Nā hopena o ka ʻimi ʻana i ka lawena hana i nā neural substrates o ka cue i hoʻokomo ʻia i ka makemake i ka maʻi pāʻani pūnaewele (2016)

Hōʻike hou

http://dx.doi.org/10.1016/j.nicl.2016.09.004

o ka Naauao

• Nānā nā kumuhana IGD i hoʻololi ʻia e ka neural cue-hoʻoikaika i nā wahi pili i uku.

• Ua hōʻemi nā kumuhana IGD i nā hōʻailona IGD ma hope o CBI.

• Hōʻike nā kumuhana IGD i kahi kiʻekiʻe e pili ana i ka hana hou ʻana ma hope o CBI.

• Hōʻike nā kumuhana IGD i ka liʻiliʻi o ka hoʻohui gyrus / precuneus ma hope o CBI.

Hōʻuluʻulu Manaʻo

Hoʻohālikelike ʻia ka maʻi pāʻani pūnaewele (IGD) e nā kiʻekiʻe kiʻekiʻe o ka ʻiʻini i nā pāʻani pūnaewele a me nā ʻōuli e pili ana. Ma muli o ka ʻike e pili ana i ka hoʻohuoi hiki ke hoʻoulu i ka hoʻoulu ʻana i nā wahi lolo e pili ana i ka hoʻoulu ʻana a me ka uku ʻana i nā uku a hiki ke hoʻoulu i nā ʻano pāʻani a i ʻole ke hoʻomaka hou ʻana, ʻo ka makemake ʻana i ka cue i hoʻoilina ʻia e lilo i pahuhopu hoʻohiki no nā kōkua no IGD. Hoʻohālikelike kēia noi i ka neural activation ma waena o 40 IGD a me 19 olakino olakino olakino (HC) kumuhana i ka manawa o ka pāʻani pūnaewele pāʻani cue-reactivity hana a ʻike ʻia ua hōʻike nā kumuhana IGD i ka hoʻoikaika ikaika ʻana i nā wahi lolo he nui, e like me ka dorsal striatum, ka ʻōnaehana lolo, substantia nigra, a me ka mua cingulate cortex, akā hoʻohaʻahaʻa haʻahaʻa i ka insula hope. Eia kekahi, he iwakāluakūmākolu mau kumuhana IGD (hui CBI +) i komo i loko o ka hoʻowalewale ʻana i ka hana (CBI) pūʻulu, akā ʻo nā mea i koe he 17 IGD (CBI - hui) ʻaʻole i loaʻa i kahi hana, a ua nānā ʻia nā mea IGD āpau i ka manawa like. wā lōʻihi. Ua hōʻike ka hui CBI + i ka hōʻemi IGD a me ka ʻiʻo i hoʻokomo ʻia e ka cue, hoʻonui i ka hoʻoulu ʻana i ka insula mua a hoʻemi i ka pili insular me ka lingual gyrus a me precuneus ma hope o ka loaʻa ʻana o CBI. Hōʻike kēia mau hopena i ka maikaʻi o ka CBI i ka hōʻemi ʻana i ka ʻiʻini a me ke koʻikoʻi ma IGD, a hana paha ia i nā hopena ma o ka hoʻololi ʻana i ka hoʻoulu ʻana o ka insula a me ka pili ʻana me nā wahi i pili i ka hana kiʻi a me ka nānā ʻana.

Keywords

ʻO ka pilikia o ka pāʻani pūnaewele;
fMRI;
Ka hana hoʻonui;
Hoʻopiʻi;
Hana Hana

1. Introduction

ʻO ka pilikia ma ka leʻaleʻa Pūnaewele (IGD) ka pilikia olakino olakino e pili ana i ka honua holoʻokoʻa, e koi ana i ka noiʻi hou ʻia, e like me ka hoʻopiʻi ʻia ʻana i loko o ka pauku 3 o ka Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) i ke kumuhana e pono ai ka nui o ka noiʻi (AhahuiʻApelika Psychiatric Association, 2013 a ʻO Potenza, 2015).). ʻO Craving kahi hiʻohiʻona koʻikoʻi o nā maʻi i hoʻoiho (Courtney et al., 2016 a Engelmann et al., 2012), me ka IGD (Han et al., 2010a a Ko et al., 2009a).). Hoʻohālike i nā lāʻau lapaʻau addictive (eg, stimulants), gaming gaming maruce dopamine release, especially in mesocorticolimbic pathways (Han et al., 2007, Kim et al., 2011, Koepp et al., 1998 a Tian et al., 2014).). ʻO ka hōʻike ʻana i nā hāmeʻa pili i ka pāʻani ke hoʻonui i ka salience o nā petele e pili ana i ka pāʻani a hāpai i ka ʻono, a ʻo ia hoʻi e paipai i ka hoʻomohala ʻana o ka IGD a hoʻonui i kāna mau hōʻailona (Ko et al., 2009a a Ko et al., 2013a).). I ka noʻonoʻoʻana i nā hiʻohiʻona uku a me ka manaʻo hoʻoikaika cue-induced craving, ua hypothesized ia i mea nui no ka hoʻopiʻi ʻia no ka wawa ʻana o ka IGD (Dong a me Potenza, 2014 a King a me Delfabbro, 2014).

Kāhea nā hana Cue-reactivity i nā hana kūpono a pono hoʻi e loiloi i ka nānā ʻana (Wilson et al., 2004) a hāʻawi i ka ʻike koʻikoʻi i ka hoʻowalewale ʻana a me ka uku ʻana i ka uku ma nā hoʻohui (Courtney et al., 2016).). Ua hoʻohana kekahi mau noiʻi i nā hana cue-reactivity e nānā ai i nā cuki-induced craving ma IGD a ua hōʻike i nā kiʻi o nā pāʻani hoʻoiho i nā wahi o ka lolo e kuleana no ka uku a me ka hoʻoulu ʻana, e like me ka striatum a me ka insula, i nā kumuhana IGD (IGD) i hoʻohālikelike ʻia me nā kumukanawai olakino. (HCs) (Han et al., 2010a, Ko et al., 2009a a Ko et al., 2013b).). Hoʻopili loa kēia mau ʻike i ka nānā ʻana i ka waiwai dependence a me nā pali pathological (Engelmann et al., 2012 a Goudriaan et al., 2013) a hoʻolālā i laila hiki ke kahele i nā substrate neural ma waena o ka IGD a me nā mea hoʻohui ʻē aʻe (Kuss a me Griffiths, 2012).). Eia kekahi, ʻoiai nā mea hōʻike pololei i ke kahua o ka IGD i ka nele, nā haʻawina i nā mea hoʻohana-hoʻohana i nā pilikia e pili ana i ka makemake me ka efficacies o interventions, me ka pane me ka mea e wānana i ka hiolo ʻana, a hiki i nā makahiki he mau makahiki.Courtney et al., 2016 a Killen et al., 1992).). Hōʻike kēia mau hopena i ka celished-cue-induced craving a hoʻololi i ka pane ʻana o ka papa neural substrates e hoʻokō i nā hopena hopena i hoʻohiki.

