ʻO Biomed Res Int. 2015; 2015: 378675. Epub 2015 Mar 24.
Volume 2015 (2015), NĀ Palapala X XUMUM, Nā 378675
http://dx.doi.org/10.1155/2015/378675
Yunqi Zhu, 1,2,3,4 Hong Zhang, 1,2,3,4 a me Mei Tian1,2,3,4
1Department o Nuclear Medicine, Ka lua o ka haukapila o Zhejiang University School Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310009, Kina
2Zhejiang Kula Pūnaewele PET a Hangzhou 310009, Kina
3Institute of Medicine Nuclear and Molecular Imaging, Ke Kulanuiʻo Zhejiang, Hangzhou 310009, Kina
ʻO ka 4Key Keena Hana No nā Molecular Imaging o Zhejiang Province, Hangzhou 310009, Kina
Loaʻa ʻo 18 Iulai 2014; ʻNlelo ʻia ʻo 8 ʻOkakopa 2014
Lunahooponopono ʻOihana: Ali Cahid Civelek
Kuleana kope © 2015 Yunqi Zhu et al. He ʻatikala ala wehe ʻia kēia i hoʻoili ʻia ma lalo o ka ʻAha Hoʻomaopopo o ka ʻAha Kūkākūkā ʻAha Mīkini, e ʻae ana i ka hoʻohana ʻole ʻia, ka hoʻoili ʻana, a me ka hoʻouluulu ʻana i nā ʻano hana, kahi i ʻike pono ʻia ai ka hana kumu.
Hōʻuluʻulu Manaʻo
ʻO ka hoʻohana ʻana ʻo Maladaptive i nā hopena pūnaewele ma ka hoʻohui ʻana i ka Pūnaewele (IA), i pili pū me nā hopena maikaʻi ʻole. Ua hoʻonui ʻia nā hana molecular me ka hoʻohana ʻana i ka hana no ka nānā ʻana i nā loli neurobiological a me nā correlates neurochemical o IA. Hoʻomaopopo kēia loiloi i nā ʻikepili a me ka hana hoʻomālamalama hana e pili ana i ka hana neurobiological o IA, e nānā ana i ka magneton resonance imaging (MRI) a me nā hana o ka hoʻoulu ʻana i ka nukle e komo pū ana i ka tomography positron. Hōʻike nā haʻawina MRI e pili ana nā loli o ka hana ma mua o cortex me ka mau hewa i hana ʻia ma nā kumuhana pili i ka pūnaewele. Hōʻike nā hōʻike Imaging nuklea e pili ana ʻo IA i ka hana ʻana o nā ʻōnaehana dopaminergic ute. ʻO ka hoʻoponopono dopamine Abnormal o ka cortex prefrontal (PFC) i hiki ke hoʻomohala i ka waiwai hoʻoikaika hoʻoikaika a me ka hana ʻole i ke kāohi ʻia ma luna o ka Pūnaewele pili i nā kumumanaʻo. Pono nā noiʻi hou aʻe e hoʻoholo i nā loli kūikawā i ka lolo o ka pūhui addictive pūnaewele, a me ko lākou mau hopena no ka hana a me ka cognition.
1. Introduction
ʻO ka hoʻohui i nā mea a i ʻole nā hana e hiki ke hoʻopilikia nui i ka olakino o nā kānaka a i kekahi manawa ke alakaʻi ʻia i nā pilikia lehulehu i [1-3]. No ka laʻana, hiki ʻole i ka hoʻohana maladaptive i ka Pūnaewele ke hiki i ka hoʻomohala ʻana o kahi mea pili i ka hanana, e alakaʻi ana i ka hōʻeha kino ʻana a i ʻole pilikia [4]. ʻO ka mea i hala koke nei, ua hoʻonui nui ka noiʻi e pili ana i ka pono o ka Pūnaewele (IA), ʻoi aku ka pilikia o ka pāʻani pūnaewele (IGD) ma ka nui a ma ka maikaʻi [5, 6]. Ua ho'ākāka pinepine ʻia ʻo IA me ka hiki ʻole o nā poʻe i ka mālama i kā lākou hoʻohana ʻana i ka Pūnaewele, e pili ana i nā hōʻailona psychological, social, a / a i ʻole nā hana hana [7]. Hoʻopili ʻo IA me nā hopena maikaʻi ʻole, e like me ka kaumaha ʻana i nā hana maoli, ka nānā ʻole ʻana o ka maka, ka huhū a me ka huhū, ka hopohopo, disfunctional coping.
