ʻO ka manaʻo lapaʻau. 2018 Apr 23; 9: 154. doi: 10.3389 / fpsyt.2018.00154. eCollection 2018.
Liu L1,2, Yao YW2, Li CR3,4, Zhang JT2, Xia CC5, Lan J1, Ma SS1, Zhou N1, ʻO Fang XY1.
Hōʻuluʻulu Manaʻo
Hōʻike ka ʻenehana o ka Pūnaewele (IGD) e cognitive a me nā naʻau hemahema. Ua hōʻike ʻia nā haʻawina mua i ka hanana ʻana o IGD a me ke kaumaha. Eia nō naʻe, ua nui ka noiʻi ʻana i ka noiʻi ʻana i ka lolo imaging ma ka cognitive deficits ma IGD. Ua liʻiliʻi nā noiʻi i ka comorbidity ma waena o ka IGD a me nā hōʻailona kaumaha a me nā kumu lalo neural. Eia, ua ʻōnaʻina mākou i kēia ʻatikala ma ka hoʻohui ʻana i kahi loiloi lōʻihi lōʻihi, kahi no ka hoʻokaʻawale ʻana o nā kūlana ma ka pāʻālua (rsFC) a me kahi noi hoʻoweliweli. Hōʻike i ka hoʻohālikelike ʻana o Autoregressive ma kahi helu palena lōʻihi o nā haumāna o ke kula. I ka pae neural, hōʻike kekahi kanaka me ka IGD i hoʻopili ʻia ʻo ka rsFC ma waena o ka amygdala hema a me ka dorsolateral prefrontal cortex (DLPFC), i mua ka mua a me ka puʻukū gyrus, hoʻohālikelike ʻia me nā mea hoʻokalakupua, a me ka hui kikowaena mua-frontoparietal ma hope o kahi wawao psychotherapy. Eia kekahi, ma hope o ka wawao ʻana, hōʻike ka poʻe me ka IGD i ka emi ʻana o ka pilina ma waena o ka amygdala hema a me ka waiho ʻana ma waena o ka frontal a me precentral gyrus, i hoʻohālikelike ʻia me ka hui pū ʻole. Ua hōʻike ʻia kēia mau ʻike ʻana e pili pū ana ka IGD me ke kaumaha; ʻO ka rsFC aberrant ma waena o ke ʻano o ka manaʻo a me nā kaila hoʻokele e hoʻomalu paha i ka hoʻonaninani a hōʻike i kahi hopena therapeutic i loko o nā mea pilikino me IGD. Ka inoa inoa: ʻO ka hoʻonaninani a me ka hana lima o ka IGD; URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405; Ka helu helu helu: NCT02550405.
KEYWORDS:
amygdala; nāʻauhaʻeha; fMRI; nā hana pāʻani pūnaewele; ho‘ohana ho‘omehapili ka hana; subgenual anterior cingulate cortex
PMID: 29740358
PMCID: PMC5924965
DOI: 10.3389 / fpsyt.2018.00154
URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405;
Helu inoa inoa: NCT02550405.
Introduction
Hoʻohui i nā ʻano hana kūpono a me nā hana hoʻonaninani ke hōʻike i nā hōʻike kino he nui me ka comorbidities e like me ke kaumaha.1]. Ua manaʻo ʻia ka addiction pūnaewele (IA) he addative whanity behavioral. Ua komo ka hapanui o ka pāʻani pūnaewele (IGD), ma ke ʻano he ʻano maʻamau o IA, i ka lima ʻelima o ka Diagnostic and Statistical Manual of Mental Disorders (DSM-5) ma ke ʻano he hōʻoia i ke aʻo hou aʻe [2]. ʻO nā maʻi psychiatric ua manaʻo ʻia i nā ʻoihana hoʻonaninani like ʻole. Eia nō naʻe, ma ka hoʻomakaʻana o ka Research Domain Criteria (RDoC), ua manaʻo ʻia nā māka ne loʻi e pili ana i ka ʻōpū a me ka ʻāʻīwī ʻana i ka manaʻo nui he mea nui nui i ka papa diagnostic a hiki ke kaʻana ma waena o nā kūlana neuropsychiatric [3]. Ma keʻano kūikawā, ua hāʻawi ka imaging imaging i kahi mea pono e maopopo ai kēia mau neural. Nānā mua i nā noiʻi mua i nā kumu neural o ka hoʻopilikia cognitive e like me ka hemahema o ka pale a me ka hoʻokaumaha ʻana i nā hoʻoholo hoʻoholo ma IGD [4, 5]. Eia nō naʻe, ua kū ka nui o nā ʻuhane a me ke kaumaha (lalo, ke kaumaha) a me nā hana neural i lalo o kēia lehulehu a ʻaʻole i maopopo ka manaʻo e pili ana i ka hōʻea o ka IGD a me ke kaumaha.
Hōʻike pinepine nā maʻi kaumaha i ka poʻe me IA / IGD [6]. Ua hōʻike ʻia he meta-analima ka nui o ka nui o ka poʻe maʻi me ka pohō i ka poʻe me ka IA (26.3%) ma mua o nā mana olakino (11.7%) [7]. Ua hōʻike pū nā haʻawina ma IGD i nā mea haʻahaʻa kiʻekiʻe loa i ka poʻe i hōʻeha ʻia a i ʻole IGD, me ka hōʻemi ʻana i ka pōpilikia i ka wā o ke kala ʻana mai IGD [8-10]. Eia naʻe, ʻaʻole hiki i kēia mau ʻāpana ʻāpana ke wehewehe i ka kuhikuhi ma waena o IA / IGD a me ke kaumaha.11, 12]. Ma ke ʻano he haʻawina maikaʻi e kōkua hou i ka hōʻike ʻana i ka pilina o waena o nā hōʻailona o ka IGD a me ke kaumaha.
Ua kū mai ka fMRI hoʻomaha - ʻo ia ka mea hoʻohana e hoʻohana pinepine ai i ka noiʻi ʻana i ka hana lolo intrinsic [13, 14] a me ka cerebral dysfunction i nā maʻi neuropsychiatric he nui, e komo ana i ka IGD a me nā mea nui kaumaha kaumaha (MDD) [15, 16]. ʻO ka mea nui, ʻike ʻia nā IGD a me MDD e kaʻana like i ka hoʻololi ʻana i ka hoʻohui ʻana o ka mana o ka mana (rsFC) i loko o ka ʻōpū o ka naʻau, e pili ana i ka amygdala a me ka subgenual anterior cingulate cortex (sgACC). Kūlike loa, hāʻawi ka amygdala i ka ʻike a me ka hoʻopili ʻana i ka ʻike mokulele a me ka autonomic, a me ka hoʻoulu ʻana i ka naʻau, a i ka hoʻokumu ʻana a me ka mālama ʻana i nā manaʻo hoʻomanaʻo maikaʻi ʻole [11, 15, 17-19]. Ke hana nui nei ka sgACC i ka hana koʻikoʻi i ka hoʻoponopono ʻana i ka hanu e pane ana i nā mea e pili ana i ka manaʻo a me nā mea e hoʻonāukiuki ʻia.20, 21]. Ua hōʻike mua nā haʻawina mua i nā pili maladaptive o ka amygdala me nā wahi o ka mana hoʻokele o ka hoʻokele, me ka cortex o lateral prefrontal cortex (PFC), i ka pilina me nā pane nui loa i ka hōʻeuʻeu kino i MDD [22-24] a me IGD [25]. ʻO ka sgACC ke kikowaena pili pili pili [15, 22] a me ka pathogenesis o ke kaumaha [15, 26]. Hoʻopili ʻia me ka sgACC a me amygdala, ʻo ka PFC ka ʻāpana o ka hana o ka hoʻokele o nā hana e hoʻoponopono i ka manaʻo.27]. Ua hōʻike ka poʻe maʻi MDD i ka pilina kiʻekiʻe ma waena o ka sgACC a me dorsolateral / dorsomedial PFC, i hui pū me ka hoʻopukapuka pono ʻana i ka manaʻo holoʻokoʻa [28, 29]. Ua loaʻa nō hoʻi ka hoʻonui ʻia ʻana o ka hoʻohui ʻia sgACC-PFC i nā mea pilikino me ka hoʻohana ʻana i ka lāʻau lapaʻau [30, 31]. No laila, ʻo ka nānā ʻana i nā hono hoʻohui ma waena o ka amygdala, sgACC, a me PFC, a me ko lākou pilina me ke kaumaha a me ka hōʻemi i ka hakakā, e hōʻike mai i nā kikoʻī neural koʻikoʻi o ka IGD.
