Hōʻikeʻia ka Hōʻaho i nā Ui likeʻole i ka Haʻawina Maʻemaʻe i nā Haumāna me ka Hoʻopilikiaʻana i kaʻImi Pūnaewele a me ka Hui Pūnaewele Pūnaewele (2018)

. 2018; 9: 130.

Hoʻopukaʻia ma ka pūnaewele 2018 Apr 10. doi:  10.3389 / fpsyt.2018.00130

PMCID: PMC5902502

PMID: 29692743

Hōʻuluʻulu Manaʻo

Introduction

Kūleʻa ka pāʻani pūnaewele ma ka Pūnaewele (IGD) a me ka pili o ka panakena (GD) e like me nā hiʻohiʻona like o ka maʻi akā e hōʻike i nā ʻōnaehana like ʻole o ka lolo. Ua ʻike ʻia ʻo Bupropion ka maikaʻi no ka mālama ʻana i nā maʻi i ka IGD a me GD. Ua hypothesized mākou e kūpono paha ka bupropion no ka mālama ʻana i ka maʻi pakanō pūnaewele ʻolele (ibGD) a me IGD a me nā pilina ma waena o ka pūnaewele mode default (DMN) a me ka ʻike cognitive control (CCN) ʻokoʻa i waena o nā maʻi ibGD a me IGD ma hope o 12 nā lā pule o ka bupropion.

Nā Papahana

Ua hōʻemi ʻia nā maʻi 16 me IGD, 15 nā maʻi me ka ibGD, a me nā kumuhana ololi 15 i kēia noiʻi. Ma ka papa hana a ma hope o ka wiki he 12 o ka mālama bupropion, ua loiloi ʻia nā hōʻailona lapaʻau o nā mea maʻi me ka IGD a i ʻole IbGD, a loiloi ʻia ka hana o ka lolo me ka hoʻohana ʻana i ka hoʻomaha ʻana i ka hoʻokō magnetic resonance imaging.

Results

Ma hope o ka mālama ʻia ʻana o ka bupropion 12-pule, nā maʻi maʻi, me ka hōʻeha ʻana o ka IGD a i ʻole GD, nā hōʻailona kaumaha, ka nānā ʻana, a me ka impulsivity i hoʻomaikaʻi ʻia i nā hui ʻelua. Ma ka pūʻulu IGD, ka pilina pili me (FC) i loko o ka DMN posterior e like me ka FC ma waena o DMN a me CCN i hōʻemi ʻia ma hope o ka mālama ʻana. Eia kekahi, ʻo FC i loko o ka DMN i ka pūʻulu IGD ua hoʻopili maikaʻi ʻia me nā loli me nā pae liʻiliʻi o ka Internet Internet Addiction Scale ma hope o ka manawa mālama o ka bupropion. I ka hui ibGD, ua emi iho ka FC i loko o ka DMN i ka wā o ka FC i loko o ka CCN ma hope o ka manawa mālama o ka bupropion. Eia kekahi, ʻo FC i loko o ka CCN i ka hui ibGD ua ʻoi aku ka nui ma mua o ka pūʻulu IGD.

Panina

Loaʻa ʻo Bupropion i ka hoʻomaikaʻi ʻana i nā hōʻailona lapaʻau i nā poʻe maʻi me ka IGD a me nā IbGD. Eia naʻe, ʻokoʻa nā mea ʻokoʻa i loko o ka pharmacodynamics ma waena o nā hui ʻelua. Ma hope o nā wiki he 12 o ka mālama bupropion, ʻo FC ma loko o ka DMN e like me ka DMN a me CCN a emi i loko o nā mea maʻi me IGD, aʻo ka FC i loko o ka CCN i hoʻonui nui ʻia i nā maʻi me ka ibGD.

Keywords: Kuhi pūnaewele hoʻoili pūnaewele, pilikia o ka pāʻani, bupropion, pūnaewele ukaʻi, ke kikowaena kākā

Introduction

ʻO ka pāʻani pūnaewele Pūnaewele ke ʻano hoʻololi o ka pili ʻana i ka hoʻohana ʻana i nā polokalamu pono e pili ana i ka Pūnaewele, ʻo ia hoʻi nā kamepiula, kelepona kelepona hele, a me nā kīʻaha kelepona (, ).). Ma muli o nā hiʻohiʻona o nā ʻōnaehana pūnaewele e like me ka wikiwiki a me ka maʻalahi o ka mea i maʻalahi, hiki i ka ʻōnaehana pūnaewele ka loaʻa ʻana o ka ʻōnaehana wikiwiki wikiwiki a hoʻolako i ka maʻalahi o nā koho koho hoʻololi ʻole (, ).). I nā mau makahiki he iwakālua i hala aku nei, ua manaʻo ʻia ka maʻi pā pāʻani Pūnaewele (IGD) i kahi maʻi noʻonoʻo i ka ʻano o ka hoʻolalelale ʻana no ka pāʻani (pāʻani āpau, ke pāʻani ʻana, ka manawa pāʻani nui, a me nā hopena hōʻino.).). Ma muli o nā like like ma waena o ka IGD a me ka pelekikena pili pūnaewele holoʻokoʻa (ibGD) me ka mahalo i nā hōʻailona kino o ka hoʻohana nui ʻana a me nā hopena pōʻino ʻē aʻe, ua manaʻo kekahi mau noiʻi e like me ka IGD e like me ka ibGD ().). Ma muli o kēia mau hiʻohiʻona diagnostic, nā lāʻau lapaʻau no ka palaka pila (GD), me ka escitalopram a me ka bupropion, ua hoʻopili ʻia hoʻi me ka IGD (-).). Eia nō naʻe, ua manaʻo ʻia ka paio e pili ana i ka helu ʻana o ka IGD he mea hoʻohui a ʻoki poʻokela paha e kū ka mana (, , ) e like me nā ʻokoʻa ma ka ʻili o ka hana noʻonoʻo (FC) i loko o ka pūnaewele cognitive ma waena o nā maʻi ʻelua ().). No laila, ua hoʻohālikelike ka hoʻohālikelike o nā hopena o ka lāʻau lapaʻau ma nā maʻi ʻelua.

