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)

Ilimin Halayyar Dan Adam na Gaba. 3 ga Agusta 2018;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

Maganin halayyar fahimta (CBT) yana da tasiri wajen magance matsalar caca ta intanet (IGD). Duk da haka, hanyoyin da CBT ke inganta alamomin asibiti da suka shafi IGD ba a san su ba. Wannan binciken yana da nufin gano hanyar warkewa ta CBT a cikin mutanen IGD ta amfani da hoton maganadisu mai aiki na hutawa (rsfMRI). Mutane ashirin da shida na IGD da kuma 30 masu kula da lafiya (HCs) sun sami gwajin rsfMRI da kimantawa na asibiti; mutane ashirin da shida na IGD sun kammala CBT sannan aka sake duba su. An kwatanta girman ƙimar ƙananan mitoci (ALFF) da haɗin aiki (FC) tsakanin ƙungiyar IGD da ƙungiyar HC a farkon, da kuma ƙimar ALFF da FC kafin da bayan CBT a cikin ƙungiyar IGD. Kafin magani, ƙungiyar IGD ta nuna ƙaruwar ƙimar ALFF sosai a cikin putamen na biyu, cortex na tsakiya na dama (OFC), yankin motar ƙarin haɗin gwiwa (SMA), gyrus na baya-bayan hagu, da kuma cingulate na gaba na hagu (ACC) idan aka kwatanta da ƙungiyar HC. Ƙungiyar HC ta nuna ƙaruwar ƙimar FC sosai tsakanin tsakiyar hagu na OFC da putamen idan aka kwatanta da ƙungiyar IGD, ƙimar FC na ƙungiyar IGD tana da alaƙa mara kyau da maki BIS-11 kafin magani. Bayan CBT, lokacin wasanni na mako-mako ya yi gajeru sosai, kuma maki CIAS da BIS-II sun yi ƙasa sosai. Ƙimar ALFF a cikin batutuwa na IGD ta ragu sosai a cikin OFC mai girma na hagu da putamen na hagu, kuma FC tsakanin su ya ƙaru sosai bayan CBT. Matsayin canje-canjen FC (Δ _FC/Pre-FC ) yana da alaƙa mai kyau da girman canje-canjen maki na CIAS (Δ _{CIAS/Pre-CIAS} ) a cikin batutuwa na IGD. CBT na iya daidaita sauye-sauyen ƙananan mitoci marasa kyau a cikin yankuna na prefrontal-striatal a cikin batutuwa na IGD kuma yana iya inganta alamun da suka shafi IGD. Canje-canjen yanayin hutu a cikin yankuna na prefrontal-striatal na iya bayyana hanyar magani na CBT a cikin batutuwa na IGD.

KALMOMI MAI KYAU: yawan canjin yanayi mai ƙarancin mita; maganin halayyar fahimta; haɗin aiki; hoton maganadisu mai aiki; matsalar caca ta intanet

PMID: 30123144

PMCID: PMC6085723

DOI: 10.3389/fpsyt.2018.00341

Free PMC Mataki na ashirin da

Gabatarwa

Matsalar caca ta intanet (IGD), wacce aka fi sani da matsalar amfani da intanet, ita ce yawan amfani da wasannin intanet na kan layi da kuma yawan maimaitawa ( 1 ). Kwanan nan, an lissafa IGD a matsayin yanayin wasanni mai dorewa ko maimaituwa wanda ke da nasaba da rashin iko a kan wasanni; an ƙara fifiko ga wasanni fiye da sauran ayyuka har zuwa lokacin da wasanni suka fi fifiko fiye da sauran abubuwan sha'awa da ayyukan yau da kullun; da kuma ci gaba da wasanni duk da faruwar mummunan sakamako ( 2 , 3 ). Kodayake babu wani takamaiman ka'idojin ganewar asali na yanayin tabin hankali wanda ya ƙunshi yanayin amfani da intanet mai yawa da kuma tsangwama a bugu na huɗu na Littafin Bincike da Kididdiga (DSM-IV) ( 4 ), kwamitin DSM-V yana la'akari da amfani da ka'idojin da aka samar don amfani da miyagun ƙwayoyi da cututtukan jaraba ga IGD kuma ya haɗa da IGD a cikin sashin da ke nuna ƙarin bincike ( 5 ).

Masu bincike sun kwatanta IGD da matsalolin sarrafa motsin rai ( 6 ). Nazarin hotunan jijiyoyi sun gano cewa yawan wasannin intanet yana da alaƙa da rashin aikin hutawa a cikin goshin gaba, yankin kwakwalwa wanda ke da alhakin tsarin fahimta, kamar sarrafa hanawa ( 7 ). Rashin aikin prefrontal (PFC) na iya dangantawa da babban sha'awa, wanda, bi da bi, zai iya ba da gudummawa ga rashin ikon hanawa da ke da alaƙa da IGD ( 8 ). Ingantaccen ikon kula da hankali yana da alaƙa da haɗakar ɗaukar ma'aikata daban-daban na sama-ƙasa, da'irorin prefrontal-striatal ( 9 , 10 ). Nazarin da suka gabata ya nuna alaƙar da ke tsakanin rashin daidaituwar tsari da aiki a cikin prefrontal cortex (PFC) da rashin ikon kula da hanawa a cikin IGD ( 11-16 ) . Misali, an gano cewa raguwar kauri na cortical da ƙaruwar ƙimar ƙarancin sauyi na mita (ALFF) a cikin OFC suna da alaƙa da raunin aikin kula da hankali a cikin matasa masu fama da IGD ( 12 ). Wani bincike da aka yi amfani da hanyar Reho ya gano cewa mutanen IGD sun nuna ƙaruwar haɗin gwiwa a cikin gyrus na gaba mafi girma idan aka kwatanta da masu kula da lafiya (HCs), wanda ya nuna ƙaruwar ayyukan jijiyoyi da ke da alaƙa da aikin kula da fahimta ( 17 ). Ko et al. ( 10 ) sun nuna cewa aikin da ya lalace a yankunan prefrontal-striatal na iya bayyana raguwar ƙarfin hanawa a cikin IGD. Waɗannan nazarin hoto sun bayyana yadda tsarin lobe na gaba da ayyukansa ke canzawa dangane da rashin ikon hanawa a cikin IGD. Bugu da ƙari, an lura da rashin aikin dopamine a cikin striatum (raguwar masu karɓar dopamine D2 da raguwar sakin dopamine) da kuma alaƙarsa da raguwar metabolism na glucose na asali a cikin PFC ( 18 , 19 ).