Eia kekahi, ua hōʻike ʻia nā haʻawina mua e hana pono ana ka pale ʻana o ka hana kūpono i ka hoʻomaʻamaʻa ʻana i ka paʻakikī ʻelua.32, 33] a me nā hōʻailona kaumaha i nā poʻe me IGD a IA hoʻi i ka laulā [34-36]. E nānā i ke ʻano o ka hoʻopili ʻana i ke ʻano o ka hoʻopili ʻana i ka hooweliweli ʻana a me nā hui ʻana me ka hoʻohaʻahaʻa ʻana i ke kaumaha a me ke kumu hoʻohui i hāʻawi i nā hōʻike hou e kākoʻo ai i nā neural substrates o IGD a me ke kaumaha.
Ma ka noiʻi o kēia manawa, hōʻike mākou i nā ʻike mai kahi loiloi 4 makahiki ka lōʻihi e makaikai ai i ka pili o ke ʻano o ka hōʻeha o ke kaumaha a me ka hoʻohui i loko o ka IGD. Eia kekahi, i ka hoʻopuka ʻana i nā ʻoihana neural i lalo o ke kaumaha i loko o nā poʻe me ka IGD, ua hana mākou i kahi hoʻopaʻa cross-sectional rsFC e kū nei i ka amygdala a me ka sgACC. ʻO ka hope, ua nānā mākou pehea pehea ka hoʻomaʻamaʻa ʻana o ka mālama ʻana i ka hoʻohaʻahaʻa i ke kino a me ka remfated circuit dysfunction e hoʻopili ai me ka pohō i ke kanaka me ka IGD. Koho ʻia i nā hōʻike hōʻike mua [11, 12, 37], ke kuhi nei mākou i kahi pilina bidirectional ma waena o ka wā i hala a me ka wā e hiki mai ana ʻo ka ʻāʻī o nā mea pili i ka pūnaewele a me nā manawa e neʻe nei. Eia hou, pili i nā haʻawina neʻe mua (neuropsychiatric)25, 38], ke hōʻike nei mākou i nā mea me ka IGD e hōʻike i nā maʻi kaumaha a me ka hoʻololi ʻana iā rsFC o ka amygdala a me ka sgACC me nā wahi o ka ʻoihana hoʻoponopono hoʻokele, i hiki ke hoʻēmi ʻia e ka wawa pono ʻana no ka IGD.
Nā Pono a me nā Una
i komo
No ka Haʻawina 1, ua hōʻiliʻili ʻia nā ʻikepili ma ke ʻano he ʻāpana lōʻihi o ka hoʻohana ʻana o nā haumāna o ke koleke i kahi pūnaewele ma Beijing ma nā nalu ʻehā, e hoʻomaka ana i ka makahiki 2011. loiloi ʻia nā haumāna i kēlā me kēia makahiki. Hāʻawi nā mea komo āpau i ka palapala ʻae palapala a uku kālā ʻia no ko lākou manawa, e like me kahi kuʻina i ʻae ʻia e ka Board Review Board o ke Kula o Psychology, ke Kulanui Normal ʻo Beijing.
Ua komo i nā poʻe noiʻi i nā haʻawina wale nō inā ua pāʻani lākou i nā pāʻani pūnaewele a hoʻolilo ʻia ma luna o 20% o kā lākou manawa i kēlā me kēia lā e hoʻohana ai i ka pūnaewele no ka pāʻani i kēlā me kēia o nā makahiki mau ʻehā o ia mau mea i lawe ʻia ai nā hōʻike. He nui o nā haumāna 2,182, 1,619 (1,253 wahine, 366 kāne) ʻaʻole i kūlike i nā koina o ka hoʻopili ʻana a ua haʻalele ʻia mai ka aʻo ʻana. Loaʻa ka palena o ka wahine (90.99%) ma mua o nā kāne (45.47%) (χ2 = 550.056, P <0.001). No laila, ua loaʻa nā ana ʻana mai nā haumāna he 563 (124 mau wahine a me nā kāne 439) no ke aʻo ʻana. Mai 16 a 21 mau makahiki ko lākou mau makahiki (mean ± SD = 18.31 ± .89) i ka manawa 1.
ʻO ka hoʻopaʻa ʻana 2 a me 3 nā ʻāpana ʻelua o kahi papahana nui o ka hoʻomohala ʻana a me ka loiloi ʻana i kahi hana i hana ʻia no IGD. Ua kiʻi ʻia nā mea komo ma o ka Pūnaewele a me nā hoʻolaha i kau ʻia ma nā kulanui kūloko, me nā pae hoʻohālikelike i hoʻokomo ʻia: (1) kahi helu> 67 ma ka CIAS [39]; (2)> 14 h i kēlā me kēia pule e pāʻani nei i ka pāʻani Pūnaewele, no ka liʻiliʻi o 1 makahiki. ʻO nā pae hoʻohālikelike no ka mālama olakino (HC) nā mea komo: (1) kahi helu <60 ma ka CIAS; (2) ʻaʻole i hoʻolimalima ma mua o 2 h i kēlā me kēia pule e komo nei i ka pāʻani Pūnaewele. ʻO nā mea komo āpau he kāne lima ʻākau. ʻO nā pae hoʻohālikelike kahi hoʻohana i kēia manawa a i ʻole ma mua o nā mea kū ʻole i ke kānāwai a me ka piliwaiwai (me ka piliwaiwai pūnaewele), nā moʻolelo o ka maʻi psychiatric a i ʻole neurological a me ka hoʻohana ʻana o nā lāʻau psychotropic i kēia manawa, e like me ka loiloi ʻia e kahi ninaninau semi-struktured. Ua komo pū kekahi 76 mau kānaka me IGD a me 41 HCs i ka Study 2. No Study 3, 63 poʻe me ka IGD i kiʻi ʻia, a ma waena o 44 i ʻae e komo i loko o ka hana i loko o ka hana (CBI + pūʻulu) a ʻo ke koena he 19 i ka pūʻulu hoʻomalu. (CBI− hui) ma muli o kā lākou papa hana. Iwakāluakūmākolu mau kānaka i loko o ka hui CBI + i komo i ka mokuʻāina fMRI ma mua a ma hope o CBI. ʻUmikūmāono mai ka 19 CBI− i nānā like ʻia ma nā helu manawa like. ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ ʻ A A A A A A A A A A I A 2 3 A A O A A O A A O A A O O A A O O A O O A O A O A.
