Han DH, Bolo N, Daniels MA, Arenella L, Lyoo IK, Renshaw PF.
Pūʻulu Pūʻali. 2011 Jan-Feb;52(1):88-95.
kahi
Ke Keʻena o ke Psychiatry, Chung Ang University, College of Medicine, Seoul 104-757, South Korea.
Hōʻuluʻulu Manaʻo
KANAWAI:
Ua hōʻike ʻia nā noiʻi hou ʻana i ka makemake ʻana o ka lolo i ka hōʻiliʻili cue-induction makemake no nā wikiō wikiō e like me ka mea i loaʻa e nā cues i pili i nā lāʻau a me ka waiʻona. Hōʻike mākou i kēlā makemake no nā pāʻani wikiō pūnaewele i ka wā o ka hōʻike cue i hoʻohua i nā wahi like ʻole o ka lolo i nā mea i pili pū me ka makemake ole i nā lāʻau lapaʻau a i ʻole nā petologic gaming.
KANAKA:
Ua pili kēia noiʻi ʻana i ka loaʻa ʻana o ke kiʻi diagnostical magnetic resonance imaging a me ka hana magnetic resonance imaging data mai 19 kāne makua kāne olakino (makahiki, 18-23 mau makahiki) ma hope o ke aʻo ʻana a me kahi manawa maʻamau o 10 mau lā o ke pāʻani me kahi pāʻani wikiō wikiō i hōʻike ʻia, ʻO War Rock ”(K2 Pūnaewele, Irvine, CA). Ke hoʻohana nei i nā ʻāpana o ka videotape me 5 mahele 90-ʻelua pili o ka hoʻomaha hoʻomaha, ka hoʻohālikelike ʻana, a me nā hiʻohiʻona e pili ana i ka pāʻani wikiō, ua loiloi ʻia ka makemake e pāʻani i ka pāʻani me ka hoʻohana ʻana i kahi pālākiō analogue hiʻohiʻona 7 ma mua a ma hope o ka hōʻike ʻana o ka videotape.
Nā hopena:
I ka pane ʻana i nā hoʻokūkū pāʻani wikiō Pūnaewele, i hoʻohālikelike ʻia me nā stimulus control neutral, ʻike ʻia ka hana ʻoi aku ka nui o ka gyrus frontal hema hema, ka gyrus hemaippocampal hema, ka ʻākau a me ka hema o ka loʻi parietal, ka thalamus ʻākau a me ka hema, a me ka cerebellum ʻākau (ka helu ʻike loaʻa hewa <0.05, P <.009243). Hoʻohui maikaʻi ʻia ka makemake pilikino i hōʻike ʻia me nā waiwai β o ka gyrus frontal hema hema, ka gyrus hemaippocampal hema, a me ka thalamus hema a hema. Hoʻohālikelike ʻia me nā mea pāʻani maʻamau, nā mea i hoʻokani i nā pāʻani wikiō ʻoi aku ka nui o ka hana i ka lobial frontal pono, ka mua a me ka hema o ka gyrus mua, ka gyrus postetral pono, ka gyrus parahippocampal pono, a me ka gyrus parietal hema. ʻO ke kāohi ʻana no ka manawa pāʻani holoʻokoʻa, hōʻike ʻia ka makemake no ka pāʻani wikiō Pūnaewele ma nā kumuhana i pāʻani i nā pāʻani wikiō pūnaewele i hoʻopili maikaʻi ʻia me ka hoʻoulu ʻana i ka lobe frontal medial pono a me ka gyrus parahippocampal pono.
KA HOOHOLO:
Hōʻike ka mea i loaʻa i kēia manawa i ka hoʻowalewale cue i ka hoʻoulu wikiō wikiō e like paha me ka mea i nānā ʻia ma ka hōʻike ʻana o ka cue i nā poʻe me ka waiwai hilinaʻi a i ʻole ka petologic gaming. Ma keʻano kūikawā, ʻike nā cues i nā hana maʻamau elicit i ka dorsolateral prefrontal, orbitofrontal cortex, parahippocampal gyrus, a me thalamus.
Introduction
Me ka piʻi wikiwiki o ka hoʻohana ʻana i ka pūnaewele ma mua o ka makahiki i hala, ʻo ke kumumanaʻo o ka pono pili pūnaewele ma ke ʻano he maʻi hou i loko o ka pā o nā maʻi hōʻemi he mau kumumanaʻo ia ke kumuhana o ka hoʻopaʻapaʻa nui. I kēia manawa, ka hoʻohui honua, like me ka hōʻino a me ka hilinaʻi, ua wehewehe ʻia ka hemahema o ka poʻe e hoʻokele i kā lākou hoʻohana pūnaewele, ka hopena o ka hopohopo a me ka hana ʻole i loko o nā kāʻei mokuʻāina: elemakuleʻenehana, pāpaho, hana, hoʻomohala ʻia,1-3]. Eia kekahi, ʻo ke kaumaha nui, nā hopohopo kaumaha, ADHD, a me schizophrenia ua manaʻo ʻia he comviid psychiatric disorders [1]. Ma nā hihia koʻikoʻi, ua hōʻike ʻia ka pāʻani wikiō wikiō e alakaʻi nei i ka make i hōʻike ʻia ma Korea ʻelua [4] a me ʻAmelika Hui Pū ʻIa [5].
