Yanayin Saukewa na Harkokin Yanayi na Gabatarwa a Intanit Game da Cikin Gida: Canje-canje tare da Harkokin Ƙarƙashin Ƙwararrun Ƙwararri da Masu Mahimmancin Maganin Jiyya (2018)

Shafin Farko. 2018 Aug 3; 9: 341. doi: 10.3389 / fpsyt.2018.00341

Han X¹, Wang Y¹, Jiang W², Bao X², Sun Y¹, Ding W¹, Cao M¹, Wu X¹, Du Y², Zhou Y¹.

Abstract

Ilimin halin mutumci (CBT) yana da inganci don magance rashin lafiyar caca ta yanar gizo (IGD). Ko yaya, hanyoyin da CBT ke inganta alamun cututtukan da ke da alaƙa da IGD ba a san su ba. Wannan binciken ya yi niyyar gano fasahar warkewa ta hanyar CBT a cikin batutuwa na IGD ta amfani da hutu-yanayin aikin hoto na Magnetic resonance imaging (rsfMRI). Ashirin da shida batutuwa na IGD da 30 sun dace da sarrafawa masu lafiya (HCs) sun karɓi gwajin rsfMRI da kimantawa na asibiti; Abubuwan 20 IGD sun kammala CBT sannan kuma an sake sake bincika su. An kwatanta girman ƙimar ƙarancin-lokaci (ALFF) da haɗin haɓaka aiki (FC) tsakanin ƙungiyar IGD da ƙungiyar HC a matakin tushe, kazalika da ƙimar ALFF da FC kafin da bayan CBT a cikin ƙungiyar IGD. Kafin magani, ƙungiyar IGD ta nuna ƙimar ALFF a cikin haɓaka biyu, madaidaiciyar medial orbitofrontal cortex (OFC), yankin haɗin gwiwar haɗin gwiwar (SMA), gyrus na hagu, da hagu na gaba cingulate (ACC) idan aka kwatanta da kungiyar HC. Hungiyar HC ta nuna mahimmancin ƙimar FC tsakanin tsakanin hagu na OFC da putamen idan aka kwatanta da ƙungiyar IGD, ƙimar FC na ƙungiyar IGD suna da mummunar alaƙa da maki BIS-11 kafin jiyya. Bayan CBT, lokacin wasannin mako-mako ya yi matukar gajarta, kuma maki CIAS da BIS-II sun ragu sosai. Valuesimar ALFF a cikin abubuwan IGD sun ragu sosai a cikin hagu na OFC da hagu putamen, kuma FC tsakanin su yana ƙaruwa sosai bayan CBT. Matsayin FC ya canza (Δ_{FC / Pre-FC}) an sami daidaituwa sosai tare da sikelin canje-canje na CIAS (Δ_{CIAS / Pre-CIAS}) a cikin batutuwa na IGD. CBT zai iya daidaita yanayin rashin daidaituwa na ƙananan yanayi a yankuna na prefrontal-striatal a cikin abubuwan IGD kuma yana iya inganta alamomin da ke da alaƙa da IGD. Canjin-jihar sakewa a yankuna-pre-preatatal na iya bayyana tsarin warkewa na CBT a cikin batutuwa na IGD.

KEYWORDS: amplitude na low-mita hawa da sauka; fahimi halin farji; haɗin aiki; Tasirin maganadisu na Magnetic; matsalar caca ta yanar gizo

PMID: 30123144

PMCID: PMC6085723

DOI: 10.3389 / fpsyt.2018.00341

Free PMC Mataki na ashirin da

Gabatarwa

Rashin caca ta yanar gizo (IGD), wanda kuma aka sani da amfani da yanar gizo mai matsala, shine wuce kima da maimaita amfani da wasannin Intanet (1). Kwanan nan, IGD da aka jera a matsayin mai ɗorewa ko halayen wasa na yau da kullun da aka mamaye shi ta hanyar mai tasiri akan caca; haɓaka fifikon da aka baiwa ƙwararraki akan sauran ayyukan har zuwa caca da fifikon fifiko akan sauran sha'awa da ayyukan yau da kullun; da kuma ci gaba da caca duk da faruwa na mummunan sakamakon (2, 3). Kodayake babu ka'idojin bincike na yau da kullun game da yanayin ƙwaƙwalwar ƙwaƙwalwa wanda halin haɓaka da rikice-rikice na yin amfani da Intanet an haɗa su a cikin bugu na huɗu na Manhajin bincike da ƙididdiga (DSM-IV)4), kwamitin DSM-V yana nazarin yin amfani da ƙayyadaddun ka'idoji don amfani da abubuwan maye da rikice-rikice don IGD kuma ya haɗa da IGD a cikin sashin yana nuna ƙarin bincike (5).

Masu bincike sun gwada IGD da rikicewar rikicewar cuta (6). Binciken neuroimaging ya gano cewa wasan ƙwallon Intanet wuce kima yana da alaƙa da aikin hutawa na yau da kullun a cikin yanki na gaba, kwakwalwar da ke da alhakin ƙira, kamar sarrafa inhibitory (7). Imarancin aiki na prefrontal (PFC) na iya danganta da babban buguwa, wanda, bi da bi na iya ba da gudummawa ga kulawar inhibitory mai dangantaka da IGD (8). Ingantaccen ikon kula da hankali yana da alaƙa da ɗaukar matakan daukar hoto na sama-ƙasa, tashoshin pre-preatalal striatal (9, 10). Karatun da ya gabata ya nuna ƙungiyar tsakanin rabe-rabe da raunin aiki a cikin cortex prefrontal cortex (PFC) da ƙarancin sarrafa inhibitory a cikin IGD (11-16). Misali, rage girman kazamin cortical da karuwar amurka na yawan canzawa (ALFF) a cikin OfC an samu daidaituwa tare da raunin ayyukan kula da hankali a cikin batutuwan matasa tare da IGD (12). Binciken da aka yi amfani da hanyar Rehoc ya gano cewa batutuwa na IGD sun nuna haɓaka aiki tare a cikin manyan ƙwayar goshi na gaban idan aka kwatanta da kulawar lafiya (HCs), wanda ya ba da shawarar haɓaka aikin jijiyoyin da ke da alaƙa da aikin kula da hankali (17). Ko et al. (10) nuna cewa aikin mai rauni a cikin yankuna na pre-preatal-striatal na iya yin bayani game da raguwar iyawar inhibitory a cikin IGD. Wadannan nazarin zane-haɗe sun fasalta yadda duka biyun gabbai keɓantattun abubuwa biyu da kuma ayyukansa ke canzawa cikin haɗuwa da ƙarancin inhibitory iko a cikin IGD. Bugu da ƙari, rashin aiki dopamine mai rauni a cikin mahaɗa (an sami raguwa a cikin masu karɓa na Dopamine D2 da rage dopamine saki) da kuma haɗin gwiwa tare da rage yawan ƙwayar glucose metabolism a cikin PFC (18, 19).

