke faruwa ga duka, abinci da magunguna. Musamman, yayin da sabbin abubuwan da ke haifar da lada ke shafar yankunan ventral na striatum (NAc), tare da sake bayyanawa, alamun da ke da alaƙa da lada sannan suna haifar da ƙaruwar DA a yankunan dorsal na striatum [50] . Wannan sauyi ya yi daidai da shigar farko ta VTA da kuma ƙara shigar SN da hanyar sadarwa ta dorso-striatal-cortical da ke da alaƙa, tare da amsoshi masu haɗaka da kuma ayyukan yau da kullun.

Manyan abubuwan da ke haifar da glutamatergic ga DA neurons daga yankuna da ke da hannu a cikin sarrafa jijiyoyi (insula ko gustatory cortex), homeostatic (hypothalamus), lada (NAc da ventral pallidum), motsin rai (amygdala da hippocampus) da multimodal (orbitofrontal cortex [OFC] don bayanin salience), suna daidaita ayyukansu don mayar da martani ga lada da kuma alamun da aka tsara [51] . Hakazalika, hasashen glutamatergic ga hypothalamus yana da hannu a cikin canje-canjen neuroplastic da ke biyo bayan azumi kuma wanda ke sauƙaƙa ciyarwa [52] . Ga hanyar sadarwar lada, hasashen daga amygdala da OFC zuwa DA neurons da zuwa NAc suna da hannu a cikin martanin da aka tsara ga abinci [53] da magunguna [54, 55] . Na tabbata, nazarin hoto ya nuna cewa lokacin da aka nemi maza marasa kiba su hana sha'awar abinci yayin da ake fallasa su ga alamun abinci, sun nuna raguwar ayyukan metabolism a cikin amygdala da OFC (da kuma a cikin hippocampus), insula da striatum, kuma raguwar OFC yana da alaƙa da raguwar sha'awar abinci [56] . An lura da irin wannan hana ayyukan metabolism a cikin OFC (da kuma a cikin NAc) a cikin masu cin zarafin cocaine lokacin da aka nemi su hana sha'awar miyagun ƙwayoyi lokacin da suka kamu da alamun cocaine [57].

Ya kamata a ambata a cikin wannan mahallin cewa, idan aka kwatanta da alamun abinci, alamun magani sun fi ƙarfin abubuwan da ke haifar da ɗabi'ar ƙarfafawa bayan lokacin kauracewa abinci, aƙalla a yanayin dabbobin da ba a hana su abinci ba [ 58] . Haka kuma, da zarar an kashe su, halayen da aka ƙarfafa da miyagun ƙwayoyi sun fi saurin kamuwa da dawo da su daga damuwa fiye da halayen da aka ƙarfafa da abinci [58].

Duk da haka, bambancin ya bayyana a matsayin mataki maimakon manufa . Hakika, damuwa ba wai kawai tana da alaƙa da ƙaruwar cin abinci mai daɗi da ƙaruwar nauyi ba, har ma da matsananciyar damuwa kuma tana gano alaƙa mai ƙarfi tsakanin BMI da kunnawa mai ƙarfi don mayar da martani ga shan milkshake a cikin OFC [59] , wani yanki na kwakwalwa wanda ke ba da gudummawa ga tsarin narkewar abinci da motsawa. Dogaro da martanin da aka bayar ga alamun abinci akan matsayin abinci mai gina jiki [60, 61] yana nuna rawar da cibiyar sadarwar homeostatic ke takawa wajen sarrafa hanyar sadarwar lada, wanda hakan kuma yana shafar hanyoyin neuronal waɗanda ke sarrafa damuwa.

Tasirin datti a cikin sarrafa kai

Bayyanar sha'awar da aka yi wa alama ba zai yi illa ba idan ba a haɗa su da ƙaruwar ƙarancin ƙarfin kwakwalwa na hana halayen da ba su dace ba. Hakika, ikon hana martanin da ba su dace ba da kuma nuna kamun kai zai taimaka wa mutum ya guji yin halaye masu yawa, kamar shan ƙwayoyi ko cin abinci fiye da lokacin da ya ƙoshi, don haka yana ƙara masa rauni ga jaraba (ko kiba) [62, 63].

