TAIMAKAWA: Wannan wani sabon juyi ne na Dokta Hilton "Batsa na Batsa: Hannun Tsinkayen Neuroscience", ana samun sa a cikin wannan sashin. Ya gamsu, kamar yadda muke, cewa ladaran yanayi na iya zama jaraba kuma ya haifar da canzawar kwakwalwa kamar magunguna. Sabuwar takarda da aka sake duba takwarorinsa ita ce Batsa na batsa - wani karin kuzari wanda aka yi la'akari da shi a cikin yanayin yanayin yanayin rayuwa | Hilton | Ilimin halin dan adam da Ilimin halin dan adam (2013).
Janairu 20, 2011
Donald L. Hilton, Jr. MD, FACS
Clinical Associate Professor
Ma'aikatar Neurosurgery
Jami'ar Texas Cibiyar Kimiyyar Lafiya ta San Antonio
An tsara kwakwalwar ɗan adam don ƙarfafa halayen da ke taimakawa rayuwa. Tsarin dopaminergic na mesolimbic yana ba da lada ga cin abinci da jima'i tare da ihisani mai ƙarfi. Cocaine, opioids, barasa, da sauran kwayoyi ɓoye, ko sata, waɗannan tsarin jin daɗin, kuma suna sa kwakwalwa tayi tunanin babban magani ya zama dole don tsira. Shaidun yanzu suna da ƙarfi cewa ladaran yanayi kamar su abinci da jima'i suna shafar tsarin lada ne daidai da yadda kwayoyi ke shafar su, saboda haka sha'awar yanzu a cikin 'jarabar halitta.' Addiction, ko don hodar iblis, abinci, ko jima'i yana faruwa lokacin da waɗannan ayyukan suka daina ba da gudummawa ga yanayin homeostasis, kuma a maimakon haka su haifar da mummunan sakamako. Misali, lokacin da cin abinci ke haifar da kiba mai cutarwa 'yan ƙalilan zasuyi jayayya cewa kwayar halitta tana cikin ƙoshin lafiya. Hakanan, batsa tana haifar da lahani yayin da ta lalata ko lalata ikon mutum don haɓaka kusancin motsin rai.
Shekaru goma da suka gabata shaidu sun fara nuna yanayin shan maye na yawan amfani da ɗabi'un yanayi waɗanda ke haifar da lada mai ƙwanƙwasawa a cikin kwakwalwa. Misali, Dokta Howard Shaffer, Daraktan Binciken Addini a Jami’ar Harvard, ya ce a 2001, “Na yi matukar wahala da abokan aiki na lokacin da na ba da shawarar cewa yawan jaraba sakamakon gogewa ne, maimaici, babban haushi, mai girma -kwarewar kwarewa. Amma ya bayyana karara cewa neuroadaptation –wato, sauye-sauye a cikin sassan jiki wanda ke taimakawa dorewar halayyar – yana faruwa koda babu shan kwayoyi ”[1] A cikin shekaru goma tun da ya faɗi haka, ya mai da hankali kan bincikensa game da ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa ta al'ada kamar caca. Lura da masu zuwa daga wannan Science takarda daga 2001
Masana suna jin dadin cewa tsangwama ya faru ne lokacin da al'ada ta "sata" kwakwalwar kwakwalwa wadda ta samo asali don inganta dabi'ar rayuwa kamar yadda cin abinci da jima'i. "Ya kamata a yi la'akari idan za ku iya tsara wadannan sassan da fasaha, kuna iya yin hakan tare da ladabi," in ji Masanin ilimin psychologist Stanford University Brian Knutson. Saboda haka, kwayoyi ba su kasance cikin zuciyar kwayoyin halitta ba. "Abin da ke faruwa a hankali a matsayin babban mahimmin batun ... an ci gaba da yin alkawari game da lalacewar kai duk da tasiri," in ji Steven Grant na NIDA.[2]
A cikin shekaru goma tun bayan da aka fara bayyana wadannan ra'ayoyin juyin-juya-halin, hujjoji game da dabi'ar lada ta dabi'a ta karu ne kawai. A cikin 2005 Dr. Eric Nestler, yanzu shugaban kimiyyar kwakwalwa a Dutsen Sinai Medical Center a New York ya buga wata alama a cikin Nature Neuroscience mai taken "Shin Akwai Hanyar gama gari don ictionara?" Ya ce: “Hujjoji masu girma suna nuna cewa hanyar VTA-NAc da sauran yankuna masu laushi da aka ambata a sama kamar haka suna yin sulhu, aƙalla a wani ɓangare, mummunan sakamako na motsin rai na sakamako na halitta, kamar abinci, jima'i da hulɗar zamantakewa. Wadannan yankuna guda ɗaya an sanya su cikin abin da ake kira 'ƙwarewar yanayi' (ma'ana, tilasta amfani da lada na ɗabi'a) kamar su yawan cin abinci na cuta, caca ta hanyar cuta da jima'i. Binciken farko ya nuna cewa hanyoyin raba hanya na iya kasancewa: [misali shi ne] wayar da kai da ke faruwa tsakanin lada na dabi'a da magungunan zagi. ”[3]
A cikin 2002 wani nazarin ilimin cocaine ya wallafa wanda ya nuna asarar tasiri mai zurfi a wurare da dama na kwakwalwa, ciki har da lobes.[4] Dabarar ita ce a yi amfani da wata yarjejeniya ta MRI wacce ake kira voxel-based morphometry (VBM), inda ake kirga kwatankwacin kwakwalwar milimita ɗaya. Wani binciken na VBM an buga shi a 2004 akan methamphetamine tare da irin wannan binciken.[5] Duk da yake sha'awa, wadannan binciken ba abin mamaki ba ne ga ko masanin kimiyya ko mai lakabi, kamar yadda wadannan "kwayoyi masu kyau ne."