Hāʻawi nā hana Cue -activity i kahi ala kūpono e nānā i nā hana neural i hiki ke hoʻokuʻi ʻia nā mea kikowaena; Eia nō naʻe, i ka ʻike maikaʻi loa o kā mākou ʻike, ʻelua mau noiʻi wale nō i nānā i ka hopena o ka hopena i ka hopena cue-induced activation ma IGD. Ua hōʻike, hoʻokahi hōʻike e hōʻike ana ʻo 6-wiki o ka mālama me ka bupropion i hoʻohaʻahaʻa i ka cra-induced craving a me ka hana ʻana i ka gialus frontal gyrus ma IGDs (Han et al., 2010a), kahi no ka noiʻi hou aʻe i hoʻonui ka ʻohana ʻohana i ka hōʻuluʻulu ʻohana a hoʻemi i ka hoʻowalewale ʻia ʻana o ka pāʻani cue-cue-hoʻowahāwahā ʻia i ka mua o ke alo o mua a me nā ʻekipili (Han et al., 2012).). Eia nō naʻe, ʻaʻohe mea noiʻi fMRI i noiʻi pehea e komo pū ai kahi kohu kikowaena kūpono e pili ana i ka craving ma nā pae neural. ʻO ka noho maikaʻi ʻole ma mua o nā ʻano lāʻau lapaʻau e mālama nui i nā haʻawina ʻo IGD, ʻoiai ke kūleʻa nei kēia āpana a ʻoi aku ka pono o nā mea hōʻike (King a me Delfabbro, 2014, Winkler et al., 2013, ʻO Young, 2011 a ʻO Young, 2013).). Eia kekahi, hoʻoweliweli ka hana komo ʻana i nā hana like ʻole (e laʻa, ka noʻonoʻo ʻana, ka mālama ʻana cognitive) e hōʻemi i ka makemake nui ʻana ma mua o nā hana pono ʻole wale nō.ʻO Potenza et al., 2011 a ʻO Young, 2011).). No kēia kumu, ʻo nā loiloi e loiloi i nā hopena neural o ka hoʻopili ʻana e pili ana i ka hoʻopiʻi ʻana i nā makemake e pono ai i ka pānaʻi o ka IGD no ka mea e hoʻomaikaʻi nō lākou i ka ʻike ʻana i nā hana lalo o ka IGD a hāʻawi i ka ʻike i nā ala e hiki ai ke hoʻomaikaʻi i ka hopena lapaʻau.

Ma ka noiʻi o kēia manawa, ʻo ka pahuhopu nui ka nānā ʻana i nā hopena o kahi craving interal intervent (CBI), i hoʻomohala ʻia e hōʻemi ai i ka makemake no ka pāʻani, ma ka cue-induced craving a me ka hana neural ma nā wahi i komo i ka uku a me ka hoʻowalewale hoʻoikaika. Eia kekahi, makemake mākou e noiʻi i ka hana pono o nā ʻokoʻa a nā wahi i hoʻololi ʻia e CBI me nā wahi ʻē aʻe e ʻimi ai i nā ʻoihana neural ma kahi e lawelawe ai ʻo CBI. Ma muli o nā ʻike i hala, ua hypothesized mākou, hoʻohālikelike me HC, ʻo IGD e hōʻike i ka hiki ʻana i ka lolo ma nā wahi e pili ana. i ke cue-in craving (Engelmann et al., 2012, Jasinska et al., 2014 a Meng et al., 2014).). Ua hoʻohālikelike pū nō hoʻi mākou ʻo CBI e hoʻoikaika i kona mau hopena ma ka hoʻohaʻahaʻa ʻana i ka hoʻōla ʻana o ka lolo i nā wahi i komo i ka hoʻomaʻamaʻa ʻana a me ka hoʻomaikaʻi ʻana i ka hoʻōla ʻana o ka lolo i nā wahi i komo pū me ka mana cognitive (eg, dorsolateral prefrontal cortex) ((Konova et al., 2013 a Yalachkov et al., 2010).

2. Nā pono hana a me nā ʻano

2.1. Hoʻolaha ʻōlelo

Ua hoʻopaʻapaʻa ʻia kēia haʻawina ʻana me ka Hōʻikeʻike o Helsinki. Hāʻawi i nā mea a pau i hōʻike ʻae ʻia a kākau ʻia nā kālā no ko lākou manawa. Ua apono ʻia ka protocol e ka Papa Hoʻolālā Institution o ka State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University.

2.2. Nā mea komo

ʻO kēia haʻawina ʻo ia kekahi o ka noiʻi nui ʻana o ka hoʻomohala ʻana a me ka loiloi ʻana i ka hoʻoulu ʻana paha o ka psychobehavioral koʻikoʻi no ka IGD. Ua koho ʻia nā mea komo e nā hoʻolaha hoʻolaha pūnaewele a me ka huaʻōlelo a ka waha a i koho ʻia ma ka nīnau ninaninau a me ka screening in-person semi-i hoʻopaʻa ʻia. ʻO kahi hapa o 44 IGD a me 22 HC i komo i loko o ka hana fMRI cue-reactivity hana e pili ana i ko lākou makemake a kūpono i nā fMRI, a ʻo nā mea āpau a pau nā kāne kūpono ʻole. No ka mea, haʻalele ʻia nā 4 IGD a me 3 HC ma muli o ke poʻo kaua nui; no laila, ua hōʻike ka ʻikepili mai 40 IGDs a me 19 HC i nā hōʻike hope ʻana.

Ua koho ʻia nā mea i komo e like me ko lākou manawa pāʻani pūnaewele Pūnaewele a me nā helu ma ka Internet Internet addiction scale (CIAS; Chen et al., 2003).). Loaʻa ka CIAS i nā mea 26 ma kahi kiko 4-point Likert (pae: 26-104). Nā mea kikoʻī i hoʻopili ʻia no nā IGD e like like me nā haʻawina mua (Liu et al., 2016, Yao et al., 2015, Zhang et al., 2016a a Zhang et al., 2016b) a hoʻopili ʻia: 1) kahi helu o 67 a i ʻole ma luna o ka Internet Internet Addiction Scale (CIAS) (Chen et al., 2003 a Ko et al., 2009b); 2) ke komo ʻana i ka pāʻani Pūnaewele ma mua o 14 h i kēlā me kēia pule no ka liʻiliʻi o hoʻokahi makahiki; a, 3) hōʻike ʻana i kekahi o nā pāʻani Pūnaewele makemake nui ʻia e like me kā lākou hana pūnaewele mua (Keʻa Kī: 4, Pale Kaua o ka Mana Kahiko 1: 11, Pale Kaua o ka Mana Kahiko 2: 2, Hui Pū ʻIa o 21: World, ʻO Warcraft: 2).

ʻO nā pae hoʻohālikelike no nā HCs: 1) kahi helu o 60 a i ʻole lalo ma ka CIAS; a me 2) ʻaʻohe a i ʻole kekahi manawa ke komo ʻana (<2 h i kēlā me kēia pule) i ka pāʻani pūnaewele. Ko et al. (2009b) Kāhea i nā helu CIAS o 63 a i ʻole hoʻohaʻahaʻa i nā HC. Ua hoʻohana mākou i kahi paepae nui o CIAS (60 a i lalo) a i ʻole ka palena manawa no ka pāʻani wikiō e hōʻoia i ka HC mai ʻole mai ka IGD (Yao et al., 2015, Zhang et al., 2016a a Zhang et al., 2016b).

ʻO nā poʻe i hōʻike e pili ana i ka hoʻohana ʻana i nā pono kīnā ʻole a me kekahi ʻike luhi (me ka pili ʻana i ka pāʻani pūnaewele) ʻaʻole i hāʻawi ʻia ka lawehala o ka ʻauhau ma Kina. Ua nānā ʻia nā loiloi hou o ka wehe ʻana ma o ka ninaninau pilikino semi-hoʻonohonoho ʻia, e kūlike me nā haʻawina mua ma IGD (Yao et al., 2015 a Zhang et al., 2016a).). Hoʻokomo nā kulekele kahi: (1) kekahi moʻolelo hōʻike ponoʻī no kekahi psychiatric a neurological maʻi paha; a, (2) hoʻohana i kēia manawa i kekahi lāʻau lapaʻau psychotropic.

Iwakāluakūmākolu mau IGD (CBI + pūʻulu) i makemake e komo i kahi hui 6-wiki CBI a ua nānā ʻia ma mua a ma hope o ka CBI. ʻO nā koena he 17 IGD (CBI - hui) ʻaʻole i loaʻa i kekahi hana a ua nānā ʻia ʻelua manawa, me nā wā like ma waena o nā scans no ka hui CBI +.