Ua hahai ʻia nā laina noiʻi nui e hoʻoikaika i ko mākou ʻike ʻana i nā loli e pili ana i ka pili ʻana i ka lāʻau lapaʻau, ka waiʻona, a me ka pili ʻana i ka pāʻani pili. Kalivas me Volkow [6] hōʻuluʻulu i nā pōpoki pili i ke ʻano o ka dorsolateral prefrontal cortex (DLPFC), orbitofrontal cortex (OFC), thalamus, amygdala a me hippocampus. Eia kekahi, manaʻoʻo dopamine e lilo i mea hoʻoponopono koʻikoʻi ma lalo o ka mea i hoʻohui ʻia i ka pūnaewele. ʻO ka hapa nui o nā lāʻau, a me ka wai ʻawaʻawa hoʻi, e hoʻolalelale i ka nui o ka dopamine i ka nui o ka dopamine i loko o ka nucleus accumbens, kahi e pili ai i ka euphoria a me ka makemake.7, 8].
Ua ho'ākāka ʻia ka nānā ʻana i ka lāʻau "makemake nui no nā hopena i loaʻa i ke ʻano o ka psychoactive"9]. Hiki ke koi ʻia kēia makemake a hoʻonui i ka pane ʻana i nā kukuna o loko a i waho. Hiki ke hoʻokaʻawale ʻia nā kākiu i ʻelua mau ʻāina. Pili ka ʻāina craving mua me nā mea kūlohelohe e like me ka hoʻohana ʻana i ka drug-priming a i ʻole cue-indosedat reinstatement ʻoiai ʻo ka lua o ka inoa i hōʻike ʻia e ke ʻano o ka haʻalele ʻana i ka maʻi ma hope o ka waiho ʻana o ke kinohi.9]. No ka mahalo i ka cue-exposure, ua hōʻike ʻia nā haʻawina neuroimaging hou e hoʻonui ai i ka hana ma DLPFC, OFC, thalamus, amygdala, a me ka hippocampus e pili ana i ka ʻili.1 Pūnaewele). Keikialoha me ke al.10] hōʻike ʻia kahi kuʻikahi ma ke kahawai ka hoʻoili ʻia ʻana o ka ʻike, ma o ka frontal ikaika, parahippocampal a me cortex occipital, o nā mea pīhoihoi kuʻuna i ka pane ʻana i ka ʻano cody-induced type stimulus. I ka pane ʻana i nā cues mea, ua hōʻike ʻia ka hana i hoʻonui ʻia i ka DLPFC a me OFC i nā mea maʻi me ka waiʻona, cocaine, nicotine, a i ʻole ka pāʻani i ka pāʻani pūnaewele.11-16]. Ma hope o ka inu ʻana i ka wai liʻiliʻi, ua hoʻoneʻe ʻia ka cortex prefrontal cortex hema a me ka thalamus anterior i nā mea maʻi me ka hilinaʻi i ka waiʻona e hoʻohālikelike ʻia ana i nā kiʻi waiʻona.12] Eia kekahi, Wrase et al [16] Ua hōʻike aku ʻo basal ganglia a me nā orbitofrontal gyrus i ka nui waʻawaʻawa ua hoʻāla ʻia ka pane ʻana i nā kiʻi ʻokē. ʻBlelo like me ke al [11] hōʻike i ka hōʻike o nā kīʻaha ʻawaʻawa e hiki ke hoʻōla i nā wahi lolo e like me ka prefrontal cortex, striatum, ventral tegmental area a substantia nigra i loko o nā mea maʻi me ka hilinaʻi i ka ʻona. I ka hōʻike ʻana o nā mea hoʻokani olakino e pili ana i ka hōʻike o ka kokela ma nā kumuhana ʻeono me ka mōʻaukala kokoti, ua hana ʻia ka anterior cingulate a haʻalele dorsolateral prefrontal cortex [14]. Ke hōʻike nei i nā pōpoki hili i ka hoʻoweliweli ʻana i ka striatum, amygdala, orbitofrontal cortex, hippocampus, medial thalamus, a waiho i nā insula i nā mea ulaula, i hoʻohālikelike ʻia me ka hana ʻole i ke kūpaʻa.17]. I ka paneʻana i nā hiʻohiʻona pili o heroin, nā mea maʻi me ka hilinaʻi opioid, akā, ʻaʻole ka hoʻokele kumuhana, hōʻike i ka hoʻonui i ka hana o ka hippocampus [18]. I ka pane ʻana i nā kiʻi pāʻani, hiki i ka orbitofrontal cortex kūpono, ka uha nucleus kūpono, bilateral anterior cingulate a me ka medial frontal cortex, pololei dorsolateral prefrontal cortex, a me ka hana caudate kūpono i hana ʻia ma 10 kumuhana pili honua, hoʻohālikelike ʻia i ka hui mālama olakino [13]. I ka hōʻike ʻana o kahi wikiō pili pili i ka pili, ua hōʻike nā kumuhana pākēnō i nā hana nui i ka cortex prefrontal cortex kūpono (DLPFC), ka mea haʻahaʻa a me ka medial frontal gyri, ka gyrus parahippocampal kūpono, a waiho i ka cortex occipital, i hoʻohālikelike ʻia i nā kumumanaʻo [10].