Pākuhi
No ke aʻo ʻana ʻo 1, 2, a me 3, ke ana mākou i ka nui o ka loaʻa ʻana o ka Pūnaewele ma waena o nā mea pāʻani o ke kolamu e hoʻohana ana i ka Chinese Addiction Scale (CIAS; 40), nona nā mea 26 ma kahi kiko 4-point Likert scale e nānā nei i nā ʻāpana o 5 o nā hōʻailona / hopena e pili ana i ka hana hoʻomau, hoʻihoʻi, ʻae a me nā pilikia o ka pilina interpersonal a me ke olakino / hoʻokele ʻana i ka manawa. Ua hōʻike ʻia ka hilinaʻi a me ka loaʻa ʻole o ka CIAS ma mua o nā haumāna kula.40], a i loko o ka hoʻokolohua o kēia manawa, ʻo nā kōpena alpha o Cronbach o kēia pālākiō i 0.933-0.950 ma nā kikoʻehā manawa. No ka Nānā 1, ua ana mākou i nā hōʻailona depressive me ka hoʻohana ʻana i nā mea he ʻumikūmākolu mai ka Sylistom Checklist (SCL-90) [41]. Ua helu ʻia kēia mau mea ma ka pālākiō o 1 (ʻaʻole ʻoiaʻiʻo) i ka 4 (ʻoiaʻiʻo mau). I ka hoʻokolohua o kēia manawa, ʻo nā kōpena alpha o ka Cronbach no kēia pālākiō he 0.888-0.936 ma waena o nā helu manawa ʻehā. I ke aʻo ʻana 2 a me 3, ua ana ʻia nā ʻōuli kaumaha o nā poʻe ma ka hoʻohana ʻana iā Beck Depression Inventory (BDI) [42].
MRI KuhiʻIkepili
No nā noi ʻ Xlelo 2 a me 3, ua loaʻa ka ʻĀina palapala kiʻi a me ka preprocessing MRI i nā kikoʻī ma ka noiʻi mua [33]. ʻO ka pōkole pōkole, hoʻomaha ka mokuahi fMRI i loaʻa ma kahi scan 3.0 T Siemens Trio ma Brain Imaging Center, Beijing Normal University. Nā kāmeʻa no ka ʻikepili a ka EPI: ka manawa hoʻi ka helu = 2,000 ms, echo time = 30 ms, kaʻaoʻao flip = 90 °, nā kahuaʻike = 200 × 200 mm2, hoʻoiho waiwai = 64 × 64, voxel nui = 3.1 × 3.1 × 3.5 mm3, wī = 33, manawa kiko = 200. Loaʻa kekahi ʻike kiʻekiʻina ʻo WNUMX-wighted me nā ʻāpana ʻokoʻa: ka manawa hana = 1 ms, ka manawa e = 2,530 ms, ka ʻaoʻao kīpē = 3.39 °, kahua ʻike = 7 × 256 mm2, vox ka lahui = 1 × 1 × 1.33 mm3, wānana helu = 144.
Ka Hoʻohui Kūlohelohe ʻana (CBI)
Ua hoʻokumu ʻia ka CBI ma ka hoʻokumu ʻana o kahi ʻano hoʻokolohua i hana mua ʻia.33]. Hoʻopili ʻia nā kaʻina kūlohelohe kūloko me ka wīwī i hoʻoweliweli.43], makemake nui ka makemake i ka hana nui i ka hoʻomohala ʻana a me ka mālama ʻana o ka IGD. ʻO nā hōʻiliʻili e kōkua ai i nā mea a pau e hōʻemi a hōʻemi i ka makemake makemake e hāpai i nā hopena maikaʻi a pale i ka hoʻihoʻi ʻana (e ʻike i ka pauku Methods o nā kumuwaiwai no nā kikoʻī hou.
ʻIkeʻIke Heluhelu
Hōʻikeʻike Autoregressive Cross-Lagged
No ke aʻo ʻana 1, ua hana mākou i ka hoʻohālikelike ʻana me ka autoregressive cross-lagged model (ACLM) e loiloi i ka pilina lōʻihi a me ka hopena ma waena o ka paʻakikī o ka hoʻohui a me nā hōʻailona kaumaha. Mālama ʻia ka ACLM no ka nānā ʻana i nā pilina ma waena o nā mea kūkulu ʻelua i ka wā lōʻihi. Ma ACLM, hōʻike ke ʻano autoregressive i ka nui o ka ana ma mua o ka yt wānana mua ʻia o ke ʻano aʻe o ka y(t + 1) ka hi., a me ke kaena kalaiwa i hōʻike ai i pehea e mua i ke ana zt e wānana i kekahi ana hope o ka y(t + 1) ka hi. ʻo luna a ma waho aʻe o ka ana o ka yt [44, 45]. Hoʻohana nui ʻia ka ACLM i ka hoʻopili ʻana i ka pili kino o ke kino o ka lapaʻau me nā hōʻailona hoʻohui.37, 46, 47]. Ua hōʻike ʻia ke ʻano o nā hoʻohālikelike autoregressive cross-lagged i Mplus 7.4 [48]. Hoʻohana ka Mplus i ka ʻike kikoʻī ʻikepili kiʻekiʻe (FIML) no ka nānā ʻana i ka ʻikepili nalowale (e ʻike i nā kumuhana me nā mea kikoʻī. Ua hoʻohana ʻia ʻo SPSS 20.0 no nā helu helu wehewehe.
ʻO ka hoʻokolohua hoʻokolohua hoʻāla maʻa loa
Hoʻokomo ka ACLM i ʻewalu mau haleʻaina: ke kaumaha a me ka hōʻino i ka hōʻeha ma ka Times 1, 2, 3, a me 4. I kēlā me kēia manawa, ua kā ʻo CIAS subscales i ka hoʻololi i ka Internet addity Severity, a me ke kaumaha kaumaha i kuhikuhi ʻia e ke kaumaha subscale score o ka SCL-90. No ka loiloi i ka hopena autoregressive a cross-lagged, ua nānā mākou i ka hoʻonohonoho, hoʻonohonoho metric (ʻo ia hoʻi, ke kau ʻana) a me ka hoʻowalewale ʻōhua. Hoʻohālikelike mākou i nā ʻōmole kūpono i nā hoʻohālikelike ʻehā o ʻehā mau papa 1).
1 Pūnaewele. ^ E Ha yM. ʻO ka hoʻohālikelike o nā hiʻohiʻona cross-lagitor autoregressive.
Ua lawelawe ʻo Model 1 ma ke kumu hoʻohālikelike me ka ʻole o ka koi ʻana e hoʻokau i ka invariance hoʻonohonoho. Ma Ke Kāohi 2, ua hoʻāʻo mākou i ka mea ʻike kuʻuna me ka hoʻohālikelike ʻia i nā koina hāmeʻa e like me ka manawa (Pepa S2), e hōʻoia i ka ʻike like ʻana o nā kuhi i kēlā me kēia manawa.50, 51]. I loko o ke Kākoʻo 3, ua kāohi mākou i nā ala hele i ke ʻia no ka kaumaha nui (T) 
aloha kauka (T + 1) a me ka hoʻohui hoʻohui (T) ʻoi loa ka kaumaha (T + 1) i mea ma waena o kēlā me kēia manawa. I ka hopena hope loa, ma Model 4, ua kāohi mākou i nā ala ʻokiʻoki i kēlā me kēia no ke kaumaha a me ka hōʻino i ke kaumaha i nā manawa a e like ai (Kiʻi. 1). A laila hoʻohālikelike mākou i nā ʻōkuhi kūpono o nā hoʻohālikelike ʻehā no kēlā me kēia koho i ke ʻano maikaʻi loa. ka χ2 kumumea, nā waiwai hoʻohālikelike kūpono (CFI), Tucker-Lewis index (TLI) a me ke kumu o ke kumu kekahī ʻāwili o ka approximation (RMSEA) i hoʻopili ʻia e hoʻohālikelike i ka hoʻohālike kiko.49].