Nazarin Positron emission tomography (PET) ya gano raguwa mai yawa a cikin samuwar dopamine 2 receptor (D2R) a cikin yanayin mutanen da ke shan kwayoyi waɗanda ke ci gaba da kasancewa na tsawon watanni bayan tsawaita shan ƙwayoyi (an sake duba shi a cikin [64] ). Hakazalika, nazarin asibiti a cikin beraye da waɗanda ba na ɗan adam ba sun nuna cewa maimaita shan kwayoyi yana da alaƙa da raguwar matakan D2R na striatal da kuma siginar D2R [65-67] . A cikin striatum, D2Rs suna shiga tsakani sigina a cikin hanyar striatal kai tsaye wadda ke daidaita yankunan cortical na gaba; kuma ragewarsu yana haɓaka jin daɗin tasirin magunguna a cikin samfuran dabbobi [68] , yayin da haɓakawarsu yana tsoma baki da shan ƙwayoyi [69, 70] . Bugu da ƙari, hana D2R na striatal ko kunna ƙwayoyin halittar D1R masu bayyanawa (waɗanda ke shiga tsakani sigina a cikin hanyar striatal kai tsaye) yana ƙara jin daɗin tasirin magunguna masu lada [71-73] . Duk da haka, har yanzu ba a gano irin waɗannan hanyoyin da suka saba wa juna ba don hanyoyin kai tsaye da kuma na kai tsaye a cikin halayen cin abinci.

A cikin mutane masu shan ƙwayoyi, raguwar D2R mai tsauri yana da alaƙa da raguwar ayyukan yankunan prefrontal, OFC, anterior cingulate gyrus (ACC) da dorsolateral prefrontal cortex (DLPFC) [67, 74, 75] . Ganin cewa OFC, ACC da DLPFC suna da hannu a cikin siffantawa, sarrafa hanawa/tsarin motsin rai da yanke shawara, bi da bi, an yi hasashen cewa rashin kyawun tsarinsu ta hanyar siginar DA ta D2R a cikin waɗanda suka kamu da cutar na iya haifar da haɓaka ƙimar motsa jiki na magunguna a cikin halayensu da kuma asarar iko akan shan ƙwayoyi [62] . Bugu da ƙari, saboda raunin da ke cikin OFC da ACC suna da alaƙa da halayen tilastawa da rashin himma, rashin daidaituwar DA na waɗannan yankuna na iya ba da gudummawa ga shan ƙwayoyi na tilastawa da ba da himma da aka gani a cikin jaraba [76].

Yanayin da aka mayar da hankali a kai zai dogara ne akan raunin da ake da shi na amfani da miyagun ƙwayoyi a yankunan da ke gaba, wanda wataƙila ya ƙara ta'azzara sakamakon ƙarin raguwar D2R mai tsauri da aka haifar ta hanyar yawan amfani da miyagun ƙwayoyi. Hakika, wani bincike da aka yi a kan mutanen da, duk da cewa suna da babban haɗarin kamuwa da giya (tabbataccen tarihin barasa na iyali) ba masu shan giya ba ne, ya nuna cewa akwai D2R mai tsauri fiye da na yau da kullun wanda ke da alaƙa da metabolism na yau da kullun a cikin OFC, ACC da DLPFC [77] . Wannan yana nuna cewa, a cikin waɗannan mutanen da ke cikin haɗarin kamuwa da giya, aikin prefrontal na yau da kullun yana da alaƙa da haɓaka siginar D2R mai tsauri, wanda hakan na iya kare su daga shan barasa . Abin sha'awa, wani bincike na baya-bayan nan game da 'yan'uwa waɗanda ke da rashin jituwa game da jarabarsu ga magungunan ƙarfafawa [78] ya nuna bambance-bambancen kwakwalwa a cikin yanayin OFC, waɗanda suka fi ƙanƙanta a cikin 'yan'uwan da ke shan muggan kwayoyi fiye da na sarrafawa, yayin da a cikin 'yan'uwan da ba sa shan muggan kwayoyi, OFC bai bambanta da na sarrafawa ba [79].

An kuma gano shaidar siginar D2R mara tsari a tsakanin mutane masu kiba. Nazarin asibiti da na asibiti sun bayar da shaidar raguwar D2R mai tsauri, wanda, ta hanyar NAc, ke da alaƙa da lada da kuma ta hanyar dorsal striatum tare da kafa halaye da al'ada a cikin kiba [80-82] . Zuwa yanzu, binciken da ya kasa gano raguwa mai mahimmanci a cikin D2R mai tsauri tsakanin mutane masu kiba da masu kula da marasa kiba [83] , wataƙila ya sami cikas saboda ƙarancin ƙarfinsa na ƙididdiga ( n = 5/rukuni). Yana da mahimmanci a jaddada cewa, yayin da waɗannan nazarin ba za su iya magance tambayar ko alaƙar da ke tasowa tsakanin ƙarancin D2R da babban BMI yana nuna dalili ba, raguwar samuwar D2R mai tsauri an danganta shi da cin abinci mai tilastawa a cikin beraye masu kiba [84] da kuma raguwar ayyukan rayuwa a cikin OFC da ACC a cikin mutane masu kiba [63] . Ganin cewa rashin aiki a cikin OFC da ACC yana haifar da tilastawa (duba bita [85] ), wannan na iya zama wani ɓangare na hanyar da siginar D2R mai ƙarancin ƙarfi ke sauƙaƙe hyperphagia [86, 87] . Bugu da ƙari, tunda raguwar siginar da ke da alaƙa da D2R mai tsauri shima yana iya rage jin daɗin wasu lada na halitta, wannan ƙarancin a cikin mutane masu kiba na iya taimakawa wajen cin abinci mai yawa [88] . Yana da mahimmanci a ambaci cewa rashin daidaito tsakanin ladan kwakwalwa da da'irorin hanawa ya bambanta tsakanin marasa lafiya da ke fama da cutar Prader-Willi (wanda ke da alaƙa da hyperphagia da hyperghrelinemia) da marasa lafiya masu kiba kawai [87] , wanda, yana nuna girman rikitarwa na waɗannan rikice-rikice da bambancinsu.