 | 1 Pūnaewele
Hoʻokomo ʻia ʻo Cue craving a me nā lolo i loko o nā mea maʻi me ka hōʻino kino a me ka papaʻa pathological. |
Hoʻokumu ʻia i nā hōʻike i hala e pili ana i ka hana hōʻino a me ke keʻaheʻe i ka hana make me nā ʻenekini like ʻole (prefrontal cortex, orbitofrontal cortex, amygdala, hippocampus a thalamus), ʻike mākou i ka makemake o ka pāʻani wikiō ʻ internetlelo pili me ka hana o ka dorsolateral prefrontal cortex, orbitofrontal cortex, amygdala, hippocampus, a me thalamus i mea e pane ai i ka hōʻike ʻana i nā kīʻaha palaka.
hana
Nā Kaupapa
Ma o ka hoʻolaha ʻana ma ke kula nui o Bentley, ʻumikūmālua mau haumāna i ʻākoakoa hou ʻia. I loko o kēia iwakāluakūmākolu, ua kāpae ʻia ʻelua mau haumāna ma muli o nā ʻōuli o ke kaumaha nui ma nā helu Beck Depression Inventory (BDI). Ua hala kekahi kumuhana i ka lā o ka nānā ʻana o fMRI a ʻaʻole i mālama kekahi kumuhana i ka papa kuhikuhi no ka pāʻani wikiō wikiō ma ka pūnaewele. ʻO ka mea hope loa, ua loiloi mākou i nā haumāna kāne he ʻumikūmāiwa (mean makahiki = 20.5 ± 1.5years, palena iki 18, maximum 22) me ka moʻolelo o ka hoʻohana pūnaewele (3.4 ± 1.5 hola / lā, ka palena iki o 0.5 hola, ka nui o 6 mau hola) a me ka hoʻohana kamepiula (3.8 ± 1.3 mau hola / lā, ka palena iki o 1.5 hola, ʻoi aku 6 mau hola) akā ʻaʻole i hoʻokō i nā pae hoʻohālikelike no ka hōʻalo (nā helu helu helu ʻōpio ʻōpio <40) 19 i loko o 6 mau mahina i hala. Mai nā kumuhana 19, ua inu nā mea he 10 i ka waiʻona (inu inu kaiaulu, alapine, 2.3 ± 2.6 / mahina) a he poʻe puhipaka nā kumuhana āpau (2 Pūnaewele). Hoʻopili ʻia nā kumuhana āpau me ke Kāleka Hoʻolālā Structured no DSM-IV, BDI [20] ((ʻoki ʻia ka helu = 9, ʻo ka helu = 6.1 ± 2.0), a me Beck An depression Inventory [21] ((ʻoki ʻia ka helu = 21, ʻo ka helu = 4.8 ± 3.5). Hoʻokomo ʻia nā koina i haʻalele ʻia (1) nā haumāna me nā moʻolelo a i ʻole kēia manawa o nā haumāna Axis I psychiatric maʻi (2) me nā mea hōʻeha kino (koe wale nō ka waiʻona) a me (3) nā haumāna me nā maʻi neurological a me nā maʻi maʻi. ʻO ka Papa Hoʻonaʻau Hōʻikeʻike hoʻonaʻauao ʻo McLean a me ka Papa Hoʻonaʻauao Kumukanawai o Bentley ua apono ʻia ka protocol noiʻi o kēia noi. Hāʻawi ʻia nā haumāna āpau i komo i ke aʻo ʻana i ʻae ʻia me ka ʻae a kākau ʻia.