2.3. Ka hoʻoweliweli ʻana i ke ʻano e pili ana i ka lawena (CBI)

Ua hoʻomohala ʻia ka CBI hoʻohui ʻia ma ke kumu o ka ʻenekino intervent theori (Dong a me Potenza, 2014), ka nānāʻeha i ka hoʻolālā palena o nā kūlana palena.McCarthy et al., 2010), a me ka hoʻokō o nā pono noʻonoʻo no ka hoʻohana pūnaewele.Suler, 1999).). Ma muli o ka minamina hiki i ka hopena nui i ka hoʻomohala ʻana a me ka mālama ʻana o ka IGD, nā ʻano e kōkua ai i nā kumuhana e hoʻomau a hōʻemi i ka makemake makemake e hoʻomaikaʻi i nā hopena therapeutic a pale i ka hoʻi hou ʻana (Brand et al., 2014 a Dong a me Potenza, 2014). Ua alakaʻi ʻia ʻo CBI i kēlā me kēia pule me 8 a 9 mau kumuhana IGD i kēlā me kēia hui. ʻO ke kumuhana no kēlā me kēia kau ʻana: 1) e ʻike nei i ka ʻiʻini koʻikoʻi; 2) ʻike a hoʻāʻo ʻana i nā manaʻo hilinaʻi ʻole e pili ana i ka ʻiʻini; 3) ke ʻimi nei i ka ʻiʻini a me ka hoʻomaha ʻana i nā ʻino maikaʻi ʻole e pili ana i ka ʻiʻini; 4) ka hoʻomaʻamaʻa ʻana i ke kū ʻana i nā ʻiʻini a me ka hoʻololi ʻana i ka hoʻokō ʻana o nā mea i ka noʻonoʻo; 5) ke aʻo ʻana i ka hoʻokele manawa a me ka hoʻomaʻamaʻa hoʻomaʻamaʻa no ke kū ʻana i ka ʻiʻini; 6) loiloi, hana, a me ka hoʻokō ʻana i nā mākau. Hoʻohui ʻia, ua hoʻokomo ʻia ka hoʻomaʻamaʻa noʻonoʻo i kēlā me kēia kau.

2.4. Nūpepa Palepa

ʻO ke kūlana kaumaha a me ke kaumaha a nānā ʻia i ka hoʻohana ʻana i ka Beck Depression Inventory (Beck et al., 1961) a me ka Beck An pagkabū kaumaha;Beck et al., 1988) ae ia no hoi. ʻO ka cigarette a me ka hoʻohana ʻana i ka wai inu ua hoʻopaʻa ʻia, a me ka Fagerstrom Test no ka Nicotine Dependence (Fagerstrom, 1978) a me nā nīnau no ka inu wai mai ka hōʻike ʻana i nā hōʻike ʻehaʻeha kūwaho a me ka wai inu (ʻO Bush & al., 1998) i hoʻohana ʻia e nānā i ka hilinaʻi nikotine a me ka hoʻohana ʻana i ka wai ʻona pōkole.

2.5. fMRI cue-reactivity hana

Hana ʻia ka hana cue-réactivity hana paʻa ʻia mai nā haʻawina mua (Han et al., 2010a a Han et al., 2010b). Ua noi ʻia nā mea e komo pono e nānā ʻekolu mau ʻano wikiō a helu i ko lākou ʻiʻini koke ma hope o kēlā me kēia pāʻina wikiō e hoʻohana ana i nā unahi aniani ʻike kiʻi 7-kiko. ʻEono mau kekona wikiō ʻelua kekona (G) i pana ʻia mai nā pūnaewele kūhelu a i ʻole nā kolamu pāʻani e 30 mau mea pāʻani pāʻani pūnaewele hou aʻe (10 mau mea pāʻani no kēlā me kēia 2 e ukali nei i nā pāʻani Pūnaewele kaulana: Cross Fire, Defense of the Old mana 5, Pale o ka ʻO ka mana kahiko 1, League of Legends, World of Warcraft) ka mea i komo ʻole ma hope i ka fMRI a me ka hoʻopaʻa haʻawina noiʻi. Ua hoʻokaʻawale ʻia ke ʻano o nā pāʻina pāʻani no ka pāʻani mua a nā IGDs a hāʻawi ʻino ʻia i nā HC i pāʻani ʻole i nā pāʻani Pūnaewele.

Ua koho ʻia nā paʻi wikiō (C) mai kahi pāʻani pāʻani pūnaewele punaewele ʻole i ʻike ʻole ʻia a i pāʻani ʻia e nā poʻe komo ʻē aʻe i loko o ke aʻo ʻana. Ua mālama hou ʻia kēia mau kiʻi (e like me ka hōʻike ʻia i loko Laau. 1) i hiki ʻole i nā poʻe komo ke ʻike i nā ʻike a me nā kikoʻī o kēia mau pakalōlō. Ua hana mākou i nā ʻano hana e kāohi ai i nā hopena o ka neʻe a me ke kala i nā kiʻi pāʻani. Hoʻohui ʻia, ʻeono 30-kekona keokeo / keʻa-ʻeleʻele (Fixation, F) mau kiʻi i hoʻohana ʻia ma ke ʻano he pae kumu. Ua hoʻoponopono ʻia ke kauoha o nā pakuhi: GFC GCF CFG CGF FCG FGC. Ua ukali ʻia kēlā me kēia kaha e ka pālākiō helu 4 kekona. Ua hōʻike ʻia kēia hana e E-Prime 2.0 a ua hala 620 s. Hōʻike ʻia ka hoʻolālā kiʻi o ka hana ma Laau. 1.

Pane 1.

Hōʻikeʻike kiʻiʻoniʻoni o 2 poloka o ka fMRI Pūnaewele-pāʻani cue-reactivity.

Nā koho kiʻi

2.6. Hoʻomoe ʻana i ka loaʻa a me ka hoʻomākaukau ʻana

Ua loaʻa ka ʻikepili ma ka hoʻohana ʻana i kahi 3.0 T SIEMENS Trio scanner ma ka Imaging Center no ka Brain Research, ke Kulanui Normal ʻo Beijing. Ua loaʻa ke kaʻina gradient-echo echo-planar imaging (EPI) (TR = 2000 ms; TE = 25 ms; ʻaoʻao lele = 90 °; matrix = 64 × 64; hoʻonā = 3 × 3 mm²; ʻoki = 41). Huli ʻia nā ʻāpana 30 ° uʻuli mai ka mokulele AC-PC e loaʻa ai nā hōʻailona ʻoi aku ka maikaʻi ma nā ʻaoʻao mua. Ua loaʻa kahi scanning sagittal kaumaha T1 no ke kūmole anatomical me ka ʻikepili EPI (TR = 2530 ms, TE = 3.39 ms, TI = 1100 ms, FA = 7 °, FOV = 256 × 256 mm², nui voxel = 1 × 1 × 1.3 mm o³, ʻoki = 144).

ʻO ka hoʻolaha ʻana i ka ʻikepili ua hana mua ʻia me ka hoʻohana ʻana i SPM8 (http://www.fil.ion.ucl.ac.uk/spm/software/spm8). Hoʻonohonoho hou ʻia ka ʻikepili hana, kākau inoa ʻia me nā kiʻi o ka hanana, i hoʻokaʻawale ʻia no ka normalization i kahi maʻamau MNI maʻamau, a i hoʻomālikelike ʻia me kahi kernel Gaussian 5-mm ma ka laulā piha ma ka hapalua maximum (FWHM). ʻO nā kumuhana me ka neʻe ʻana o ke poʻo> 3 mm a i ʻole 3 ° i kāpae ʻia mai ka loiloi hou (4 IGDs a me 3 HCs i kāpae ʻia).

2.7. ʻO ka hoʻāʻo ʻana i ka hōʻike pili ʻāina

Kuhi ʻia ka ʻikepili ʻano me ka hoʻohana ʻana i ka loli SPSS 20.0. Nā ʻokoʻa ʻokoʻa i ka pae kulua, ka hiʻona Pūnaewele pūnaewele (ka helu CIAS, ka lōʻihi o ka pāʻani ma ke ʻano hebedoma) a me nā cue-induced craving ma waena o nā IGD a me ka HC i nānā ʻia me ka hoʻohana kūʻokoʻa t-Nā hōʻike. Ua kālailai ʻia nā hopena o ka CBI ma luna o ka ʻiʻini a me nā ʻano pāʻani pāʻani pūnaewele me ka hoʻohana ʻana i nā anamanaʻo o ka variance (ANOVAs) me nā ana hou me ka hui (CBI + a me CBI -) ma ke ʻano he kumu ma waena o ke kumuhana a me ke kau (baseline a me nā hoʻāʻo ʻelua) ma ke ʻano he kumumanaʻo o loko-kumuhana. ʻO ke kūlana koʻikoʻi ka P <0.05.