Hasashe na cin abinci mai yawa ya yi daidai da shaidar asibiti da ke nuna cewa raguwar ayyukan DA a cikin VTA yana haifar da ƙaruwa mai yawa a cikin cin abinci mai yawan kitse [89] . Hakazalika, idan aka kwatanta da mutanen da ke da nauyin al'ada, mutanen da suka yi kiba waɗanda aka gabatar musu da hotunan abinci mai yawan kalori (ƙwarin gwiwa wanda aka sanya musu magani) sun nuna ƙaruwar kunna jijiyoyi a yankuna waɗanda ke cikin da'irar lada da ƙarfafawa (NAc, dorsal striatum, OFC, ACC, amygdala, hippocampus da insula) [90] . Sabanin haka, a cikin sarrafa nauyi na al'ada, an gano cewa kunna ACC da OFC (yankuna da ke da hannu a cikin rarraba salience wanda ke nunawa cikin NAc) yayin gabatar da abinci mai yawan kalori yana da alaƙa da BMI ɗinsu [91] . Wannan yana nuna hulɗa mai ƙarfi tsakanin adadin abincin da aka ci (wanda aka nuna a wani ɓangare a cikin BMI) da kuma amsawar yankunan lada ga abincin mai yawan kalori (wanda aka nuna a cikin kunna OFC da ACC) a cikin mutanen da ke da nauyin al'ada amma wanda ba a lura da shi ba a cikin mutanen da ke da kiba.

Abin mamaki, mutanen da ke da kiba sun nuna ƙarancin kunna da'irar lada daga ainihin abincin da ake ci ( kyauta ta abinci mai amfani ) fiye da mutanen da ba su da kiba, yayin da suka nuna ƙarin kunnawa na yankuna masu kama da na somatosensory cortical waɗanda ke sarrafa ƙima lokacin da suka yi tsammanin amfani [91] . Wannan lura ta ƙarshe ta yi daidai da yankuna inda wani bincike da aka yi a baya ya nuna ingantaccen aiki a cikin mutanen da ke da kiba da aka gwada ba tare da wani ƙarfafawa ba [92] . Ingantaccen aiki a cikin sassan kwakwalwa wanda ke sarrafa ƙima na iya sa mutane masu kiba su fi son abinci fiye da sauran masu ƙarfafawa na halitta, yayin da raguwar kunna maƙasudin dopaminergic ta hanyar ainihin cin abinci na iya haifar da yawan shan abinci a matsayin hanyar rama raunin siginar D2R [93] . Wannan martanin da aka samu ga cin abinci a cikin da'irar lada na mutanen da ke da kiba yana tunatar da raguwar ƙaruwar DA da ke haifar da shan ƙwayoyi a cikin mutanen da ke da jaraba idan aka kwatanta da waɗanda ba sa jaraba [94] . Kamar yadda aka gani a cikin jaraba, yana yiwuwa wasu matsalolin cin abinci na iya haifar da rashin jin daɗi ga alamun abinci mai kyau. Hakika, a cikin mutanen da ba su da kiba da BED, mun rubuta sakin DA fiye da yadda aka saba a cikin dorsal striatum (caudate) lokacin da aka fallasa su ga alamun abinci kuma wannan ƙaruwar ta annabta tsananin halayen cin abinci mai yawa [95].