An gano ƙwaƙwalwar halayyar ƙwaƙwalwa (CBT) don yin tasiri a cikin lura da rikicewar rikice rikice, ciki har da caca pathological (20). Nazarin abubuwan da ke addabar kwayoyi sun nuna cewa CBT tana ƙarfafa batutuwa don ganewa da kuma guje wa yanayin da wataƙila za su iya amfani da abubuwa da kuma amfani da dabarun magance ƙin shan miyagun ƙwayoyi da haɓaka aikin sarrafa inhibitory (21, 22). Binciken da aka yi amfani da aikin Stroop ya gano cewa CBT na iya hadewa tare da rage yawan amfani da abu, kuma yana iya shafan tsarin jijiyoyin da ke cikin kulawar hankali, sha'awar, motsawa, da hankali (23). Wani bincike mai nuna sauti na Magnetic (FMRI) wanda ya yi amfani da jinkirin ba da lamuni (MID) a cikin dogaro na cannabis ya ba da rahoton cewa mahalarta masu cannabis sun nuna raguwar ƙididdigar haɗin gwiwa biyo bayan CBT, wanda ya nuna cewa takamaiman fannin aikin putamen da tsarin yana da nasaba da magani sakamakon (24). Matashiya ya yi imanin cewa, sa hannun a cikin Addiction Intanet (IA) ya kamata ya mayar da hankali kan hana amfani da yanar gizo, dangane da wannan, yana ba da shawarar tsarin kula da dabarun ilimin halin IA (CBT-IA), wanda aka tabbatar da inganci a kan kula da IGD (6). Drungiyar Dr Du ta gano cewa rukunin makarantar CBT na da tasiri ga samari tare da IGD, musamman don inganta yanayin motsin rai da ikon tsara doka, halayya da tsarin sarrafa kai (20). Kodayake CBT ta nuna ingantacciyar tasiri a cikin maganin IGD, karancin karatu sunyi bincike game da hanyoyin warkewa na CBT a cikin abubuwan IGD ta amfani da fMRI. Binciken kwakwalwa yana canzawa kafin da kuma bayan jiyya ba zai iya inganta fahimtarmu ba kawai game da pathogenesis na IGD da hanyoyin warkewa na CBT akan IGD, amma kuma yana iya taimakawa wajen lura da tasirin magani.

Munyi amfani da Barratt impulsiveness Scale-11 (BIS-11) don tantance aikin hana halayen IGD. Dangane da binciken da muka gabata, mun sanya tunanin cewa (1) batutuwa tare da IGD na iya nuna aikin kwakwalwa mara kyau / haɗi a cikin yankuna prefrontal-striatal, waɗanda ke da alhakin tsari na hankali, kamar sarrafa inhibitory; (2) CBT zai iya tsara aikin mahaukaci na yankuna pre-preatal-striatal.

Ka tafi zuwa ga:

kaya da matakai

Mahalarta da kimantawa na asibiti

Kwamitin Binciken icsabi'ar Bincike na asibitin Ren Ji da Makarantar Magunguna, Jami'ar Shanghai Jiao Tong, China No. [2016] 097k (2) sun amince da binciken. Dukkanin mahalarta da masu sa hannu sun sanya hannu kan takardar rubutacciyar sanarwa kafin fara binciken. Mahalarta waɗanda aka yiwa rajista, tambayoyin bincike da kuma ka'idodin ficewar duk an bayyana su ne a littafinmu na baya (15). Abubuwa ashirin da shida na IGD waɗanda suka cika ka'idodin Diagnostic Tambaya don Addariyar Intanet (watau YDQ) gwajin Beard da Wolf wanda aka gyara (25) sun dauko su daga Sashin kula da lafiyar yara da na matasa na Cibiyar Kiwan Lafiya na Shanghai. Shekaru talatin-da tsakanin maza da mata masu lafiya waɗanda ba su da tarihin rayuwar mutum ko na iyali game da cututtukan ƙwaƙwalwar ƙwaƙwalwa an ɗauke su azaman ƙungiyar kulawa da lafiya (HC) ta hanyar tallace-tallace. Ganin yadda aka sami ci gaba na IGD a cikin maza da mata, maza ne kawai suka haɗa cikin (26). Duk mahalarta sun kasance masu hannun dama ne, kuma babu wani daga cikinsu da ya bugu.

Dukkanin mahalarta sun sami sauki a gwajin jiki, wanda ya hada da hawan jini da ma'aunin bugun zuciya, kuma mahaukacin likita ya yi hira da shi game da tarihin likitancinsu na jijiyoyi, motsi, narkewa, numfashi, wurare dabam dabam, endocrine, urinary, da matsalolin haihuwa. Daga nan sai aka bincika su game da rikicewar kwakwalwa tare da Mini International Neuropsychiatric Interview for Yara da matasa (MINI-KID) (27). Sharuɗɗan ƙa'idodin tarihin tarihin shan kwayoyi ne ko dogaro; asibiti da ya gabata don cutar hauka; ko babban cutar tabin hankali, kamar su schizophrenia, ɓacin rai, tashin hankali damuwa, da / ko aukuwa na psychotic.

An yi amfani da tambayoyin bayanan asali don tattara bayanan alƙaluma kamar jinsi, shekaru, shekarar ƙarshe ta karatun da aka kammala, da awanni na amfani da Intanet a mako. An yi amfani da tambayoyin guda huɗu don tantance abubuwan asibiti na mahalarta, wato, Scale Addiction Scale (CIAS) (28), ƙimar damuwa na kanka (SAS) (29), sikelin Matsayi da kansa (SDS) (30), da kuma Barratt impulsiveness Scale-11 (BIS-11) (31). CIAS, wanda Chen ya haɓaka, ya ƙunshi abubuwa na 26 akan sikelin Likert mai huɗu-huɗu kuma yana nuna tsananin zafin jaraba na Intanet. An yi amfani da SAS da SDS don nuna cewa duk abubuwan da aka gabatar sun cika ka'idodin hada abubuwa yayin binciken. Dukkannin tambayoyin an rubuta su da Turanci sannan kuma aka fassara su zuwa Sinanci. Sa’annan, darajojin 26 IGD, iyayensu da malamansu sun shiga cikin jerin ƙungiyar CBT na son rai, wanda ya ƙunshi zaman 12 (20). Kowane zaman yana 1.5 – 2 h. A kowane zaman rukuni na rukuni, an tattauna wani batun daban. Waɗannan batutuwa sun haɗa da yadda zaka gane da sarrafa yadda kake ji; ka'idodi na ingantacciyar sadarwa tsakanin iyaye da yara; dabaru don ma'amala da haɓaka alaƙar da aka ci gaba ta hanyar Intanet; dabaru don ma'amala da abubuwan da aka dandana ta hanyar Intanet; dabarun sarrafa abubuwan sha'awar ku; dabarun ganewa lokacin da dabi'ar jaraba ke faruwa; da kuma yadda za a dakatar da dabi’ar jaraba. Taro na karshe shine zaman bita.

Bayan shiga tsakani, mun sake nazarin halayen asibiti na abubuwan IGD, kuma an sake duba guda 20 daga cikinsu a kan aikin na agaji bisa ga ka'idojin pre-CBT.