An gano cewa maganin halayyar fahimta (CBT) yana da tasiri wajen magance matsalolin sarrafa sha'awa, gami da caca ta hanyar cututtuka ( 20 ). Nazarin da aka yi kan jarabar miyagun ƙwayoyi ya nuna cewa CBT yana ƙarfafa mutane su gane kuma su guji yanayin da za su iya amfani da abubuwa da kuma amfani da dabarun magance su don tsayayya da amfani da miyagun ƙwayoyi da inganta aikin hana hana shan ƙwayoyi ( 21 , 22 ). Wani bincike da aka yi amfani da aikin Stroop ya gano cewa CBT na iya alaƙa da raguwar amfani da abubuwa, kuma yana iya shafar tsarin jijiyoyi da ke da hannu a sarrafa fahimta, sha'awar sha'awa, kwarin gwiwa, da hankali ( 23 ). Wani binciken aikin magnetic resonance imaging (fMRI) wanda ya yi amfani da aikin jinkirta kuɗi (MID) a cikin dogaro da cannabis ya ruwaito cewa mahalarta da suka dogara da cannabis sun nuna raguwar yawan putamen na biyu bayan CBT, wanda ya nuna cewa takamaiman fannoni na aikin putamen da tsari suna da alaƙa da sakamakon magani ( 24 ). Young ya yi imanin cewa shiga tsakani a cikin jarabar Intanet (IA) ya kamata ya mai da hankali kan hana amfani da Intanet, bisa ga wannan, ya ba da shawarar hanyar maganin halayyar fahimta-IA (CBT-IA), wanda aka tabbatar yana da tasiri kan maganin IGD ( 6 ). Ƙungiyar Dr. Du ta gano cewa ƙungiyar CBT da ke makaranta tana da tasiri ga matasa masu fama da IGD, musamman wajen inganta yanayin motsin rai da ikon tsara hali, salon ɗabi'a da kuma kula da kai ( 20 ). Duk da cewa CBT ta nuna tasiri sosai wajen magance IGD, ƙananan bincike sun binciki tsarin maganin CBT a cikin mutanen IGD ta amfani da fMRI. Binciken kwakwalwa yana canzawa kafin da bayan magani ba wai kawai zai iya inganta fahimtarmu game da cutar IGD da tsarin maganin CBT akan IGD ba, har ma zai iya taimakawa wajen sa ido kan 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 Da'a na Bincike na Asibitin Ren Ji da Makarantar Magunguna, Jami'ar Shanghai Jiao Tong, China No. [2016] 097k (2) ne ya amince da wannan binciken na yanzu. Duk mahalarta da masu kula sun sanya hannu kan fom ɗin izini da aka rubuta kafin binciken. An bayyana mahalarta da aka yi wa rajista, tambayoyin bincike da kuma sharuɗɗan keɓewa a cikin littafinmu na baya ( 15 ). An ɗauki mutane ashirin da shida na IGD waɗanda suka cika ƙa'idodin gwajin Tambayoyin Bincike don jarabar Intanet (watau, YDQ) wanda Beard da Wolf suka gyara ( 25 ) daga Sashen Kula da Lafiyar Yara da Matasa na Cibiyar Lafiyar Hankali ta Shanghai. An ɗauki mutane talatin masu lafiya waɗanda shekarunsu da jinsinsu suka yi daidai da juna ba tare da tarihin cututtukan tabin hankali na mutum ko na iyali ba a matsayin ƙungiyar kula da lafiya (HC) ta hanyar tallace-tallace. Ganin yawan IGD a cikin maza da mata, mahalarta maza ne kawai aka haɗa ( 26 ). Duk mahalarta suna hannun dama, kuma babu ɗayansu da ke shan taba.

An yi wa dukkan mahalarta gwajin jiki mai sauƙi, wanda ya haɗa da auna hawan jini da bugun zuciya, kuma likitan tabin hankali ya yi musu tambayoyi game da tarihin lafiyarsu na matsalolin jijiyoyi, motsi, narkewar abinci, numfashi, zagayawar jini, endocrine, fitsari, da haihuwa. Daga nan aka duba su don matsalolin tabin hankali tare da Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) ( 27 ). Sharuɗɗan warewa sune tarihin shan muggan kwayoyi ko dogaro da kai; a baya an kwantar da su a asibiti saboda matsalolin tabin hankali; ko kuma wata babbar matsala ta tabin hankali, kamar su schizophrenia, baƙin ciki, rashin lafiyar damuwa, da/ko abubuwan da suka shafi tabin hankali.

An yi amfani da tambayoyin bayanai na asali don tattara bayanai na alƙaluma kamar jinsi, shekaru, shekarar ƙarshe ta makaranta da aka kammala, da kuma sa'o'in amfani da intanet a kowane mako. An yi amfani da tambayoyi huɗu don tantance siffofin asibiti na mahalarta, wato, Chen Internet Addiction Scale (CIAS) ( 28 ), Self-rating Pension Scale (SAS) ( 29 ), Self-rating Pension Scale (SDS) ( 30 ), da Barratt Impulsiveness Scale-11 (BIS-11) ( 31 ). CIAS, wanda Chen ya ƙirƙira, ya ƙunshi abubuwa 26 akan sikelin Likert mai maki huɗu kuma yana nuna tsananin jarabar intanet. An yi amfani da SAS da SDS don nuna cewa duk darussan sun cika sharuɗɗan haɗawa a lokacin binciken. An fara rubuta duk tambayoyin da Turanci sannan aka fassara su zuwa Sinanci. Sannan, ɗalibai 26 na IGD, iyayensu da malamansu sun shiga cikin ƙungiyar CBT mai bin diddigin ra'ayinsu, wacce ta ƙunshi zaman 12 ( 20 ). Kowane zaman ya ɗauki awanni 1.5-2. A kowane zaman jiyya na rukuni, an tattauna wani batu daban. Waɗannan batutuwa sun haɗa da yadda za a gane da kuma sarrafa yadda kuke ji; ƙa'idodin sadarwa mai kyau tsakanin iyaye da yara; dabarun magance dangantaka da aka haɓaka ta Intanet; dabarun magance abubuwan da aka samu ta Intanet; dabarun sarrafa sha'awarku; dabarun gane lokacin da halayen jaraba ke faruwa; da kuma yadda za a dakatar da halayen jaraba. Zaman ƙarshe 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