Cortex prefrontal (PFC) yana taka muhimmiyar rawa a aikin zartarwa, gami da sarrafa kai. Ana aiwatar da waɗannan hanyoyin ta hanyar D1R da D2R (mai yiwuwa kuma D4R) kuma don haka, ayyukan raguwa a cikin PFC, duka a cikin jaraba da kuma kiba, da alama yana iya taimakawa gudummawar talaucin mara kyau, ƙazantawa da haɓakar babban iko. Availabilityarancin ƙarancin al'ada na D2R a cikin tasirin mutane masu kiba, wanda ke da alaƙa da rage aiki a cikin PFC da ACC [63] saboda haka yana iya bayar da gudummawa ga karancin sarrafa abincin. Tabbas, mummunar hulɗar tsakanin BMI da D2R mai ɗaukar hankali ta ruwaito cikin kiba [81] kuma cikin kiba [96] mutane, kazalika da daidaituwa tsakanin BMI da rage yawan hauhawar jini a yankuna na gaba a cikin mutane masu lafiya [97, 98] da kuma rage magudin prefrontal a cikin abubuwan da suka kiba [63] goyi bayan wannan. Kyakkyawan fahimtar hanyoyin da ke haifar da lalacewar aikin PFC a cikin kiba (ko jaraba) na iya sauƙaƙe haɓakar dabarun don daidaitawa, ko watakila ma juyawa, takamaiman rashin ƙarfi a cikin mahimman yanki na fahimi. Misali, jinkirin ragi, wanda shine dabi'ar rage darajar kyauta a matsayin aiki na jinkiri na wani lokaci na isar da ita, yana daya daga cikin ayyukanda aka zurfafa bincike akan abin da ya shafi rikice-rikice masu alaƙa da ruɗani. Jinkirta jinkirin an bincika sosai ga masu shan kwayoyi waɗanda ke nuna fifiko na ƙaramar-amma-nan da nan kan manyan lada-amma-ba da jinkiri ba [99]. Koyaya, binciken da aka yi tare da mutane masu kiba sun fara fallasa shaidar zaɓi na ɗorewa, lada nan da nan, duk da yuwuwar karuwar wahala mafi girma hasara mai zuwa. [100, 101]. Wani binciken ƙaramin abu mai ɗaukar nauyin maganaɗisu (fMRI) game da aikin zartarwa a cikin mata masu tsufa, alal misali, gano bambance-bambance na yanki a cikin kunnawar kwakwalwa yayin jinkirin rage ayyukan da ke hasashen ƙimar nauyi a nan gaba [102]. Duk da haka, wani binciken ya gano ingantacciyar dangantaka tsakanin BMI da magana rangwame, game da gaba korau ana biyan bashin da ba shi da kyau idan ba a biya ba [103]. Abin sha'awa shine, ragi na jinkirta da alama ya dogara da aikin aikin ventral striatum [104] da na PFC, gami da OFC [105] da kuma haɗinsa na NAc [106], kuma yana kula da DA jan amfani [107].

Overlapping dysfunction a cikin motsi motsi

Siginar dopaminergic kuma tana daidaita kwarin gwiwa. Halayen ɗabi'a kamar ƙarfi, juriya da kuma ci gaba da saka hannun jari don cimma buri, duk suna ƙarƙashin daidaitawa ta hanyar DA tana aiki ta yankuna da dama da aka nufa, ciki har da NAc, ACC, OFC, DLPFC, amygdala, dorsal striatum da ventral pallidum [108] . Siginar DA mara tsari yana da alaƙa da haɓaka kwarin gwiwa don siyan magunguna, alama ce ta jaraba, shi ya sa mutanen da ke shan miyagun ƙwayoyi galibi ke shiga cikin halaye masu tsauri don samun magunguna, koda lokacin da suka haifar da sakamako mai tsanani da mara kyau kuma suna iya buƙatar halaye masu ɗorewa da rikitarwa don samun su [109] . Saboda shan miyagun ƙwayoyi ya zama babban abin ƙarfafawa a cikin jarabar miyagun ƙwayoyi [110] , waɗanda ke shan miyagun ƙwayoyi suna tasowa kuma suna motsa su ta hanyar tsarin samun maganin amma suna zama masu janyewa da rashin kulawa lokacin da aka fallasa su ga ayyukan da ba su da alaƙa da miyagun ƙwayoyi. An yi nazarin wannan canjin ta hanyar kwatanta yanayin kunna kwakwalwa da ke faruwa lokacin da aka fallasa su ga alamun da ke faruwa tare da waɗanda ke faruwa a rashin irin waɗannan alamun. Sabanin raguwar ayyukan prefrontal da aka ruwaito a cikin masu cin zarafin cocaine da aka cire lokacin da ba a motsa su da alamun magani ko magunguna ba (duba bita [64] ), waɗannan yankuna na prefrontal suna kunnawa lokacin da masu cin zarafin cocaine suka fuskanci abubuwan da ke haifar da sha'awa (ko dai magunguna ko alamu) [111-113] . Bugu da ƙari, lokacin da aka kwatanta martanin iv methylphenidate tsakanin mutanen da ke shan cocaine da waɗanda ba sa shan cocaine, na farko ya mayar da martani tare da ƙaruwar metabolism a cikin ventral ACC da medial OFC (tasirin da ke da alaƙa da sha'awa), yayin da na ƙarshen ya nuna raguwar metabolism a waɗannan yankuna [114] . Wannan yana nuna cewa kunna waɗannan yankuna na prefrontal tare da fallasa miyagun ƙwayoyi na iya zama takamaiman ga jaraba kuma yana da alaƙa da haɓaka sha'awar miyagun ƙwayoyi. Bugu da ƙari, wani bincike da ya sa waɗanda ke shan cocaine su hana sha'awa da gangan lokacin da aka fallasa su ga alamun magunguna ya nuna cewa waɗancan mutanen da suka yi nasara wajen hana sha'awa sun nuna raguwar metabolism a cikin medial OFC (wanda ke sarrafa ƙimar ƙarfafawa) da NAc (wanda ke annabta lada) [57] . Waɗannan binciken sun ƙara tabbatar da shigar OFC, ACC da striatum cikin ƙarin kwarin gwiwa don siyan maganin da aka gani a cikin jaraba.