2.8. fMRI ka ikepili helu

Ua kālailai ʻia nā ʻikepili kiʻi me ka hoʻohana ʻana iā SPM8. Ua hoʻokaʻawale ʻia nā regresor ʻekolu: nā pāʻani wikiō a me ka mālama ʻana i nā wikiō a me nā helu i makemake ʻia. Kūkulu ʻia nā mea kuʻikuʻi e ka hoʻopili ʻana i nā onsets o kēia mau mea hoʻonāukiuki me kahi hana pane hemodynamic canonical. Ua hoʻokomo pū ʻia ʻeono mau palena kikoʻī i mau hoʻoponopono o ka hoihoi ʻole. Ua noi ʻia kahi kānana pass-high (128 Hz) e hemo i ka neʻe ʻana o ka hōʻailona haʻahaʻa haʻahaʻa. I ka hōʻuluʻulu hopena hopena hopena mua, kūkulu ʻia kahi kiʻi ʻokoʻa o ka pāʻani> kūkulu wikiō e nānā i ka hoʻoulu ʻana o ka lolo i loko o ka cue. I ka hoʻohālikelike ʻana i ka hoʻoulu ʻana o ka cue ma waena o nā IGD a me nā HCs i ka pae mua, ua hoʻokomo ʻia nā kiʻi ʻokoʻa i kahi ʻanuʻu hopena ʻelua o nā pae i hoʻohana ʻia i kahi laʻana ʻelua t-ʻaʻa. No ka nānā ʻana i kahi hui (CBI + a me CBI -) ma ke kau ʻana (laina a me nā hoʻokolohua ʻelua) i ka launa pū ʻana me ka cue-induce activation, ua hoʻokomo ʻia nā kiʻi ʻokoʻa i kahi ʻanuʻu o nā hopena o ka hopena ʻelua ma ka hoʻohana ʻana i kahi hoʻolālā factorial maʻalahi. E nānā i ka pilina o ka hana ma waena o nā wahi e pili ana i ka cue reactivity (gaming> control clip) i loli ma waena o nā kau ʻelua, ua alakaʻi mākou i kahi anamanaʻo psychophysiological (PPI) i loko o ka CBI + a me ka CBI - nā hui e hoʻohana ana i kahi hoʻolālā factorial maʻalahi. Ma ka pae pae, ua hana ʻia ka nānā ʻana o ka lolo holoʻokoʻa e hoʻohālikelike i ka hoʻoneʻe ʻana o ka lolo i hoʻokumu ʻia ma waena o nā IGD a me nā HC a ua hoʻoponopono ʻia e nā Gaussian Random Field Theory (GRFT) me ka pae voxel. P <0.001 a me ka pae-pae P <0.05 e hopena i ka helu hemahema hemahema ʻohana o 5%. No nā kumu noiʻi, ua hoʻoponopono ʻia ka hui pūʻulu e ka hui i ka hoʻoulu ʻia i hoʻokomo ʻia e ka cue a me ka hoʻopili ʻana o ka hana e kahi loiloi liberal (pae voxel P <0.005 a me ka pae-pae P <0.05). Ua nānā ʻia nā hopena me ka hoʻohana ʻana iā BrainNet Viewer (Xia et al., 2013) a me DPABI (http://rfmri.org/dpabi).

3. Nā hualoaʻa

3.1. Kūlike nā palapala Demarkics a me ka pāʻani pūnaewele

E like me ia i hōʻikeʻia 1 Pūnaewele, ʻAʻole ʻokoʻa ka IGD a me HC i ka wā, ka hoʻonaʻauao, a i ʻole hoʻohana ʻana i ka waiʻona a me nā mea ʻoki. A kūlike me nā helu hoʻohui ʻana, ua piʻi kiʻekiʻe nā IGD ma luna o ka CIAS a hōʻike i kahi kiʻekiʻe nui no ka pāʻani pāʻani a me ke kiʻi ʻoniʻoni a me ke hoʻoponopono ʻana i hoʻohālikelike ʻia me HC. Eia kekahi, hōʻike nā IGD i nā kiʻekiʻe o ke kaumaha a me ke kaumaha.

1 Pūnaewele.

Nāʻike Demarkics a me ka pāʻani pūnaewele pūnaewele o nā IGD a me HC i ka pae kahua.

	IGD (n = 40)	Nā HCs (n = 19)	t/ χ² waiwai	P	Nui ʻāpana^a
	Kahawai ± SD	Kahawai ± SD	t/ χ² waiwai	P	Nui ʻāpana^a
Makai, mau makahiki	21.95 ± 1.84	22.89 ± 2.23	- 1.72	0.091	- 0.47
Nā makahiki o ka hoʻonaʻauao	15.75 ± 1.90	16.58 ± 1.98	- 1.54	0.13	- 0.43
CIAS score	79.88 ± 8.67	42.11 ± 8.27	15.86	<0.001	4.42
Hoʻohālikelike o nā pāʻani wikiō, hola	27.26 ± 10.58	1.67 ± 0.58^b	15.00	<0.001	8.98
Ke makemake nei no nā kiʻi pāʻani	5.36 ± 1.18	2.06 ± 1.57	8.99	<0.001	2.51
Ke makemake nei i nā mana hoʻokipa	3.61 ± 1.36	1.75 ± 1.15	5.13	<0.001	1.43
Ke makemake nei no ka hoʻoponopono	3.75 ± 1.24	1.52 ± 0.61	9.24	<0.001	2.57
ʻOkoʻa ka puni ʻana (hoʻoheheʻe - ʻohi)	1.75 ± 1.21	0.31 ± 0.59	6.14	<0.001	1.71
Loaʻa BAI	5.35 ± 5.82	2.00 ± 3.18	2.85	0.006	0.79
Loaʻa BDI	9.13 ± 5.35	2.79 ± 4.21	4.53	<0.001	1.26
Ka hoʻohanaʻana i ka waiʻona	30/40	13/19	0.28	0.60	0.07
Loaʻa AUDIT-C	3.20 ± 1.90^c	2.23 ± 1.17^d	1.70	0.10	0.56
ʻO ka hoʻohana lāʻau	4/40	0/19	-	-	-
Palapala FTND	3.25 ± 0.50^e	-	-	-	-

IGDs = Nā pilikia maʻi pāʻani pūnaewele; HCs = nā kumuhana hoʻokele olakino; SD = hoʻololi maʻamau; CIAS = Pākuʻi hoʻohui pūnaewele Chen; AUDIT-C = nīnau nīnau inu waiʻona mai ka Hōʻike ʻIlikino Hoʻohālikelike Hōʻike Hōʻikeʻike; FTND = Hōʻike Fagerstrom no ka hilinaʻi o ka nikotine; BAI = ʻO Beck Hoʻolaha Inventory; BDI = ʻO Beck Depression Inventory.

ʻO Cohen's d waiwai no t-e hōʻoia a me ka waiwai o Cramer V no χ² hōʻike.

n = 3.

n = 30.

n = 13.

n = 4.

Nā koho papa

3.2. Nā hopena o CBI ma nā kaʻina hana

ʻO ka CBI + a me CBI - ua hui maikaʻi nā hui i ka makahiki, ka naʻau, a me nā hopohopo a me nā kaumaha kaumaha ma ka pae hoʻomaka (2 Pūnaewele).). ANOVA me nā hana ʻōkuhi i nā helu CIAS, (ka hopena nui o ke kau ʻana: F_(1,38) = 77.83, P <0.001, hapa η² = 0.67; hopena nui o ka hui: F_(1,38) = 1.15, P = 0.29, hapa η² = 0.03; hopena pilina: F_(1,38) = 22.65, P <0.001, hapa η² = 0.37), nā lōʻihi o ka pāʻani wiki (hopena nui o ke kau: F_(1,38) = 12.57, P = 0.001, hapa η² = 0.25; hopena nui o ka hui: F_(1,38) = 5.58, P = 0.02, hapa η² = 0.13; hopena pilina: F_(1,38) = 4.34, P = 0.04, hapa η² = 0.10), a me ka makemake pili i ka pāʻani (hopena nui o ke kau: F_(1,38) = 25.77, P <0.001, hapa η² = 0.40; hopena nui o ka hui: F_(1,38) = 4.40, P = 0.04, hapa η² = 0.10; hopena pilina: F_(1,38) = 5.73, P = 0.02, hapa η² = 0.13) hōʻike i nā hopena like.