Hōʻike 1. ^ E Ha yM. ʻO ke ʻano loiloi hoʻopaʻa ʻia. Hōʻike mākou i ke invariance helu, hoʻonohonoho invariance, a me ka komo ʻana o ka covariance hewa ma ka manawa e hoʻohana ana i nā leka ma nā ala. Hoʻololi ʻia nā helu i ke ala ākea (* *P <0.05; ***P <0.001).
Palapala Uila helu ʻikepili Haʻaʻike
I ke aʻo ʻana 2, ʻelua mau ʻāpana tUa hana ʻia nā hōʻike e hoʻohālikelike i ka hoʻohui a me ka hōʻeha kaumaha ma waena o nā hui IGD a me HC. Ua hoʻohana ʻia nā hana hoʻohālikelike o nā ʻano (ANOVA) me nā hana hou i ka hoʻopaʻa ʻana iā 3 e nānā ai i nā hopena o CBI ma nā ʻano pāʻani o ka Pūnaewele, me ka hui (CBI + a me CBI−) ma waena o kahi kumuhana-kumuhana, a me ke kauā (baseline a me ka lua hoʻokolohua) e like me he kumu kūpono-kumu.
Kūkaha Pūnaewele MRI
Ua hoʻomākaukau ʻia nā ʻike a ua hōʻike ʻia ma ka hoʻohana ʻana i ke DPABI version 1.2 (http://rfmri.org/dpabi) a me SPM8 (http://www.fil.ion.ucl.ac.uk/spm). Ua hoʻoneʻe ʻia nā leo 10 mua. ʻO ka ʻikepili EPI pilikino kahi i hoʻokaʻawale ʻia. ʻO nā poʻe i komo ʻole ke poʻo o ke poʻo ma ka 3.0 mm i ka unuhi a i ʻole 3 ° i ka huki (ua lawe ʻia nā kumuhana 2 IGD). Hoʻomaopopo hou mākou i nā hemahema o ke poʻo me ka hoʻoponopono ʻana Friston-24. Ua hoʻopiʻi hou mākou i nā hōʻailona mai ka wai o cerebrospinal a me ka mea keʻokeʻo e hōʻemi i nā hopena hiki i nā mea kūlohelohe physiological. A laila hoʻoululu ʻia ka ʻikepili a EPI i ka wahi o Montreal Neurological Institute (MNI). Ua hoʻohana ʻia kahi kānana spatial o 4 mm piha ākea ma ka hapalua ākea Gaussian kernel. Ma hope aku, ua hoʻolauna ʻia kahi pā leʻa ʻōpala (0.01-0.10 Hz) i ka hoʻohaʻahaʻa ʻana i nā haʻahaʻa haʻahaʻa me nā leo haʻahaʻa kiʻekiʻe.
Kēkē hoʻokō rsFC
ʻO Bilateral subgenual ACC a me nā lula amygdala i ʻike ʻia mai kahi hoʻohui o kahi palaka kōtili pili.52], a mai atlas o Brodmann ʻāpana (Brodmann ʻāpana 34, e nānā i ke kiʻi S1). Ua hoʻoponopono hou ʻia ka moʻo o ka manawa ma waena o kēlā me kēia hua e kūʻē i nā voxel o ka lolo holoʻokoʻa e hana i nā palapala ʻāina kūlike. Ua hoʻololi ʻia nā mea hoʻopili hoʻopili i nā helu Z me ko Fisher's r-to-z transform.
Ua hoʻohālikelike mākou i ka IGF a me nā hui HCFC 'rsFC i ka sgACC a me amygdala no Study 2, a ua hoʻohālikelike i nā hoʻololi rsFC ma waena o nā hui CBI + a me CBI− ([rsFC ma ka nānā ʻelua] - [rsFC ma ka laina hoʻomaka]) ma Study 3 me ʻelua -ʻaʻano tUa hoʻoponopono ʻia nā ʻoi aku a me nā palapala i hoʻololi ʻia e nā Gaussian random theory theory (GRFT, voxel-level P <0.001 hui pū ʻia me ka pae pae P <0.05 i hoʻoponopono ʻia no ka hewa hemahema o ka ʻohana).
Ma loko o ka hui IGD ma Study 2, ua alakaʻi hou mākou i nā loiloi registation ROI e nānā i nā pilina ma waena o BDI, CIAS score, a me rs-FC, me nā ROI i ʻike ʻia mai ka lolo holoʻokoʻa ma waena o ka hoʻohālikelike ʻana o ka hui. Ua hōʻike mākou i nā hana nui o ka lolo i loko o nā ROI i hoʻoponopono ʻia e nā GRFT me ka pae voxel P <0.005 a me ka pae-pae P <0.05 (PSVC-FWE <0.05).
No ke aʻo 3, ua lawe ʻia nā loiloi hoʻoponopono ʻana i ka ROI i loko o ka hui CBI + e nānā i nā pilina ma waena o nā loli i ka BDI a me nā helu CIAS a ua hoʻololi ʻia ka rsFC e like me ka ʻike ʻana i ʻelua-hōʻike t-tests (voxel-pae P <0.005 a me ka pae-pae P <0.05; PSVC-FWE <0.05).
Results
E aʻo 1: He loiloi lōʻihi lōʻihi o ka hōʻeha a me ka hōʻemi i ka hoʻohālikelike i nā Gamers Pūnaewele
Hōʻike nā bivariate correlations i ka loli mau loa o nā ʻano like ʻole i waena o nā neʻe ʻehā, nā neʻe koʻikoʻi i waena o nā hoʻololi i loko o kēlā me kēia neʻe, a me nā hopena lōʻihi lōʻihi ma waena o nā nalu (ʻike i ka Papa S1). Ma keʻano kūikawā, ma nā nalu ʻehā, ʻo ka nui o ka hoʻohui ʻana i ka pūnaewele i hoʻopili ʻia me ke kaumaha ʻoi aku ka nui o ke kaumaha ma hope iho (r 's mai e 0.19 a i 0.27, P <0.01), a ʻo ke kaumaha kiʻekiʻe ma mua ua pili pū me ka ʻoi loa o ka hōʻona ma hope (r 's mai e 0.25 a i 0.30, P <0.01).