OFC kuma tana da hannu wajen danganta darajar abinci ga abinci [115, 116] , wanda ke taimakawa wajen tantance jin daɗinsa da kuma sauƙin ci kamar yadda yake a cikin mahallinsa. Nazarin PET tare da FDG don auna metabolism na glucose na kwakwalwa a cikin mutanen da ke da nauyin al'ada sun ba da rahoton cewa fallasa ga alamun abinci ya ƙara yawan aikin metabolism a cikin OFC, wanda ke da alaƙa da sha'awar abinci [117] . Ingantaccen kunna OFC ta hanyar ƙarfafa abinci yana iya nuna tasirin dopaminergic na ƙasa kuma ya shiga cikin shigar DA cikin ƙoƙarin cin abinci. OFC tana taka rawa wajen koyon haɗin gwiwa na ƙarfafawa da ƙarfafa abinci [118, 119] , tana tallafawa ciyarwa da aka samar da yanayin [120] kuma wataƙila tana ba da gudummawa ga yawan cin abinci ba tare da la'akari da alamun yunwa ba [121] . Hakika, lalacewar OFC na iya haifar da hyperphagia [122, 123].

A bayyane yake cewa, wasu bambance-bambancen da ke tsakanin mutum da aikinsa na zartarwa na iya zama haɗarin kamuwa da kiba daga baya a wasu mutane, kamar yadda aka bayyana ta wani bincike na baya-bayan nan na aji na aji 997 a cikin shirin hana kiba a makaranta [124] . Abin sha'awa, kodayake ana iya hasashen hakan, wani bincike na sassa daban-daban na ikon yara na daidaita kansu, magance matsaloli da kuma shiga cikin halayen lafiya da aka tsara bisa manufa ya nuna ƙwarewar aikin zartarwa yana da alaƙa mara kyau ba kawai da amfani da ƙwayoyi ba har ma da cin abincin abun ciye-ciye masu yawan kalori, da kuma halayen zama a gida [125].

Duk da wasu rashin daidaito tsakanin nazarin, bayanan hoton kwakwalwa kuma suna goyon bayan ra'ayin cewa canje-canje a cikin tsari da aiki a yankunan kwakwalwa da ke da alaƙa da aikin zartarwa (gami da sarrafa hana hanawa) na iya alaƙa da babban BMI a cikin mutanen da ke da lafiya. Misali, wani binciken MRI da aka yi a cikin tsofaffi mata, ta amfani da tsarin voxel, ya gano mummunan alaƙa tsakanin BMI da yawan abubuwa masu launin toka (gami da yankunan gaba), wanda, a cikin OFC, yana da alaƙa da rashin aikin zartarwa [126] . Ta amfani da PET don auna metabolism na glucose na kwakwalwa a cikin sarrafawa masu lafiya, mun ba da rahoton mummunan alaƙa tsakanin BMI da aikin metabolism a cikin DLPFC, OFC da ACC. A cikin wannan binciken, aikin metabolism a cikin yankunan prefrontal ya annabta aikin waɗanda abin ya shafa a cikin gwaje-gwajen aikin zartarwa [98] . Hakazalika, wani bincike na magnetic resonance spectroscopic a cikin kula da tsofaffi masu lafiya ya nuna cewa BMI yana da alaƙa mara kyau da matakan N-acetyl-aspartate (alamar amincin neuronal) a cikin cortex na gaba da ACC [98, 127].