| 2 Pūnaewele
ʻO ka ʻike demographic, ka pae o Yong Internet Addiction Scale, ke pāʻani nei i ka manawa o ka pāʻani, a me ka makemake i ka pāʻani wikiō ma waena o GP a me EIGP. |
Ke kaʻina noiʻi
Pāʻani pāʻani wikiō a me nā pākuʻi fMRI
Ma ka huakaʻi hele mua mua, ua hele nā haumāna i komo i ka aʻo ʻana i kahi sciening lapaʻau mua, i loaʻa iā kahi scan MRI ka mālama ʻana i nā mea ʻoluʻolu i loko o ka scanner a no ka hoʻokaʻawale ʻana i nā mea hōʻike i ke ʻano o ka hoʻopalapala ʻōnaehana waena. Eia kekahi, ua nānā ʻia ka paʻakikī o ka lawe ʻana ma ka pūnaewele e Young's Addiction Scale (YIAS) [3]. ʻO ka nānā ʻana o nā mea lapaʻau e ukali ʻia e kahi hālāwai aʻo aʻo pōkole no ke aʻo ʻana i ke ʻano o ka pāʻani wikiō pūnaewele. ʻO kēia pāʻani wikiō, ʻo "War Rock", kahi mea pāʻani mua (FPS) kahi mea pāʻani, e pāʻani nei ma ka pūnaewele me nā mea pāʻani he nui i ka manawa like. Hoʻonohonoho ʻia ka pāʻani ma hope o ke kaua ʻana i kēia lā, e hoʻohana ana i nā ʻano mea maoli, ʻano hana like ʻole, me nā mea kaua. Hāʻawi ʻia kēlā me kēia mea pāʻani i kahi kime nāna e ʻae i ka hoʻopau ʻana i nā lālā o ka hui kūkaʻi a luku ʻole i kahi hoʻolālā kumu ma ke kanu ʻana i kahi mea pāʻani. No ka mea ua hoʻomake a hoʻomake ʻia a hana ʻia ma Malaki 2007, nā mea hana ma ka ʻimi noiʻi ʻānō i pāʻani ai "War Rock" i ka manawa mua loa. Ua noi ʻia nā haumāna e kākau inoa ana a me ka ʻōlelo huna e pāʻani ai “War Rock” ma kā lākou kamepiula ponoʻī, 60 mau minuke i kēlā me kēia lā no 10. Me ka ʻae o nā kumumanaʻo, ua kāʻei ʻo ka ʻoihana K2-Network i ka manawa pāʻani, ka helu, a me ke kahua pāʻani i ka wā o 10-lā. ʻO ke ʻano o ka manawa holoʻokoʻa "War Rock" i pāʻani ʻia he ʻumikūmāiwa he 795.5 ± 534.3 mau minuke. I ka hopena o 10 ka lā, ka loiloi o ka lolo i ka wā o ka pāʻani pāʻani e loiloi me ka hana ʻikepili (magneto resonance imaging) (fMRI), a ua nānā ʻia ka makemake no ka pāʻani ʻana i ka pāʻani wikiō pūnaewele me ka hōʻike pono e hōʻike nei i kahi kikoʻī he kiko kikoʻī ʻekahi hiku. VAS).
ʻO ka loiloi o ka hana noʻonoʻo a me ka makemake no ka pāʻani wikiō wikiō pūnaewele
Hana ʻia nā ʻōmole āpau āpau āpau i kahi hōʻike 3.0 Tesla Siemens Trio scanner (Siemens, Erlangen, Kelemānia). Ua hoʻolālā ʻia kēia haʻawina e hoʻohālikelike i kekahi mau haʻawina makemake o fMRI e hoʻopili ʻia ana i ka hōʻike o nā cues drug.11-16]. Nānā ka poʻe komo i kahi wikiō lua 450 kekona lua ʻole me ke kani kaʻe o nā ʻelima 90 mau kekona mau ʻelima. Aia i kēlā me kēia mahele 90 ka lua kekona i hoʻoulu ʻia, e like me kēlā me kēia 30 kekona ka lōʻihi: kahi keokeo keʻokeʻo ma kahi ʻaoʻao uliuli (B); kahi kaona kūleʻa (N, nui mau kiʻi kaua hoʻonaninani); a me ke cue wikiō wikiō (C). Ua kauoha ʻia kēlā mau ʻāpana ʻelima penei: BNC, BCN, CBN, NBC, a me CNB. ʻO ka cog video i hoʻopaʻa ʻia ka wikiō e hōʻike ana i ka pāʻani wikiō ma ka pūnaewele ʻo "War Rock". Kēia lekiu i hōʻike ʻia i kēlā me kēia kumuhana ma o ka nonferrous reflective-mirror visual system i hoʻokahi o ka fMRI scanning session. No ka makina fMRI, 180 echo planar image (EPI, 40 irisan kiko, 5.0 mm mānoanoa, vox ka nui o 3.1 × 3.1 × 5.0 mm, TE = 30msec, TR = 3000ms, ke kihi Flip = 90 °, i loko o ka hopena = 64 × 64 mau kāwili, hoʻokeleʻike (FOV) = 200 × 200 mm) i hoʻopaʻa ʻia ma ka pōkole lua 3. No ka hoʻohui kino ʻana, e hōʻuluʻulu ʻia ka pākeke ʻo 3D T1 ka nui a me ka hōʻuluʻulu ʻana me ka pākuʻina (XMUMX) 2100 ms, TE = 2.74 ms, FOV = 256 × 256 mm, 128 mau ʻāpana, 1.0 × 1.0 × 1.3 mm voxel lahilahi, flip sudut = 12 °. E hoʻomaopopo i ka helu o kēlā me kēia haumāna ka makemake o "War Rock"™, ʻehiku mau kikoʻī nānā kikowaena kikoʻī (kahi mai 1 = "ʻaʻole loa" a 7 = "koʻikoʻi") i lawelawe ma mua ʻelua a ma hope o ke kahakaha ʻana. Ua nīnau kiko ʻia, nā haʻawina: "Pehea ʻoe e makemake ai e pāʻani i ke pāʻani ʻo War Rock?" Me ka hoʻohana ʻana i ka ʻōnaehana aniani moʻoono nonferrous a me nā loiloi i uku ʻia ko lākou makemake e pāʻani i ka pāʻani me ka hauʻoli ʻana.