No ka hoʻāʻo ʻana i ka pilina pili ma waena o ka hoʻohui a me ka hōʻeha kaumaha, ua kūpono mua mākou i ka Model 1 me ka ʻole o covariates a i ʻole ka pilikia. He kūpono ka kumu hoʻohālikelike no kēia ʻano loea [χ2(210)
= 441.049, P <0.001, CFI = 0.972, RMSEA = 0.044, SRMR = 0.070]. Hoʻohālikelike ʻo Model 1 i kumu hoʻohālikelike no ka hoʻohālikelike ʻana me nā hiʻohiʻona i kāohi ʻia, kahi i kāohi ʻia ai kēlā me kēia ala keʻa i kaulike ʻia ma nā ana. Kūlike me kā mākou kuhiakau, hōʻike Model 2 i ʻoi aku ka maikaʻi ma mua o ka Model 1 me RMSEA ʻoi aku ka maikaʻi akā ʻaʻohe mea nui i χ2, Iā CFI a me TLI mau waiwai [Δχ2(12)
= 10.912, P > 0.05; ΔCFI <0.01, ΔTLI <0.01]. No laila, ua kākoʻo ʻia ka metric invariance o ka hoʻowalewale pūnaewele, e ʻōlelo ana i ka ʻike a me ka loiloi ʻia ʻana o ka paʻakikī e ka poʻe pāʻani pūnaewele ma nā makahiki 4. ʻO ka lua, ua ʻoi aku ka maikaʻi o ka Model 3 i Model 2, me RMSEA ʻoi aku ka maikaʻi akā ʻo CFI, TLI a me χ hoʻokahi2 waiwai. ʻO ia ka mea, nā hopena pili i loaʻa i nā pilina ʻelua [kaumaha / hoʻoweliweli hōʻeha (T) addiction / hōʻeha kaumaha (T + 1)] i like me nā makahiki 4. A laila, ʻokoʻa ka Model 4 mai ka Model 3 i χ2 akā ʻaʻole nā ʻikepili kūpono ʻē aʻe (ΔCFI <0.01, ΔTLI <0.01, ΔRMSEA <0.01), e ʻōlelo ana i kēlā me kēia hopena autoregressive o nā loli ʻelua i kū paʻa a kūlike hoʻi ma nā makahiki 4. Koho ʻia ke ʻano 4 ma ke ʻano he kumu hoʻohālikelike no kēia noi.
papaʻaina 2 ka papa inoa i nā mākaukau o ke ala o Model 1 a me 4, a ke hōʻike nei ke koʻikoʻi o ka hoʻohui ʻana i ka pūnaewele a me nā hōʻailona kaumaha. Eia kekahi, ʻo ka hopena o ke kaumaha ma ka uaki maoli (β = 0.118, 0.126, 0.127) ʻoi aku ka kiʻekiʻe ma mua o ka hopena o ka hana hōʻemi i ke kaumaha (β = 0.070, 0.066, 0.070). E hui pū, ua hāʻawi kēia mau hualoaʻa i nā ana helu kuʻuna o ka pilina pili kino ma waena o ka minamina a me ka hōʻiliʻili nui.
2 Pūnaewele. ^ E Ha yM. Kuhi nā ʻōmole o ka hoʻohālikelike kumu a me ka ARCL Model 6.
E aʻo 2: Nā neʻe pili kino o ke kaumaha ma ka pāʻani pūnaewele ma ka pūnaewele
Nā Kūlana Democics a me ka Pūnaewele Pāʻani Pūnaewele o IGD a me nā kumuhana HC
ʻAʻole ʻokoʻa nā kumuhana a ka IGD a me ka HC i ka wā o ka makahiki, ka hoʻonaʻauao, a i ʻole ke hoʻohana ʻana i ka waiʻona a me nā ana e hiki ai ka ulaula. E like me ka mea i manaʻoʻia, hōʻike ʻia nā kumuhana IGD kiʻekiʻe loa BDI (8.78 ± 5.54 vs. 2.85 ± 3.64; t = 6.91, P <0.001) a me nā helu kiʻekiʻe ʻo CIAS (78.46 ± 8.40 vs. 43.49 ± 9.64; t = 20.27, P <0.001), i ka hoʻohālikelike ʻana i nā kumuhana HC (Papa S3).
rsFC Nā ʻokoʻa ma waena o nā Kumana IGD a me HC
Ke hoʻohālikelike nei i ka HC, hōʻike nā kumuhana IGD nui loa i ka pualikua kiʻekiʻe ma waena o ka amygdala hema a me ka DLPFC hema 2 a me ka papa 3). Eia naʻe, ʻaʻohe ʻike nui ma waena o nā pūʻulu o nā hui i mālama ʻia no nā ʻāpono amygdala kūpono a i ʻole nā hua lua ʻo ka lāateral sgACC. Ma ka hoʻohana ʻana i kahi moena hou ʻole (libel pae kiʻekiʻe P <0.005 a me ka pae-pae P <0.05), hōʻike nā mea IGD i ke kiʻekiʻe kiʻekiʻe o ka rsFC ma waena o ka hema sgACC a me ka DLPFC ʻākau (Kiʻi S2 a me ka Papa S4).
Hōʻike 2. ^ E Ha yM. Hoʻonohonoho ka hana e hoʻomaha nei i ka hana ma IGD a me nā kumuhana HC (A) a me ka hui me ke kaumaha ma ka pūʻulu ʻo IGD (B).
3 Pūnaewele. ^ E Ha yM. Nā wahi kanu a me nā wahi e hōʻike ana i nāʻokoʻa nui i ka pilina ma waena o nā kumuhana IGD a me HC (GRFT, pae kiʻekiʻe P <0.001 a me ka pae-pae P <0.05).
ʻO nā pilina pili kino
I loko o ka pūʻulu IGD, hōʻeha hewa ka helu kaumaha me ka pilina ma waena o ka amygdala hema a me ka DLPFC hema (MNI: 57, 9, 30; r = −0.35; Kiʻikuhi 2). ʻAʻohe mea nui ma waena o ka uulino i hoʻohui ʻia a me ka waiho lima amygdala — ʻo ka hoʻopili pololei ʻana ʻo ka DLPFC.
ʻO 3 Study: ʻO nā hopena o ka hoʻoweliweli wai kūpono i ka hoʻohālikelike ʻana a me nā pilikia kūloko o ka ulu lāʻau.
Nā Kūlana Democics a me ka Pūnaewele Pūnaewele
Ua hōʻike ʻo ANOVA me nā ana pinepine i kahi hui (CBI + & CBI−) e ka hālāwai (nā hōʻike mua a me ka lua) no ka paʻakikī o ka IGD [F(1, 59) = 22.62, P <0.001] a me ka helu BDI [F(1, 59) = 7.89, P <0.01] (Pākaukau 4). Hoʻohālikelike i ka hui hoʻomalu, hōʻike ka pūʻulu hui i nā hōʻemi nui i nā CIAS a me nā hōʻeha i hoʻohaʻahaʻa ʻia ma hope o ka mālama ʻana.
4 Pūnaewele. ^ E Ha yM. ʻO nā hoʻohālikelike o nā loli hoʻohālikelike ʻia ma waena o ka CBI + a me ka hui ʻo CBI at i nā manawa manawa o ka wā ma mua a ma hope o ka wawa.
ʻO nā hoʻololi i ka rsFC i ka CBI + a me nā hui ʻo CBI−
Hoʻohālikelike me ka hui o CBI−, hōʻike ka pūʻulu CBI + i hōʻemi nui i ka pakanui o ka pakanui hema a me ka hana make me ka make a me ka GP PAI 3A a me ka papa 5). Eia naʻe, ʻaʻohe ʻike nui ma waena o nā pūʻulu o nā hui i mālama ʻia no nā ʻāpono amygdala kūpono a i ʻole nā hua lua ʻo ka lāateral sgACC. Me ka pae hoʻomaʻamaʻa ʻē aʻe (pae voxel kiʻekiʻe P <0.005 a me ka pae-pae P <0.05), ua hōʻike nui nā kumuhana CBI + i ka pili o ka hana ma waena o ka sgACC hema a me ka gyrus postcentral hema (Kiʻi S3 a me ka Papa S5).