Labarin ya kara zama mai kayatarwa idan muka kalli dabi'a ta dabi'a kamar yawan cin abinci mai haifar da kiba. A cikin 2006 an buga nazarin VBM yana kallon musamman akan kiba, kuma sakamakon ya yi kama da karatun hodar iblis da na methamphetamine.[6] Nazarin kiba ya nuna yankuna da yawa na asarar nauyi, musamman a cikin lobes na gaba, yankunan da ke da alaƙa da hukunci da iko. Duk da yake wannan binciken yana da mahimmanci wajen nuna lalacewar da ke bayyane a cikin jarabar dabi'a ta halitta, sabanin jarabar shan kwaya, har yanzu yana da sauƙi mu yarda da hankali saboda za mu iya gani sakamakon illa a cikin mutum mai girma.
To yaya batun jima'i? A cikin 2007 nazarin VBM daga Jamus ya kalli musamman a kan lalata, kuma ya nuna kusan gano iri ɗaya ga hodar iblis, methamphetamine, da nazarin kiba.[7] Mahimmancin wannan binciken dangane da wannan tattaunawar ya fi dacewa a cikin hakan Yana nuna cewa tilasta yin jima'i na iya haifar da canjin jiki, canzawa a cikin kwakwalwa, watau, cutarwa. Abin sha'awa, wata takarda ta kwanan nan ta sami babban alaƙa tsakanin lalata batsa da lalata yara.[8] Wannan ya lura, takarda ta mai da hankali ne akan rukunin ƙungiyoyi tare da, tare da wasu matsalolin, tsananin buri na batsa. Duk da yake zamu iya zana bambancin ɗabi'a da na doka tsakanin yaro da batsa na batsa, ƙwaƙwalwa ba ta da irin wannan yanayin dangane da shekaru dangane da raunin lalata ƙwayoyin cuta da ƙimar girma. Shin ƙwaƙwalwar tana kula ko mutumin yana fuskantar jima'i, ko yin hakan ta hanyar abin da ya shafi jima'i, watau batsa. Tsarin madubin kwakwalwa yana jujjuya kwarewar batsa ta batsa zuwa ainihin kwarewa, har zuwa kwakwalwar. Wannan yana tallafawa ta hanyar binciken da aka yi kwanan nan daga Faransa wanda ke nuna kunnawa na yankunan da ke da alaƙa da jijiyoyin madubi a cikin kwakwalwar ɗan adam a cikin maza masu kallon hotunan batsa. Marubutan sun kammala, “muna ba da shawarar cewa - mirror tsarin madubin-neuron ya sa masu kallo su yi tunani tare da kwarin gwiwar wasu mutane da ke bayyana a bayyane na mu'amalar jima'i.”[9] Binciken farko yana tallafawa lalacewa na gaban gaba daya musamman a marasa lafiya marasa ikon kula da halayensu.[10] Wannan binciken ya yi amfani da MRI mai yaduwa don kimanta aikin yaduwar jijiya ta cikin abu mai fari, inda ake samun axons, ko wayoyi masu haɗa ƙwayoyin jijiyoyin. Ya nuna rashin aiki a cikin yankin gaba na gaba, yankin da ke haɗuwa da tilas, alama ce ta jaraba.