Nazarin hoton kwakwalwa da aka kwatanta da mutanen da suka yi kiba da waɗanda ba su da kiba sun kuma ba da rahoton ƙarancin yawan launin toka a yankunan gaba (operculum na gaba da gyrus na gaba na tsakiya) da kuma a cikin gyrus na baya-bayan tsakiya da putamen [ 128] . Wani bincike ya gano babu wani bambanci a cikin yawan launin toka tsakanin waɗanda suka yi kiba da waɗanda ba su da kiba; duk da haka, ya sami kyakkyawar alaƙa tsakanin yawan farin abu a cikin tsarin kwakwalwa na asali da rabon kugu zuwa kugu, wani yanayi wanda aka canza shi kaɗan ta hanyar cin abinci [129] . Abin sha'awa, an gano cewa yankunan cortical, kamar DPFC da OFC waɗanda ke da hannu a cikin sarrafa hana hana abinci, an kuma gano cewa suna aiki a cikin masu cin abinci masu nasara saboda cin abinci [130] , yana nuna yuwuwar manufa don sake horar da ɗabi'a wajen magance kiba (da kuma a cikin jaraba).

Shigowar abubuwa masu shiga tsakani

Nazarin hotunan jijiyoyi ya nuna cewa tsakiyar insula yana taka muhimmiyar rawa wajen sha'awar abinci, hodar iblis da sigari [131-133] . Wani bincike ya nuna muhimmancin insula ta hanyar rahoton cewa masu shan taba da suka lalace a wannan yanki (amma ba masu shan taba wadanda suka sha wahala daga raunukan da ba na insula ba) sun iya daina shan taba cikin sauƙi ba tare da fuskantar sha'awa ko komawa baya ba [134] . Insula, musamman yankunan da ke gaba da shi, yana da alaƙa da yankuna da dama na limbic (misali ventromedial prefrontal cortex, amygdala, da ventral striatum) kuma da alama yana da aikin hulɗa, yana haɗa bayanan kai tsaye da na ciki tare da motsin rai da kwarin gwiwa, don haka yana ba da sanin waɗannan sha'awar da kyau [135] . Hakika, nazarin raunukan kwakwalwa ya nuna cewa ventromedial PFC da insula sune muhimman sassan da'irorin da aka rarraba waɗanda ke tallafawa yanke shawara ta motsin rai [136] . Daidai da wannan hasashe, nazarin hotuna da yawa sun nuna bambancin kunnawar insula yayin sha'awa [135] . Saboda haka, an ba da shawarar cewa amsawar wannan yanki na kwakwalwa ta zama alamar alama don taimakawa wajen hasashen sake dawowa [137].

Insula kuma babban yanki ne na gustatory, wanda ke shiga cikin fannoni da yawa na halayen cin abinci, kamar dandano. Bugu da ƙari, rostral insula (wanda aka haɗa da babban dandano cortex) yana ba da bayanai ga OFC wanda ke tasiri ga wakilcin sa na multimodal na jin daɗi ko darajar lada na abinci mai shigowa [138] . Saboda shigar insula cikin fahimtar juna ta jiki, a cikin fahimtar motsin rai [139] da kuma a cikin kwarin gwiwa da motsin rai [138] , gudummawar raunin insular a cikin kiba bai kamata ya zama abin mamaki ba. Kuma hakika, fadada ciki yana haifar da kunna insula na baya, daidai da rawar da yake takawa a cikin sanin yanayin jiki (a wannan yanayin cikewa) [140] . Bugu da ƙari, a cikin siriri, amma ba a cikin masu kiba ba, fadada ciki ya haifar da kunna amygdala da kashe insula na gaba [141] . Rashin amsawar amygdalar a cikin masu kiba na iya nuna rashin fahimtar yanayin jiki da ke da alaƙa da gamsuwa (cikakken ciki). Ko da yake ba a yi bincike sosai kan yadda DA ke daidaita ayyukan insular ba, an fahimci cewa DA tana da hannu a cikin martanin ɗanɗano abinci mai daɗi wanda aka haɗa ta hanyar insula [142] . Nazarin hoton ɗan adam ya nuna cewa ɗanɗano abinci mai daɗi yana kunna yankunan insula da tsakiyar kwakwalwa [143, 144] . Alamar DA kuma na iya zama dole don jin daɗin abun cikin kalori na abinci. Misali, lokacin da mata masu nauyin al'ada suka ɗanɗani mai zaki mai kalori (sucrose), sassan tsakiyar kwakwalwa na insula da dopaminergic sun fara aiki, yayin da ɗanɗano mai zaki mara kalori (sucralose) kawai yana kunna insula [144] . Masu kiba suna nuna ƙarin kunnawa na insular fiye da sarrafawa na yau da kullun lokacin da suke ɗanɗano abinci mai ruwa wanda ya ƙunshi sukari da mai [143] . Sabanin haka, lokacin da suke ɗanɗano sucrose, waɗanda suka warke daga anorexia nervosa ba sa nuna ƙarancin kunnawa na insular kuma babu wata alaƙa da jin daɗi kamar yadda aka gani a cikin sarrafawa [145] . Bugu da ƙari, wani bincike na fMRI na baya-bayan nan wanda ya kwatanta martanin kwakwalwa ga maimaita gabatarwar hotunan abinci masu daɗi da marasa daɗi a cikin mutanen da ke da kiba mai yawa vs. waɗanda ba su da kiba [146] ya sami canje-canje masu aiki a cikin amsawa da haɗin kai tsakanin manyan yankuna na da'irar lada wanda zai iya taimakawa wajen bayyana yawan hankali ga alamun abinci a cikin mutanen da ke da kiba. Canje-canjen da aka lura sun nuna yawan shigarwa daga amygdala da insula; waɗannan, bi da bi, na iya haifar da ƙarin koyo game da amsawar ƙarfafawa da ƙarfafawa ga alamun abinci a cikin ƙwayar dorsal caudate, wanda zai iya zama mai ban mamaki idan aka yi la'akari da raunin hanawa ta yankunan gaba-gaba.