2 Pūnaewele.

Nā hiʻohiʻona a me nā ʻano pāʻani pāʻani o CBI + a me CBI - nā pūʻulu.

	CBI + (n = 23)	CBI - (n = 17)	t waiwai	P	ʻO Cohen's d waiwai
	Kahawai ± SD	Kahawai ± SD	t waiwai	P	ʻO Cohen's d waiwai
makahiki	21.91 ± 1.83	22.00 ± 1.90	t (38) = - 0.15	0.89	- 0.05
Nā makahiki o ka hoʻonaʻauao	16.09 ± 1.86	15.29 ± 1.93	t (38) = 1.31	0.20	0.43
Loaʻa BAI	3.78 ± 3.61	7.63 ± 7.73	t (38) = - 1.85	0.08	- 0.60
Loaʻa BDI	8.83 ± 5.73	9.56 ± 5.09	t (38) = - 0.41	0.46	- 0.13
CIAS hōʻailona: kahua kikowaena	82.09 ± 8.75	76.88 ± 7.85	t (38) = 1.94	0.06	0.63
CIAS score: hōʻike ʻelua	60.26 ± 9.83	70.35 ± 7.80	t (38) = - 3.49	0.001	- 1.13
Hōʻalo nā pāʻani pāʻani wikiō, mau hola: baseline	27.20 ± 10.42	27.35 ± 11.13	t (38) = - 0.05	0.96	- 0.02
Hōʻalo nā pāʻani pāʻani wikiō, mau hola: hōʻike lua	11.36 ± 8.07	23.24 ± 17.51	t (38) = - 2.88	0.007	- 0.93
Ke makemake nei no nā kiʻi pāʻani: baseline	5.30 ± 1.21	5.43 ± 1.17	t (38) = - 0.33	0.74	- 0.11
Ke makemake nei no nā wikiō pākuhi: hōʻike ʻelua	3.42 ± 1.50	4.75 ± 1.44	t (38) = - 2.82	0.008	- 0.91

CBI + = nā kumuhana me nā maʻi pāʻani Pūnaewele i loaʻa ka ʻiʻina hana i ka hana; CBI - = nā kumuhana me nā maʻi pāʻani Pūnaewele i loaʻa ʻole ka ʻiʻina hana i loko; SD = hoʻololi maʻamau; CIAS = Pākuʻi hoʻohui pūnaewele Chen; BAI = ʻO Beck Hoʻolaha Inventory; BDI = ʻO Beck Depression Inventory.

Nā koho papa

E like me ia i hōʻikeʻia 2 Pūnaewele, hoʻohālikelike hoʻokahi no ke kau i hōʻike ʻia ʻo CBI + a me CBI - ʻaʻole ʻokoʻa ka hapa nui o nā hui ma nā helu CIAS ma ke kumu, ka lōʻihi o ka pāʻani ʻana i kēlā me kēia pule, a ʻo ka CBI + hui i hoʻohālikelike ʻia me ka CBI - ua hōʻike ka hui i nā hōʻemi nui ma kēia mau mea. ana i ka hōʻike lua. Eia kekahi, hoʻokahi hoʻohālikelike no ka hui i hōʻike ʻia ua hōʻike ka hui CBI + i nā hōʻemi koʻikoʻi ma nā helu CIAS (t₍₂₂₎ = 9.49, P <0.001, d = 2.34), nā lōʻihi o ka pāʻani wiki (t₍₂₂₎ = 6.88, P <0.001, d = 1.69), a me ka makemake pili i ka pāʻani (t₍₂₂₎ = 5.21, P <0.001, d = 1.38), akā ʻo ka CBI - hōʻike wale ka hui i ka hōʻemi nui ʻana i nā helu CIAS me kahi liʻiliʻi o ka hopena (t₍₁₆₎ = 3.16, P <0.001, d = 0.84) i ka lua o ka hoʻokolohua hoʻohālikelike ʻia me ka laina haʻahaʻa (Laau. 3).

3.3. nā hopena fMRI

ʻO ka mua, ua hana mākou i kahi pālua ʻelua t-Test ma waena o nā pūʻulu IGD ʻelua (CBI + a me CBI -) ma ka laina hoʻomaka. Ma muli o ka ʻokoʻa nui ma waena o ka CBI + a me ka CBI - ua ʻike ʻia nā hui, ua hoʻohui mākou iā lākou i kahi hui IGD no nā kālailai laina hope. Ke hoʻohālikelike nei i ka hoʻoulu ʻana o ka lolo i pili i ka pāʻani ma waena o nā IGD a me nā HCs ma ka laina ma ka hoʻohana ʻana i kahi laʻana ʻelua t-Loaʻa, nā IGD e like me ka HC i hōʻike i ka hoʻōla nui aʻe i nā wahi kīʻaha ma ka ʻaoʻao me ka dorsal striatum (caudate), ʻekikopa, substantia nigra, cortex ana ainterior, a me nā pōpō cingulate cortex; hana haʻahaʻa ʻia i ʻike ʻia i kahi mahele iki o ka posterula kūpono. 3 Pūnaewele a Laau. 2).). Ua hana hou mākou i kahi loiloi correlational ma waena o ka waiwai o ka waiwai beta o kēia mau ʻōpū a me nā ʻokoʻa i ka makemake ʻana i ka ikaika no ka pāʻani ʻana i ka pāʻani ʻana i nā pāʻani wikiō a loaʻa i kahi hui kūpono i loko o MTG (r = 0.34, P = 0.035).

3 Pūnaewele.

hualoaʻa hopena fMRI.

	ʻAne ʻāina	aoao	BA	ʻO ka nui o nā pua	Hoʻonohonoho ʻo MNI			piko t/F Hawaiʻi	Nui ʻāpana^a
	ʻAne ʻāina	aoao	BA	ʻO ka nui o nā pua	X	Y	Z	piko t/F Hawaiʻi	Nui ʻāpana^a
Kahikina: IGDs> HCs	Hoʻoikaika / caudate	L		62	- 6	- 15	- 9	4.57	1.21
	Kūʻai kikowaena / SN	R / L		92	0	- 24	- 24	5.01	1.33
	Precuneus / PCC / ACC	R / L	7/24/31	1478	3	- 57	45	6.84	1.81
	MFG / ACC	R	9/10	104	6	51	33	4.96	1.31
	IPL / MTG	L	40	649	- 48	- 60	15	5.68	1.50
	IPL / STG	R	39/40	740	51	- 30	45	5.95	1.58
	IFG	R	9/44	188	57	9	21	5.72	1.52
	IFG	L	9/44	147	- 54	9	33	4.81	1.27
	MFG	R	6/8/9	924	24	30	42	7.04	1.86
	MFG / SFG	L	6/8/9	855	- 24	6	63	6.97	1.85
	MTG	R	21	138	63	- 3	- 18	4.31	1.14
	Cerebellum posterior lobe	L		131	- 48	- 48	- 15	4.94	1.31
Kahikina: HCs> IGDs	Hoʻokū	R	13	50	36	- 18	21	4.94	1.31
Nā hui hui a me ke ʻano	Hoʻokū	R	13	29	42	3	- 6	14.97	0.28
PPI: R insula seed, hui a me ka hui pū ʻana	ʻO Lingual gyrus	L	18/30	215	- 6	- 72	3	21.95	0.40
PPI: R insula seed, hui a me ka hui pū ʻana	ʻO precuneus / lingual gyrus	R	18/31	170	15	- 60	18	17.22	0.31

P_GRFT <0.05 no ka loiloi lolo holoʻokoʻa.