I waena o nā lāʻau lapaʻau ʻike ʻia ka mea kūpono no ka hōʻemi ʻana i nā hōʻailona o GD (, ), ua hōʻike ʻia ʻo bupropion e hoʻomaikaʻi i nā hōʻailona o ka IGD (, ).). Maikaʻi ʻo Bupropion no ka mālama ʻana i nā maʻi me ka GD ma ka hoʻohaʻahaʻa ʻana i ke ʻano o nā pāʻani pili a me ka nui o nā kālā i lilo (, ).). ʻEleʻele al. (() ua hōʻike a ua kūpono ʻo bupropion a ua hōʻoluʻolu maikaʻi ʻia i nā mea maʻi me ka GD ().). Dannon et al. (() ua noi aku e ʻoi aku ka maikaʻi o ka bupropion e like me ke naltrexone e kau ana i ka hana o ka hoʻoponopono i ka hoʻokuʻu dopamine. Hoʻopili ka Bupropion i ka hoʻoneʻe ʻana i ka dopamine a me ka norepinephrine ma o ka hoʻoulu ʻana i ka acetylcholine, hydroxytryptamine, ka leo hauma aminobutyric receptor, a me ka endorphin hōʻailona ().). E pili paha kēia mau ʻōnaehana neurochemical i ka ʻūhā, nānā nui, a me ka leʻaleʻa e hele pū ana me nā ʻano lawaiʻa a me ka hoʻohui ʻana i nā lāʻau hōʻeuʻeu.).). Hiki i ka opioid antagonist naltrexone ke ālai i ka hoʻokuʻu ʻia dopamine-wai a ke kumu i loko o ka ulu ʻana o nā nucleus, e hōʻemi ana i ka makemake o ka waiʻona a paipai i ka haʻalele ʻana ().). Ua hōʻike nā haʻawina e hiki i ka bupropion ke hoʻomaikaʻi i nā hōʻailona o ka IGD ma ka hoʻomaikaʻi ʻana i nā hōʻailona mau hoʻopalapula comorbid a me ka hoʻouluʻana i nā loli i ka hana lolo (, ).). Ua hōʻike ʻia he mau ʻumikūmālua ʻumikūmālua o ka mālama bupropion e hoʻomaikaʻi i nā hōʻailona IGD e like me nā hōʻailona kaumaha i nā mea maʻi me nā maʻi kaumaha kaumaha a me ka IGD ().). Ma kekahi haʻawina, ʻo 6 wiki o ka mālama bupropion i hōʻemi loa i ka hōʻeha o ka IGD ma ka hoʻohaʻahaʻa ʻana i ka hana o ka lolo i loko o ka cortex cortex dorsolateral i pane i ka hoʻoulu ʻana i ka pāʻani ().

Ma kā mākou noi mua i hoʻohālikelike ʻia i ka pili ʻana o ka lolo o ka pūnaewele mode mode (DMN) a me ka ʻike cognitive control network (CCN) ma waena o IGD a me ibGD, ua hōʻike nā hui ʻelua i ka emi like o FC ma DMN. Eia nō naʻe, ua hoʻonui ʻia ʻo FC i loko o ka CCN i ka pūʻulu IGD akā ʻaʻole ka hui ibGD ().). Wahi a ka DMN i nā mahele hui pū ʻia i hui pū ʻia i ka wā hana a hana i ka wā hoʻomaha (ka hana)).). Manaʻo ʻia ka DMN e pili ana i ka posterulate cingulate cortex (PCC), precuneus, cortex frontal cortex (mPFC), ventral anterior cingulate cortex (ACC), a me ka lateral (LP) a me ka lobes parietal inferior (IP) ().). I nā mea maʻi me ka hilinaʻi mea nui, ua kū maikaʻi ʻia ka lolo ʻo FC i loko o ka DMN me ka impulsivity ().). I loko o nā maʻi me GD, hoʻemi i ka FC i loko o ka DMN mai PCC i ka gyrus frontal gialus maikaʻi, kipi waena waena kūpono, a ua hōʻike ʻia ka precuneus. Eia kekahi, ʻo ka paʻakikī o GD ua hoʻopili maikaʻi ʻia me ka FC mai ka PCC huaʻa a precuneus ().). Eia nō naʻe, ua hōʻike ʻia nā haʻawina mua ma FC i loko o ka DMN a IGD., ).). ʻO ka FC i waena o nā ʻaoʻao o ka DMN i nā maʻi me nā IGD ua hōʻemi ʻia ().). Ma ka hoʻohālikelike ʻana, hoʻonui ʻia ʻo FC ma waena o ka DMN a me ka ʻoihana salience i nā mea maʻi me ka IGD ().