An yi wa dukkan waɗanda aka yi wa gwajin fMRI na yanayin hutu a matakin farko tare da tsarin daukar hoton MR na 3.0-T (GE Signa HDxt3T, Amurka) tare da na'urar daukar hoton kai ta yau da kullun. Don guje wa motsi da kuma rage hayaniyar na'urar daukar hoton, an yi amfani da na'urori masu laushi, kuma an ba wa waɗanda aka yi wa gwajin cikakken umarni don yin watsi da motsi yayin gwajin da kuma bayani game da dalilin da ya sa motsi bai fi kyau ba, ban da umarnin cewa motsi da ya wuce kima zai haifar da sake duba. An samo bayanan fMRI na yanayin hutu ta amfani da jerin echo-planar na gradient-echo kamar yadda aka bayyana a cikin bincikenmu na baya ( 16 ). An sami yanka masu layi talatin da huɗu [lokacin maimaitawa [TR] = 2,000 ms; lokacin echo [TE] = 30 ms; filin kallo [FOV] = 230 × 230 mm; da girman voxel 3.6 × 3.6 × 4 mm] da suka rufe dukkan kwakwalwa tare da layin kwamiti na gaba-bayan. Don wannan jerin binciken, an sami juzu'i 220 masu aiki yayin da mutanen ke hutawa (wanda ya haifar da tsawon scan na daƙiƙa 440). A lokacin binciken, an umurci mahalarta da su tsaya cak idanuwansu a rufe, ba tare da motsi ba, kuma kada su yi barci ko tunani game da komai. Bayan binciken, an nemi mutanen da abin ya shafa su tabbatar ko sun kasance a farke yayin binciken. An kuma sami wasu jerin jeri biyu: (1) jerin juyawa mai sauri na T1 mai nauyin axial (TR = 1,725 ​​ms; TE = 24 ms; FOV = 256 × 256 mm; yanka 34; da girman voxel 0.5 × 0.5 × 4 mm) da (2) jerin juyawa mai sauri na T2 mai nauyin axial (TR = 9,000 ms; TE = 120 ms; FOV = 256 × 256 mm; yanka 34; da girman voxel 0.5 × 0.5 × 4 mm).

Preprocessing na hoto hoto mai aiki

An yi aikin sarrafa bayanan daukar hoto kafin amfani da SPM12 da aka aiwatar a cikin MATLAB da software na fadada Tsarin Bayanai da Nazarin Hoto na Kwakwalwa na SPM12 (DPABI; http://rfmri.org/dpabi ) ( 32 ). Bayan an yi watsi da kundin farko 10 na kowane jerin lokutan aiki, an gyara sauran hotuna 210 na lokacin yanka, an sake daidaita su zuwa matsakaicin girma, sannan aka sake daidaita su ta amfani da canjin layi mai sigogi shida (jiki mai tauri). Sannan, duk hotunan aiki an daidaita su kai tsaye zuwa samfurin EPI, an sake yin samfurin kowane voxel zuwa 3 × 3 × 3 mm, kuma an gudanar da canjin santsi na sarari tare da kernel na Gaussian mai girman 8-mm. Sannan, an canza canje-canje 26 na rashin jituwa (gami da matsakaicin lokacin siginar daga voxels a cikin abin rufe farin abu, matsakaicin lokacin siginar daga voxels a cikin abin rufe CSF, da sigogin motsi na Friston 24). Bugu da ƙari, an haɗa yanayin layi a matsayin mai juyawa tunda siginar BOLD na iya nuna raguwar mitar.

Babu wani mahalarci a cikin wannan binciken da ya nuna motsi sama da 1.5 mm na matsakaicin fassarar a cikin gatari x, y , ko z ko matsakaicin juyawa na 1.5° a cikin kowane gatari 3. Don ƙara kawar da tasirin ragowar motsi akan ma'aunin fMRI na yanayin hutawa, an ƙididdige matsakaicin motsi na firam (matsakaicin FD) na motsi kai kuma an yi amfani da shi azaman covariate a cikin duk nazarin aikin ƙungiyar voxelwise, waɗanda aka samo ta hanyar algorithm na tushen matsakaiciyar murabba'i na Jenkinson kuma an yi la'akari da bambance-bambancen voxelwise a cikin motsi a cikin samowarsa ( 33 ); babu bambance-bambancen rukuni da aka samu a cikin matsakaicin FD tsakanin batutuwa na IGD da HC ( p = 0.52) a farkon tushe ko tsakanin lokutan pre-CBT da bayan-CBT ( p = 0.71).