IGDs = Nā pilikia maʻi pāʻani pūnaewele; HCs = nā kumuhana hoʻokele olakino; PPI = pilina psychophysiological; BA = ʻĀpana ʻo Brodmann; MNI = Ke Kahua Neurological Montreal; SN = substantia nigra; PCC = hope cingulate cortex; ACC = aniani cingulate mua; IPL = lohi parietal haʻahaʻa; MTG = waena manawa kino gyrus; STG = ʻoi aku ka nui o nā manawa kino; IFG = ʻaoʻao mua o ka mua; MFG = waena mua gyrus.

ʻO Cohen's d waiwai no t-ʻa ha ʻilikahi η² waiwai no F nā ho'āʻo.

Nā koho papa

Pane 2.

Ke hoʻohālikelike nei o ka hui naʻau āpau ma waena o ka IGDs a me HC i ka pāʻani ʻana o ka lolo-cue-induced activization. Ua uhi ʻia ka palapala hōʻike hoʻōhoʻo 3D ma luna o ka wai i hoʻohuli ʻia me ka BrainNet Viewer, a ʻo ka 2D kahua hoʻōla i uhi ʻia i kahi kiʻi ʻo T1 e hoʻohana ana iā DPABI.

Nā koho kiʻi

I ka loiloi o nā hopena o CBI ma ka cue-i hoʻokomo ʻia i ka hoʻoulu ʻana o ka lolo, kahi pilina nui ma waena o ka hui (CBI + a me CBI -) a me ke kau (ka lalani a me nā hōʻike ʻelua) i ʻike ʻia ma kahi ʻaoʻao mua o ka insula kūpono. Ua hōʻike ka hoʻohālikelike ʻana o kahi hui hoʻokahi i ka CBI + pūʻulu i hōʻike i kahi hoʻonui nui i ka hoʻoulu ʻana o ka insula mua pono (t₍₂₂₎ = - 2.20, P = 0.04, d = - 0.47), akā no ka CBI - hui, ua ʻike ʻia ke ʻano ʻē aʻe (t₍₁₆₎ = 3.01, P = 0.008, d = 1.08) (Laau. 3). Hoʻohui ʻia, ua alakaʻi mākou i kahi loiloi hoʻopili e nānā i ka hui ma waena o nā loli i ka ikaika o ka ʻiʻini i nā pāʻina pāʻani a me nā hoʻololi i ka hoʻoulu ʻana i nā insula mua i ka hui CBI +; akā naʻe, ʻaʻohe pili koʻikoʻi i ʻike ʻia (r = - 0.10, P = 0.66).

Pane 3.

Panela A: Nā helu CIAS, ka lōʻihi o ka pāʻani ʻana i kēlā me kēia pule, a me ka ʻiʻini i nā pāʻina pāʻani ma o nā hui a me nā kau. Panela B: Hoʻokomo ʻia ka cue pūnaewele i ka hoʻouluulu i ka insula mua pono ma waena o nā hui a me nā kau. Panela C: Ka pilina pili pono (pāʻani pāʻani me nā pakalōlō kāohi) ma waena o ka insula mua pono a me ka gyrus lingual hema (ʻākau) a me ka precuneus / lingual gyrus (hema) ma waena o nā hui a me nā kau. CIAS = Pākuʻi hoʻohui pūnaewele Chen; R = pono; L = hema.

Nā koho kiʻi

Ua alakaʻi hou mākou i kahi anamanaʻo PPI me nā insula kūpono ma ke ʻano he ʻanoʻano hua (ʻike ʻia i ka hoʻokolokolo mua) e loiloi i kāna pilina hana me nā wahi lolo ʻē aʻe i ʻike ʻia ma ka ʻokoʻa o nā pāʻani me nā kaha kiʻi. Ua loaʻa iā mākou kahi pilina koʻikoʻi ma waena o ka hui a me ke kau e hoʻopili ana i ka gyrus lingual bilual a me ka precuneus pono. Ua hōʻike ka hoʻohālikelike ʻana o kahi hui hoʻokahi i ka hui CBI + i hōʻike i ka pilina o ka insula kūpono a me kēia mau puʻupuʻu ʻelua.t₍₂₂₎ = 3.89, P = 0.001, d = 0.66, a t₍₂₂₎ = 3.05, P = 0.006, d = 0.57), akā ʻo ka CBI - hōʻike ka hui i ka hoʻohālikelike ʻē aʻe (t₍₁₆₎ = - 3.24, P = 0.005, d = - 0.90, a t₍₁₆₎ = - 2.83, P = 0.01, d = - 0.87) (2 Pūnaewele a Laau. 3).

4. Kōkua

I ka maikaʻi o kā mākou ʻike, ʻo kēia aʻo ʻana ka hopena loiloi mua loa o CBI ma ka pāʻani ʻana i ka lolo i hoʻokomo ʻia e ka cue i hoʻokomo ʻia i IGD. Ua ʻike mākou i ka mea i hoʻohālikelike ʻia me nā HCs, ua hōʻike ʻia nā IGD i ka hoʻoneʻe ʻana o ka lolo i loko o nā lolo he nui e like me nā wahi pili i ka uku, me ka hoʻoliʻiliʻi o ka hoʻohaʻahaʻa haʻahaʻa i nā insula o hope. Hoʻohui ʻia, hōʻike ka hui CBI + i ka hoʻonui nui ʻana i ka insula mua pono ma hope o ka pau ʻana o CBI, akā ʻo ka CBI - ua hōʻike ka hui i kahi ʻano ʻē aʻe. Eia kekahi, ʻo ka hui CBI +, ke hoʻohālikelike ʻia me ka CBI - hui, ua hōʻike i ka hoʻoliʻiliʻi o ka hoʻopili ʻana o ka hana ma waena o ka insula mua pono a me ka gyrus lingural bilateral a me ka precuneus pono. Hōʻike kēia mau hopena i CBI e hoʻokau i kāna mau hopena ma o ka hoʻololi ʻana i ka hana insula mua a me ka hoʻopili ʻana me nā wahi o ka lolo i hoʻopili mua ʻia i ka hana kiʻi a me ka nānā ākea.

Kūlike me kā mākou hypothesis, nā IGD i kēia noiʻi ua hōʻike i nā ala ikaika i ka leʻaleʻa-cue-induction a me ka hoʻoikaika ʻana i ka lolo i nā wahi koʻikoʻi e loaʻa ana i ka mesocorticolimbic (e laʻa, cima aʻō cincex anterior) a me nigrostriatal (eg, caudate, substantia nigra) e hoʻohālikelike ai me nā HCs. ʻO nā ala mesocorticolimbic a me nigrostriatal nā ala ʻelua he puna kumu nui o ka hoʻokuʻu dopaminergic a kōkua i nā hopena hoʻoikaika o nā kīʻaha pili pili i ka pili ʻana. (Jasinska et al., 2014, ʻO Koob a me Volkow, 2010 a ʻO Robinson a me Berridge, 1993). Hoʻohui hou, hōʻike ʻia nā IGD e hoʻonui i ka caphex parietal (eg, precuneus) i hana ʻia i ka bias attentional a me nā kiʻi hoʻomanaʻo memo (Cavanna me Trimble, 2006). I ka manawa like, ua ʻike nui kēia mau ʻike i nā hopena o nā noi i hala ma IGD (Han et al., 2010a, Ko et al., 2009a a Liu et al., 2016) a me nā mea hoʻohui'ē aʻe (Engelmann et al., 2012, Goudriaan et al., 2013 a Jasinska et al., 2014) a paipai i nā IGDs e hypersensitive i nā pāʻani e pili ana i ka pāʻani i mea e hōʻoi aku i ka hana neural ʻoi aʻe ma nā wahi noʻonoʻo i pili i ka uku a me ka nānā.