Hoʻopili ʻia ka CCN me ke kaʻina o ka hoʻohana ʻana i nā hana koʻikoʻi, me ka nānā ʻana, hoʻolālā, a me ka hoʻomanaʻo ʻana no ka alakaʻi ʻana i nā ʻano kūpono e hoʻokō pono i nā pahuhopu kūikawā ().). E pili ana i nā wahi dorsal o ka cortex prealontal cortex (DLPFC), ACC, a me ka cītī parietal ().). Aia ka pili ʻana o ka pāʻani pili a me ke pāʻani pūnaewele pūnaewele i ka hoʻoholo ʻana i ka hoʻoholo i ka manaʻo.), ua manaʻo kekahi mau loea e pili ana i ka FC i loko o ke CCN e pili pū me ka pāʻani a me ka IGD ().). Eia kekahi, ke hakakā a me ka maopopo ʻole mai ka hopena o ka hoʻoholo i ka hoʻoholo i ka wā hana hana hiki ke hoʻōla i ka cortex cortex dorsal ().

Ua hypothesized mākou e kūpono paha ka bupropion no ka mālama ʻana iā ibGD a me IGD. Eia nō naʻe, ʻokoʻa ka ʻano o ka hana o ka bupropion ma ka mālama ʻana i ka ibGD a me ka IGD ma ka ʻōlelo o ka pilina o ka lolo ma waena o DMN a me CCN. Ua hōʻike mākou i ka hoʻōho o ka bupropion ma waena o ka DMN a me CCN i ka hui o IGD, akā e hoʻonui i ka FC i loko o ka CCN i ka hui ibGD.

Nā Pono a me nā Una

i komo

ʻO nā mea maʻi 15 me nā maʻi IGD a me 14 me nā ibGD i komo i loko o kā mākou noiʻi mua e hoʻohālikelike ana i ka hoʻohui palekikena (), Nā maʻi maʻi 12 me IGD a me 12 nā mea maʻi me ka ibGD ʻae i komo i kēia noiʻi. Eia kekahi, ʻehiku nā mea maʻi me ka IGD a me nā mea maʻi ʻeono me ibGD i kipa aku i ka keʻena outpatient o ka haukapila OO i hōʻea hou i kēia noiʻi (Kiʻi. (Figure1) .1).). Ua nānā ʻia nā mea āpau a me ke kūkākūkā a me ka papa hana DSM-IV no ka nānā ʻana i ka comorbidity psychiatric ().). I ka wā hoʻolimalima, ʻekolu mau mea maʻi me ka IGD a ʻekolu mau mea maʻi me ka ibGD ua emi i lalo no ka hopena o ka hopena a me ka hoʻololi i ka lāʻau lapaʻau. I ka hopena, ʻo 16 nā mea maʻi me ka poʻe maʻi IGD a me 15 me ka IbGD i hoʻopau i ka protocol study (Figure (Figure1) .1). Penei nā pae hoʻohālikelike: (1) ʻike ʻia me ka IGD e pili ana i ka DSM-5 a i hoʻoholo ʻia paha e loaʻa i ka ibGD. Ua hoʻohana mākou i nā pae hoʻohālikelike o ka GD a ua hoʻololi iā ia e hana i nā pae hoʻohui no ibGD, akā ua hoʻololi i ka "piliwaiwai pilikia" i ka DSM-5 i "ibGD," (2) makua (> 18 mau makahiki), (3) kāne, a me (4) ka lāʻau psychiatric-naif. Penei nā pae hoʻohālikelike: (1) nā maʻi olakino a psychiatric paha, (2) haʻahaʻa haʻahaʻa (IQ) (ʻoi aku ma mua o 80), (3) contraindications no ka loiloi MRI e like me claustrophobia a me metant implantation, a (4) ka mōʻaukala o ka hōʻino ʻana i nā lāʻau a koe wale nō ka inu lama ʻona ʻana a me ka puhi baka ʻana.

 

He faila waho e paʻa ana i kiʻi, kiʻi, a me nā inoa Object he fpsyt-09-00130-g001.jpg

Ke kaʻina noiʻi. He hōʻuluʻulu: IGD, Pūnaewele Ke Ana Pūnaewele; ibGD, pilikia pili i ka Pūnaewele; D / O, hiolo mai; fMRI, hoʻokō uila i nā meʻa resonance pilikino.