Sayar da bayanan MR

Dukkanin abubuwanda aka samu halartar jihar-hutu ta FMRI a cikin kwata-kwata tare da tsarin daukar hoto na 3.0-T MR (GE Signa HDxt3T, Amurka) tare da daidaiton matattarar kai. Don hana motsi kuma don rage amo, yin amfani da kumburi mai laushi, kuma an ba batutuwa cikakkun bayanai don rashin motsi yayin gwajin da kuma bayani game da dalilin da yasa ba a fifita motsi ba, ban da umarnin da yawaitar motsi zai haifar da sake dawowa . An samo bayanan FMRI na hutawa-ta amfani da jerin grajient-echo echo-planar kamar yadda aka bayyana a cikin karatunmu na baya (16). Makonni talatin da huɗu masu canzawa [maimaitawa [TR] = 2,000 ms; lokacin echo [TE] = 30 ms; filin hangen nesa [FOV] = 230 × 230 mm; da 3.6 × 3.6 × 4 mm voxel size] rufe dukkan kwakwalwa an samu su ta hanyar layin kwamishiti-na gaba-gaba. Don wannan jerin bayanan, an samo kundin aikin 220 yayin da abubuwan suke hutawa (sakamakon sakamakon tsinkayen 440 s). A yayin binciken, an umurci mahalarta da su ci gaba da rufe idanunsu, ba motsi-wuri, kuma kada su yi barci ko tunani game da komai. Bayan kammala binciken, an nemi masanan da su tabbatar ko sun kasance a farke a yayin binciken. Hakanan an sake samun wasu jerin biyu: (1) jerin kwatancen-T1-mai nauyi mai sauri-echo jerin (TR = 1,725 ms; TE = 24 ms; FOV = 256 × 256 mm; 34 yanka; da 0.5 × 0.5 × 4 mm voxel size) ) da (2) jerin silsila mai nauyin T2-mai nauyi mai sauri-echo jerin (TR = 9,000 ms; TE = 120 ms; FOV = 256 × 256 mm; yanka 34; da 0.5 × 0.5 × 4 mm girman siginan kwamfuta).

Preprocessing na hoto hoto mai aiki

An aiwatar da aiwatar da bayanan hoto ta amfani da SPM12 da aka aiwatar a cikin MATLAB da SPM12 na faɗaɗa software Bayanai na Bayanai da Tattaunawa game da Brawayar Brain (DPABI; http://rfmri.org/dpabi) (32). Bayan da aka watsar da kundin 10 na farko na kowane jerin lokaci na aikin, sauran hotunan 210 da aka daidaita sau-sau, an daidaita su zuwa maɗaukakiyar tsakiya, kuma an daidaita su ta hanyar amfani da canji na madaidaiciya shida (jiki mai tsauri). Sa’annan, duk hotuna masu aiki an daidaita su kai tsaye zuwa samfurin EPI, an sake saita kowace murfin zuwa 3 × 3 × 3 mm, kuma an gudanar da canjin yanayin motsa jiki tare da 8-mm mai cikakke-rabi rabin matsakaitan Gaussian kernel. Bayan haka, kayan maye na 26 na hayaniya (gami da ma'anar lokacin ma'anar alamun daga voxels a cikin farin abin rufe fuska, ma'anar lokacin alamun daga voxels a cikin rufe CSF, da kuma sigogin motsi na Friston 24). Bugu da ƙari, an hada da salon layi a matsayin mai rikodin rikicewa tunda siginar BOLD na iya nuna frequencyarancin motsi kaɗan.

Babu wani ɗan takara a cikin wannan binciken da ya nuna motsi mafi girma fiye da 1.5 mm na mafi girman fassarar a cikin x, y, ko z gatari ko matsakaicin juyawa na 1.5 ° a kowane ɗayan gatari 3. Don ci gaba da fitar da ragowar tasirin motsi akan matakan fMRI na hutawa, an ƙididdige matsakaiciyar ƙaura (ma'anar FD) na motsi kai kuma anyi amfani da ita azaman rarrabawa a cikin dukkanin nazarin aikin rukuni, wanda aka samo daga tushen dangin Jenkinson yana nufin maƙerin algorithm kuma yayi la'akari da bambance-bambance a cikin motsi a cikin asalinsa (33); ba a sami bambance-bambancen kungiya ba a ma'anar FD tsakanin abubuwan IGD da HC (p = 0.52) a tushe ko tsakanin lokacin kafin CBT da post-CBT lokacin aiki (p = 0.71).

Analysisididdigar bayanan hoto mai aiki

Binciken ALFF an yi shi ta amfani da software na DPABI. ALFF daidai gwargwado ga ƙarfin ko ƙarƙashi na ƙananan ƙididdigar sauƙaƙe ana tunanin zai iya nuna yanayin aiki ne na lokaci-lokaci (34, 35). A takaice, bayan gabatarwar da aka ambata a baya, jerin lokutan kowane voxel ya canza zuwa yankin mitoci ba tare da tace bandwid ba, kuma an sami bakan wutar. Bayan haka, ƙarfin bakan ya zama tushen murabba'in square kuma an ƙaddara shi ta kowane fanni 0.01-0.08 Hz a kowane ƙarami. Matsakaicin murabba'in tushen ƙarfi a cikin wannan mitar bandar an ɗauka azaman darajar ALFF. Bayan haka, tare da tsarin daidaitawa, kowane taswirar ALFF ya daidaita ta mahimmancin mutum na duniya ALFF; ƙari musamman, ana lasafta ma'anar duk faya-fayan taswirar taswirar ALFF, kuma an rarraba darajar kowane voxel ta hanyar ma'anar ɗaiɗaikun mutane. Mun fara kwatanta asalin ALFF na rukunin IGD da na kungiyar HC don bincika canjin canjin yanayin a cikin batutuwan IGD ta hanyar samfurin biyu t-gwaji. Gyara don kwatancen da yawa wanda ya haifar da saurin gyarawa na p <Anyi amfani da 0.05, tare da ƙaramar hadaddiyar ƙaramar voxels 42 (AlphaSim-an gyara shi tare da sigogi masu zuwa: voxel guda p = 0.001; Hanyoyin kwaikwayon 5,000; ma'anar daidaitaccen yanayin daidaitawa na 8.04 × 10.60 × 10.46 mm FWHM; da kuma abin rufe fuska na duniya). Don bincika tasirin CBT akan abubuwan IGD, an haɗa su t-Ya aikata don lissafta taswirar banbancin kungiyar ALFF kafin da kuma bayan CBT. Gyara don kwatancen mahara dayawa wanda ya haifar da saurin gyarawa na p <Anyi amfani da 0.05, tare da ƙaramar hadaddiyar ƙaramar voxels 40 (AlphaSim-an gyara shi tare da sigogi masu zuwa: voxel guda p = 0.001; Hanyoyin kwaikwayon 5,000; ma'anar daidaitaccen yanayin daidaitawa na 9.70 × 10.30 × 9.52 mm FWHM; da kuma abin rufe fuska na duniya). An kiyasta kwaya mai laushi wanda aka danganta da taswirar t. Ana ba da rahoton abubuwan haɗin gwiwar yankuna tare da mahimman bambance-bambancen rukuni a cikin Cibiyar Montreal Neurologic Institute (MNI).