Yawancin karatu suna nuna canje-canje na ilimin ƙwayoyin cuta a cikin neurochemistry yayin da kwakwalwa “ke koya” don zama mai kamu. Wadannan canje-canje na jaraba a cikin tsarin sakamako na dopamine suma ana iya yin sikaninsu tare da sikanin kwakwalwa kamar aikin MRI, PET, da SPECT scans. Duk da yake muna sa ran nazarin binciken kwakwalwa don nuna rashin daidaituwa a cikin kwayar cutar kwayar cutar dopamine,[11] za mu yi mamakin ganin cewa binciken da aka yi a kwanan nan ya nuna rashin jin dadi na waɗannan cibiyoyin cibiyoyin tare da caca.[12] Abun da ke haifar da kiba, wani jaraba na al'ada, yana nuna irin wannan cututtuka.[13]
Har ila yau, mahimmanci shine takarda daga Cibiyar Mayo a kan maganin shan jima'i na Intanit tare da naltrexone, mai karɓar mai karɓa na mai karɓa.[14] Drs. Bostsick da Bucci a asibitin Mayo sun bi marasa lafiya da rashin iya yin amfani da batsa na Intanet.
An sanya shi a kan naltrexone, wani magani wanda ke aiki akan tsarin opioid don rage ƙarfin dopamine don motsa ƙwayoyin halitta a cikin ƙananan ƙwayoyin cuta. Da wannan maganin ya sami ikon mallakar rayuwar jima'i.
Mawallafa sun gama:
A takaitaccen bayani, sauye-tafiye na wayar salula a cikin sakamakon PFC na shan magunguna ya haifar da ƙarin jin daɗin ci gaba da maganin miyagun ƙwayoyi, rage rage jin daɗin ciwon maganin miyagun ƙwayoyi, da rage yawan sha'awar bin abubuwan da ake gudanarwa akan burin ci gaba. Baya ga yarda da naltrexone daga Gudanar da Abincin da Drug don magance shan giya, shaidu da dama da aka wallafa sun nuna cewa yana da damar yin maganin caca, lalacewar jiki, kleptomania, da kuma halayyar halayyar halayyar mata. Mun yi imani wannan shine bayanin farko game da amfani da shi don magance jima'i na jima'i.
Royal Society of London an kafa shi a cikin 1660, kuma yana wallafa mujallar kimiyya mafi tsawo a duniya. A cikin 'yan kwanan nan na Ayyukan Falsafa na Royal Society, an kawo rahoton halin fahimtar jaraba kamar yadda wasu manyan masana kimiyyar jaraba na duniya suka tattauna a taron kungiyar. Taken mujallar da ke bayar da rahoto game da taron shi ne "Labaran kwayar halitta na jaraba - sabbin vistas." Abin sha'awa, daga cikin labaran 17, biyu suna da damuwa musamman game da jarabar yanayi: caca na cuta[15] da kuma takarda da Dokta Nora Volkow ya yi game da abubuwan da suka dace a cikin kwakwalwar kwakwalwa a cikin maganin ƙwayar magungunan ƙwayoyi da kuma ciyayi[16]. Takarda ta uku da Dokta Nestler yayi magana game da dabbobin dabba na jarabar dabi'a da kuma game da DFosB.[17]
DFosB wani sinadari ne wanda Dokta Nestler ya yi nazarinsa, kuma ya bayyana ana samun sa a cikin jijiyar batutuwa masu larura. Yana da alama yana da rawar aikin ilimin lissafi yana da kyau, amma yana da alaƙar gaske cikin jaraba Abin sha'awa, an fara samo shi a cikin ƙwayoyin kwakwalwa na dabbobin da aka yi nazari game da shan kwaya, amma yanzu an same shi a cikin ƙwayoyin kwakwalwa a cikin ƙananan ƙwayoyin da ke da alaƙa da yawan cin abinci na halitta lada.[i] Wani takardun binciken da aka yi a kwanan nan game da DFosB da kuma rawar da ake yi a kan amfani da abubuwa biyu na ladabi, cin abinci da jima'i, ya kammala:
A takaice dai, aikin da aka gabatar a nan ya ba da shaida cewa, baya ga magungunan zalunci, sakamakon lada na haifar da matakan DFosB a cikin Nac ... sakamakonmu ya haifar da yiwuwar shigar da DFosB a cikin NAc na iya magance ba kawai ɓangarorin magungunan miyagun ƙwayoyi ba, amma har ma wasu al'amurra da ake kira halittu masu ban sha'awa da suka shafi amfani da kyauta.[18]
Dokta Nora Volkow ita ce shugabar Cibiyar Nazarin Magunguna ta Kasa (NIDA), kuma tana ɗaya daga cikin fitattun masanan kimiya a duniya. Ta fahimci wannan juyin cikin fahimtar jarabar yanayi kuma ta bada shawarar canza sunan NIDA zuwa Cibiyar Kula da Cututtuka na Addini ta Nationalasa. Jaridar Science ya ruwaito: "NIDA darektan Nora Volkow kuma ya ji cewa sunan makarantar ya kamata ya kewayeaddinan kamar batsa, caca, da abinci, in ji mai ba da shawara na NIDA Glen Hanson. 'Ta so a aika saƙon cewa [ya kamata mu] dubi dukan filin.' "[19] (girmamawa kara da cewa).