Hōʻike 3. ^ E Ha yM. Nā hopena i ke aʻo ʻana ʻo 3. ʻO nā hoʻohālikelike o nā loli o ka rsFC ([[rsFC ma ka lua o ka ʻikena] - [rsFC ma ka palena)) ma waena o nā hui CBI + a me CBI− ma luna o ka amygdala hema me MFG, precentral gyrus a me SFG (A); ʻO ka hui pili ʻana ma waena o ka FC o ka amygdala hema a me ka DLPFC hema a ma ke kīhaka me ka helu o ke kaumaha o ke kaumaha ma ka hui CBI + (B); Hōʻike ʻia ka Scatterplot ma ka pilina ma waena o ka loli o ka BDI a me nā waiwai beta no nā pua i ola i loko o ka baseline rsFC o amygdala-DLPFC (C).
5 Pūnaewele. ^ E Ha yM. Nā wahi kanu a me nā wahi e hōʻike ana i nāʻokoʻa nui i ka pilina ma waena o ka hui o CBI + a me CBI− (GRFT, pae aila P <0.001 a me ka pae-pae P <0.05).
ʻO nā pilina pili kino
ʻOiai ʻaʻohe ʻike nui i waena o nā loli o ka rsFC a me nā pae o ke kaumaha a i ʻole ka hōʻemi i ka minamina a i ʻike ʻia i ka hui ʻana o CBI +, ʻo ka pilina ma waena o ka amygdala hema a me ka pololei ʻo DLPFC ma ka pae kahua i hoʻopili hewa ʻia me ka loli hoʻololi o ke kaumaha ([Post-Pre], MNI: 42, 15, 27, r = 0.63; SVC; Nā kiʻi 3B, C) i kā CBI + hui. Eia naʻe, ʻaʻole ʻoi aku ka maikaʻi o ka hui i ka wā i kāohi ʻia ai no ka hōʻeha o ka baseline.
kūkākūkā
Ua loiloi mākou i ka pilina ma waena o nā hōʻailona o ke kaumaha a me ka addiction a me nā mīkini neural underpinning e ka hoʻohui ʻana i kahi noiʻi longitudinal survey, kahi cross-sectional resting-state functional connectionivity (rsFC) a me kahi noi noi intervent. Ma ka laulā, ka mālama honua a me ke kaumaha e mālama i kahi pilina bidirectional ma waena o nā mea hana pūnaewele ma ke ʻano he addiction a me nā kaumaha i hoʻohālikelike ʻia i kekahi i kekahi ma kahi o ka makahiki 4. Ma ka hoʻohālikelike pinepine ʻana i nā mea pilikino me nā kumuhana IGD a me ka HC, ʻike mākou ua hōʻike ka pūʻulu IGD i ke kiʻekiʻe kiʻekiʻe o ka kaumaha a me amygdala-DLPFC rsFC, me ka ikaika o ka pilina ma mua o ka hoʻopiʻi ʻana i ka hōʻeha i ka pūʻulu IGD. Eia kekahi, hōʻike ka poʻe me ka IGD i ka hōʻemi o ka hōʻeha ʻana a me ka rsFC ma waena o ka amygdala a me ka DLPFC ma hope o ka loaʻa ʻana o kahi ʻano hana no ka IGD. Ma o nā pilina ma waena o ka naʻau a me ka ʻoihana hoʻokele e hoʻomohala i ka hopena o ke kaumaha i loko o ka IGD, a me nā wawao e nānā ana i kēia mau aberrations e hōʻemi i nā hōʻailona ʻelua i ka hoʻohui i ka Pūnaewele a me ke kaumaha. Ka hui, hāʻawi kēia mau ʻike i ka kākoʻo ikaika e pili pili ana ka hoʻohui ʻana o ka pāʻani pūnaewele a me ke ʻano kaumaha.
Kūlike nā hopena me ke kuhiakau e pili ana nā ʻōuli a nā mea pāʻani pūnaewele i kekahi i kekahi. ʻO ke kikoʻī, ke kaumaha / kaumaha ma ka Pūnaewele ma kahi manawa ma mua e wānana pono ai i ka hōʻino / kaumaha kaumaha ma kahi manawa hope. No laila, pili ʻaoʻao ʻelua ka lawena a me ke kaumaha kaumaha i nā mea pāʻani pūnaewele, e kūlike me nā mea i loaʻa i nā maʻi ʻōpala ʻē aʻe [53, 54]. ʻOiai ʻo nā haʻawina mua i hōʻike aku i ke kaumaha kiʻekiʻe ma waena o nā mea hana pūnaewele.5, 16, 55, 56], a me ka pili i ka pilina ma waena o ke kaumaha a me ka hana hoʻoweliweli me ka hoʻohana ʻana i ka ʻike longitudinal [57], ʻo nā makana o kēia manawa ka mea mua e hōʻike i kahi pilina bidirectional paʻa ma waena o nā hōʻailona o ke kaumaha a me ka hoʻoukaʻana i nā mea pāʻani pūnaewele. Pili paha ka pilina o ka bidirectional no ka mea (1) i hoʻohālikelike ʻia i ko lākou mau pōpilikia i ka pāʻani ʻana i nā pāʻani pūnaewele.2, 58]; (2) e hoʻolōʻihi i ka pāʻani pūnaewele ma ka pūnaewele me ka haʻalulu ma muli o ka nele a haʻalele paha mai nā pilina ola maoli [58, 59]. Eia kekahi, ʻo kekahi mau mea like e like me ke ola olakino, ʻike a me nā hanana mua paha e hoʻonui i ka hopena o ke kaumaha a me ka IGD, a me kā lākou hui pū ʻana [58, 60]. Eia kekahi, ʻo ka hopena o ke kaumaha ma ka ululā o ke kaumaha ua ʻike ʻia ʻoi aku ka kiʻekiʻe ma mua o ka hopena o ke kaukaʻi ma ke kaumaha, kahi pilikia e koi ai hou.