Yankunan ban sha'awa (ROIs) an ƙaddara su zama yankuna inda ƙimar ALFF ta canza sosai tsakanin abubuwan da ke tsakanin pre-da post-CBT. Valuesa'idodin FC na yankuna zuriya (hagu na OFC (MNI daidaitawa: x = −12, y = 24, z = −21, radius = 6 mm) da putamen na hagu (daidaitawa na MNI: x = −3, y = 3, z = 9, radius = 6 mm) an fitar da su ta amfani da DPABI. A cikin tushe, samfurin biyu t- Anyi amfani dashi don kwatanta ƙimar FC tsakanin ƙungiyar IGD da ƙungiyar HC kuma an gudanar da nazarin ƙididdigar Pearson tsakanin ƙimar FC da ƙimar CIAS / BIS-11 a cikin ƙungiyar IGD. Sannan a hade t-An yi amfani da gwajin don kwatanta darajan FC tsakanin maki-da bayan lokacin kulawa. An gudanar da nazarin daidaituwa na Pearson tsakanin darajar canji a cikin ƙimar ƙimar FC (Δ_{ALFF / Pre − ALFF} ko Δ_{FC / Gabada − FC}) da sikelin raguwa a cikin sakamakon CIAS (Δ_{CIAS / Pre − CIAS}) / BIS-11 (Δ_{BIS − 11 / Pre − BIS − 11}) gwaji don bincika ko canje-canje na FC zai yi hasashen rage raguwar cutar ta hanyar CBT, bisa ga hanyoyin da aka bayyana a binciken da ya gabata (36). Guda biyu p- darajar 0.05 an dauki shi a ƙididdigar mahimmanci.

Nazarin ƙididdiga na ƙididdigar mutum da matakan asibiti

Samfurin guda biyu t-An gudanar da gwaje-gwaje ta amfani da SPSS (Kunshin ƙididdiga na software na Social Sciences, SPSS version 19, IBM, USA) don ci gaba da masu canji don tantance bambance-bambance tsakanin ƙungiyar IGD da ƙungiyar HC. An haɗa su tAn yi amfani da -tests don bincika tasirin CBT akan halayen asibiti tsakanin lokacin-da-bayan post-CBT.

Ka tafi zuwa ga:

results

Demographics da matakan asibiti na abubuwan IGD da HC

Batutuwa na IGD da HC ba su bambanta a cikin shekaru biyu ba (p = 0.31) ko ilimi (p = 0.10). Kamar yadda aka zata, abubuwan IGD sun nuna matukar matukar girman CIAS, SAS, SDS, da BIS-II (p <0.001, p = 0.02, 0.04, 0.001), kazalika da tsawon lokacin wasanni na mako-mako fiye da abubuwan da HC suka yi (p <0.001; Tebur Table11).

Table 1

Abubuwan ɗabi'a da halayen ƙungiyar IGD da ƙungiyar HC.

	IGD (n = 26)	HC (n = 30)	P-value
	(Yana nufin ± SD)	(Yana nufin ± SD)
Age (yeas)	16.81 ± 0.75	17.00 ± 0.89	0.31
Ilimi (yeas)	11.53 ± 0.70	11.20 ± 0.81	0.10
Lokaci don amfani da intanet a mako guda (awanni)	32.54 ± 10.34	1.70 ± 5.36
Chen Intanit na ictionarar Intanet (CIAS)	71.88 ± 5.56	41.97 ± 11.31
Matsayar kai Rating damuwa (SAS)	45.65 ± 10.24	40.10 ± 7.28	0.02
Matsayi na kai mara nauyi (SDS)	48.23 ± 8.34	43.43 ± 8.97	0.04
Barratt impulsiveness Scale-11 (BIS-11)	59.62 ± 9.11	52.27 ± 6.90	0.001

SD, daidaitattun daidaito; IGD, cuta ta hanyar intanet; HC, kula da lafiya; CBT, ilimin halin halayyar hankali.

ALFF da FC bambance-bambance tsakanin abubuwan IGD da HC

Idan aka kwatanta da batutuwan HC, abubuwan IGD sun nuna ƙimar ALFF mai mahimmanci a cikin ma'amalar biyu, dama na INC, ɓangaren haɗin motocin haɗin gwiwa (SMA), gyrus na hagu, da na hagu na gaba (ACC; Table; Table2,2, Hoto Figure1) .1). FC-reshen jihar hutu tsakanin ta hannun lambobin hagu OFC da putamen ya ragu sosai a kungiyar IGD (p = 0.002).

Table 2

Yankunan da ke nuna bambance-bambancen kungiya akan ALFF tsakanin ƙungiyar IGD da ƙungiyar HC.

Bayanin tari	BA	MNI tsarawa			Girbin ƙwayar	ganiya t Ci
		X	Y	Z
Karshen (L)		-33	0	-3	95	6.02
Usammar (R)		33	3	-3	56	5.19
Matsakaici na orrtitofrontal bawo (R)	11	12	60	3	214	5.33
Karin yankin yanki (L)	6	-12	-7	56	464	7.21
Gabatarwa gyrus (L)	6	-42	-15	45	103	7.91
Fuskar murfin ciki (L)	24	-6	14	31	62	6.26
Karin kayan aikin mota (R)	6	12	9	57	276	6.16

BA, yankin Brodmann; IGD, matsalar caca ta intanet; HC, kula da lafiya. Gwajin samfurin-T guda biyu P <0.05, AlphaSim-gyara (P <0.001, girman voxel> 42).

Figure 1

Yankunan kwakwalwa waɗanda suka nuna sama da ƙimar ALFF a cikin ƙungiyar IGD fiye da rukunin HC a gininp <0.05, an gyara AlphaSim). Sashin hagu na adadi yana wakiltar gefen dama na mai halarta, kuma bangaren dama yana wakiltar gefen hagu na mai halarta. ALFF, amplitude na low mita hawa da sauka; IGD, matsalar caca ta intanet; HC, kula da lafiya.

Demographics da matakan asibiti kafin da kuma bayan CBT

Bayan CBT, lokacin wasannin mako-mako da sakamakon CIAS da BIS-11 sun ragu sosai (duka ps = 0.001). Wadannan binciken sun nuna cewa CBT ta yi tasiri kan lura da batutuwan IGD (Tebur (Table33).

Table 3

Abubuwan al'adu da halayyar halayya kafin da kuma bayan fahimtar halayyar hankali (CBT) a cikin ƙungiyar IGD.

	Kayan CBT (n = 26)	Post-CBT (n = 26)	P-value
	(Yana nufin ± SD)	(Yana nufin ± SD)
Lokaci don amfani da intanet a mako guda (awanni)	32.54 ± 10.34	27.27 ± 9.36	0.001
Chen Intanit na ictionarar Intanet (CIAS)	71.88 ± 5.56	50.00 ± 11.99	0.001
Matsayar kai Rating damuwa (SAS)	45.65 ± 10.24	44.65 ± 10.24	0.630
Matsayi na kai mara nauyi (SDS)	48.23 ± 8.34	46.77 ± 9.89	0.500
Barratt impulsiveness Scale-11 (BIS-11)	59.62 ± 9.11	52.69 ± 10.04	0.001

SD, daidaitattun daidaito; IGD, rashin lafiyar gidan caca.

Canje-canje a cikin ayyukan hutu na-jihar kafin da kuma bayan CBT

Bayan CBT, darajar ALFF ta ragu sosai a cikin ƙwaƙwalwar hagu ta OFC da putamen (Table (Table4,4, Hoto Figure3) .3). Bugu da kari, filin hutu na tsakanin kungiyar kwallon kafa ta hagu na OFC da putamen sun kara sosai.

Table 4

Yankunan da ke nuna bambance-bambancen kungiya akan ALFF tsakanin pre-CBT da post-CBT a cikin ƙungiyar IGD.