Ua hōʻike ʻia ka hana Brain me ka hoʻohana ʻana i ka polokalamu Brain Voyager software package (BVQX 1.9, Brain Innovation, Maastricht, The Netherlands). ʻO ka pūʻulu manawa fMRI no kēlā me kēia kumuhana ua hoʻopaʻa pū ʻia i ka data anatomical 3D set a me ka hoʻohana ʻana i ka algorithm multi-scale i hāʻawi ʻia e BVQX. Ua kiʻi maoli ʻia nā kiʻi pili kino ponoʻī i kahi kikoʻī ʻo Talairach maʻamau.22]. Ua like ka like me ka hoʻololi ʻana no ka manuahi nonlinear i ka hōʻike ʻana o ka manawa like me ka T2 *. Ma hope o nā hana mākaukau e hoʻomaʻamaʻa ʻana i ka manawa hoʻoponopono a me ka hoʻoponopono ʻana i ka ʻae ʻana o 3D, ua hoʻomaʻamaʻa ʻia ka ʻikepili hana me ka pahu kohu Gaussian me kahi FWHM o 6mm a hoʻoneʻe koke ʻia me ka hoʻohana ʻana i ka kernel Gaussian o 4 e hoʻohana ana i nā algorithms i hāʻawi ʻia e BVQX
Ua hana ʻia nā kaona helu helu ma ke hoʻohālike ʻana i ka manawa kikoʻī nā fMRI no nā kūlana like ʻole (cue wikiō a me nā hōʻalo kūlohelohe) ma ke ʻano pahu hana i hoʻopili ʻia me ka hana hemodynamic-pane. Ua hoʻohana ʻia nā hana hoʻohālike e like me nā wehewehe hoʻohālike i loko o ka pōʻaiapau o ka hoʻohālike laina maʻamau (GLM) e hoʻopili ai i ka loiloi regression laina laina i nā manawa mM hōʻailona hōʻailona-aʻo i kahi lox ma ka mana o voxel. A loiloi hopena hopena i hoʻohālikelike ʻia me nā pūʻulu helu helu helu parametric o ka lolo hoʻonaninani ʻae i ka pāʻani wikiō cue vs kūʻai kūʻē. No nā kikoʻī āpau, ua manaʻo ʻia nā hui i ʻike ʻia inā he ʻoi ʻole ka False Discovery Rate (FDR) ma mua a i like a me 0.05 (hoʻoponopono ʻia no nā hoʻohālikelike he nui) i nā hēkē pili i kanaha. Ke kāohi nei i ka loaʻa o ka manawa pāʻani, ʻo ke ʻano o nā kaupaona beta e pili ana i nā hana hoʻohālike e hoʻohana ai i ka ʻimi i ka ʻikepili ʻokoʻa ma waena o ke ana o ka makemake no nā pāʻani pāʻani ʻōpio a me nā hana hoʻoliʻi kūloko. Ua hoʻohana ʻia kahi lua o ka helu hōʻike pākuʻi ʻ randomlelo ANOVA me ʻelua mau mea i loko o ka manaʻo (video cue vs neutral stulus) a me ʻelua ma waena o nā kumumanaʻo (ka nui o nā mea pāʻani wikiō wikiō ma ka ʻenehana wikiō maʻamau) i hoʻohana ʻia e hōʻike i nā ʻano ʻuhane like ʻole ma kahi ka pāʻani pā pāʻani wikiō pūnaewele nui. Ke kāohi nei no ka manawa holoʻokoʻa, ua ʻikepili ʻia ka mahele ma waena o ka makemake no ka pāʻani wikiō pūnaewele a me ke ʻano ʻo nā kaupaona beta.
Hoʻoulu ʻia ka pāʻani wikiō pūnaewele ʻāleʻa e pale i ka pale ʻana
ʻO ka makemake maʻamau no ka pāʻani wikiō pūnaewele ma ʻumikūmāiwa mau kumuhana ʻo 3.3 ± 1.6 (ka palena iki o 1 a ʻoi paha ka 5.5). I ka pane ʻana i nā hoʻokūkū pāʻani wikiō pūnaewele, i hoʻohālikelike ʻia i nā stimuli kūpaʻa, ʻike ʻia ka hana ʻoi aku ka nui o nā hana i ʻeono (FDR <0.05, p <0.0009243): cluster 1 (Talairach x, y, z; 56, 35, 23; parietal pono. ʻupena, −59, −41, 23; ʻūpā hema pari (Brodmann 7, 40), 32, −84, 23; ʻupena ʻoki ʻākau, −26, −84, 23; ʻupena ʻoki ʻoki hema), cluster 2 (38, - 40, −29; ʻupena mua aniani cerebellum, 39, −73, −29; ʻūhā o ka cerebellum hema), ʻāpana 3 (14, 64, −39; ʻupena puʻuwai cerebellum akau), ʻāpana 4 (20, -31, 2 ; thalamus ʻākau), cluster 5 (−22, −25, 3; left thalamus, −38, −25, −17; left parahippocampal gyrus (Brodmann 36)), and cluster 6 (-17, 19, 25; left low frontal gyrus (Brodmann 9), dorsolateral prefrontal cortex i overlaps me ka DLPFC ma Callicott et al's a me Cotter et al ka noiʻi [23, 24]) ((Hōʻike 1). Ua hoʻopili maikaʻi ʻia nā helu beta ma waena o nā puʻupuʻu 4, 5, a me 6 (cluster 4 vs cluster 5: r = 0.67, p <0.01; cluster 4 vs cluster 6: r = 0.63, p <0.01; cluster 5 vs. puʻupuʻu 6: r = 0.64, p <0.01). ʻAʻole hōʻike nā ʻōpili ʻē aʻe i kahi pilina ma waena o kā lākou waiwai beta.