He kūpaʻa me kā mākou hypothesis mua, hōʻike ʻia nā IGD e ka hypoactivation o nāulaula maikaʻi i hoʻohālikelike ʻia me HCs. ^ E Ha yM. Eia nō naʻe, ua like kēia ʻike i nā hualoaʻa o nā haʻawina mua o ka IGD me ka hoʻohana ʻana i nā kī heʻani e like me nā petele e pili ana i ka pāʻani a me ka hoʻohana ʻana o ka Internet i nā kīʻaha pili ʻole i ka pāʻani.Liu et al., 2016). Hoʻonui pū ka loaʻa ʻana me nā mea mai kahi meta-ka nānā ʻana o ka puʻuwai cue-induced activation i ka obesity (Brooks et al., 2013). Eia kekahi, ʻo kahi hui ʻino ma waena o ke kuko ponoʻī ʻana a me nā mānoanoa cortical o ka insula pololei i hōʻike ʻia i loko o nā mea ulaula (Morales et al., 2014). Eia nō naʻe, ʻike ʻia nā hōʻike kūlike a hōʻike ʻia i ka hoʻōla ʻia o ka cue i loko o ka insula e ʻoi aku ka ikaika i ka poʻe addicted pili i ka HCs (Ko et al., 2009a a Luijten et al., 2011). Hiki i nā hopena like ke ʻokoʻa i ka ʻokoʻa i ka metekema (ka laʻa, ka ʻano hoʻonaninani kaohi ʻia) a i ʻole nā ʻokoʻa i ke kūlana o nā kānaka i aʻo ʻia (ʻo ia hoʻi, me ka mahalo i ka ʻimi loiloi). Eia kekahi, no ka insula he ʻano multimodal i pili i ka ʻaoʻao ma ke komo ʻana i ka ʻike salience a me ka hoʻomohala kognitive, akā, ka hapa o ka ʻaoʻao i lilo i ka hana a me ka hoʻōla a me ka hoʻolako a me ka hoʻopili ʻana i nā ʻike mai nā hana ʻelua (Cauda et al., 2011, Paulus lāua ʻo Stewart, 2014 a Zhang et al., 2016b), nā ʻokoʻa i nā ʻike ma nā noiʻi e pili ana i nā ʻāpana o ka insula i hoʻopili ʻia. Hypoactivation o ka posterula insula i ʻike ʻia i loko o ke aʻo ʻana i kēia manawa e hōʻike i ka hyposensitivity i ka māʻona ma o ka nānā ʻana i nā kiʻi pāʻani (ʻaʻole hoʻi e pāʻani i nā pāʻani) i nā IGD.

E pili ana i nā hopena o CBI, ka hui CBI +, hoʻohālikelike ʻia me ka CBI - hui, hōʻike i ka hoʻonui ʻia ʻana o ke neural i ka insula mua pono a hoʻemi i ka pili insular me ka gyrus lingual gyrus a me ka precuneus pono ma hope o ka loaʻa ʻana o CBI. Mai ka hoʻohui ʻana o nā hana kūpono (ma, e noʻonoʻo ai ka noʻonoʻo ʻana, a he ʻano koʻikoʻi nō hoʻi o CBI) e hoʻonui ai i ka nui o ka hina o nā mea anula insula kūpono.Hölzel et al., 2008) a hoʻomaikaʻi i ka hana hoʻomalu cognitive (Tang et al., 2015), hiki i ka CBI ke hoʻoikaika i kona mau hopena ma o ke keake ʻana i ka hana o ka insula anterior e hoʻoikaika i ka mana cognitive ma o ka hana o luna. Eia kekahi, ʻo ka lingual gyrus a me ka precuneus e kōkua nui i ka nānā ʻana i ka ʻike maka a me ka hiki.Cavanna me Trimble, 2006 a Hopfinger et al., 2000) a ua loaʻa iā ia e hoʻāla ʻia e nā ʻike pili pili ʻana mai ka nānā aku (Hanlon et al., 2014). ʻO ka hoʻokaʻawale ʻia nā pilina ma waena o nā insula anterior kūpono a me kēia mau ʻāina e pili ana i ka ʻike ʻili a me ke ʻano o ka hōʻala o ka ʻike.Naqvi et al., 2014 a Paulus lāua ʻo Stewart, 2014), ʻoiai he mea pono e noiʻi pololei ʻia. Hōʻike kēia mau hopena i ka CBI hiki ke hoʻoikaika i kona hopena i ka hōʻemi ʻana i ka makemake c--ue-induction ʻaʻole wale ma o ke hoʻololi ʻana ʻana i ka loaʻa o nā ʻāpana o nā lolo a ʻoiai hoʻi i ka hōʻemi ʻana i ka pilina ma loko o nā wahi neural.

Hōʻike kā mākou haʻawina ʻoi ke oki nei ʻo CBI i ka cue-induced craving a me IGD Severity i kahi pae amio. Ma kahi kū i neural, ʻaʻole nō ia i hoʻohālikelike i ka hoʻōla o ka puʻuwai abnormal cue-kahi i hoʻolaʻa ʻia mai ka hoʻohālikelike ʻana, akā ua hoʻohuli ʻia kekahi wahi ʻē aʻe (ke anula insula) ʻaʻole i hōʻike i nā ʻokoʻa i ka pae kahua ma IGDs a me HCs, ke hōʻike nei paha ka CBI nui paha hana hoʻololi i nā wahi i hoʻololi ʻia i ka hana cognitive i kauoha ʻia ma mua o ka hoʻololi pono ʻana i ka poʻe i komo. Manaʻo nō naʻe, ʻike kā mākou ʻike ʻana i ka insula (a i ʻole nā ʻāpana ʻokoʻa a mua a me nā ʻāpana kūhili) paha i hōʻike ʻia ka hopena koʻikoʻi no ka pale ʻana, a me ka huli ʻana i nā ʻāpana like ʻole o ka insula e hoʻokō i nā hopena therapeutic ʻē aʻe. Eia nō naʻe, he mea weliweli ia i hōʻike ʻole ʻo CBI i nā hopena koʻikoʻi i nā wahi koʻikoʻi i loko o ka pahuhopu makana (me ka laʻa, ʻo ka ventral striatum), a ke manaʻo nei mākou e hoʻoweliweli i nā mea e hiki mai ana.ʻO Potenza et al., 2011), nā non-invasive kaʻina e like me ka transcranial magnetic stimulation (Hayashi et al., 2013), a i ʻole nā kaʻina hana paha e like me ka hoʻouluʻana i ka hohonu-lolo.Luigjes et al., 2012) e hoʻopololei pololei i ka striatum ventral a i ʻole nā ʻāina ʻē aʻe i pili i ka cue-réactivity e ʻimi paha a hiki i ka hopena hope loa.

Kahi kūpono loa nā ʻike o ka noiʻi ʻana i kēia manawa.Brand et al., 2014, Dong a me Potenza, 2014 a Ko et al., 2014) ke kuhi nei i kahi kuleana koʻikoʻi no ka makemake i ka pāʻani a i nā cues pili i ka mālama ʻana o ka hoʻolaʻa ʻana mai ka IGD, a me nā wahi o ka lolo i komo i ka hoʻomaʻamaʻa ʻana o ka uku (eg, striatum, PCC), ka mana hoʻokele (e laʻa, DLPFC), a i ʻole nā kaʻina ʻelua (e laʻa. , insula, ACC) launa pū kekahi me kekahi me ka coryex sensory e kōkua nei i ka makemake no ka pāʻani ma IGD (Brand et al., 2014, Dong a me Potenza, 2014 a Meng et al., 2014), ka like me nā ʻike ma nā ʻano hana ʻē aʻe a i ʻole nā kūlana hypothetically e pili ana (e like me, obesity) (Brooks et al., 2013, Engelmann et al., 2012, Hanlon et al., 2014 a Jasinska et al., 2014).). Eia kekahi, hōʻike kēia mau ʻike i ka insula a me kāna hana pono me ka cortices visite a me ka parietal e kōkua nui i ka manaʻo o ka gaming-cue-induced a hiki ke lawelawe i ka hopena kūpono neʻe, kūpono me nā aʻoaʻo therapeutic e hiki ai i ka paleʻana o ka noʻonoʻo e hoʻomaʻopili i ka luna o lalo i lalo o ka lalo. -up nā hana e hāpai ana i ka ʻeha (Konova et al., 2013 a ʻO Potenza et al., 2011).). A e ʻike paha, ʻaʻole paha i kaupalena ʻia ko mākou ʻike ʻana i ka IGD a nui paha i nā ʻano hana ʻē aʻe e like me ka hoʻohana ʻana i nā wikiō pūnaewele pilikia, ʻoiai ua pili kēia mau kuhi i nā ʻano like ʻole a me nā ʻano hana neural e pili ana i ka cue-induced craving (Brand et al., 2016).). Hiki i nā haʻawina o ka wā e hiki ke loiloi pololei inā e hoʻoneʻe ana ka hana hoʻololi i nā hana insula e hōʻemi i ka cue-induced craving ma IGD a me nā mea ʻē aʻe e pili ana i ka hana.