Bayanin tari	BA	MNI tsarawa			Girbin ƙwayar	ganiya t Ci
		X	Y	Z
Mafi kyawun cortex na orbitofrontal (L)	11	-12	24	-21	41	-5.18
Karshen (L)		-15	12	-4	68	-6.19

BA, yankin Brodmann; CBT, ilimin halin wayewar hankali, IGD, rikicewar caca na intanet

An gwada-T gwajin P <0.05, AlphaSim-gyara (P <0.001, girman voxel> 40).

Figure 3

Yankunan kwakwalwa waɗanda suka nuna rage darajar ALFF a cikin ƙungiyar IGD bayan ilimin halin halayyar hankali.p <0.05, an gyara AlphaSim). Sashin hagu na adadi yana wakiltar gefen dama na mai halarta, kuma bangaren dama yana wakiltar gefen hagu na mai halarta. IGD, Rikicin caca na Intanet; ALFF, amplitude na low mita hawa da sauka.

Clinical matakan dangantaka

A cikin ƙungiyar IGD, ƙimar FC tsakanin medial OFC da putamen suna da alaƙa da maki BIS-11 (r = -0.733, p <0.001; Hoto Figure2) .2). Canje-canje a cikin ƙaddarar ƙimar FC (Δ_{FC / Gabada − FC}) tsakanin hagu OFC da hagu putamen an daidaita da daidaituwa da ragin rage yawan maki CIAS (Δ_{CIAS / Pre − CIAS}; r = 0.707, p <0.001; Hoto Figure4) .4). Babu wata muhimmiyar hulda tsakanin canje-canjen ƙimar FC (Δ_{FC / Gabada − FC}) da sikelin raguwa a cikin maki BIS-11 (Δ_{BIS − 11 / Pre − BIS − 11}) an gano shi (r = 0.396, p = 0.084).

Figure 2

A cikin ƙungiyar IGD, ƙimar FC tsakanin medial OFC da putamen suna da alaƙa da maki BIS-11 (r = -0.733, p <0.001). IGD, Rikicin caca na Intanet; FC, haɗin haɗin aiki; OFC, kobitofrontal bawo; BIS-11, Siffar ratarfin Barratt-11.

Figure 4

Canje-canje a cikin ƙimar FC (ΔFC / Pre-FC) tsakanin madaidaiciyar OFC da hagu putamen suna da alaƙa da sikelin raguwa a cikin maki CIAS a cikin abubuwan IGD. (ΔCIAS / Pre-CIAS; r = 0.707, p <0.001). FC, haɗin haɗin aiki; OFC, kobitofrontal bawo; CIAS, Chen Siffar Intanet na Chen; IGD, Rikicin caca na Intanet.

Ka tafi zuwa ga:

tattaunawa

A cikin wannan binciken na tsawon lokaci, ana amfani da hanyar ALFF da FC don bincika kwakwalwa na kwakwalwa tsakanin ƙungiyoyi na IGD da HC da kuma magunguna na CBT a cikin batutuwa na IGD. Mun gano cewa shafukan na IGD sun nuna aikin haɓaka na wasu yankuna na gabas da suka shafi batutuwa na HC da kuma cewa CBT na iya tayar da ƙananan abubuwan da ke aiki a cikin OFC da kuma ƙaddamar da haɓaka tsakanin su, baya ga inganta halayen IGD.

A cikin wannan binciken, FC-FC-FC tsakanin magungunan hagu na OFC da ƙaddamarwa sun kasance da ƙananan raguwa a kungiyar IGD. BIS-11 yayi daidai da sauyawa na FC ya nuna cewa rashin daidaituwa a cikin hanyoyi na farko na iya zama tasiri kan halin haɓaka na batutuwa na IGD. Binciken neuroimaging baya ya ruwaito cewa rashin aikin aiki a cikin yankunan PFC an hade shi da babban impulsivity a IGD (37). Hanyoyi na gaba-gaba sun haɗa da madaidaiciyar mahimmanci, wanda ya haɗu da caudate da tsaminit tare da yankuna na gaba. Dangane da binciken binciken binciken da ba a yi ba a kwanan nan, an gano sauye-gyare na aiki a wasu yankuna da dama (ciki har da na OFC, SMA da kuma hagu na ACC) da kuma yankunan basal ganglia (tsarin sulhu) a cikin rikici, ciki har da IGD (12, 38, 39). Volkow et al. ya bada shawarar cibiyoyin sadarwa na neuronal a cikin batutuwa masu maganin miyagun ƙwayoyi, ciki har da OFC-, ACC-, gyrus na gaba (IFG) -, da kuma ƙananan magunguna na farko (DLPFC) -driatal circuits, wanda zai iya yin la'akari da halin kirkira, irin su rashin kulawar kai da halayyar nakasawa (40) da kuma matsaloli wajen yin kyakkyawan yanke shawara, wanda ke nuna jaraba; lokacin da mutanen da ke tare da IGD ci gaba da yin wasanni ko da yake sun fuskanci mummunan sakamako, wannan zai iya danganta da aikin da ba shi da kyau na circuits-striatal circuits (41). Ofaya daga cikin mahimman halayen IGD shine rashi kulawar rashin ƙarfi tare da rashin iko akan wasan caca na yanar gizo. Wani binciken da ya gabata ya haɗaka da tushen motsi na tushen voxel (VBM) da ƙididdigar FC sun bayyana sa hannu a cikin yawancin yankuna prefrontal da kuma nau'ikan da'irorin prefrontal-striatal (ACC-, OFC-, da DLPFC-striatal ወረዳ) a cikin aiwatar da IGD kuma sun ba da shawarar IGD na iya raba irin waɗannan hanyoyin ƙirar tare da dogaron sinadarai a matakin da'ira (41). Binciken na yanzu yana da mahimmanci, kamar yadda madadin ayyukan kwakwalwa / haɗin haɗi a cikin da'irorin pre-prealal-striatal waɗanda aka lura da dovetails tare da karatun da suka gabata. Bugu da kari, SMA an haɗa shi a cikin hanyar sadarwa, wanda ke daidaita aikin wasu hanyoyin sadarwa yayin da ake buƙatar canje-canje mai sauri a cikin hali, kamar lokacin da ake amfani da maballin cikin sauri yayin wasa wasanni (42). Yuan et al. bayar da rahoton mafi girma ALFF dabi'u a cikin SMA a cikin batutuwa na IGD (12), kuma mun sami sakamako irin wannan a cikin wannan binciken, wanda ya ba da shawarar cewa SMA na iya kasancewa yanki mai mahimmanci a cikin halayen jaraba (41).