Analysisididdigar bayanan hoto mai aiki

An yi nazarin ALFF ta amfani da manhajar DPABI. ALFF ya yi daidai da ƙarfi ko ƙarfin oscillations masu ƙarancin mitoci kuma ana tsammanin yana nuna aikin jijiyoyi na bazata ( 34 , 35 ). A taƙaice, bayan an riga an ambata a baya, an canza jerin lokutan kowane voxel zuwa yankin mitar ba tare da tace bandpass ba, kuma an sami bakan wutar lantarki. Sannan, an canza bakan wutar lantarki kuma an daidaita shi a tsakanin 0.01–0.08 Hz a kowane voxel. An ɗauki matsakaicin tushen ƙarfin murabba'i na wannan bakan mitar a matsayin ƙimar ALFF. Sannan, tare da tsarin daidaitawa, kowane taswirar ALFF an daidaita shi ta hanyar matsakaicin ALFF na mutum; musamman, an ƙididdige matsakaicin a fadin voxels na taswirar ALFF, kuma an raba ƙimar kowane voxel ta hanyar matsakaici daban-daban. Da farko mun kwatanta ALFF na farko na ƙungiyar IGD da na ƙungiyar HC don bincika ayyukan jijiyoyi da aka canza a cikin batutuwa na IGD ta hanyar gwajin t- samfuri biyu . An aiwatar da gyara don kwatancen da yawa wanda ya haifar da madaidaicin matakin p < 0.05, tare da ƙaramin girman rukuni na voxels 42 (An gyara AlphaSim tare da sigogi masu zuwa: voxel guda ɗaya p = 0.001; kwaikwayo 5,000; matsakaicin kimantawa na sarari na 8.04 × 10.60 × 10.46 mm FWHM; da abin rufe fuska na launin toka na duniya). Don bincika tasirin CBT akan batutuwa na IGD, an yi gwajin t -gwaji guda biyu don ƙididdige taswirar bambancin rukuni na ALFF kafin da bayan CBT. An aiwatar da gyara don kwatancen da yawa wanda ya haifar da madaidaicin matakin p < 0.05, tare da ƙaramin girman rukuni na voxels 40 (An gyara AlphaSim tare da sigogi masu zuwa: voxel guda ɗaya p = 0.001; kwaikwayo 5,000; matsakaicin kimantawa na sarari na 9.70 × 10.30 × 9.52 mm FWHM; da abin rufe fuska na launin toka na duniya). An kiyasta ƙwayar laushi bisa ga taswirar t. An bayar da rahoton daidaiton yankuna masu bambance-bambancen rukuni masu mahimmanci a cikin sararin Montreal Neurologic Institute (MNI).

An ƙaddara cewa yankunan da ake sha'awa (ROIs) su ne yankunan da ƙimar ALFF ta canza sosai tsakanin lokutan kafin da bayan CBT. An cire ƙimar FC na yankunan iri (OFC mai girma na hagu (hagu mai daidaitawa MNI: x = −12, y = 24, z = −21, radius = 6 mm) da kuma hagu mai daidaitawa (MNI mai daidaitawa: x = −3, y = 3, z = 9, radius = 6 mm) ta amfani da DPABI. A farkon farawa, an yi amfani da gwajin t- samfuri guda biyu don kwatanta ƙimar FC tsakanin ƙungiyar IGD da ƙungiyar HC kuma an gudanar da nazarin alaƙar Pearson tsakanin ƙimar FC da maki na CIAS / BIS-11 a cikin ƙungiyar IGD. Sannan an yi amfani da gwajin t- guda biyu don kwatanta ƙimar FC tsakanin maki kafin da bayan magani. An gudanar da nazarin alaƙar Pearson tsakanin matakin canji a cikin ƙimar FC da aka cire (Δ _{ALFF/Pre−ALFF} ko Δ _FC/Pre−FC ) da sikelin raguwar maki na CIAS (Δ _{CIAS/Pre−CIAS} ) /BIS-11 (Δ _{BIS−11/Pre−BIS−11} ) don bincika ko canje-canjen FC za su An yi hasashen rage alamun cutar ta hanyar CBT, bisa ga hanyoyin da aka bayyana a cikin binciken da ya gabata ( 36 ). An ɗauki ƙimar p mai wutsiya biyu na 0.05 a matsayin muhimmiyar mahimmanci a kididdiga.

Nazarin ƙididdiga na ƙididdigar mutum da matakan asibiti

An gudanar da gwaje-gwajen t- samfuri guda biyu ta amfani da SPSS (Kwafi na Ƙididdiga don software na Kimiyyar Zamani, SPSS sigar 19, IBM, Amurka) don ci gaba da canzawa don tantance bambance-bambancen da ke tsakanin ƙungiyar IGD da ƙungiyar HC. An yi amfani da gwaje-gwajen t- haɗe guda biyu don bincika tasirin CBT akan halayen asibiti tsakanin lokutan kafin da bayan CBT.

Ka tafi zuwa ga:

results

Demographics da matakan asibiti na abubuwan IGD da HC

Batutuwan IGD da HC ba su bambanta a cikin shekaru biyu ba ( p = 0.31) ko ilimi ( p = 0.10). Kamar yadda aka zata, batutuwan IGD sun nuna maki mafi girma na CIAS, SAS, SDS, da BIS-II ( p < 0.001, p = 0.02, 0.04, 0.001), da kuma tsawon lokacin wasa na mako-mako fiye da batutuwan 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)	Darajar P
	(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, Daidaitaccen karkacewa; IGD, matsalar caca ta intanet; HC, kula da lafiya; CBT, maganin halayyar fahimta.

ALFF da FC bambance-bambance tsakanin abubuwan IGD da HC

Idan aka kwatanta da waɗanda suka yi nasara a HC, waɗanda suka yi nasara a IGD sun nuna ƙaruwar ƙimar ALFF sosai a cikin putamen na biyu, OFC na tsakiya na dama, yankin ƙarin motsi na biyu (SMA), gyrus na baya na hagu, da kuma cingulate na gaba na hagu (ACC; Tebur ​Table2,2 , Hoto ​Hoto na 1).1 ). FC na hutawa tsakanin tsakiyar hagu na OFC da putamen ya yi ƙasa sosai a cikin ƙungiyar 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	Maki mafi girma
		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. Gwaji biyu na T-P < 0.05, an gyara AlphaSim (P < 0.001, girman voxel> 42).

Figure 1

Yankunan kwakwalwa waɗanda suka nuna ƙimar ALFF mafi girma a cikin ƙungiyar IGD fiye da ta ƙungiyar HC a farkon matakin ( p < 0.05, AlphaSim-an gyara). Sashen hagu na adadi yana wakiltar gefen dama na mahalarta, kuma ɓangaren dama yana wakiltar ɓangaren hagu na mahalarta. ALFF, girman canjin mitar ƙasa; IGD, matsalar caca ta intanet; HC, kula da lafiya.