Ma ka pae neural, i hoʻohālikelike ʻia me HC, hōʻike ka pūʻulu IGD i hōʻike kiʻekiʻe loa i ka rsFC ma waena o ka amygdala hema a me ka DLPFC hema, kahi i pili hewa me ka hōʻeha o ka naʻau ma waena o ka hui IGD. Ke hana nei ka amygdala i kahi kūlana koʻikoʻi i ka hana hoʻomehana, ʻike, a me nā hana hoʻomanaʻo.11, 17, 19]. ʻO ka mea nui, hiki ke hoʻololi ʻia ka hoʻololi ʻana me ka amygdala e ka PFC, a me ka pilina neural neʻoneʻelima ma waena o kēia mau ʻāina ʻelua i hōʻike ʻia i ka minamina. Eia kekahi, hiki ke hoʻololi ʻia ka hoʻololi ʻana me ka amygdala e ka PFC, a me ke ʻano o ka pili neural i waena o kēia mau ʻāina ʻelua i hōʻike i ke kaumaha. No ka laʻana, nāwaliwali rsFC ma waena o ka amygdala a me PFC i hōʻike ʻia ma nā haʻawina hoʻomaha hoʻomaha ma mua i ke kaumaha.23, 24, 61], IGD [25], a eo aku la i ka inu hewa [62]. Hoʻoikaika ia i ka hoʻohui ʻo PFC-amygdala i ka wā o nā hana i pili i ka naʻau i hōʻike ʻia i ka MDD [27, 38, 63]. Kākoʻo ka DLPFC i ka hoʻomohala kognitive a me ka pilina.64], a hoʻololi ʻia ka pilina ma waena o ka DLPFC a me ka amygdala e pili ana i ka paʻakikī a hoʻopau ʻole paha i ka hoʻoponopono kūleʻa maikaʻi ʻole. Ke hoʻohālikelike nei me ka hapa nui o nā noi ma mua ma MDD, ua hōʻike ʻia nā mea i hōʻike ʻia i ka hoʻāla ʻia amygdala-DLPFC. An ad-hoc ka ho'ākāka 'ia nā mea e hana ai ka poʻe IGD i ka pāʻani ma ke ʻano he hana coping e pakele ai mai nā hewa ʻino.58, 61], ka hoʻokomo ʻana i ka DLPFC i ka kāohi o nā manaʻo maikaʻi ʻole, ka mea e pili iki a paʻa wale paha i ka poʻe me ka IGD [65], pili i ka poʻe me MDD. Pono e hoʻomaopopo ʻia he mau haʻahaʻa IGD me nā haʻahaʻa haʻahaʻa kiʻekiʻe i hōʻike i ka pilina haʻahaʻa ma waena o ka amygdala a me ka DLPFC, e hōʻike nei ʻaʻole i pili ʻole ka pilina ma waena o ka maʻi kaumaha a me kaʻu pilina kelepaʻi ʻole. No laila, ʻo nā kumuhana o ka IGD me nā haʻahaʻa haʻahaʻa haʻahaʻa e hoʻonui ai i ka mana prefrontal ma luna o ka hana o amygdala e hoʻokele i nā pilikia olakino, akā ʻaʻole like ʻia kēlā hoʻokolohua e like me ka hoʻopiʻi ʻana paha i ka poʻe me nā maʻi ʻehaʻeha loa. E hui pū, ka pane o ka hoʻololi i ka pili o ka hoʻohui ʻana o ka laugdala i noi nui ʻia, e pono ai ka noiʻi hou aku, me ka noʻonoʻo pono ʻana o ka palaualelo, ʻehaʻeha, ke kaumaha, heterogeneity o nā sub-rehiyon prefrontal, a me nā hopena o nā lāʻau lapaʻau. "
E kū like me nā mea mai ka meta-analysis o nā hōʻino pili hewa ma ka IGD.34], ke kaila noi wawaile o kēia manawa i hōʻike i ka hōʻemi nui ʻana i ka hoʻoweliweli ʻana o ka Pūnaewele a me ke kaumaha i ka neʻe ʻana o ka hui CBI + ma hope o ka loaʻa ʻana o ka wawao ʻana i hoʻohālikelike ʻia me ka hui CBI−. Eia kekahi, hōʻike ka pūʻulu CBI + i hōʻemi rsFC o ka amygdala me nā wahi cortical frontal. No laila, ʻae ʻo CBI i ka hoʻohālikelike i ka pilina o amygdala-DLPFC ma o ka hoʻokaʻawale ʻana iho i nā kiko o ka hōʻeuʻeu ʻana o ka puʻuwai, no laila e koi ana nā kumuhana IGD i nā kumuwaiwai haʻahaʻa no ka hoʻoponopono o ka naʻau. Ma ka hui pū ʻana, hōʻike kēia mau ʻike i ka pili pono ma waena o ka amygdala a me DLPFC e lilo i mea kūpono hiki i ka neurobiological hōʻailona o nā hōʻailona hōʻeha i loko o ka IGD a me ka pahuhopu koho no ka pale ʻana i nā lāʻau lapaʻau.
Kūlike ʻole i nā hōʻike mai MDD [15, 29, 64], ʻaʻole i ʻike ʻia ka hoʻololi ʻia ʻana o ka lākiō psAC e pili ana i ka lā hoʻokahi me ka IGD, a ʻaʻole hoʻi i ka hopena o CBI i ka remediating rsFC ma waena o ka sgACC a me ka cortex prefrontal. ʻO kahi wehewehe hoʻokahi paha, i ke aʻo ʻana ʻo 2 a me 3, ua haʻalele mākou i nā kumuhana IGD me ka pohō nui loa e pale ai i nā mea hoʻohilahila paha, a hiki ʻole i ka sgACC dysconnectivity ke ʻike ʻia i loko o ka poʻe me ka haʻalulu ʻoi loa ke kaumaha. ʻO kekahi koho e pili ana i nā hana ʻokoʻa i lalo o nā maʻi kaumaha kiʻekiʻe i nā kumuhana IGD a me nā maʻi MDD, kahi hihia e nīnau hou ʻia e nā haʻawina o nā poʻe me ka maʻi hoʻokahi a me ka comorbid. Eia nō naʻe, e pono e hōʻike i nā hopena i hōʻike i nā hiʻohiʻona like o waena ma waena o ka sgACC a me amygdala, i kūlike me nā haʻawina ma MDD na aberrant rsFC o ka pūnaewele pili i hoʻopili ʻia ma ka cortex prefrontal [23, 29].
Ua hōʻike ka noiʻi i kahi pilina bidirectional ma waena o ke kaumaha a me ka hōʻino i ka hoʻonaninani ʻana i ke ʻano o ka neural i loko o ka IGD. Ma ka liʻiliʻi loa, hāʻawi kēia mau hōʻike i nā hōʻike hōʻike no ka mea pili neural koʻikoʻi neʻe - he hiki paha iā RDoC [3] -ʻE IGD. Hiki i kēia mau hopena ke kau iho i ke kukui hou no ka hoʻomohala ʻana o nā ʻoihana hou e pono ai no ka IGD. ʻO ka hana i hoʻopilikia ʻia a me ke kaumaha e manaʻo ʻia he mea nui ka hopena therapeutic i mea hoʻohui ma muli o kona hui me ka hoʻomaha.66]. Wahi a nā ʻike i kēia manawa, ke kaumaha, a me nā ʻuhaneʻeha ʻē aʻe e noʻonoʻo i ka wā e hoʻolālā ana i ka wawao a me ka loiloi ʻana i ka hopena therapeutic ma IGD. ʻO kēia, hiki i nā ala like e like me ka manawa maoli fMRI neuro-feedback [67] e hoʻololi i ka rsFC o ka amygdala a me ka sgACC hiki paha ke hoʻomaikaʻi maikaʻi i nā hōʻailona IGD a me ke kaumaha a me ka hoʻohui ʻana i nā ʻano ʻē aʻe e hoʻokō ai i nā hopena maikaʻi aʻe.