Zuwa yau, an nuna cewa kungiyar ta CBT tana da fa'ida ga taimaka wa matasa da matsalar jaraba ta yanar gizo (20). A cikin binciken da ake gabatarwa, lokacin wasannin mako-mako yayi matukar gajarta, kuma an rage yawan abubuwan CIAS da BIS-II bayan CBT. Ya ba da shawarar cewa mummunan sakamakon zai iya juyawa idan har za a iya dawo da jarabar intanet cikin ɗan gajeren lokaci. Mun lura da rage ƙimar ALFF a cikin hagu na OFC da hagu putamen da haɓaka haɗin OFC-putamen bayan CBT, waɗanda sune binciken da suka dace da abubuwan lura na baya waɗanda suka ba da shawara cewa yanayin kewaye na OFC-striatal na iya kasancewa mai yuwuwar warkewa a duk jaraba. cuta (43). Dokar OFC na da hannu a ka'idar motsa jiki baya ga yanke shawara, don haka haɗuwa tsakanin OFC da zabin yana nufin kyakkyawan iko akan halayyar motsa jiki na batutuwa na IGD (44). Ya yi daidai da sakamakon rage ƙarancin BIS-11 bayan jiyya. The putamen yana ɗayan ɓangarorin sassan damƙar kuma ya kasance yanki na kwakwalwa da ke da alaƙa da ayyukan wayewar kai da aka raba su da ƙwayoyin caudate. Specificallyari musamman, putamen yana da alaƙa da sarrafa halayyar ɗabi'a da ayyukan da aka sa gaba-da-manufa (45). Mun lura cewa mafi girma ALFF ya ragu a cikin putamen na hagu bayan CBT, yana ba da shawarar cewa CBT na iya zama da taimako a haɓaka ikon kula da ɗabi'un al'adu da ayyukan da aka tsara na abubuwan IGD. Wannan yana nufin cewa CBT na iya hana amfani da wasan motsa rai mara amfani ta hanyar canza hulɗa na da'irorin prefrontal-striatal. Nazarin da suka gabata na CBT sun ba da rahoton cewa CBT yana canza yanayin kunnawa-jihar kunnawa a cikin cortex prefrontal kuma cewa CBT yana daidaita matakan dysfunctional hankali (46). A halin yanzu, canje-canje a cikin haɗin OFC-putamen na iya hango hasashen tasirin CBT.

Wani rauni na wannan binciken shine cewa ba a sanya abubuwan IGD ba da izini ga rukunoni biyu (rukuni ɗaya na mahalarta za su karɓi CBT, yayin da wata ƙungiyar da ba ta karɓi magani ba zata zama mai iko). Na biyu, kawai muka dauki mahalarta maza kawai; don haka, ana buƙatar ƙarin karatu tare da mahalarta mata don tabbatarwa da faɗaɗa sakamakon yanzu. Na uku, iyakataccen samfurin samfurin ya kara haɗarin rashin tunani kuma ya hana gwajin don kimanta alaƙa tsakanin canje-canje a ƙimar FC da tasirin magani. Na hudu, Ya zama dole a gyara don kwatancen dayawa don sarrafa kuskuren ingancin-qarya. Anyi amfani da gyaran alphaSim anan saboda ba za'a iya samun tari lokacin amfani da hanyoyin FWE ko FDR ba. Koyaya, muna tsammanin za a iya karɓar gyaran AlfaSim a cikin bincikenmu tunda yana ɗaya daga cikin zaɓukan da suka shahara don gyaran kwatancen da yawa kuma anyi amfani dashi cikin karatu da yawa (34).

A taƙaice, bincikenmu ya nuna cewa IGD yana haɗuwa da aikin canzawa na wasu na'urori na gaba-da-gaba da kuma cewa CBT zai iya magance abubuwan haɓaka na aiki na OFC da kuma ƙararrakin kuma ƙara haɓaka tsakanin su. Wadannan binciken zasu iya ba da wata mahimmanci don bayyana magungunan maganin na CBT a cikin batutuwa na IGD kuma su kasance masu cin gashin halitta mai yiwuwa wanda zai iya hango hangen nesa na gaba bayan CBT a cikin batutuwa IGD.

Ka tafi zuwa ga:

Takardun marubuta

YZ, YD sun kasance masu alhakin manufar nazarin da ƙira. YD, WJ, XB, MC, XW, da WD sun ba da gudummawa ga sayan bayanai. YS, XH, da YW sun taimaka da nazarin bayanai da fassarar binciken. XH ya rubuta rubutun. Duk marubutan sunyi zurfin nazarin abun ciki kuma an tabbatar da sigar karshe don bugawa.

Rikici na sanarwa mai amfani

Mawallafa sun bayyana cewa an gudanar da binciken ne a cikin babu wata kasuwanci ko kudi da za a iya ɗauka a matsayin mai rikici na sha'awa.

Ka tafi zuwa ga:

Bayanan kalmomi

Kudin kuɗi. Wannan aikin ya sami goyan bayan Gidauniyar Kimiyyar Kimiyya ta Kasa ta Sin (No.81571650), Kwamitin Jagorar Gudanar da Kiwon Lafiyar Kimiyya da Fasaha ta Shanghai (likitancin yamma; ), Gidauniyar Bincike na Injiniyancin Injiniya na Jami'ar Shanghai Jiao Tong (A'a. YG17411964300QN20172013), da Asusun Tsarin Bincike na Asibitin Ren Ji, Makarantar Medicine, Jami'ar Shanghai Jiao Tong (RJZZ2017-47). Shirin haɗawa da bincike na asibiti da kuma kirkirar asibitin Ren Ji, Makarantar Magunguna, Jami'ar Shanghai Jiao Tong (PYIII-17-016, PYIV-17-027). Masu ba da rancen ba su da rawar takawa a cikin zanen nazari, tattara bayanai da bincike, shawarar yankewa, ko shirya rubutun.

Ka tafi zuwa ga:

References

1. Ko Ko, GLiu C, Yen JY, Chen CY, Yen CF, Chen CS. Kwakwalwa na ma'amala game da sha'awar wasan caca ta hanyar layi a cikin bayyanannu a cikin batutuwa tare da jarabar wasan caca na Intanet da kuma abubuwan da aka tanada. Addict Biol. (2013) 18: 559 – 69. 10.1111 / j.1369-1600.2011.00405.x [PubMed] [Cross Ref]

2. King DL, Delfabbro PH, Wu A, Doh YY, Kuss DJ, Pallesen S, et al. . Jiyya na rashin lafiyar caca ta yanar gizo: Yin bita akan tsarin ƙasa da kimantawa. Clin Psychol Rev. (2017) 54: 123 – 33. 10.1016 / j.cpr.2017.04.002 [PubMed] [Cross Ref]

3. Ko Ko, Liu TL, Wang PW, Chen CS, Yen CF, Yen JY. Yawan tashin hankali, rashin jituwa, da damuwar rayuwa a yayin shaye-shaye ta yanar gizo a tsakanin samari: karatun da akeyi. Compr Psychiatry (2014) 55: 1377 – 84. 10.1016 / j.comppsych.2014.05.003 [PubMed] [Cross Ref]

4. Tareda JJ. Batutuwan don DSM-V: jarabar intanet. Am J Psychiatry (2008) 165: 306 – 7. 10.1176 / appi.ajp.2007.07101556 [PubMed] [Cross Ref]

5. APungiyar AP. Binciken Bincike da kuma istididdigar Manhaja na Rashin Tsarin Hauka, 5th Edn Washington, DC: Associationungiyar Masana ilimin halayyar Amurka; (2013).