Demographics da matakan asibiti kafin da kuma bayan CBT

Bayan CBT, lokacin wasanni na mako-mako da kuma maki na CIAS da BIS-11 sun ragu sosai (duk p s = 0.001). Waɗannan binciken sun nuna cewa CBT yana da tasiri wajen magance waɗanda ke fama da IGD (Tebur ​(Tebur 33 ).

Table 3

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

	Kafin CBT ( n = 26)	Bayan CBT ( n = 26)	Darajar P
	(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, Daidaitaccen karkacewa; IGD, matsalar caca ta intanet.

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

Bayan CBT, ƙimar ALFF ta ragu sosai a tsakiyar OFC na hagu da putamen (Tebur ​(Tebur 4,4 , Hoto ​Hoto na 3).3 ). Bugu da ƙari, FC na hutawa tsakanin tsakiyar OFC na hagu da putamen ya ƙaru 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	Maki mafi girma
		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

Gwajin T Mai Haɗaka P < 0.05, an gyara AlphaSim (P < 0.001, girman voxel> 40).

Figure 3

Yankunan kwakwalwa waɗanda suka nuna raguwar ƙimar ALFF a cikin ƙungiyar IGD bayan maganin halayyar fahimta ( p < 0.05, AlphaSim-corrected). Bangaren hagu na adadi yana wakiltar gefen dama na mahalarta, kuma ɓangaren dama yana wakiltar gefen hagu na mahalarta. IGD, Rashin lafiyar wasannin intanet; ALFF, girman canjin ƙarancin mita.

Clinical matakan dangantaka

A cikin ƙungiyar IGD, ƙimar FC tsakanin tsakiyar hagu na OFC da putamen sun kasance suna da alaƙa mara kyau da maki BIS-11 ( r = −0.733, p < 0.001; Hoto ​Hoto na 2).2 ). Canje-canje a cikin ƙimar FC da aka cire (Δ _FC/Pre−FC ) tsakanin babban OFC na hagu da putamen na hagu sun kasance suna da alaƙa mai kyau da sikelin raguwar maki CIAS (Δ _{CIAS/Pre−CIAS} ; r = 0.707, p < 0.001; Hoto ​Hoto na 4).4 ). Babu wata muhimmiyar alaƙa tsakanin canje-canjen ƙimar FC (Δ _FC/Pre−FC ) da sikelin raguwar maki BIS-11 (Δ _{BIS−11/Pre−BIS−11} ) da aka gano ( r = 0.396, p = 0.084).

Figure 2

A cikin ƙungiyar IGD, ƙimar FC tsakanin tsakiyar hagu na OFC da putamen sun kasance suna da alaƙa mara kyau da maki BIS-11 ( r = −0.733, p < 0.001). IGD, matsalar wasannin intanet; FC, haɗin aiki; OFC, cortex na orbitofrontal; BIS-11, Sikelin Barratt Impulsiveness-11.

Figure 4

Canje-canje a cikin ƙimar FC (ΔFC/Pre-FC) tsakanin OFC mai girma na hagu da putamen na hagu sun kasance suna da alaƙa mai kyau da sikelin raguwar maki CIAS a cikin waɗanda ke cikin IGD. (ΔCIAS/Pre-CIAS; r = 0.707, p < 0.001). FC, haɗin aiki; OFC, cortex na orbitofrontal; CIAS, Sikelin Addiction na Intanet na Chen; IGD, matsalar caca ta 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 mai hutawa tsakanin tsakiyar hagu na OFC da putamen ya yi ƙasa sosai a cikin ƙungiyar IGD. Alamomin BIS-11 na canjin FC sun nuna cewa raunin da ke cikin da'irorin prefrontal-striatal na iya yin tasiri ga halayen motsa jiki na mutanen IGD. Nazarin neuroimaging na baya sun ba da rahoton cewa raunin aiki a yankunan PFC yana da alaƙa da babban sha'awar IGD ( 37 ). Da'irorin prefrontal-striatal sun haɗa da madauri na fahimta, wanda galibi yana haɗa caudate da putamen tare da yankunan prefrontal. Daidai da binciken da aka yi kwanan nan na nazarin neuroimaging na aiki, an lura da canje-canjen aiki a yankuna da dama na prefrontal (gami da tsakiyar dama na OFC, SMA na biyu da ACC na hagu) da yankunan basal ganglia (putamen na biyu) a cikin cututtukan jaraba, gami da IGD ( 12 , 38 , 39 ). Volkow et al. An ba da shawarar hanyoyin sadarwa na jijiyoyi a cikin waɗanda ke shan miyagun ƙwayoyi, gami da OFC-, ACC-, inferior frontal gyrus (IFG)-, da dorsolateral prefrontal cortex (DLPFC)-striatal da'irori, waɗanda za su iya nuna halaye masu gani, kamar rashin ikon sarrafa kai da rashin sassaucin hali ( 40 ) da matsaloli wajen yanke shawara mai kyau, waɗanda ke siffanta jarabar; lokacin da mutanen da ke da IGD suka ci gaba da yin wasanni duk da cewa suna fuskantar mummunan sakamako, wannan na iya danganta da rashin aikin da'irori na prefrontal-striatal ( 41 ). Ɗaya daga cikin manyan halayen IGD shine ƙarancin ikon sarrafa motsin rai tare da rashin iko akan wasan caca ta Intanet. Wani bincike da ya gabata wanda ya haɗa da nazarin morphometric na tushen voxel (VBM) da FC ya nuna shigar da yankuna da dama na prefrontal da da'irori masu alaƙa da prefrontal-striatal (ACC-, OFC-, da DLPFC-striatal da'irori) a cikin tsarin IGD kuma ya ba da shawarar cewa IGD na iya raba irin waɗannan hanyoyin jijiyoyi tare da dogaro da abu a matakin da'ira ( 41 ). Binciken da aka yi a yanzu yana da mahimmanci, kamar yadda sauye-sauyen ayyukan kwakwalwa/haɗin kai a cikin da'irorin prefrontal-striatal waɗanda aka lura sun yi daidai da binciken da aka yi a baya. Bugu da ƙari, SMA an haɗa shi a cikin hanyar sadarwa ta salience, wanda ke daidaita aikin sauran hanyoyin sadarwa lokacin da ake buƙatar canje-canje cikin sauri a cikin hali, kamar lokacin sarrafa madannai cikin sauri yayin wasa ( 42 ). Yuan et al. sun ba da rahoton ƙimar ALFF mafi girma a cikin SMA a cikin batutuwa na IGD ( 12 ), kuma mun sami irin wannan sakamako a cikin wannan binciken, wanda ya nuna cewa SMA na iya zama yanki mai mahimmanci a cikin halayen jaraba ( 41 ).