ʻOiai ua kālaiʻo IA i ka nānā nui ʻana mai ka honua ʻepekema, ʻaʻohe o kēia mau laʻamau no ka maʻi diagnostic. Ua hōʻike ʻia kekahi mau laikini diagnostic e hoʻopaʻa i ka IA. ʻO ka hoʻohana pinepine ʻana no ka noi diagnostic ʻo Young's Diagnostic Questionnaire [8-10]. Hoʻokumu ʻia ma ka Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), ʻo Iā Mamua ua kūkulu i kahi nīnau noiʻewalu kāwalu helu i loiloi ʻia IA [8]. I ka hoʻohana ʻana i kēia mau koi, ua helu ʻia nā mea hoʻohana me ʻelima a i ʻole o nā ʻewalu mau i hōʻike ʻia i loko o nā mahina ʻo 6 i hala. Ua hana hou ʻo Young i kahi nīnau no 20-item, i kapa ʻia ʻo ka Pūnaewele Hoʻomau Hōʻike Pūnaewele [10]. Ma ka nīnau nīnau 20-item, ua hoʻokumu ʻia kēlā me kēlā me kēia ma kahi kiko he 5-point Likert e loiloi ana i ka loaʻa ʻana o nā pilikia ma o ka hoʻohana pūnaewele. Hōʻike i nā helu ma 50 i nā pilikia e pili ana i ka pūnaewele a i ʻole ka maʻamau a me nā helu ma luna o 80 e hōʻike i nā pilikia nui e pili ana i ka ola [10]. Ua hoʻāʻo ʻia ka Pūnaewele Hoʻomau Pūnaewele he mea kūpono a pono e hiki ke hoʻohana ʻia ma ka helu ʻana i ka IA [11]. ʻO nā mea hoʻohana ʻē aʻe a me nā mea nānā screening a me ka mea i hana ʻia e loiloi ai i ka IA [12-16].
ʻO kahi mea nui he subtype koʻikoʻi a IA, ua loaʻa ka IGD a me ka nānā hou aku mai ka honua holoʻokoʻa. Ua hoʻokomo ʻia ʻo IGD i ka manawa i loaʻa iā DSM-V, me ka pahuhopu e hoʻoikaika ai i nā haʻawina hou [4]. Ka wehewehe ʻana ka DSM-V i ka IGD ma "ka hoʻohana mau ʻana a ka ʻoihana pūnaewele e hana i nā pāʻani, pinepine me nā mea pāʻani ʻē aʻe, e alakaʻi ana i ka hōʻeha poʻokela paha a hopohopo paha e hōʻike ʻia ana e ka ʻelima a ʻoi aku paha (mau manaʻa) i kahi mahina 12" 5].
I nā makahiki i hala iho nei, ua māhuahua ka lōʻihi o nā mehele a me nā hana lawelawe imaging no ka hoʻopaʻa ʻana i ka hana neurobiological ma lalo o IA. ʻO ka imaging molecular he mākā wikiwiki e hoʻomohala ana i ka hāʻawi ʻana i nā ʻike molekone pili i ka maʻi ma o nā noiʻi diagnostic imaging [17]. Hiki ke wehewehe nui ʻia ka huaʻōlelo ʻo ka molaging molaging e like me ka vivo characterization a me ke ana ʻana o nā kaʻina biologic ma ka pūpū o ka cellular a me nā molekula [18]. I mea e pale ai a mālama i ka IA, he mea nui ia e ʻike i kahi hoʻomohala ʻana i kāna mau hana lalo. ʻO ka holomua ʻana o ka ʻenehana ua hoʻohana ʻia i ka hoʻohana nui ʻana o ka hana hoʻonaninua ʻenehana a me nā hana hana, no ka laʻana, ka magnetic resonance imaging (MRI), positron emission tomography (PET), a me nā kiʻi foton i hoʻohālikelike i ka tomography (SPECT), e kōkua ai i ka nānā ʻana i nā ʻano ʻokoʻa. nā maʻi maʻi me ka hoʻopaʻa ʻia ʻana o IA. Maanei mākou e hōʻike ai i nā haʻawina hoʻonaninani a me nā hana loea hou i hāʻawi ʻia i nā ʻike nui i nā hana neurobiological o IA, e noʻonoʻo pono ana i nā ala ʻo MRI a me PET.