Ke Kaʻina hana

Ma ka papa ʻōlelo, ua noi ʻia nā mea a pau e hoʻopiha i nā nīnau no ka ʻike demographic a me nā hōʻailona lapaʻau. ʻO ka hōʻike koʻikoʻi o ka IbGD a me IGD i loiloi ʻia me ka Yale-Brown Obsessive Compulsive Scale no ka papa ʻalani pathologic (YBOCS-PG) () a me nā pāpaho ʻōpio Pūnaewele Pūnaewele (YIAS) () ae ia no hoi. ʻEhā hou ʻia nā unuhi kaulike hōʻailona no nā maʻi āpau: ʻo ka Beck Depression Inventory (BDI) () no nā hōʻailona hoʻohālikelike, ke kaumaha o ka ADHD Rating Scale (K-ARS) () no ka nānā ʻana i ka hōʻailona, ​​a me nā ʻōnaehana hoʻoili pono ʻana o ka ʻōnaehana a me nā ʻōnaehana hoʻoweliweli ʻana e hoʻōla ai no ka pale a me ka hoʻoweliweli.).). Ua aʻo ʻia ka IQ o nā mea hoʻohana a pau me ka hoʻohana ʻana i ka Korean-Wechsler Adult Intelligence Scale ().). Eia kekahi, ua nānā ʻia nā mea āpau e nānā i ka lolo o FC Via hoʻomaha hoʻomaha kūlana hana magneton resonance imaging (rs-fMRI). Ua hoʻomaka ʻia nā mea maʻi me ka IGD a me ka IbGD ma ka bupropion SR 150 mg / lā, a laila hoʻohui ʻia i 300 mg / lā. ʻO ka hoʻoholo i ka hoʻoponopono ʻana i ka ʻimi holo ʻia e kekahi psychiatrist (Doug Hyun Han) i ka lua o ka pule o ka wiki ma ke kumu o ka hoʻomanawanui a me ka hana ʻana. I ka pau ʻana o nā wiki o 12 o ka mālama bupropion, ua hōʻike hou ʻia nā kaulike lapaʻau a me nā ʻōiwi rs-fMRI i nā hoa āpau (Kiʻi. (Figure1) .1).). Ua apono ʻia ka Papa Hoʻonaʻau Hōʻikeʻike Hōʻikeʻike Chung-Ang University i ka ʻōna noiʻi no kēia noiʻi, a ua hāʻawi ʻia ka ʻae hoʻomaopopo a nā poʻe i komo.

MRI Kumukuai a me ka Hana Kahi

E nānā ʻia o Brain FC ma ka hoʻomaha hoʻomaha, me ka hoʻohana ʻana o 3 T koko-oxygen-level depend MRI (Philips Achieva 3.0 T TX MRI scanner; TR = 3 s; ka manawa nānā, 12 min; ka nui o 240; 128 × 128 matrix; 40 ʻokoʻa ma 4.0 s; kahi hihihi 3-mm mauʻu). ʻO ka hana mua i ka hoʻowahāwahā ʻia (AFNI: 12dDespike), neʻe ʻeke (SPM 12b), ka manawa e hoʻokaʻawale ai i ke kiʻi ʻo Magnetization Hoʻomaʻamaʻa ʻia ʻo RApid Gradient Echo (SPM 12b), normalization i ka wahi MNI (SPM XNUMXb), ka hoʻihoʻi kino (Matlab: detrend.m) kānana. a me nā ʻūlū palā helehelena (Matlab) e like me ka mea i hōʻike mua ʻia ().). Ke kū nei i ka hiki o ka hoʻāla o ke poʻo micro-poʻo e pili ana i nā hopena pili.), censoring o nā kiko manawa me ka neʻe poʻo> 0.2 mm i hana ʻia, akā ʻaʻole hana regression o ka hōʻailona honua ().

Ua kiʻi mākou i nā ʻāina ʻo 12 o ʻelua mau ʻekepili o ka lolo [ʻehā mai ka DMN: mPFC, ʻākau a hema a waiho ʻia parietal cortex (LPRt / LPLt), a me PCC; ʻewalu mai ka CCN: ʻākau / hema DLPFC (DLPFCRt / DLPFCLt), ʻākau / hema hema PFC (IFGRt / IFGLt), pololei / hema posterior parietal cortex (PPCRt / PPCLt), a me ka ʻaoʻao / hema motor presupplemente] mai ka AAL atlas o ka lolo (pūnaewele.nii / .txt / .info). Ke hoʻohana nei i ka pahu hana hoʻohui pūnaewele CONN-fMRI (ver.15; www.Nitrc.org/projects/conn), Ua helu ʻia nā coefficients hoʻopili hoʻololi ʻia e Fisher no kēlā me kēia ʻāpana o ka hoihoi i kēlā me kēia kumuhana. Ua manaʻo ʻia nā hopena ma waena o ka hui me ka nui o ka loaʻa ʻana o ka pae cluster pae pae (FDR) q <0.05, e noʻonoʻo ana i ka hoʻoponopono hoʻohālikelike he nui no ka hoʻoponopono ʻana o 66 mau pālua o 12 mau ʻāina.