Ma kahi ʻano loiloi ma waena o nā waiwai beta o nā ʻeke a me ka makemake pono ʻole i ka pāʻani wikiō pūnaewele, makemake ʻia ka makemake me ka cluster 4 (ʻokoʻa thalamus r = 0.50, p = 0.03), cluster 5 (hema thalamus, haʻalele parahippocampal gyrus ( Brodmann 36), r = 0.56, p = 0.02) a me nā pua 6 (waiho hema hema gyrus (Brodmann 9), r = 0.54, p = 0.02). ʻAʻohe mea nui ma waena o nā ʻeke āpau a me ka makemake i ka pāʻani wikiō wikiō (Hōʻike 2).
 | Hōʻike 2
ʻO nā hoʻoponopono ma waena o Cluster 4, Cluster 5, Cluster 6, a me Craving (mean ± 0.95 CI) |
Nā kumuhana i pāʻani i nā pāʻani wikiō wikiō ʻokoʻa (MIGP) ʻĀpana pāʻani pā pāʻani wikiō maʻamau (GP)
Ua ʻike mākou i kekahi mau mea hoʻopaʻa haʻawina i pāʻani i ka pāʻani wikiō ma mua o nā mea ʻē aʻe. Ma muli o kēia nānā ʻana, ua hoʻokaʻawale mākou i nā kumuhana i ʻelua mau hui, nā mea i pāʻani i ka pāʻani wikiō wikiō (MIGP) a me kahi hui pāʻani (GP). No nā kumuhana he ʻumikūmāiwa, ʻeono mau kumuhana i pāʻani i ka pāʻani wikiō ma mua o 900 mau minuke (150% o ka manawa i manaʻo ʻia, 600 mau minuke) i wae ʻia ma ke ʻano he kumuhana i pāʻani i ka pāʻani wikiō wikiō hou aʻe (MIGP) Ua pāʻani ka MIGP i ka pāʻani wikiō pūnaewele 1500.0 ± 370.9 minuke / 10 mau lā ke pāʻani ka GP i ka pāʻani no 517.5 ± 176.6 minuke / 10 mau lā. Hoʻohālikelike ʻia iā GP, i ka pane ʻana i ka cue wikiō wikiō punaewele, ua hōʻike ʻo MIGP i ka hana i ʻoi aku ka nui o nā hana i ʻeono mau hui (FDR <0.05, p <0.000193): cluster 7 (Talairach x, y, z; 5, 48, ,13; front medial pono gyrus broadmann area (BA) 11), cluster 8 (52, −13, 38, frontal pre-central gyrus front), cluster 9 (20, -29, −5; pono parahippocampal gyrus), cluster 10 (6, −52 , 66; gyrus post-central gyrus pono), cluster 11 (−25, −13, 52; left frontal pre-central gyrus), cluster 12 (-17, −99, −17; left occipital lingual gyrus) (Hōʻike 3).). Ke kāohi nei no ka wā pāʻani holoʻokoʻa, makemake ʻia ka makemake no ka pāʻani wikiō pālani wikiō me ka cluster 7 (pololei medial frontal gyrus, r = 0.47, p = 0.047) a me cluster 9 (pololei parahippocampal gyrus, r = 0.52, p = 0.028) (Hōʻike 4).). ʻAʻole i hoʻoponopono nui ʻia ma waena o nā mea i hele a me ka makemake i ka pāʻani wikiō pūnaewele.
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o kēia hui kūkā
Hōʻike ka mea i loaʻa i kēia manawa i ka circuitly neural e hoʻopili ana i ka makemake cue-induction no ka pāʻani wikiō wikiō like ia me ka nānā ʻana ma hope o ka hōʻike ʻana o nā cue i nā poʻe me ka waiwai hilinaʻi a i ʻole ka palaka papa. I nā mea pāʻani a pau, aia nā wikiō pāʻani wikiō, i ka hoʻohālikelike ʻana i nā cue kūlohelohe, ʻike ʻia i nā hana maʻamau i ka corsex dorsolateral prefrontal cortex, parahippocampal gyrus, a me thalamus [6, 25]. I ka pane ʻana i nā cune wikiō wikiō, ua hoʻonui nui ʻia ka MIGP i ka hoʻōla ʻana o ka gyrus frontal gial kūpono maikaʻi (orbitofrontal cortex), gyrus preculate, parahippocampal gyrus, a me gypus lingualipali, a hoʻohālikelike ʻia me GP. Ma keʻano kūikawā, ka cortex dorsolateral, orbitofrontal cortex, parahippocampal gyrus, a me thalamus i pili me ka makemake no ka pāʻani wikiō wikiō.