Zuwa yanzu, an nuna cewa ƙungiyar CBT tana da tasiri wajen taimaka wa matasa masu fama da jarabar intanet ( 20 ). A cikin wannan binciken, lokacin wasanni na mako-mako ya yi gajeru sosai, kuma an rage yawan maki na CIAS da BIS-II bayan CBT. Ya nuna cewa za a iya kawar da mummunan sakamakon idan za a iya kawar da jarabar intanet cikin ɗan gajeren lokaci. Mun lura da raguwar ƙimar ALFF a cikin OFC mai girma na hagu da hagu da kuma ƙaruwar haɗin OFC-putamen bayan CBT, waɗanda sune binciken da suka yi daidai da abubuwan da aka lura a baya waɗanda suka nuna cewa da'irar OFC-striatal na iya zama wata manufa ta warkewa a cikin cututtukan jaraba ( 43 ). OFC tana da hannu a cikin ƙa'idar motsa jiki ban da yanke shawara, don haka haɗin gwiwa tsakanin OFC da putamen yana nuna kyakkyawan iko akan halayen motsa jiki na mutanen IGD ( 44 ). Ya yi daidai da sakamakon raguwar maki BIS-11 bayan magani. putamen yana ɗaya daga cikin sassan striatum kuma ya kasance yanki na kwakwalwa da ke da alaƙa da hanyoyin fahimta waɗanda galibi ana raba su da ƙwayar caudate. Musamman ma, putamen yana da alaƙa da sarrafa halaye na al'ada da ayyukan da aka tsara don cimma burin ( 45 ). Mun lura cewa mafi girman ALFF ya ragu a cikin putamen na hagu bayan CBT, yana nuna cewa CBT na iya taimakawa wajen haɓaka ikon sarrafa halaye na al'ada da ayyukan da aka tsara don cimma burin waɗanda ke cikin IGD. Wannan yana nufin cewa CBT na iya hana amfani da wasanni na yau da kullun ba tare da motsin rai ba ta hanyar canza hulɗar da'irorin prefrontal-striatal. Nazarin da aka yi a baya na CBT sun ba da rahoton cewa CBT yana canza kunnawar yanayin hutawa a cikin prefrontal cortex kuma CBT yana gyara hanyoyin fahimta marasa aiki ( 46 ). A halin yanzu, canje-canje a cikin haɗin OFC-putamen na iya annabta tasirin CBT.

Wani rauni na wannan binciken shine cewa ba a raba mutanen IGD zuwa ƙungiyoyi biyu bazuwar (ƙungiyar mahalarta ɗaya za ta sami CBT, yayin da wata ƙungiya da ba ta sami maganin ba za ta yi aiki a matsayin iko). Na biyu, mun ɗauki mahalarta maza kawai; don haka, ana buƙatar ƙarin bincike tare da mahalarta mata don tabbatarwa da faɗaɗa sakamakon yanzu. Na uku, ƙarancin girman samfurin ya ƙara haɗarin rashin lafiyar ƙarya kuma ya takaita gwajin don kimanta alaƙar da ke tsakanin canje-canje a cikin ƙimar FC da tasirin magani. Na huɗu, ya zama dole a gyara don kwatantawa da yawa don sarrafa kuskuren ƙarya-positive. An yi amfani da gyaran AlphaSim a nan saboda ba za a iya samun wani rukuni ba lokacin amfani da hanyoyin gyara FWE ko FDR. Duk da haka, muna tsammanin za a iya karɓar gyaran AlphaSim a cikin bincikenmu na bincike tunda yana ɗaya daga cikin shahararrun zaɓuɓɓuka don gyaran kwatancen da yawa kuma ana amfani da shi a cikin bincike 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

Tallafin Kuɗi. An tallafa wa wannan aikin ne daga Gidauniyar Kimiyyar Halitta ta Ƙasa ta China (Lambar 81571650), Kwamitin Kimiyya da Fasaha na Shanghai (Maganin Yamma; Lamba 17411964300), da Hukumar Ilimi ta Gundumar Shanghai - Tallafin Tallafin Magungunan Asibiti na Gaofeng (Lambar 20172013), Gidauniyar Bincike ta Giciye ta Injiniyan Likitanci na Jami'ar Jiao Tong ta Shanghai (Lambar YG2017QN47), da Asusun Bincike na Asibitin Ren Ji, Makarantar Magunguna, Jami'ar Jiao Tong ta Shanghai (RJZZ17-016). Shirin Ƙara Bincike don Binciken Asibiti da Ƙirƙirar Asibitin Ren Ji, Makarantar Magunguna, Jami'ar Jiao Tong ta Shanghai (PYIII-17-027, PYIV-17-003). Masu ba da tallafin ba su da wani tasiri a cikin tsara nazari, tattara bayanai da nazarin su, yanke shawarar bugawa, ko shirya rubutun.