LIKE

Nā hōʻike Demographic a me nā hiʻohiʻona o ka IGD, ibGD, a me nā haʻawina hoʻohālikelike olakino e loiloi ʻia me ka hoʻohana ʻana i ka ʻano o ka hoʻololi (ANOVA) i ʻike ʻia me nā helu helu helu i kau ʻia ma p <0.05. Ua loiloi ʻia nā pilina ma waena o nā kaulike lapaʻau a me ka pilina o ka lolo me ka hoʻohana ʻana i ka pilina Spearman me ka helu helu helu i kau ʻia ma p <0.05. Ua hoʻokō ʻia nā loiloi helu āpau me ka hoʻohana ʻana iā SPSS 18.0 (SPSS Inc., Chicago, IL, USA).

Results

ʻO nā hoʻololi i nā ʻōkuhi Clinical Ma hope o 12 Weeks o ka Hoʻōho Bupropion

Ma ka papa haʻahaʻa, ʻaʻohe ʻokoʻa o ka ʻokoʻa o ka makahiki, nā makahiki hoʻonaʻauao, a me IQ ma waena o nā mea maʻi IGD, nā maʻi maʻi ibGD, a me nā kumuhana hoʻohālikelike olakino. Eia nō naʻe, aia nā mana nui i BISBAS (F = 6.56, p <0.01), BDI (F = 4.68, p = 0.02), K-ARS (F = 24.09, p <0.01), YIAS (F = 70.94, p <0.01), a me YBOCS-PG (F = 82.68, p <0.01) helu ma waena o nā pūʻulu ʻekolu. ʻO ka mahope iho hōʻike ʻole ka hōʻike hōʻike ʻole ʻokoʻa i waena o nā BDI, K-ARS, a me BISBAS nā hōʻailona ma waena o nā hui IGD a me nā ibGD. ʻOi aku ka nui o nā helu YIAS ma ka hui IGD ma mua o nā mea i ka hui ibGD (z = 4.58, p <0.01) ʻoiai ʻo nā helu YBOCS-PG i ka hui ibGD i ʻoi aku ma mua o nā mea i ka hui IGD (z = 4.60, p <0.01) (Pākaukau (Table11).

1 Pūnaewele

Nā hiʻohiʻona a me ke kumu lāʻau.

 IGD_pHGGHC
 
 
 ʻO BaselineNānā houʻO BaselineNānā hou 
makahiki25.3 ± 5.225.0 ± 4.925.7 ± 4.7
Makahiki hoʻonaʻauao12.8 ± 2.612.1 ± 2.513.1 ± 2.3
IQ99.0 ± 12.597.7 ± 15.3103.8 ± 9.9
Alika (ʻae / ʻaʻole)10/610/512/3
Lōheʻe (ʻae / ʻaʻole)8/89/68/7
BDI9.7 ± 56.25.7 ± 2.814.1 ± 8.39.4 ± 3.46.1 ± 4.2
K-ARS13.0 ± 4.59.3 ± 3.118.8 ± 7.714.4 ± 4.95.4 ± 3.4
BISBAS47.6 ± 4.947.6 ± 4.950.7 ± 6.050.7 ± 6.049.0 ± 8.1
YIAS68.9 ± 8.854.8 ± 8.238.3 ± 9.036.5 ± 7.437.6 ± 6.6
YBOCS-PG5.7 ± 2.25.1 ± 1.817.8 ± 4.612.2 ± 4.34.1 ± 1.8
 

IGD, Pūnaewele Ke Alanui Pūnaewele; ibGD, kahua pili i ka pāʻani pūnaewele. HC, nā kumuhana hoʻohālikelike olakino; IQ, ka ʻike naʻau; BDI, Beck Depression Inventory; K-ARS, Kalena ADHD Rating Score; BISBAS, Pūnaehana Pelekikena Pelekikena Polokalamu Hoʻohālikelike ʻAmelika; YIAS, ʻōpio Hoʻohui Pūnaewele ʻIke Pūnaewele; YBOCS-PG, Scale Compulsive Scale no Yale-Brown no ka pāʻani petologic.

Ma hope o ka mālamaʻana o ka Bupropion 12-pule, ka BDI (z = −2.68, p <0.01), K-ARS (z = −2.81, p <0.01), BISBAS (z = −2.81, p <0.01), a me YIAS (z = −2.81, p <0.01) hoʻomaikaʻi ʻia nā helu ma ka hui IGD ʻoiai ka BDI (z = −2.09, p = 0.04), K-ARS (z = −2.81, p <0.01), BISBAS (z = −2.81, p <0.01), a me YBOCS-PG (z = −2.80, p <0.01) hoʻomaikaʻi ʻia nā helu ma ka hui ibGD. Eia nō naʻe, ʻaʻohe ʻano ʻokoʻa waena e pili ana i nā hoʻololi ʻana i nā unahi o ka maʻi i loko o ka manawa he 12 mau pule (Papa (Table11).

ʻO nā hoʻololi i ka Brain FC Ma hope o 12 Weeks o ka Hoʻōmi Bupropion

I loko o ka hui IGD ma ka papa kuhikuhi, ʻo ka FC ma waena o ka MPFC a me IFGLt (t = 3.39, FDRq = 0.0026), DLPFCLt a me LPRt (t = 3.34, FDRq = 0.0030), a me PPCLt a me IFGRt (t = 3.67, FDRq = 0.0013) ʻoi aku ka kiʻekiʻe ma mua o nā mea olakino. Ma hope o 12 mau pule o ka mālama ʻana i ka bupropion, ʻo ka FC ma waena o ka PCC a me LPRt (t = −3.26, FDRq = 0.0017), LPRt a me PPCRt (t = .3.16, FDRq = 0.0023), a me LPRt a me PPCLt (t = .3.42, FDRq = 0.0012) ʻoi aku ka haʻahaʻa ma mua o ka laina haʻahaʻa (Kiʻi (Figure22).