Da'irawar tashin hankali da wahalar da damuwa

Kamar yadda aka ambata a baya, horo (sharaɗi) akan alamar da ke hasashen lada yana haifar da harbin ƙwayoyin dopaminergic a martanin hasashen lada, ba ga lada kanta ba. A gefe guda kuma, kuma daidai da wannan dabarar, an lura cewa ƙwayoyin dopaminergic za su yi harbi ƙasa da na al'ada idan ladar da ake tsammani ta gaza bayyana [147] . Shaida mai tarin yawa [148-151] ta nuna habenula a matsayin ɗaya daga cikin yankunan da ke sarrafa raguwar harbin ƙwayoyin dopaminergic a cikin VTA wanda zai iya biyo bayan rashin samun lada da ake tsammani [152] . Don haka, haɓaka jin daɗin habenula, sakamakon fallasa magunguna na yau da kullun, na iya haifar da ƙarin amsawa ga alamun magunguna lokacin da ba a bi su da shan maganin ba ko kuma lokacin da tasirin miyagun ƙwayoyi bai cika sakamakon lada da ake tsammani ba. Hakika, kunna habenula, a cikin samfuran dabbobi na jarabar cocaine, an danganta shi da komawa ga shan miyagun ƙwayoyi bayan fallasa alamun [153, 154] . A yanayin nicotine, masu karɓar nicotinic na α5 a cikin habenula sun bayyana suna daidaita martanin da ake mayarwa ga manyan allurai na nicotine [155] , da masu karɓar α5 da α2 don daidaita janyewar nicotine [156] . Saboda martanin da habenula ke bayarwa ga na DA neurons tare da fallasa lada (katsewa vs. kunnawa) da kuma kunnawarsa tare da fallasa ga abubuwan da ke haifar da ƙiyayya, muna komawa ga siginar daga habenula a matsayin isar da shigarwar 'antireward'.

Da alama habenula tana taka rawa iri ɗaya dangane da ladan abinci. Abincin abinci mai daɗi sosai zai iya haifar da kiba a cikin beraye, tare da ƙaruwar nauyi yana daidai da ƙaruwar ɗaure peptide na μ-opioid a cikin amygdala na basolateral da basomedial. Abin sha'awa, habenula na tsakiya ya nuna babban haɗin peptide na μ-opioid (da kusan 40%) bayan fallasa ga abinci mai daɗi a cikin beraye waɗanda suka sami nauyi (waɗanda suka cinye abinci mai yawa) amma ba a cikin waɗanda ba su [157] ba . Wannan yana nuna cewa habenula na iya shiga cikin cin abinci fiye da kima lokacin da ake samun abinci mai daɗi. Bugu da ƙari, ƙwayoyin jijiyoyi a cikin ƙwayar halittar rostromedial, waɗanda ke karɓar babban shigarwa daga habenula na gefe, suna aiki zuwa ga ƙwayoyin jijiyoyi na VTA DA kuma ana kunna su bayan rashin abinci [158] . Waɗannan binciken sun yi daidai da rawar da habenula (duka na tsakiya da na gefe) ke takawa wajen daidaita martani ga abubuwan da ke haifar da tashin hankali ko ga yanayin rashin abinci kamar lokacin cin abinci ko janye magunguna.