Pono e nānā ʻia kekahi mau kau palena. ʻO ka mea mua, hoʻohana ʻo 1 i ka subscale o ka SCL-90, aʻo Study 2 a me 3 ka hana i ka BDI e ana i ka manaʻo kaumaha. ʻOiai ua hoʻohana nui ʻia nā mea loiloi e hoʻohana ʻia me nā waiwai psychometric maikaʻi, ua hoʻomau ʻia nā kiʻi ʻia e nā noi ʻana me ka ʻike ʻana i nā ana like ʻole. ʻO ka lua, ʻo IGD kekahi o nā subtypes i aʻo ʻia ʻo IA. Akā, pono e makaʻala nui i ka ʻike nui i kēia mau ʻike i kekahi mau subtypes o IA (e laʻa, addiction cybersexual).68]. ʻO ke kolu, ua hoʻonohonoho ʻia nā haʻawina ʻānō i kēia wā ʻōpiopio. ʻO ka wā'ōpiopio ka manawa koʻikoʻi no ka hoʻomohala ʻana o ka IGD a me nā pilikia pilikia he nui, me ke kaumaha;69]. Aia kekahi koi koʻikoʻi no nā noi i ka wā e nānā aku ai i ka comorbidity ma waena o ka IGD a me ke kaumaha a me nā hana neural i lalo i nā ʻōpiopio. ʻEhā, ʻaʻole ʻike i ka ʻike o kēia manawa i ka pilina kumu ma waena o ke kaumaha a me ka IGD. ʻO nā makapō ʻelua, koho pālua ʻia, nā noiʻi hoʻokele i hoʻohana ʻia e hoʻohana i ka hui pū ʻana o ka maʻi fMRI a me ka lāʻau antidepressant e pane pololei i kēia pilikia. ʻO Pōʻalima, i ke aʻo ʻana 3, ʻaʻole i hāʻawi ʻia nā kumuhana IGD ma ka pūʻulu o CBI + a me nā hui CBI−. Ka mea, ʻaʻole hiki iā mākou ke kaawale i nā mea e hilahila ai nā manaʻo e like me ka manaʻo e loaʻa ka mālama ʻana i ka ʻike o nā mea i kēia manawa a me ka imaging. ʻO ka hopena, ua hoʻoholo mākou i ka IGD e like me nā helu CIAS a me ka manawa pāʻani wikiō. Eia nō naʻe, eia ka ʻōlelo e pili ana i ka hōʻailona e nele i kahi kumu kūmaka paʻa a hoʻomā ke koʻikoʻi i ka pathologizing i nā ʻano maʻamau.70]. No laila, ʻo nā mea hana loiloi hou e pili ana i kahi wehewehe hana kūpono o ka IGD a me ka noʻonoʻo ʻana i nā koi kūʻokoʻa koʻikoʻi e noi ʻia no nā noi e hiki mai ana.
Ma ka hopena, ʻo ka hoʻohana ʻana i ka hui pū ʻana o ka hoʻokolokolo lōʻihi, fMRI a me nā noi ʻana no ka pale ʻana, ua hōʻike mākou i nā hōʻailona o ka hoʻohui ʻana i ka Pūnaewele a me ke kaumaha, ua hoʻomaikaʻi ʻia me nā hopena hoʻihoʻi ma waena o nā mea pāʻani Pūnaewele. Ua hōʻike ʻo ia nā mea kūʻokoʻa me ka IGD i ka pilina kiʻekiʻe amygdala-DLPFC, ka mea i hoʻopili hewa ʻole ʻia me nā maʻi kaumaha, a me nā loli a me ka hoʻopuni ʻana o ka fronto-cingulate, ua hōʻemi ʻia ma hope o kahi hoʻopiʻi pono ʻana no ka IGD. E noʻonoʻo pono, a me nā maʻi kaumaha kaumaha a me ka fronto-cingulato-amgydala circuit dysfunction e pono e noʻonoʻo i ka papa inoa papa inoa o ka IGD a me ka hoʻomohala ʻana i nā wawao no ka IGD.
Nā mea kōkua i kākau
ʻO J-TZ a me X-YF ke kuleana no ka noʻonoʻo manaʻo a me ka hoʻolālā; ʻO LL, C-CX, JL, a me S-SM i kōkua i ka hana hōʻuluʻulu a me ka ʻike kālā; Ua kōkua ʻo Y-WY, LL, J-TZ, a me CL me ka nānā ʻana o ka ʻikepili a me ka hoʻohālike i nā ʻike; Ua kākau ʻo LL a me Y-WY i ka kākau paʻi. J-TZ, CL, a me X-YF i hāʻawi hou i ka loiloi koʻikoʻi i ka palapala no ka ʻike pilikino. Nānā nui nā mea kākau a apono ʻia ka hopena hope loa o ka ʻatikala i hoʻouna ʻia no ka hoʻopuka.
Kōkua o ka'Āina Kuleana
Ua haʻi aku nā mea kākau i ka hanaʻana o ka noiʻiʻana ma ka nele o nāʻoihana pāʻoihana aʻoihana kālā paha i hiki ke manaʻoʻia he hopena kūpono e pili ana.
mau hoomaikai ana
Mahalo mākou i nā mea āpau no ke komo ʻana i kā mākou aʻo ʻana. Ua kākoʻo ʻia kēia hana e ka National Natural Science Foundation o Kina (No. 31170990, No. 81100992, No. 31700966); nā kālā kālā noiʻi kālā no ke Kulanui Central (no. 2017XTCX04); he hāʻawi NIH (no. K02DA026990); a me kahi haʻawina mai China Postdoctoral Science Foundation (No. 2017M620655).
Nā mea hou
Hiki ke loaʻa nā mea kōkua hou no kēiaʻatikala ma ka pūnaewele ma: https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00154/full#supplementary-material
E hoʻomaopopo '
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Huaʻōlelo: amygdala, nā kaumaha, fMRI, pāʻani pūnaewele pūnaewele, ka hoʻomaha ʻana i ka mana o ka pilina, subgenual anterior cingulate cortex
Citation: Liu L, Yao YW, Li CR, Zhang JT, Xia CC, Lan J, Ma SS, Zhou N a me Fang XY (2018) ʻO ka Comorbidity ma waena o ka Hoʻolālā Kūlohelohe o ka Pūnaewele a me ka Hoʻowalewale: Ka pilina a me nā hana hana. ʻO mua. ʻO ka hauā 9: 154. hana: 10.3389 / fpsyt.2018.00154
Loaa: 26 Ianuali 2018; ʻAe ʻia: 04 ʻApelila 2018;
Kuhiʻia: 23ʻApelila 2018.
Hoʻoponoponoʻia e:
ʻO Yasser Khazaal, Ke Kulanui de Genève, Kelemania
Nānā ':
Qinghua He, Ke Kulanui Kōkua, Kina
ʻO Aviv M. Weinstein, ʻO Ariel University, ʻIseraʻela
Kuleana kope © 2018 Liu, Yao, Li, Zhang, Xia, Lan, Ma, Zhou a me Fang. He kumuhana kahi i wehe ʻia ma lalo o nā huaʻōlelo o ka Lulā Lahui Creative Commons (CC BY). ^ E Ha yM. Ke ʻae ʻia ka hoʻohana, lawe ʻana a hana hou paha i nā ʻaha hui ʻē aʻe, ke hāʻawi ʻia ka mea kākau (kumu) a me ka mea nona ke kuleana kope a i hua ʻia a i ke kumu kuhihewa ʻia i loko o kēia pukana. ʻAʻohe mea hoʻohana, hoʻopuka a hoʻopili hou paha i kū ʻole ʻia me kēia mau ʻōlelo.
* ʻAha ʻōlelo: Jin-Tao Zhang, [pale ʻia ka leka uila]
Xiao-Yi Fang, [pale ʻia ka leka uila]
†Ua like like kēia mau mea kākau i kēia hana.
;