2. Nā ʻĀina ʻo MRI
ʻO ka MRI kahi hana mode imagingous loa e hoʻohana ana i ka mana a me ka ikehu radiofrequency e ʻike i ke ʻano o loko a me ka morphology kiko o ke kino [19]. ʻO ka pono mua o MRI ma o ka modaging imaging modality ʻo ia kona kiʻekiʻe spatial hoʻonā (micrometer), e ʻae ana i ka ʻokoʻa a me ka ʻike anatomical e ʻohi ʻia i ka manawa like. ʻO Functional MRI (fMRI) kahi hana noninvasive hiki ke hoʻohana i ka nānā ʻana i nā hana metabolic i nā loli o ka lolo [20]. Ua hōʻoia ia aia ka piʻi ʻana o ka hana neuronal ma loko o kahi ʻāpana o ka lolo e alakaʻi ai i ka piʻi nui ʻana o ka nui o ka kahe koko e hele ana i loko o kēlā wahi kikoʻī [21]. Mai ka deoxygenated hemoglobin e paramagnetic, a me ka hemoglobin oxygenated he diamagnetic, ua hoʻoneʻeneʻe ʻia ka nui-oxygen-level-dependant (BOLD) e nānā i ka lolo o ka lolo ma ka hana ʻana ma nā wahi like ʻole a me nā koi ʻana.
2.1. Nā Hoʻololi Kūlohelohe
Ke hoʻohana nei i MRI, ua hōʻike kekahi mau noiʻi ua pili nā hoʻololi o ka lolo i ka IA. Ke hoʻohana nei i ka hōʻike ʻana ʻo Stroop color-word test [22], kahi i hoʻohana nui ʻia no ka loiloi ʻana i ka pale inhibitory, ua hōʻike ʻia kahi noiʻi e hōʻike ana nā ʻōpiopio me ka IGD i nā hemahema cognitive control kakayahan [23]. Hōʻike nā hopena o nā hōʻike i ka pili ʻana o ka lolo i ka hana hoʻokele, no ka laʻana, ka ʻulaʻi orbitofrontal cortex hema (OFC), insula cortex, a me ka cortex entorhinal, hōʻike i ka hoʻohaʻahaʻa cortical mānoina ma nā kumuhana IGD i hoʻohālikelike ʻia me nā mana hoʻomohala (Figure 1). Eia kekahi, hōʻike pū nā mea kākau ua hōʻemi ʻia ka mānoanoa cortical o ka hema hema o ka hema o OFC me ka hiki ʻana o ka mana cognitive control i ka ʻōpio ʻo Hawaiʻi. E kūlike me kēia, ua hōʻike hou ʻia kekahi noiʻi i ka emi o ka mānoanoa o ka OFC o ka ʻenemi i hoʻohui ʻia i ka pūnaewele [24]. Hāʻawi ʻia i ka manaʻo e hoʻokomo ʻia ka OFC i ke ala o nā lāʻau lapaʻau a me nā mea pili i ke ʻano [25, 26], ua hōʻike nā mea kākau e hōʻike ana ʻo IA i nā ʻano like ne like me ka hana neʻe. Ma waho o ka emi o ka mānoanoa cortical, ua ʻike ʻia ka mānoanoa cortical i nānā ʻia ma ka cortex hema hema, precuneus, cortex mua waena, a me nā cortices temporal waena a me ka waena [23] (Figure 1). Hoʻopili ʻia ka precuneus me ka noʻonoʻo noʻonoʻo, ka nānā ʻana, a me ka hoʻihoʻi mai [27]. ʻO ka cortex temporal haʻahaʻa a me ke cortex mua waena i hōʻike ʻia e pili i ke kiʻi ʻana i ke ʻano o ka cues coting [28, 29]. No laila, eia nā hualoaʻa e pili ana i ka nui o nā wahi laulā cortical i IGD e pili ana me ka makemake i nā cues gaming.