He faila waho e paʻa ana i kiʻi, kiʻi, a me nā inoa Object he fpsyt-09-00130-g002.jpg

ʻO nā hoʻololi i loko o ka hana noʻonoʻo palepona ma hope o nā wiki 12 o ka mālama bupropion. ʻUlaʻula: hoʻonui i ka pilina hana lawelawe (FC), laina uliuli: hōʻemi i ka FC, I ka pūʻulu IGD ma ka papa palena, ka hana hoʻonaninani ma waena o gyrus frontal waena (MPFC) a waiho i kahi hema cortex preferontal (IFGLt) (t = 3.39, FDRq = 0.0026), left dorsolateral prefrontal Cortex (DLPFCLt) a me ka ʻaoʻao ʻākau parietal Cortex (LPRt) (t = 3.34, FDRq = 0.0030), a me ka posterior parietal Cortex (PPCLt) a me IFGRt (t = 3.67, FDRq = 0.0013). Ma 12 mau hebedoma, ka hoʻopili ʻana o ka hana ma waena o ka hope cingulate cortex (PCC) a me LPRt (t = −3.26, FDRq = 0.0017), LPRt a me PPCRt (t = .3.16, FDRq = 0.0023), a me LPRt a me PPCLt (t = −3.42, FDRq = 0.0012). I ka pūʻulu ibGD i ka palena palena, ka hoʻopili hana ma waena o ka PCC a me LPLt (t = −3.36, FDRq = 0.0014), PCC a me LPRt (t = −3.26, FDRq = 0.0027). Ma 12 mau hebedoma, ka hoʻopili hana ma waena o ka PCC a me PPCLt (t = −3.23, FDRq = 0.0031), PCC a me PPCRt (t = −3.25, FDRq = 0.0031). Ka hoʻopili hana ma waena o ka PPCLt a me ka PPCRt (t = 3.12, FDRq = 0.0042). I ka hoʻohālikelike IGD vs ibGD (ka loiloi pinepine ʻana o ka ʻokoʻa), ua hōʻike ka hui ibGD i ka hoʻonui FC ma waena o IFGRt a me PPCLt (F = 3.67, p = 0.0013), hoʻohālikelike ʻia me ka hui IGD.

Ma ka hui ibGD ma ka pae palena, ʻo ka FC ma waena o ka PCC a me LPLt (t = −3.36, FDRq = 0.0014) a me PCC a me LPRt (t = −3.26, FDRq = 0.0027) haʻahaʻa ma mua o kēlā i nā kumuhana olakino. Ma hope o 12 mau pule o ka mālama ʻana i ka bupropion, ʻo ka FC ma waena o ka PCC a me PPCLt (t = −3.23, FDRq = 0.0031) a me ka PCC a me PPCRt (t = −3.25, FDRq = 0.0031) ua hoʻemi ʻia ʻoiai ma waena o PPCLt a me PPCRt (t = 3.12, FDRq = 0.0042) ua hoʻonui ʻia i ka hoʻohālikelike ʻia me ka laina haʻahaʻa (Kiʻi (Figure22).

Ua hōʻike ʻia kahi hana ANOVA e hōʻike ana ka hui ibGD i hoʻonui ʻo FC ma waena o IFGRt a me PPCLt (F = 3.67, p = 0.0013), hoʻohālikelike ʻia me ka hui IGD (Kiʻi (Figure22).

Ke hoʻoponopono ʻana ma waena o nā hoʻololi i nā kaulike Clinical a me nā hoʻololi i ka Brain FC

Ma ka pūʻulu IGD, hoʻoponopono maikaʻi ʻia ka hana ma waena o PCC a me LPRt me nā loli ʻana i nā helu YIAS mai ka palena o ka wiki i 12 (r = 0.69, p <0.01). I ka hui ibGD, ua hoʻololi maikaʻi ʻole nā ​​hoʻololi o FC ma waena o ka PPCLt a me ka PPCRt me nā hoʻololi o nā helu YBOCS-PG mai ka palena mua a i nā 12 mau pule (r = −0.68, p <0.01) (Kiʻi (Figure33).