E ʻike ʻia kā mākou mea i loaʻa ma ka mālamalama o kekahi mau palena. ʻO ka mea mua, ʻo ka CBI + a me ka CBI - ʻaʻole i hāʻawi wale ʻia nā hui akā ma muli o ka makemake o nā IGD e komo i ka CBI, a ʻaʻole i komo ka hui CBI i kahi hana ʻē aʻe. No kēia kumu, ʻaʻole hiki iā mākou ke kāpae i nā mea hilahila e like me ka makemake e loaʻa i kahi hoʻopili a i ʻole nā hopena o nā hana like ʻole ma waena o nā hui, a e hōʻoia ʻia nā mea i loaʻa i kēia manawa i nā noiʻi e hoʻohana ana i nā hoʻokolohua hoʻokolohua placebo. ʻO ka lua, hiki i ka maʻa like ʻole no nā pāʻani a me nā kiʻi paʻi ke hoʻohuli i ka neural o ka poʻe i komo i nā ʻano stimulus, no nā IGD. Hiki i nā noiʻi e hiki mai ana ke hoʻokaʻawale i nā stimulus e pili ana i nā pāʻani ʻana mai ka pāʻani like i nā ʻāpana kiʻekiʻe a haʻahaʻa e makemake ai i kēia pilikia. ʻO ke kolu, he pōkole ke kau (4 s) ma waena o nā pāʻani a me nā kaha kiʻi. ʻOiai ke kū nei nā haʻawina me nā wā like a pōkole paha i ka hoʻokolokolo ʻana iā IGD (Han et al., 2010a, Ko et al., 2009a, Liu et al., 2016 a Sun et al., 2012), a me nā hāmeʻa hoʻoponopono 6 i hoʻohana ʻia i kēia noiʻi hiki ke manaʻo ʻia he 30 mau kekona kekona, aʻoi aku nā haʻawina ma hope e hoʻohana ana i nā manawa waena me nā lōʻihi lōʻihi e hōʻemi i ka hiki ke hoʻopilikia ʻia ma waena o nā kūlana. ʻO ka hope loa, loiloi kā ke aʻo ʻana i nā hopena koke o CBI. Ke noʻonoʻo nei i nā kumukūʻai kiʻekiʻe i ka IGD, pono e nānā ʻia nā hopena o ka lōʻihi o ka manawa a hiki ke ʻike i nā ʻike koʻikoʻi me ka mahalo e pili ana i nā hopena o nā kikowaena (King a me Delfabbro, 2014).

I ka hōʻuluʻulu manaʻo, hāʻawi kēia ʻike i nā ʻike hou i nā hopena neural o CBI e pili ana i ka cue-induced craving ma IGD. Hōʻike kēia mau hopena i hōʻike ʻia e nā IGD e hoʻomau ʻia ka hoʻonaninani-cue-kahi i hoʻolaʻa i nā wahi o ka lolo i ka hoʻōla ʻana a me nā hana cognitive kiʻekiʻe, a ʻo ka CBI hiki ke hoʻoikaika i nā hopena ma ka hoʻonui ʻana i ka hoʻomohala kohi a hoʻemi i ka salience o nā kahe pili i ka pāʻani ma o ke hoʻololi ʻana i ka. ka hana o nā insula anterior a me kona hoʻohui pono ʻana me ka wahi o ka lolo i komo i ka hoʻopili ʻana. Hōʻike mua kēlā mau ʻike i kā mākou ʻike no nā hana lalo o CBI a hiki paha i ke kōkua ʻana i ka hoʻoponopono ʻana i nā wawao no ka IGD.

Kōkua hihia

Ua hōʻike ʻo JTZ, YWY, CCX, JL, LL, LJW, BL, SSM, a me XYF ʻaʻole lākou iʻike i ka hakakā.

Ua ʻoluʻolu ʻo MNP a ʻōlelo aku iā Lundbeck, Ironwood, Shire, INSYS, River Mend Health, ʻOpiant / Lakelight Therapeutics, Jazz Pharmaceutical a me Pfizer; ua loaʻa ka pono noiʻi noiʻi mai ka Nā Papa Hoʻonaʻauao o Nā Aupuni, Mohegan Sun Hale Piliwaiwai, ka Nā kikowaena o ke kahua no ka pāʻani pili ʻana, a Pfizer nā lāʻau kūʻai; hoʻolako i ka mālama mālama lapaʻau ma ka ʻoihana ʻo Connecticut o ka Pūnaewele Mental and Addiction Services Problem Gambling Services Program; ua hana i nā loiloi no ka National Institutes of Health a me nā ʻāpana ʻē aʻe; ua hāʻawi i nā kūkākūkā haʻawina ma nā hoʻokele nui, nā hanana CME a me nā wahi ʻē aʻe a me ke ʻano ʻepekema hoʻi.

Role o ka loaʻa kālā

Ua kākoʻo ʻia kēia noiʻi e ka National National Science Science Kina (Aʻole. 31170990 a iā. 81100992), MOE (Keʻena ʻOihana Hoʻonaʻauao ma Kina) Hoʻokumu ʻo Nā Humanities a me Nā ʻImi Kūlana (ʻAʻole.15YJA190010), A Nā kālā kālā noiʻi kālā no ke kula nui o nā kula ʻo Kina (Aʻole.2015KJJCA13). Kākoʻo ʻia ke komo ʻana o MNP e Nā Papa Hoʻonaʻauao o Nā Aupuni (R01 DA035058, P50 DA09241), the Ka Nūneka National ma ke Kino ʻAmelika a me ka Hoʻāhewa wale, A me ka Nā kikowaena o ke kahua no ka pāʻani pili ʻana. ^ E Ha yM. Hōʻike nā hiʻohiʻona i ka ʻatikala i nā mea kākau a ʻaʻole pono i kēlā me nā ʻoihana waihona kālā.

E hoʻomaopopo '

AhahuiʻApelika Psychiatric Association, 2013
American Psychiatric Ahahui

o Nānā Diagnostic a me Statistic o nā maʻi noʻonoʻo

o (5th ed.) ʻAhahui Psychiatric ʻAmelika, Arlington, VA (2013)

Beck et al., 1961
AT Beck, CH Ward, M. Mendelson, J. Mock, J. Erbaugh

o kahi waihona no ke ana ʻana i ke kaumaha

o ʻAkela. Gen. Psychiatry, 4 (1961), pp. 561-571

o ka Naauao

Hōʻuluʻulu Manaʻo

Keywords

1. Introduction

2. Nā pono hana a me nā ʻano

2.1. Hoʻolaha ʻōlelo

2.2. Nā mea komo

2.3. Ka hoʻoweliweli ʻana i ke ʻano e pili ana i ka lawena (CBI)

2.4. Nūpepa Palepa

2.5. fMRI cue-reactivity hana

2.6. Hoʻomoe ʻana i ka loaʻa a me ka hoʻomākaukau ʻana

2.7. ʻO ka hoʻāʻo ʻana i ka hōʻike pili ʻāina

2.8. fMRI ka ikepili helu

3. Nā hualoaʻa

3.1. Kūlike nā palapala Demarkics a me ka pāʻani pūnaewele

3.2. Nā hopena o CBI ma nā kaʻina hana

3.3. nā hopena fMRI

4. Kōkua

Kōkua hihia

Role o ka loaʻa kālā

E hoʻomaopopo '

hoopoina koke ana Loulou