Hōʻike 1: ʻO nā hoʻokaʻawale poloka hāpili i nā wā'ōpiopio me ka IGD i hoʻohālikelike ʻia me nā mana olakino. I ʻike ʻia ka mānoanoa cortical i mau wahi i loko o nā ʻōpio me ka IGD i hoʻohālikelike ʻia i nā mana olakino, ʻo ia hoʻi, ʻo ka cortex hema hema, precuneus, cortex mua waena a me nā pōkole temporal a waena. ʻO ka hoʻoneʻe cortical kaila ma ka ʻaoʻao hema o ka OFC, insula cortex, a me ka lingual gyrus, me ka ʻaoʻao postcentral gyrus, cortex entorhinal, a me ka puʻupuʻu kahunaetal cortex i ʻike ʻia i nā wā ʻōpio me IGD [23].
ʻO ka morphometry e pili ana i Voxel kahi hana unbiased no ka hōʻike ʻana i ka nui cerebral regional a me ka hoʻoliʻi kūwili o nā kiko i nā kiʻi hoʻohālikelike magnetic [30, 31]. Ua loaʻa nui nā morphometry e pili ana i ka Voxel i ka ʻike ʻana i ka nui o ka maʻi maʻamau i loko o nā ʻano like ʻole o ka maʻi neʻe. Ua hōʻike ʻia nā haʻawina morphometry a Voxel e pili ana i ka wā ʻōpio ʻo IGD ka haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa ma ka hema cortex anterior Cortex (ACC) hema, hema hema cortex (PCC), hema insula, a waiho iā lingual gyrus [32]. Ke hoʻohana nei i ka like me kēia, ua hōʻemi ʻia ka nui o nā kumu hina hina i loko o ka bilateral dorsolateral PFC, wahi ʻokoʻa a me ka ʻUwili, OFC, cerebellum, a waiho i ka Aostostost rostral ma kahi hui o nā ʻōpio o nā ʻenekena lula [33]. Hoʻohui ʻia, hōʻike ʻia kahi haʻawina hoʻākāka mua o Voxel-morphometry i ka hoʻohuihui ʻana i ka hina haʻahaʻa ma OFC kūpono, bilateral insula, a me nā wahi kīnā pono a IGD [34]. ʻAʻole mau nā hopena o ke aniani hina ma waena o kēia mau noiʻi, ʻo ia paha ma muli o nā ʻano loiloi ʻikepili like ʻole. Ua hoʻokomo ʻia ka PFC i ka hoʻolālā ʻana i ka hanana cognitive paʻakikī, hōʻike pilikino, a me ka hoʻoholo 'ana, ka mea o ka dorsolateral PFC, ACC, a me OFC [35]. Ua lawe ʻia nā haʻawina hoʻonaʻauao lehulehu i ka hana o ka PFC i ka hoʻohui (36]. I kēia manawa ʻike maʻamau ia e hana nei nā OFC i kahi hana nui ma ka hoʻomohala a me ka hoʻoholo i [26, 37]. Ua hōʻike ʻia nā noiʻi imaging functionally hopohopo ua pili nā dorsolateral PFC a me rostral ACC i pili i ka mālama cognitive [38, 39]. ʻO ka nui o nā hina hina i loko o ka PFC e pili ana me ka mālama ʻole ʻole ʻia ma ka addict pūnaewele, e wehewehe pono i nā hōʻailona kumu o IA. Ua manaʻo ʻia ka insula e hana i kahi kūlana koʻikoʻi i ka mea i hoʻohui ʻia [40]. Hoike i kekahi mau haʻawina Imaging hāmeʻa pono e hōʻike i ka insula e pono no ka uakiʻi pono e lawe i nā lāʻau lapaʻau, a hana maʻamau kēia hana i waena o nā mea hana kolohe [41, 42]. No laila, ua kūpono kēia mau hualoa me ka ʻike mua a hōʻoia i ka mana pono o ka PFC a me ka insula no ka hoʻohui.