Ka tafi zuwa ga:

References

1. Ko CH, GLiu C, Yen JY, Chen CY, Yen CF, Chen CS. Alamomin kwakwalwa na sha'awar wasannin kan layi a ƙarƙashin fallasa ga alamu a cikin mutanen da ke da jarabar wasannin intanet da kuma a cikin waɗanda aka sallama. 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, da sauransu. Maganin matsalar caca ta intanet: Bita mai tsari na ƙasa da ƙasa da kuma kimantawar CONSORT. Clin Psychol Rev. (2017) 54:123–33. 10.1016/j.cpr.2017.04.002 [ PubMed ] [ Cross Ref ]

3. Ko CH, Liu TL, Wang PW, Chen CS, Yen CF, Yen JY. Ƙaruwar baƙin ciki, ƙiyayya, da damuwa ta zamantakewa a yayin jarabar intanet tsakanin matasa: wani bincike mai zuwa. Compr Psychiatry (2014) 55:1377–84. 10.1016/j.comppsych.2014.05.003 [ PubMed ] [ Cross Ref ]

4. Toshe JJ. Matsalolin 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. Young KS. Sakamakon magani ta amfani da CBT-IA tare da marasa lafiya masu jarabar intanet. J Behav Addict. (2013) 2:209–15. 10.1556/JBA.2.2013.4.3 [ Labarin PMC kyauta ] [ PubMed ] [ Ref Cross ]

7. Dong G, Zhou H, Zhao X. Maza masu shan intanet suna nuna ƙarancin ikon sarrafa zartarwa: shaida daga aikin Stroop mai launi. Neurosci Lett. (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 binciken kwakwalwa game da intanet da matsalar 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 cortical na gaban gaba na sakin acetylcholine a cikin cortex na baya. Neuroscience (2005) 132:347–59. 10.1016/j.neuroscience.2004.12.007 [ PubMed ] [ Cross Ref ]

10. Ko CH, Hsieh TJ, Chen CY, Yen CF, Chen CS, Yen JY, da sauransu. Canjin kunna kwakwalwa yayin hana amsawa da sarrafa kurakurai a cikin mutanen da ke da matsalar caca ta intanet: nazarin hoton maganadisu mai aiki. 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, da sauransu. Matsalolin launin toka da farin abu a cikin jarabar wasanni ta yanar gizo. 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, da sauransu. Yawan rashin daidaituwar saurin canzawa a cikin matasa masu jarabar wasannin kan layi. PLoS ONE (2013) 8:e78708. 10.1371/journal.pone.0078708 [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

13. Ko CH, Liu GC, Hsiao S, Yen JY, Yang MJ, Lin WC., da sauransu. Ayyukan kwakwalwa da ke da alaƙa da sha'awar caca ta hanyar intanet. J Psychiatr Res. (2009) 43:739–47. 10.1016/j.jpsychires.2008.09.012 [ PubMed ] [ Cross Ref ]

14. Ko CH, Liu GC, Yen JY, Yen CF, Chen CS, Lin WC. Ƙwaƙwalwar kwakwalwa don sha'awar wasanni da sha'awar shan taba a tsakanin waɗanda ke fama da jarabar caca ta intanet da dogaro da nicotine. 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, da sauransu.. Rage haɗin aikin prefrontal lobe interhemispheric a cikin matasa masu fama da matsalar caca ta intanet: wani bincike na farko ta amfani da FMRI na yanayin hutu. PLoS ONE (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, da sauransu. Bambanci a cikin haɗin aiki na cortex na gaba tsakanin masu shan sigari waɗanda suka dogara da nicotine da kuma mutanen da ke da matsalar caca ta intanet. BMC Neuroscience (2017) 18:54. 10.1186/s12868-017-0375-y [ Labarin PMC kyauta ] [ PubMed ] [ Ref Cross ]

17. Liu J, Gao XP, Osunde I, Li X, Zhou SK, Zheng HR, da sauransu. Ƙara yawan haɗin kai a yankin a cikin matsalar jaraba ta intanet: nazarin hoton maganadisu mai aiki a yanayin hutawa. Chin Med J. (2010) 123:1904–8. 10.3760/cma.j.issn.0366-6999.2010.14.014 [ PubMed ] [ Cross Ref ]

18. Brand M, Young KS, Laier C. Kulawa ta gaba da jarabar intanet: samfurin nazari da bita kan binciken neuropsychological da neuroimaging. Front Hum Neurosci. (2014) 8:375. 10.3389/fnhum.2014.00375 [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

19. Everitt BJ, Robbins TW. Daga ventral zuwa dorsal striatum: ra'ayoyi masu karkata ga rawar da suke takawa a jarabar miyagun ƙwayoyi. 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. Tasirin dogon lokaci na maganin halayyar fahimta na rukuni wanda ba a tsara shi ba, wanda aka sarrafa don jarabar intanet a cikin ɗaliban matasa a Shanghai. Aust NZJ Psychiatry. (2010) 44:129–34. 10.3109/00048670903282725 [ PubMed ] [ Cross Ref ]

21. Weingardt KR, Villafranca SW, Levin C. Horarwa bisa fasaha kan ilimin halayyar fahimta ga masu ba da shawara kan shan miyagun ƙwayoyi. Subst Abus. (2006) 27:19–25. 10.1300/J465v27n03_04 [ PubMed ] [ Cross Ref ]

22. Kiluk BD, Nich C, Babuscio T, Carroll KM. Inganci da yawa: samun ƙwarewar jurewa bayan maganin fahimta da halayyar kwamfuta don matsalolin amfani da miyagun ƙwayoyi. Addiction (2010) 105:2120–7. 10.1111/j.1360-0443.2010.03076.x [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

23. DeVito EE, Worhunsky PD, Carroll KM, Rounsaville BJ, Kober H, Potenza MN. Nazarin farko game da tasirin jijiyoyi na maganin ɗabi'a don matsalolin amfani da miyagun ƙwayoyi. Drug Barasa Dogara. (2012) 122:228–35. 10.1016/j.drugalcdep.2011.10.002 [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

24. Yip SW, DeVito EE, Kober H, Worhunsky PD, Carroll KM, Potenza MN. Ma'aunin tsarin kwakwalwa kafin a fara magani da kuma aikin kwakwalwa da ke sarrafa lada a cikin dogaro da wiwi: nazarin bincike kan dangantaka da kauracewa yayin maganin hali. Drug Barasa Dogara. (2014) 140:33–41. 10.1016/j.drugalcdep.2014.03.031 [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