6. Saurayi KS. Sakamakon jiyya ta amfani da CBT-IA tare da marasa lafiya na yanar gizo. J Behav shan tabar wiwi. (2013) 2: 209 – 15. 10.1556 / JBA.2.2013.4.3 [PMC free article] [PubMed] [Cross Ref]

7. Dong G, Zhou H, Zhao X. Masu jarabar intanet na maza sun nuna iyawar ikon sarrafa zartarwa: shaidar daga aikin-Stroop word mai launi. Leturo Neurosci. (2011) 499: 114 – 8. 10.1016 / j.neulet.2011.05.047 [PubMed] [Cross Ref]

8. Weinstein A, Livny A, Weizman A. Sabbin ci gaba a cikin bincike na kwakwalwa game da intanet da rashin lafiyar caca. Neurosci Biobehav Rev. (2017) 75: 314 – 30. 10.1016 / j.neubiorev.2017.01.040 [PubMed] [Cross Ref]

9. Nelson CL, Sarter M, Bruno JP. Tsarin tantancewa na pre ቅድመal na cortical na sakin acetylcholine a cikin sel mai gamawa. Neuroscience (2005) 132: 347 – 59. 10.1016 / j.neuroscience.2004.12.007 [PubMed] [Cross Ref]

10. Ko Ko, Hsieh TJ, Chen CY, Yen CF, Chen CS, Yen JY, et al. . Canza kunnawar kwakwalwa yayin hanawar amsawa da sarrafa kuskure a cikin batutuwan da ke tattare da matsalar caca ta yanar gizo: nazarin hoton magnetic. Eur Arch Psychiatry Clin Neurosci. (2014) 264: 661 – 72. 10.1007 / s00406-013-0483-3 [PubMed] [Cross Ref]

11. Weng CB, Qian RB, Fu XM, Lin B, Han XP, Niu CS, et al. . Grey kwayoyin halitta da fari matsala mahaukaci a cikin wasan jaraba. Eur J Radiol. (2013) 82: 1308 – 12. 10.1016 / j.ejrad.2013.01.031 [PubMed] [Cross Ref]

12. Yuan K, Jin C, Cheng P, Yang X, Dong T, Bi Y, et al. . Amplitude na ƙarancin lalacewa mai lalacewa a cikin samari tare da ƙara caca na kan layi. PLoS DAYA (2013) 8: e78708. 10.1371 / journal.pone.0078708 [PMC free article] [PubMed] [Cross Ref]

13. Ko Ko, Liu GC, Hsiao S, Yen JY, Yang MJ, Lin WC., Et al. . Ayyukan kwakwalwar da ke hade da sha'awar caca na kan layi. J Psychiatr Res. (2009) 43: 739 – 47. 10.1016 / j.jpsychires.2008.09.012 [PubMed] [Cross Ref]

14. Ko Ko, Liu GC, Yen JY, Yen CF, Chen CS, Lin WC. Thewaƙwalwar kwakwalwa don duk wasannin caca da ke haifar da sha'awar shan taba da kuma shan sigari a cikin abubuwan da suka dace da jarabar caca ta Intanet da kuma nicotine dogara. J Psychiatr Res. (2013) 47: 486 – 93. 10.1016 / j.jpsychires.2012.11.008 [PubMed] [Cross Ref]

15. Wang Y, Yin Y, Sun YW, Zhou Y, Chen X, Ding WN, et al. . Rage prefrontal lobe interhemispheric aikin haɗi a cikin matasa tare da matsalar caca yanar gizo: nazarin farko ta amfani da hutu-jihar FMRI. PLoS DAYA (2015) 10: e0118733. 10.1371 / journal.pone.0118733 [PMC free article] [PubMed] [Cross Ref]

16. Ge X, Sun Y, Han X, Wang Y, Ding W, Cao M, et al. . Bambanci a cikin haɗin haɗin aikin dorsolateral prefrontal cortex tsakanin masu shan sigari tare da dogara da nicotine da kuma mutanen da ke da matsala ta hanyar intanet. BMC Neuroscience (2017) 18: 54. 10.1186 / s12868-017-0375-y [PMC free article] [PubMed] [Cross Ref]

17. Liu J, Gao XP, Osunde I, Li X, Zhou SK, Zheng HR, et al. . Asedara yawan haɗin kai na yanki a cikin matsalar ƙwaƙwalwar intanet: hutuwar jihar da ke ci gaba da aikin binciken magnetic resonance hoto. Chin Med J. (2010) 123: 1904 – 8. 10.3760 / cma.j.issn.0366-6999.2010.14.014 [PubMed] [Cross Ref]

18. Brand M, Matasa KS, Laier C. Tsarin kulawa na prefrontal da jarabawar intanet: wani tsari mai zurfi da bita kan binciken neuropsychological da neuroimaging. Gaban Hum Neurosci. (2014) 8: 375. 10.3389 / fnhum.2014.00375 [PMC free article] [PubMed] [Cross Ref]

19. Everitt BJ, Robbins TW. Daga ventral to the dorsal striatum: taɓar da ra'ayoyi game da rawar da suke takawa a jarabar shan muggan kwayoyi. Neurosci Biobehav Rev. (2013) 37 (9 Pt A): 1946 – 54. 10.1016 / j.neubiorev.2013.02.010 [PubMed] [Cross Ref]

20. Du YS, Jiang W, Vance A. Sakamakon lokaci mai tsawo, rikicewar halayen rukuni na ƙungiyar kula da ɗabi'a don ɗaruwar Intanet a ɗaliban matasa a Shanghai. Aust NZJ Psychiatry. (2010) 44: 129 – 34. 10.3109 / 00048670903282725 [PubMed] [Cross Ref]

21. Weingardt KR, Villafranca SW, Levin C. horo na tushen fasaha a cikin ilimin halayyar ilmantarwa don masu ba da shawara game da cutarwa. Na biyu Abus. (2006) 27: 19 – 25. 10.1300 / J465v27n03_04 [PubMed] [Cross Ref]

22. Kiluk BD, Nich C, Babuscio T, Carroll KM. Ingantawa da yawa: sayan dabarar yin amfani da dabarar yin amfani da ilimin ilimin halin kwakwalwa na kwakwalwa don rikicewar amfani da abubuwa. Ictionara (2010) 105: 2120 – 7. 10.1111 / j.1360-0443.2010.03076.x [PMC free article] [PubMed] [Cross Ref]

23. DeVito EE, Worhunsky PD, Carroll KM, Rounsaville BJ, Kober H, Potenza MN. Binciken farko game da tasirin jijiyoyin cututtukan halaye don rikicewar amfani da abubuwa. Alan Ruwa na Dogaro. (2012) 122: 228 – 35. 10.1016 / j.drugalcdep.2011.10.002 [PMC free article] [PubMed] [Cross Ref]

24. Yip SW, DeVito EE, Kober H, Worhunsky PD, Carroll KM, Potenza MN. Tsarin farfaɗo da tsarin kwakwalwa da kuma aiki da ƙwaƙwalwar aiki a cikin dogaro na cannabis: bincike mai zurfi game da alaƙa da kaurace wa yayin kula da halayyar. Alan Ruwa na Dogaro. (2014) 140: 33 – 41. 10.1016 / j.drugalcdep.2014.03.031 [PMC free article] [PubMed] [Cross Ref]

25. Kanada KW, Wolf EM. Canji a cikin ƙaddarar maganin bincike don jarabar Intanet. Sawanna Behav. (2001) 4: 377 – 83. 10.1089 / 109493101300210286 [PubMed] [Cross Ref]

26. Meng Y, Deng W, Wang H, Guo W, Li T. Matsanancin lalacewa a cikin mutane tare da labarun cinikayyar Intanit: nazarin kwaskwarima game da aikin nazarin halayen magnetic aiki. Addic Biol. (2015) 20: 799-808. 10.1111 / adb.12154 [PubMed] [Cross Ref]

27. Sheehan DV, Sheehan KH, Shytle RD, Janavs J, Bannon Y, Rogers J. E, et al. . Dogara da inganci na Mini International Neuropsychiatric Interview ga Yara da Matasa (MINI-KID). J Clin Psychiatry (2010) 71: 313 – 26. 10.4088 / JCP.09m05305whi [PubMed] [Cross Ref]