 

He faila waho e paʻa ana i kiʻi, kiʻi, a me nā inoa Object he fpsyt-09-00130-g003.jpg

ʻO ka hoʻoponopono ʻana ma waena o nā loli i nā kaulike lāʻau lapaʻau a me nā loli o ka pili ʻana o ka hana noʻonoʻo. (A) Ma ka hui pū pāʻani hoʻoili pūnaewele Pūnaewele (IGD), ka pilina pili ma waena o ka cortex posterior cingort (PCC) a me ka hope parietal cortex (LPRt) i hōʻoia maikaʻi ʻia me nā loli i nā pae liʻiliʻi ʻo Young Internet Addiction Scale mai ka papa lalo i ka wiki 12 (r = 0.69, p <0.01). (B) I loko o ka hui ibGD, nā hoʻololi i waena o FC ma waena o ka cortex parietal hema hema (PPCLt) a me nā pihi kahunaetal cortex ʻokoʻa (PPCRt) i kūwaho maikaʻi ʻole me nā loli i ka Yale-Brown Obsitive Compulsive Scale no nā pathologic gaming (YBOCS-PG) i loaʻa baseline a 12 wiki (r = −0.68, p <0.01).

kūkākūkā

ʻO nā hoʻololi i nā maʻi Kānāwai i loko o ka pane ʻana i ka mālama ʻana i ka Bupropion

Ma kēia noiʻi ʻana, ʻoi aku ka maikaʻi o ka mālama ʻia ʻo 12-bupropion ka hōʻeha ʻana o ka IGD a me nā ibGD a me nā hōʻailona e pili ana i nā maʻi ma nā maʻi ʻelua. ʻO ka hopena o ka bupropion no ka mālamaʻana no ka IGD ua hōʻike ʻia ma nā haʻawina mua., ).). Ua hōʻike ʻia he mau ʻumikūmālua ʻumikūmālua o ka mālama bupropion e hōʻemi i ka nui o ka IGD a me nā hōʻailona mau loa i nā mea maʻi IGD me ka maʻi kaumaha koʻikoʻi ().). No ka hoʻohālikelike o ka hoʻolālā escitalopram a me ka bupropion, hōʻike ka bupropion i ka ʻoihana nui aʻe i ka hoʻomaikaʻi ʻana i ka impulsivity a me ka nānā ʻana ().). ʻO ka uluʻana o ka bupropion i nā maʻi me ka GD he manaʻo i ka hoʻopaʻapaʻa (, ).). ʻOiai ʻO Black et al. (() ua hōʻike i ka hana pono a me ka hāʻawi ʻana i ka bupropion i nā maʻi me ka GD, ʻoi aku ka maikaʻi o ka hōʻemi ʻana i ka hōʻailona o ka GD ʻaʻole iʻoi aku ma mua o ka plasebo ().). Eia nō naʻe, Dannon et al. (() i hoʻolaha aku o ka bupropion e like me ka maikaʻi loa me ka naltrexone i nā mea maʻi me GD ().). Ma muli o ka hana ʻelua o ka bupropion me nā mea e hoʻopiʻi ai i ka norepinephrine a me ka hoʻoulu hou ʻana i ka dopamine, ua manaʻo ʻia he mea kūpono ia no ka hoʻohaʻahaʻa ʻana i ka hewa maʻa i nā mea maʻi IGD a me nā IbGD (, ).). ʻO ka impulsivity kahi pilina kaulana loa o nā mea hoʻohui prototypical me ke ʻano kiʻekiʻe o nā uku i neʻe ʻia ().). ʻO kēia hōʻemi kiʻekiʻe o ka uku i hoʻokuʻu ʻia e pili ana me ka ʻōnaehana neuromodulatory e pili ana i ka dopamine.).

ʻO nā hoʻololi i ka Brain FC Ma hope o 12 Weeks o ka Hoʻōmi Bupropion

Ma ka pane i nā wiki o 12 o ka mālama bupropion, ʻo FC i loko o ka DMN e like me ka mea ma waena o DMN a me CCN ua emi i loko o ka pūʻulu IGD, aʻo ka FC i loko o CCN e hoʻonui i ka hui ibGD. Hōʻike nā pūʻulu IGD a me nā ibGD i nā ʻōhua like ʻole o ka FC i pane i ka mālama ʻana i ka bupropion. Ma ka pūʻulu IGD, ʻo FC i loko o ka DMN posterior e like me ka FC ma waena o ka DMN a me CCN a emi i lalo o ka hopena mālama 12-pule. Eia kekahi, ʻo FC ma waena o PCC a me LPRt i ka pūʻulu IGD me ka hoʻomaikaʻi maikaʻi ʻia me nā loli i ka YIAS ma hope o ka manawa mālama ʻia ʻo 12-pule pule. Ua kūlike kēia mau hopena i kā mākou noi ʻana ma mua e hōʻike ana i ka hoʻemi ʻana o FC i loko o ka DMN a ma waena o ka DMN a me ka network salience ().). ʻO ka hoʻokaʻawale ʻana ʻo FC ma loko o ka DMN e pili ai me ka nui norepinephrine a me ka dopamine, e like me ka nānā ʻana ma DMN i ka pane ʻana i ka hoʻokele o ka atomoxetine ().). ʻO ka hana ʻelua o ka bupropion i ka hoʻonui ʻana i ka norepinephrine a me ka hōʻailona dopamine e like me ka hana o ka modafinil ().). Ua manaʻo ʻia ka nui o ka FC i loko o ka DMN e pili me ka impulsivity, pilikia i ka hoʻoholo, a me ka nānā ʻana (, ).). No laila, ʻo ka hoʻohaʻahaʻa ʻana i ka FC ma waena o ka DMN a me ka FC ma waena o ka DMN a me nā pūnaewele ʻē aʻe i hiki ke hōʻemi i ka ʻano hoʻomālamalama, e like me ke ʻano o ka pāʻani ʻana i ka pāʻani o ka Pūnaewele a i ʻole ka palaka.