A taƙaice, a cikin shekaru 10 da suka gabata shaidun yanzu suna da cikakken goyon baya ga yanayin jarabar lada ta ɗabi'a. Dr. Malenka da Kauer, a cikin babbar takardarsu kan tsarin sauye-sauyen sunadarai da ke faruwa a cikin kwayar halittar kwakwalwar mutane, “jaraba na wakiltar wata cuta ce, amma mai karfin iko da ilmantarwa.”[20] Yanzu muna kiran waɗannan canje-canje a cikin ƙwayoyin kwakwalwa “ƙarfin aiki na dogon lokaci” da “ɓacin rai na dogon lokaci,” kuma muna magana game da kwakwalwa azaman filastik, ko batun canzawa da sake yin waya. Dr. Norman Doidge, masanin jijiyoyi a Columbia, a cikin littafin nasa Brain Wannan Canji ya bayyana yadda batsa ke haifar da sake sanya igiyoyin hanyoyin. Ya lura da wani bincike kan mazaje da ke kallon hotunan batsa na Intanet inda suke kallon "maras kyau" kamar berayen da ke tura lever ɗin don karɓar hodar iblis a cikin kwalaye Skinner na gwaji. Kamar beran da ya kamu da cutar, suna neman gyara na gaba, danna linzamin kwamfuta kamar yadda bera ya tura lever. Batsa na batsa shine frantic koyo, kuma wataƙila wannan shine dalilin da ya sa mutane da yawa waɗanda suka yi gwagwarmaya tare da yawan jaraba suka bayar da rahoton cewa shine mafi ƙarancin jaraba a gare su don cin nasara. Shaye-shayen ƙwayoyi, yayin da suke da ƙarfi, sun fi saurin wucewa ta hanyar “tunani”, yayin da kallon hotunan batsa, musamman akan Intanet, aiki ne mai aiki sosai ba tare da ilimin likita ba. Bincike da kimantawa kowane hoto ko shirin bidiyo wanda aka samar don iyawa da tasiri motsa jiki ne a cikin ilmantarwa da sake kunnawa.
Halin dan Adam ya yi amfani da hanyoyi guda biyu kamar yadda suke tattara a yayin hutun heroin.[21] Idan muka kasa fahimtar abubuwan da tasirin batsa ke da shi na sake tsara kwakwalwar a tsari, ta hanyar jijiyoyin jiki, da kuma ci gaba, ya kamata kanmu ci gaba da gazawa wajen magance wannan mummunar cuta. Koyaya, idan muka ba da wannan lada mai ƙarfi gwargwadon iko da girmamawa za mu iya taimaka wa da yawa yanzu da suka kamu da jaraba da yanke kauna don samun kwanciyar hankali da bege.
[1] Constance Holden, "Tashin hankali: Shin Sun kasance? Science, 294 (5544) 2 Nuwamba 2001, 980.
[2] Ibid.
[3] Eric J. Nestler, "Akwai hanya ta kwayoyin halitta don jaraba?" Nature Neuroscience 9(11):1445-9, Nov 2005
[4] Teresa R. Franklin, Paul D. Acton, Joseph A Maldjian, Jason D. Gray, Jason R. Croft, Charles A. Dackis, Charles P. O'Brien, da kuma Anna Rose Childress, "Rage Gashin Gizon Zuciya a cikin Mutumin, Orbitofrontal, Cingulate, da Cortices Cortices na Cocaine marasa lafiya, " Biological Psychiatry (51) 2, Janairu 15, 2002, 134-142.
[5] Paul M. Thompson, Kikralee M. Hayashi, Sara L. Simon, Jennifer A. Geaga, Michael S. Hong, Yihong Sui, Jessica Y. Lee, Arthur W. Toga, Walter Ling, da Edythe D. London, "Tsarin Abubuwa. a cikin kwakwalwa na 'yan Adam wanda ke amfani da Methamphetamine, " Jaridar Neuroscience, 24 (26) Yuni 30 2004; 6028-6036.