Cortex Hoʻopuka Dorsolateral
E like me ka hōʻike ʻana ma nā mea maʻi me ka waiʻona, kokolapa, nikotine, a me ka pāʻani pūnaewele.10, 12, 13,14], cortolateral prefrontal cortex ua hana ʻia ma ka pane ʻana i nā cune game. Me nā hōʻike hōʻike o ka hoʻālaʻa ʻana o ka DLPFC e pane aku nei i ka cue ʻike i ʻike ʻia, ʻo Crockford et al [10] manaʻo ʻia ua ʻike ʻia nā kuhi nānā ʻike i ke ʻano he nui no ka nānā ʻana a me ka pono e uku ʻia. Ua ʻōlelo ʻo Barch a me Buckner, ua pili nā lau me nā hoʻomanaʻo hana.26]. He kuleana ko ka DLPFC e mālama a hoʻonohonoho i ka hōʻike ma ka hoʻopili ʻana i kēia ʻike loiloi i kēia manawa e hoʻomanaʻo nei i ka ʻike no ka wā ma mua e hana i ka hana kūpono i kuhikuhi ʻia [27, 28]. No laila, e hoʻomanaʻo paha nā ʻōkuhi wikiō pāʻani i mua o ka pāʻani pāʻani a pili pū ʻia me kahi hana o DLPFC.
ʻO ka Orbitofrontal cortex a me ka visuo-spatial hana hana hoʻomanaʻo
I ka pane ʻana i nā cune video wikiō, ua hoʻonui ʻia ka MIGP i ka hana o ke gyrus mua medial kūpono (orbitofrontal cortex), gyrus precentral, ka parahippocampal gyrus, a me ka gualus manawa biipital lingualoa, hoʻohālikelike ʻia me GP. ʻO ka mea mahalo, ua pili nā wahi a pau i hoʻāla ʻia me MIGP me ka hoʻomanaʻo hana visuo-spatial.29]. Hōʻike nā mea hoʻohana i ka cocaine i nā kiʻekiʻe kiʻekiʻe o ka hana prefrontal medial a me ka hoʻohaʻahaʻa haʻahaʻa kiʻekiʻe i ka pane ʻana i ka hōʻola o ka kokina, e hōʻike ana he paʻakikī i ka hoʻokaʻawale ʻana mai nā mea pili i nā lāʻau lapaʻau.29]. Eia kekahi, ʻo ka hana i ka cortex orbitofrontal a me ka parahippocampal gyrus i pili me ka makemake no ka pāʻani wikiō wikiō i kā mākou aʻo. ʻO ka hyperactive OFC i ka hana lawe lāʻau.15] a me ka amygdala hyper-sensitized a me hippocampus e pane ana i ka cue-hoʻopuka [30] ua hōʻike pinepine ʻia i nā mea maʻi me ka waiwai hilinaʻi. Eia kekahi, ua hōʻike ʻia hoʻi kahi kuʻikahi ma ka kaila hoʻoilo ʻike ʻike ʻia i nā mea pīpī pathological i hāʻawi ʻia i kahi ʻano cue-induced type [10]. Kūlike nā mea ʻike i kēia manawa me nā hopena i hōʻike ʻia ma nā mea maʻi me ka waiwai hilinaʻi. Ma o ka pili me nā striatum a me nā ʻāina kūloko e like me ka amygdala [31], ua manaʻo ʻia ʻo OFC e koho i nā ʻano kūpono e pane ai i ka hoʻoulu ʻana o waho a me ka hoʻōla ʻana i ka uku ma ka hana o nā hana i kuhikuhi ʻia.32]. Hiki i ka hiki o ka OFC ke wehewehe i ka hoʻoikaika nei no ka hoʻomau ʻana o ka pāʻani wikiō wikiō i ka papa mua.