25. Beard KW, Wolf EM. Gyara a cikin ka'idojin ganewar asali da aka gabatar don jarabar intanet. Cyberpsychol Behav. (2001) 4:377–83. 10.1089/109493101300210286 [ PubMed ] [ Cross Ref ]

26. Meng Y, Deng W, Wang H, Guo W, Li T. Rashin aikin prefrontal a cikin mutanen da ke da matsalar caca ta intanet: nazarin meta na nazarin tasirin maganadisu mai aiki. Addict 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, da sauransu.. Aminci da ingancin Mini International Neuropsychiatric Interview for Children and Youngal Age (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. Ci gaban Sikelin Jarabawar Intanet na China da nazarin ilimin halayyar ɗan adam. Chin J Psychol. (2003) 45:251–66. 10.1037/t44491-000 [ Cross Ref ]

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

30. Zung WW. Ma'aunin damuwa mai ƙima da kansa. Arch Gen Psychiatry (1965) 12:63–70. 10.1001/archpsyc.1965.01720310065008 [ PubMed ] [ Cross Ref ]

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

32. Yan CG, Wang XD, Zuo XN, Zang YF. DPABI: Sarrafa Bayanai & Bincike don Hoton Kwakwalwa (Yanayin Hutu). Neuroinformatics (2016) 14:339–51. 10.1007/s12021-016-9299-4 [ PubMed ] [ Cross Ref ]

33. Power JD, Barnes KA, Snyder AZ, Schlaggar BL, Petersen SE. Alaƙa mai karya amma mai tsari a cikin hanyoyin sadarwar MRI na haɗin kai na aiki yana tasowa ne daga motsin mutum. Neuroimage (2012) 59:2142–54. 10.1016/j.neuroimage.2011.10.018 [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

34. Li F, Lui S, Yao L, Hu J, Lv P, Huang X, da sauransu. Canje-canje na tsawon lokaci a cikin aikin kwakwalwa na yanayin hutawa a cikin marasa lafiya da schizophrenia na farko: nazarin hoton MR mai aiki na shekara 1. 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, da sauransu. . Saurin saurin amsawar ƙarancin mitoci a cikin marasa lafiya marasa magani, waɗanda ke cikin kashi na farko tare da babban rashin jin daɗi: nazarin fMRI na yanayin hutawa. J Tasirin Rashin Lafiya. (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, da sauransu. Maganin halayyar fahimta ta rukuni yana daidaita haɗin aiki na yanayin hutawa na hanyar sadarwa mai alaƙa da amygdala a cikin marasa lafiya da ke fama da matsalar damuwa ta zamantakewa gabaɗaya. BMC Psychiatry (2016) 16:198. 10.1186/s12888-016-0904-8 [ Labarin PMC kyauta ] [ PubMed ] [ Ref Cross ]

37. Dieter J, Hoffmann S, Mier D, Reinhard I, Beutel M, Vollstadt-Klein S, da sauransu.. Matsayin kula da hana motsin rai a cikin takamaiman jarabar intanet - wani bincike na fMRI. Behav Brain Res. (2017) 324:1–14. 10.1016/j.bbr.2017.01.046 [ PubMed ] [ Cross Ref ]

38. Zhang JT, Yao YW, Potenza MN, Xia CC, Lan J, Liu L, da sauransu. Canza yanayin hutu da canje-canje bayan sha'awar ɗabi'a don matsalar caca ta intanet. 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, da sauransu. Canje-canje a cikin da'irar gaban-striatal da fronto-cerebellar a cikin mutanen da suka dogara da heroin: wani bincike na FMRI na jihar hutu. PLoS ONE (2013) 8:e58098. 10.1371/journal.pone.0058098 [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

40. Volkow ND, Wang GJ, Tomasi D, Baler RD. Da'irori marasa daidaito na jijiyoyi a cikin jaraba. Curr Opin Neurobiol. (2013) 23:639–48. 10.1016/j.conb.2013.01.002 [ Labarin PMC kyauta ] [ PubMed ] [ Ref Cross ]

41. Jin C, Zhang T, Cai C, Bi Y, Li Y, Yu D, da sauransu. Yanayin hutu na prefrontal cortex mara kyau na haɗin aiki da tsananin matsalar caca ta intanet. Hoton Kwakwalwa 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, da sauransu. Maganin fahimta da halayyar fahimta yana ƙara launin toka a cikin kwakwalwa a cikin marasa lafiya da ke fama da ciwo na yau da kullun. J Pain (2013) 14:1573–84. 10.1016/j.jpain.2013.07.020 [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

43. Jiang GH, Qiu YW, Zhang XL, Han LJ, Lv XF, Li LM, da sauransu. Matsalolin saurin juyawar ƙarancin mitoci a cikin masu amfani da heroin: nazarin yanayin hutawa na 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, da sauransu. . Rashin sha'awar halaye da kuma rashin aikin hana sha'awar gaba a cikin matasa masu sha'awar wasannin intanet sun bayyana ta hanyar wani bincike na fMRI na Go/No-Go. Behav Brain Funct. (2014) 10:20. 10.1186/1744-9081-10-20 [ Labarin PMC kyauta ] [ PubMed ] [ Cross Ref ]

45. Cai C, Yuan K, Yin J, Feng D, Bi Y, Li Y, da sauransu. Tsarin halittar Striatum yana da alaƙa da ƙarancin ikon sarrafa fahimta da tsananin alamun cutar caca ta intanet. Hoton Kwakwalwa 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, da sauransu. Maganin halayyar fahimta don baƙin ciki yana canza ayyukan cortex na gaba da na tsakiya waɗanda ke da alaƙa da sarrafa kai. Soc Cogn Tasirin Neurosci. (2014) 9:487–93. 10.1093/scan/nst009 [ PMC free article ] [ PubMed ] [ Cross Ref ]