[6] Nicola Pannacciulli, Angelo Del Parigi, Kewei Chen, Dama Dan NT Le, Eric M. Reiman da Pietro A. Tataranni, "Cutar da ke cikin ƙananan mutum. Neuroimage 31 (4) Yuli 15 2006, 1419-1425.
[7] Boris Schiffer, Thomas Peschel, Thomas Paul, Elke Gizewshi, Michael Forshing, Norbert Leygraf, Manfred Schedlowske, da kuma Tillmann HC Krueger, "Cikin Gidan Cikin Gidan Cikin Gida a Tsarin Frontoldriatal da Cerebellum a Pedophilia". Journal of Psychiatric Research (41) 9, Nuwamba 2007, 754-762.
[8] M. Bourke, A. Hernandez, Aikin Nazarin Magana: Redux: Rahoton Bincike akan Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙarya ta Ɗaukewar Abokan Ɗaukan Hotuna. Rajista na Rikicin iyali 24(3) 2009, 183-191.
[9] H. Mouras, S. Stole4ru, V. Moulier, M Pelegrini-Issac, R. Rouxel, B Grandjean, D. Glutron, J Bittoun, Faɗakarwa da tsarin kyamara ta hanyar zane-zane na bidiyo mai tsinkaye na tsirrai da aka gina: nazarin fMRI . NeuroImage 42 (2008) 1142-1150.
[10] Michael H. Miner, Nancy Raymond, BryonA. Meuller, Martin Lloyd, Kelvin Ol Lim, "Bincike na farko game da dabi'un da ke tattare da dabi'un da ke tattare da halayen halayen jima'i." Neman Labaran Lafiyar Neuroimaging Juzu'i na 174, Fitowa ta 2, Nuwamba 30 2009, Shafi na 146-151.
[11] Bruce E. Wexler, Christopher H. Gottschalk, Robert K. Fulbright, Isak Prohovnik, Cheryl M. Lacadie, Bruce J. Rounsaville, da kuma John C. Gore, "Ayyukan Harkokin Kasuwancin Ayyuka na Cocaine Craving," American Journal of Psychiatry, 158, 2001, 86-95.
[12] Jan Reuter, Thomas Raedler, Michael Rose, Iver Hand, Jan Glascher, da Kirista Buchel, "An haɗu da caca na caca da rage yawan aiki na tsarin raka na mesolimbic." Nature Neuroscience 8, Janairu 2005, 147-148.
[13] Gene-Jack Wang, Nora D. Volkow, Jean Logan, Naomi R. Pappas, Christopher T. Wong, Wei Zhu, Noelwah Netusil, Joanna S Fowler, "Cikar daji da kuma kiba," Lancet 357 (9253) Fabrairu 3 2001, 354-357.
[14] J. Michael Bostwick da kuma Jeffrey A. Bucci, "Harkokin Jima'i na Intanit da aka Yi da Naltrexone." Mayo Clinic Proceedings, 2008, 83(2):226-230.
[15] Marc N. Potenza, "Labaran ilimin lissafi da magungunan miyagun ƙwayoyi: fasali da sabon binciken," Ayyukan Falsafa na Royal Society, 363, 2008, 3181-3190.
[16] Nora D. Volkow, Gene-Jack Wang, Joanna S. Fowler, Frank Telang, "Rashin kayar da hanyoyi ne a cikin jaraba da kiba: hujjojin tsarin ilimin lissafi," Ayyukan Falsafa na Royal Society, 363, 2008, 3191-3200.
[16] Eric J. Nestler, "Tsarin littattafai na jaraba: rawar DFosB," Ayyukan Falsafa na Royal Society, 363, 2008, 3245-3256.
[18] DL Wallace, et al, Hanyoyin DFosB a cikin Maɗaukaki Tsuntsaye a kan La'anin Abubuwan Lada na Halitta,Jaridar Neuroscience, 28 (4): Oktoba 8, 2008, 10272-10277,
[19] Science 6 Yuli 2007:? Vol. 317. babu. 5834, p. 23
[20] Julie A. Kauer, Robert C. Malenka, "Tsarin Mulki da Abin Yara," Yanayin Bayani Neuroscience, 8, 8440858 Nuwamba 2007, 844-858.
[21] Gert Holstege, Janniko R. Georgiadis, Anne MJ Paans, Linda C. Meiners, Ferdinand HCE van der Graaf, da kuma AAT Simone Reinders, "Kungiyar kwantar da hankali a lokacin yaduwar namiji," Jaridar Neuroscience 23 (27), 2003, 9185-9193
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