Shigar habenula a matsayin cibiyar hana lada a cikin hanyoyin sadarwa na motsin rai ya yi daidai da samfuran ka'idoji na jaraba da suka gabata waɗanda suka yi hasashen cewa amsawar damuwa da mummunan yanayi (wanda aka haɗa ta hanyar haɓaka ƙarfin amygdala da ƙaruwar sigina duk da cewa abin da ke sakin corticotrophin) yana haifar da shan ƙwayoyi a cikin jaraba [159] . Irin waɗannan martanin hana lada (gami da ƙaruwar amsawar damuwa, mummunan yanayi da rashin jin daɗi) suma na iya taimakawa wajen yawan cin abinci a cikin kiba da kuma yawan haɗarin sake dawowa lokacin cin abinci bayan fuskantar wani abin damuwa ko abin takaici.

A rufe

Ikon tsayayya da sha'awar amfani da magani ko cin abinci bayan lokacin ƙoshi yana buƙatar ingantaccen aiki na da'irorin jijiyoyi da ke cikin sarrafa sama zuwa ƙasa don yin adawa da martanin da ke haifar da sha'awar cin abinci/magani. Ko ya kamata a ayyana wasu nau'ikan kiba a matsayin jarabar ɗabi'a ko a'a [160] , akwai da'irorin da za a iya gane su a cikin kwakwalwa [2] , waɗanda rashin aikinsu ke bayyana ainihin kamanceceniya tsakanin cututtuka biyu. Hoton da ke bayyana shine cewa kiba, kamar jarabar miyagun ƙwayoyi [226] , ya bayyana yana faruwa ne sakamakon rashin daidaiton sarrafawa a yankuna daban-daban da ke da alaƙa da lada/sauƙin amsawa, kwarin gwiwa/kokari, motsin rai/damuwa, ƙwaƙwalwa/kwanciyar hankali, aikin zartarwa/kame kai da hulɗa, ban da yiwuwar rashin daidaito a cikin tsarin homeostatic na cin abinci.

Bayanan da aka tara ya zuwa yanzu yana nuna cewa shine bambanci tsakanin tsammanin magunguna / abinci sakamakon (martani mai ƙima) da kuma ƙwarewar da ta samu wanda ke tallafawa shan magunguna / halayyar abinci da yawa a yunƙurin kaiwa ga sakamako. Hakanan, ko an gwada shi a farkon lokaci ko tsawan lokaci na kauracewa / cin abincin, batutuwa masu ƙara / obese suna nuna ƙananan D2R a cikin rikici (ciki har da NAc), waɗanda ke da alaƙa da raguwa a cikin ayyukan yau da kullun a cikin sassan kwakwalwa na gaba wanda ke nuna halayen salience (OFC) da kulawar inhibitory (ACC da DLPFC), wanda rushewarsa ke haifar da tursasawa da tursasawa. A karshe, shaidu ya kara bayyana game da aikin cudanya da juzu'i a cikin rashin daidaituwa na tsari wanda ke haifar da tursasawa shan kwayoyi ko abinci. Sakamakon rikicewar abubuwa a cikin da'irorin, mutane zasu iya samun (i) haɓaka ƙimar ƙwayoyi / abinci (sakandare zuwa ƙungiyoyi da aka koya ta hanyar yanayin yanayi da halaye) a cikin nauyin sauran masu karfafawa (sakandare don rage ji na sakamako na sakamako ), (ii) ikon lalacewa don hana ayyukan niyya (burin-jagoranci) ayyukan da ke haifar da ƙarfin sha'awar ɗaukar ƙwayoyi / abinci (sakandare zuwa aiki mai rauni) wanda ke haifar da tilasta tilasta shan magani / shan abinci da (iii) inganta damuwa da kuma 'antireward reactivity' wanda yake haifar da shan kwayoyi masu sa maye don tsira daga halin da suke fuskanta.

Abubuwa da yawa da ke tattare da tsarin halaye da dabi'un da aka gano tsakanin jaraba da kiba sun nuna darajar hanyoyin magance cututtukan da ke haɗuwa da cuta biyu duka waɗannan rikice-rikice. Irin waɗannan hanyoyin ya kamata suyi ƙoƙarin rage kayan ƙarfafa magunguna / abinci, sake kafa / inganta kyawawan kayan aikin madadin karfafawa, hana ƙungiyoyin da aka koya, inganta haɓaka ga ayyukan da ba magani / ayyukan da suka shafi abinci ba, rage ƙarfin damuwa, inganta yanayi da karfafa janar-manufar kame kai.

Fuskantarwa na Bayyana Shawarwari

Babu wani rikici game da sanarwa mai amfani.