'Usionlelo' ana o ka diffusion tensor imaging (DTI) kahi ala i hiki ai ke kiʻekiu i nā ʻili kelepona keʻokeʻo noninvasively. Loaʻa ka ʻōhumu o nā molekala wai i ka wikiwiki o ke kaila helehelena ma mua o nā ʻōmole iā lākou. ʻO ka ʻokoʻa ma waena o kēia mau ʻōpiehana ʻelua ke kumu o DTI [43, 44]. Hāʻawi ʻo DTI i kahi hana no ka loaʻa, ka nānā ʻana, a me ka helu ʻana o nā waiwai o ka wehe ʻana i nā mea keʻokeʻo. ʻO ka hoʻohuiʻana i nā mea hina hina, ua ʻōlelo pū ʻia nā mea keʻokeʻo keʻokeʻo ma IGD. Ke hoʻohana nei i ka DTI, kahi loiloi i nānā ʻia i ke kūloko hihia keʻokeʻo ma nā mea pono me ka IGD [45]. Ua hōʻike ʻia ka anisotropy kiʻekiʻe ʻoi fractional i loko o ka thalamus a waiho iā PCC i ka IGD pili i nā mana olakino. Eia kekahi, ʻoi aku ka nui o ka anisotropy fractional i ka thalamus i pili me ka nui o ka IGD. Ua hōʻike ʻia hoʻi nā mea lahilahi ke keʻokeʻo ma nā ʻāina ʻē aʻe o nā haʻawina ʻē aʻe. No ka mea laahi, ua hōʻike ʻia a hoʻemi ʻia ka anisotropy fractional i hoʻohui ʻia i loko o kahi noiʻi, me ka anisotropy fractional i hoʻonui ʻia i ka pihi hema o ka capsule o loko a hōʻemi iho i ka anisotropy fractional ma ka ʻaoʻao parahippocampal gyrus [33]. Ma kekahi noiʻi, ua hōʻike nui ʻia ka anisotropy fractional haʻahaʻa ma ka ʻaoʻao o ka mea i hoʻopili ʻia o ka Pūnaewele, me ka PFC a me ACC [46]. Eia naʻe, ʻaʻohe mau wahi o ka anisotropy fractional kiʻekiʻe. Ua hōʻike ʻia nā hopena like ʻole ma kekahi pūʻulu o nā wā'ōpiopio me IGD [34]. Hōʻike kēia mau mea hōʻike i ka maʻi IA i hōʻike i nā mea maʻamau o ke keʻokeʻo e pili ana, e pili ana me kekahi mau hana hoʻokaumaha. Pono e hoʻomaopopo ʻia ka hoʻololi ʻia ʻana o nā anisotropy fractional i loko o nā wahi i ka lolo, a ʻo ke ʻano o ke ʻano i loko o kēia mau noiʻi e noiʻi hou.
2.2. Nā Kūpono Kūʻai
Ke hoʻohana ʻana i ka arterial spin-labeling perfusion fMRI, Feng et al. ua noi ʻia nā hopena o IGD ma ka hoʻomaha ʻana i ke kahe koko cerebral i loko o nā ʻōpio [47]. Hoʻohālikelike ʻia me nā kumumana hoʻomalu, nā ʻōpio me ka IGD i hōʻike nui loa i ke kahe koko cerebral nui i loko o ka limu ʻula hema hema / fusiform gyrus, hema parahippocampal gyrus / amygdala, mau ke alo pono mua medial / ACC, hema insula, insula ʻākau, ʻākau waena temporal gyrus, ʻākau gyrus precentral, left motor motor supplementation, left cingulate gyrus, and right inferior parietal lobe. Ua hoʻokomo ʻia ka hapa nui o kēia mau wahi i kahi hiʻohiʻona i hāʻawi ʻia e Volkow et al. ma loko o laila ka haki i ka haki ʻana no ke kaohi ʻana o ka ʻike a me ka hoʻohui ʻana ma waena o nā ʻekekī āpau a me nā hana [48]. Ma waena o kēia mau ʻaoʻao o ka lolo, ʻo ka amygdala a me nā hippocampus kahi ʻāpana o ka lepa i komo i ka aʻo ʻana a me ka hoʻomanaʻo e pili ana i ka moʻolelo e pili ana i nā kīʻaha pili lāʻau [49]. ʻO nā insula a me ka PFC, ua ʻike ʻia he hana koʻikoʻi nui i ka addiction [36, 40]. Ua loaʻa i ke kahe koko cerebral i loaʻa i ka gyrus waena waena hema, hema gyrus waena waena, a me nā kahe cingulate kanikani i ka wā'ōpiopio IGD. Hōʻike nā hopena i ko IGD e hoʻololi i ke kahe koko o ka cerebral ma ka lolo o ka ʻōpio. Eia nō naʻe, maopopo ʻole inā he hoʻohuli ʻia nei nā kaila koko o ka cerebral e pili ana i nā maʻi neʻokeʻo a me nā loli lua e uku ʻia no kēlā mau pōʻino.