ʻO gyrus Parahippocampal a thalamus
Ma kahi o ka hoʻopili ʻana i ka DLPFC a me OFC, ke nānā aku nei nā hāmeʻa wikiō e pili ana i ka nui o ka hana o ka gahus parahippocampal a me ka thalamus, a ʻo kēlā mau wahi i hōʻoia maikaʻi ʻia me ka makemake hōʻike. Kalivas me Volkow [6] kuhikuhi e pili ana i nā hana limu no ke aʻo ʻana a me ka hoʻomanaʻo ʻana. Hiki i nā cue nā hopena lapaʻau ke hoʻowalewale i ka makemake i nā mea maʻi me ka hāʻawi ʻana i ka lāʻau lapaʻau [33] a ʻo kēia hana hoʻoikaika i ka mea pili me ka pahuhopu uku dopamine [7] aʻo ka aʻo ʻana a me nā hana hoʻomanaʻo i loko o ka hippocampus a me ka amygdala [30, 34]. Aliʻi al35] ua hōʻike i ka hoʻāla ʻana o ka amygdala i nā kumuhana e pāʻani ana i nā pāʻani wikiō pā mua-kanaka. Eia kekahi, pane mai ka maʻi kino a me ka hoʻopiʻi i ka hōʻeuʻeu ʻana o ka ʻike no ka uku a i hoʻopaʻi ʻia paha e pili ana i ka ʻikepili i hoʻohālikelike ʻia i hāʻawi ʻia e ka amygdala. [36] ʻO ka amygdala a me nā hippocampus lākou ʻaʻole i hana ʻia i ka hoʻopaʻa ʻana i kēia manawa, hiki i ka hanana parahippocampal gyrus ke hōʻike i nā hana o ka amygdala, ʻoi aku ka hoʻomanaʻo-modulation i ka wā e hoʻāla ai nā hanana.37], a me ka hippocampus i ka hoʻomaopopo ʻana i nā loulou kahiko i ka hoʻomanaʻo ʻana i nā mea ʻike ʻike ʻike.38]
Me nā hōʻike e kākoʻo nei i kahi hui ma waena o dopamine a me nā ʻōnaehana uku ma ka pāʻani wikiō pālani wikiō [35, 36, 39, 40] E hiki ke hoʻomaka i ka pāʻani wikiō wikiō e pili ana i nā ʻōnaehana hoʻoikaika like e like me ka mea i hoʻokūkū i ka lāʻau lapaʻau a me ka inu ʻona. ʻO ka pilina ma waena o ka ʻōnaehana uku dopaminergic a me nā pāʻani wikiō pūnaewele i hōʻike ʻia ma mua o kahi noiʻi genetic ma mua.39] a me ka hoʻokuʻu ʻana o dopamine i loko o ka thalamus i ka pāʻani wikiō i hōʻike ʻia e Koepp [40].
hoʻokau
ʻO nā noi i kēia manawa he mau palena. ʻO ka mea mua, pono mākou i kahi hoʻohālike nui a me ka like ʻole (me nā wahine a me nā ʻōpio) no ka hōʻoia ʻana i ka pane pololei ʻana o ka lolo i ka pāʻani wikiō wikiō. ʻO ka lua, ʻaʻole mākou i hoʻohana i kahi mea diagnostic no ka nānā ʻana i ka paʻakikī o ka makemake no ka pāʻani wikiō pūnaewele, ʻoiai ua hoʻopili mākou i nā helu addict pūnaewele ʻo Young, ka nui o ka manawa pāʻani, a me nā pae hoʻokolohua kikoʻī o ka makemake. "ʻO ke kolu, ʻo ka loiloi i ka wā i ʻike ʻia ai ka ʻike nui ʻole e ʻike i ka hoʻōho a me ka hana ʻana i ka amygdala a me ka hana hippocampal e pane ai i ka pāʻani wikiō ma muli o ka hoʻomanaʻo o ka pāʻani pāʻani i ʻole a i ka makemake, ʻoiai ua ʻike mākou i kahi hopena koʻikoʻi ma waena o ka makemake a me ka lolo ka hana a ke pale ʻana no ka wā pāʻani holoʻokoʻa. Eia kekahi, manaʻo ʻia nā pane makemake e kūkulu ʻia ma lalo o ke kaʻina o ka pona a, e like me ia, e hōʻike ai i kahi hōʻailona koʻikoʻi o nā pilikia addictive [9]. Ma kēia noiʻi ʻana, ʻaʻole i loaʻa nā kumuhana i nā pāʻani wikiō pūnaewele akā ʻo nā kumumanaʻo i noi ʻia e pāʻani i kahi ʻano kikoʻī, a me nā pāʻani novel wale no nā lā 10. ʻAʻole hiki iā mākou ke koho i ʻole ka pane ʻana o ka lolo i ka hoʻoulu ʻana i ka pāʻani mai ka hopena i ka manaʻo noʻonoʻo i ka pāʻani pāʻani a i ʻole ka hoʻokaʻina mua o kahi papa hana hoʻowalewale i ka papa hana aʻo ʻana.41]. "
Panina
Hāʻawi ka haʻawina o kēia manawa i ka ʻike e pili ana i nā hoʻololi ʻana i ka lolo e kākoʻo i ka hoʻoulu ʻana e hoʻomau i ka pāʻani ʻana i kahi pāʻani wikiō pūnaewele i nā manawa mua. Hoʻokumu ʻia i nā haʻawina mua o ka cue-induced craving in substance abusers, ke ʻike nei ka ʻike i kēia manawa i ka neural circuitry e hoʻolilo i ka makemake cue-induction no ka pāʻani wikiō wikiō e like me ka nānā ma hope o ka hōʻike ʻana i ka cue i nā poʻe me ka waiwai hilinaʻi. Ma keʻano kūikawā, ʻike nā cues i nā hana maʻamau elicit i ka cortex prefrontal cortex dorsolateral, orbitofrontal cortex, parahippocampal gyrus, a me thalamus ..
mau hoomaikai ana
Hoʻolālā kālā a kākoʻo a me ka hoʻomaikaʻi
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Nāʻaoʻao hemahema
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E hoʻomaopopo '
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