28. Chen SH, Weng LJ, Su YJ, Wu HM, Yang PF. Bunkasa Sigar Tsarin Sinawa na Sinanci da kuma karatunsa na ilimin halin dan Adam. Chin J Psychol. (2003) 45: 251 – 66. 10.1037 / t44491-000 [Cross Ref]

29. Zung WW. Kayan aiki don raunin damuwa. Psychosomatics (1971) 12: 371 – 9. 10.1016 / S0033-3182 (71) 71479-0 [PubMed] [Cross Ref]

30. Zung WW. Matsakaicin talaucin kai. Arch Gen Psychiatry (1965) 12: 63 – 70. 10.1001 / archpsyc.1965.01720310065008 [PubMed] [Cross Ref]

31. Patton JH, Stanford MS, Barratt ES. Tsarin tsari na sikelin Barratt impulsiveness. J Clin Psychol. (1995) 51: 768-74. 10.1002 / 1097-4679 (199511) 51: 6 <768 :: AID-JCLP2270510607> 3.0.CO; 2-1 [Mazaje NePubMed] [Cross Ref]

32. Yan CG, Wang XD, Zuo XN, Zang YF. DPABI: Gudanar da Bayanai & Nazari don (Hutun-Jiha) Hoto ta Hoto. Neuroinformatics (2016) 14: 339-51. 10.1007 / s12021-016-9299-4 [XNUMX]PubMed] [Cross Ref]

33. Power JD, Barnes KA, Snyder AZ, Schlaggar BL, Petersen SE. Uraƙwalwa amma tsarin daidaituwa a cikin tashoshin sadarwa na MRI sun tashi ne daga motsi na magana. Neuroimage (2012) 59: 2142 – 54. 10.1016 / j.neuroimage.2011.10.018 [PMC free article] [PubMed] [Cross Ref]

34. Li F, Lui S, Yao L, Hu J, Lv P, Huang X, et al. . Canjin lokaci mai tsawo a cikin ayyukan hutu na-cikin jihar a cikin marasa lafiya tare da schizophrenia na farko-mataki: binciken shekara-shekara na aikin kwaikwayo na 1 na aikin MR. Radiology (2016) 279: 867 – 75. 10.1148 / radiol.2015151334 [PubMed] [Cross Ref]

35. Liu F, Guo W, Liu L, Long Z, Ma C, Xue Z, et al. . Narancin ƙananan ƙarancin oscillations a cikin magunguna-butulci, marasa lafiya na farko-farkon marasa lafiya tare da babban raunin damuwa: nazarin fMRI na jihar-hutu. J Shafar cuta. (2013) 146: 401 – 6. 10.1016 / j.jad.2012.10.001 [PubMed] [Cross Ref]

36. Yuan M, Zhu H, Qiu C, Meng Y, Zhang Y, Shang J, et al. . Coungiyoyin masu ilimin halayyar ɗabi'a suna daidaita yanayin haɗin gwiwar-jihar aiki na cibiyar sadarwa mai dangantaka da amygdala a cikin marasa lafiya tare da rikicewar damuwa na zamantakewar al'umma. BMC Psychiatry (2016) 16: 198. 10.1186 / s12888-016-0904-8 [PMC free article] [PubMed] [Cross Ref]

37. Dieter J, Hoffmann S, Mier D, Reinhard I, Beutel M, Vollstadt-Klein S, et al. . Matsayin ikon hana motsa rai a cikin takamaiman jarabar intanet - nazarin fMRI. Behav Brain Res. (2017) 324: 1-14. 10.1016 / j.bbr.2017.01.046 [XNUMX]PubMed] [Cross Ref]

38. Zhang JT, Yao YW, Potenza MN, Xia CC, Lan J, Liu L, et al. . Canje-canje wurin hutawa-jihar neural aiki da canje-canje bin wata sha'awar halayyar halayyar yanar gizo cuta. Sci Rep. (2016) 6: 28109. 10.1038 / srep28109 [PMC free article] [PubMed] [Cross Ref]

39. Wang Y, Zhu J, Li Q, Li W, Wu N, Zheng Y, et al. . Canza fronto-striatal da fronto-cerebellar da'irori a cikin mutane-dogara-mutum: nazarin gidan-hutu na jihar FMRI. PLoS DAYA (2013) 8: e58098. 10.1371 / journal.pone.0058098 [PMC free article] [PubMed] [Cross Ref]

40. Volkow ND, Wang GJ, Tomasi D, Baler RD. Rashin daidaituwa da'irar jijiyoyi a cikin jaraba. Opr Neurobiol na Curr. (2013) 23: 639 – 48. 10.1016 / j.conb.2013.01.002 [PMC free article] [PubMed] [Cross Ref]

41. Jin C, Zhang T, Cai C, Bi Y, Li Y, Yu D, et al. . Rashin ƙarfi pre ቅድመal cortex hutawa jihar aiki haɗi da kuma tsananin matsalar yanar gizon cuta. Hoton Brain Behav. (2016) 10: 719 – 29. 10.1007 / s11682-015-9439-8 [PubMed] [Cross Ref]

42. Seminowicz DA, Shpaner M, Keaser ML, Krauthamer GM, Mantegna J, Dumas J. A, et al. . Cognitive-hali therapy ƙara prefrontal bawo launin toka abu a cikin marasa lafiya da na kullum zafi. J Pain (2013) 14: 1573 – 84. 10.1016 / j.jpain.2013.07.020 [PMC free article] [PubMed] [Cross Ref]

43. Jiang GH, Qiu YW, Zhang XL, Han LJ, Lv XF, Li LM, et al. . Amplitude low-mita oscillation abnormalities a cikin masu amfani da tabar heroin: nazarin hutu na jihar fMRI. Neuroimage (2011) 57: 149 – 54. 10.1016 / j.neuroimage.2011.04.004 [PubMed] [Cross Ref]

44. Ding WN, Sun JH, Sun YW, Chen X, Zhou Y, Zhuang ZG, et al. . Itarfin halayen ɗabi'a da kuma lalacewar aikin inzagewa mai hana mutum aiki a cikin samari tare da jarabar wasan caca ta yanar gizo wanda binciken Go / No-Go fMRI ya nuna. Behav Brain Funct. (2014) 10: 20. 10.1186 / 1744-9081-10-20 [PMC free article] [PubMed] [Cross Ref]

45. Cai C, Yuan K, Yin J, Feng D, Bi Y, Li Y, et al. . Striatum morphometry yana da alaƙa da rashi kulawar hankali da kuma tsananin rauni a cikin matsalar caca ta yanar gizo. Hoton Brain Behav. (2016) 10: 12 – 20. 10.1007 / s11682-015-9358-8 [PubMed] [Cross Ref]

46. Yoshimura S, Okamoto Y, Onoda K, Matsunaga M, Okada G, Kunisato Y, et al. . Farfesa halayyar halayyar kwakwalwa don baƙin ciki yana canza yanayin medial prefrontal da na jijiyoyin jijiyoyin ciki wanda ke da alaƙa da aikin kai-da-kai. Soc Cogn ke cutar da Neurosci. (2014) 9: 487 – 93. 10.1093 / scan / nst009 [PMC free article] [PubMed] [Cross Ref]