I ka hui ibGD, ua emi iho ka FC i loko o ka posterN DM poster i ka manawa i hoʻonui ʻia i loko o ka CCN ma hope o ka manawa mālama ʻia ʻo 12-pule bupropion. Eia kekahi, ʻo ka FC i loko o CCN (IFGRt - PPCLt) i ka hui ibGD, ʻoi aku ka kiʻekiʻe ma mua o ka pūʻulu IGD. ʻO ka FC i loko o ka CCN (PPCLt - PPCRt) i loko o ka pūʻulu IGD ua hoʻopololei maikaʻi loa ʻia me nā loli i nā helu YBOCS-PG ma hope o ka manawa mālama ʻia ʻo ka 12-pule bupropion. ʻO ka hana ʻole o ka hoʻoponopono ponoʻī ʻana i ka poʻe maʻi me ka GD i manaʻo ʻia e hiki mai ana ma muli o ka nele ʻana i ka mana hoʻomalu prefrontal-mediated.).). Hoike ʻia ka luna kiʻekiʻe i luna e pili me nā hala o ka hoʻoholo.) me ka hoʻouka dopamine ().). Eia kekahi, ʻo nā ʻāpana o nā cortices fronto-parietal e pili ana i ka makaʻohi a ma luna o ka mālama cognitive ().). No laila, hiki i ka hana pharmacodynamic o bupropion (dopamine stimulation) ke hoʻoikaika i ka CCN (fronto-parietal mau wahi) ma o ka hoʻolaha ʻana i ka hana ma loko o ka lula o ka pae i lalo o ka poʻe maʻi me ka ibGD. Lawe ʻia i ka ʻike, e ʻike ʻo IGD a me ibGD e like like me ka hoʻohaʻahaʻa i ka impulsivity a hoʻemi ʻia ʻo FC ma loko o ka DMN ma hope o ka mālama bupropion. Eia naʻe, ʻoi aku ka maikaʻi o ka bupropion ma ka hoʻonui ʻana o ka FC i loko o CCN, ka mea i pili me ka hoʻoponopono ʻana i nā hala hoʻoholo.

hoʻokau

Nui nā palena i kēia noiʻi. ʻO ka mea mua, liʻiliʻi ka helu liʻiliʻi o nā kumuhana e hoʻopaʻa i ka laulā o nā hopena. Ma muli o ka helu liʻiliʻi o nā kumuhana, ua hoʻohana wale ʻia nā naʻau olakino e hoʻohālikelike ai i nā loli o ka FC ma waena o nā hui ʻelua i pane i ka mālama ʻana i ka bupropion. ʻO ka lua, no ka mea ʻaʻole i loaʻa i kēia pūʻulu kuleana mana pletebo, ʻaʻole hiki iā mākou ke kāpae i ka hiki ke ʻike ʻia kahi hopena pletebo. ʻO ka mea hope loa, no ka mea, ʻaʻole i komo nā kumuhana olakino i nā loiloi loiloi, ʻaʻohe ʻai ʻia o nā ʻano like-testest. Pono nā haʻawina o ka wā e loaʻa mai i kahi nui o nā kumumanaʻo a me ka ʻike pili ʻana no nā kumuhana olakino olakino.

Panina

Hōʻike ka Bupropion i ka hoʻohiki no ka hoʻomaikaʻi ʻana i nā ʻano pilikia ma ʻelua IGD a me ibGD. Eia nō naʻe, ʻokoʻa ka pharmacodynamics o ka bupropion ma waena o nā hui ʻelua, kahi i hoʻoili ai ʻo FC ma loko o ka DMN a me waena o ka DMN a me CCN i nā mea maʻi me IGD, a ʻo ka FC i loko o CCN e hoʻonui i nā mea maʻi me ka ibGD ma hope o nā wiki 12 o ka mālama bupropion.

Ka'ōlelo Kaumaha

Ua apono ʻia ka Papa Hoʻonaʻau Hōʻikeʻike Hōʻikeʻike Chung-Ang University i ka ʻōna noiʻi no kēia noiʻi, a ua hāʻawi ʻia ka ʻae hoʻomaopopo a nā poʻe i komo.

Nā mea kōkua i kākau

Ua kōkua ʻo JH, SK a me DH i kahi hōʻiliʻili o ka poʻe maʻi, hōʻiliʻili o ka ʻikepili, a me ka ʻohi ʻana. Na SB, JH, a me DH me ka ʻike i ka ʻike. Ua komo ka poʻe kākau a pau i ke kākau ʻana i ka kākau kope, pili i ka hana naʻauao no ka ʻatikala, a heluhelu a apono ʻia ka kākau hope.

Kōkua o ka'Āina Kuleana

ʻAʻohe mea hoʻokūkū pilikino, ʻike a ʻoihana paha.

Nāʻaoʻao hemahema

 

Kākoʻo kālā. Ua kākoʻo ʻia kēia aʻo ʻana e kekahi palapala mai ka Korean Creative Content Agency (R2014040055).

 

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