Ua nānā ʻia nā hana hoʻopili pili pono i nā poʻe me IA. Ua hōʻike kahi haʻawina hou loa i hōʻike ʻia nā kumuhana me ka IGD i ka hoʻonui ʻia o ka hana hoʻopili paʻa ʻana i ka pebileli posterior biletralum a me ka gyrus waena waena i hoʻohālikelike ʻia me ka hui pū [50]. ʻO ka lua wai i hoʻowalewale i ka hoʻoweliweli parietal o ka gyrus temporalal i hōʻike i ka hoʻohaʻahaʻa. Ua hōʻike ʻia kekahi noiʻi ʻē aʻe i ka wā ʻōpio me IA i hōʻemi ʻia ka pili ʻana i ka hana me ka cortico-subcortical circuits, a ʻo ka bilateral putamen ka mea i hoʻopili nui ʻia ma ka ʻekekaumaha kaʻina subortical [51]. Hōʻike kēia mau hopena i ka pili ʻana o IA i kahi pālahalaha nui a me ka nui o ka hoʻohuihui ʻana i hana ʻia i kahi ʻoha i māhele ʻia.
Ua hōʻike ʻia e pili pū ka impulsivity me IA [52]. ʻO ka hiki ke kāohi i ka pane o ka mīkini i hoʻolālā ʻia e hoʻohana pinepine ʻia me ka hoʻohana ʻana i ka hōʻailona-i ʻole a i ʻole / hele-no paradigms [53]. Ua hōʻike ʻia kahi noiʻi hou ʻana i ka pane ʻana a me ka hoʻokaʻawale hewa ʻana i nā kumuhana me IGD [54]. Ua hana nā kumu āpau i kahi hana i pili i ka hanana / no-hele ma lalo o fMRI a ua hoʻopau i nā nīnau nīnau pili i ka IA a me ka impulsivity. Loaʻa i ka pūʻulu IGD ka helu kiʻekiʻe no ka impulsivity a hōʻike i ke kiʻekiʻe o ka hoʻoweliweli ʻana i ka wā e hoʻōla ana i ka pane ʻana o ka pane ma ka hema o OFC a me ka bilateral caudate nucleus ma mua o nā kaohi. Ua hui pū ka OFC me ka pane ʻana o [tugon ma 37, 55]. No laila, kākoʻo kēia mau hopena i ka ʻoiaʻiʻo i pili i ka pūnaewele fronto-striatal pili i ka pale ʻana i ka pane. Ua nānā ʻia kahi like like me nā neural correlations o ka pale ʻana i nā kāne me IA me ka hoʻohana ʻana i kahi hanana i pili ʻia puhaluhi like fMRI Stroop [56]. Ua hōʻike ka pūʻulu IA nui loa i ka hana "Stroop effect"-pili pili ma ka ACC a me PCC hoʻohālikelike ʻia me nā koina olakino. Ua hōʻike ʻia ʻo ACC e pili i ka hoʻopiʻi kaua a me ka mana hoʻomohala [57, 58]. ʻO ka nui o ka hana ACC ma mua o ka hana Stroop color-word task e noʻonoʻo i ka emi ʻana o "ka noʻonoʻo cognitive" i ka pūʻulu IA. ʻO PCC kahi kikowaena o ka paʻamau mode paʻahana a ua hoʻokomo ʻia i nā kaʻina attentional [59]. ʻO ka hoʻonui nui aʻe ma ka PCC hiki ke hōʻike i ka piha piha ʻana o ka ʻike mode like ka hopena i ka hiki ʻole ʻana i nā hana pili i ʻike ʻia i loko o ka pūʻulu IA. Hōʻike kēia mau hopena i nā mea hōʻike me IA i hōʻike i ka emi ʻana o ka hana o ka hoʻomaʻamaʻa pane-inhibition.
ʻO ke ʻano homogeneity o ka ʻāina ka nui o ka hoʻohana ʻana i nā haʻawina fMRI e ana i ka hana kiko o kekahi voxel i hāʻawi ʻia me kona mau hoalauna kokoke, a hiki ke hoʻohana ʻia e loiloi i nā hana ʻoluʻolu o ka lula e pili ana i ka hypothesis e pili ana i nā leo kīkē e pili kokoke ana i nā hana pilikino. 60]. Hōʻike nā kumuhana IGD i ka nui e hoʻonui i ka home homogeneity i loko o ka limulu parietal inferior, waiho i ka posterior cerebellum, a waiho i kahi gyrus waena waena a hoʻemi i ka homogeneity kūloko ma ka wā kino, occipital, a me nā ʻāpana ʻula o ka parietal i hoʻohālikelike ʻia me nā mana olakino [61]. Hōʻike nā hopena i ka pāʻani lōʻihi o ka pāʻani pūnaewele ma ka lolo ʻana i ka naʻau o ka naʻau i ka hoʻoponopono ʻana i ka sensory-motor e pili ana i nā wahi o ka lolo a me ka hoʻohaʻahaʻa ʻana i ka mana o nā lolo o ka noʻonoʻo a me ka auditory.
Nui nā noiʻi i noiʻi i nā wahi o ka lolo e pili ana i ka pāʻani cue-induced gaming urges [62-65]. Hāʻawi ʻia nā mea i hōʻike i nā kiʻi pāʻani ma ke kiʻi ʻana i ka fMRI. Hōʻike kēia mau noiʻi i ka hana hoʻomohala i nā wahi noʻonoʻo i hoʻolilo ʻia (e like me, dorsolateral PFC, inetior parietal lobe, ACC, parahippocampal gyrus, OFC, a me PCC) i ka hui hoʻohui me ka hui pū ʻana. Ua hōʻuluʻulu maikaʻi nā ʻōnaehana hoʻōla i hoʻōla ʻia me nā pīkau ʻana o ka pāʻani pili ponoʻī. Ua hoʻokaʻawale ʻia nā mea maʻamau i loko o kēia mau ʻāina i ka hoʻohui i nā haʻawina a hiki ke pili pū me nā hana i loko o ka hoʻomohala cognitive, craving, hoʻopaʻi i kuhikuhi ʻia, a me nā hana hana i nā kumuhana IGD [66].
Pili kekahi haʻawina hoihoi i nā kumuhana o ka IGD me nā kumuhana o ke kala ʻana mai ka IGD a me ka kaohi i loko o ka cue-induced craving e pāʻani i nā pāʻani pūnaewele [67]. Pateral dorsolateral PFC, precuneus, left gyrus parahippocampal, PCC, a me ACC ʻĀkau i hana ʻia e pane ai i nā puʻupuʻu pāʻani i ka hui ʻo IGD i hoʻohālikelike ʻia me ka hui mana. ʻO kēia mau ʻōkuhi kuhi hoho e hōʻike ana i ka lolo olakino e pili ana i ka ʻoihana o ke hoʻohui lāʻau [38, 39, 59]. Eia kekahi, hōʻike ka pūʻulu kala i ka hoʻemi ʻana o ka hoʻoneʻe ʻana ma luna o ka pors dorsolateral kūpono a waiho i ka gyrus parahippocampal ma mua o ka pūʻulu IGD. No laila, ua hōʻike aku nā mea kākau e lilo nā ʻaoʻao ʻelua i mākaʻi moho no nā mea hoʻohui i kēia manawa ma ka pāʻani pūnaewele.
Ua hoʻohana ʻia hoʻi ʻo MRI e loiloi i nā hopena therapeutic o ka lapaʻau lāʻau lapaʻau kūikawā ma IA. ʻO ka Bupropion he norepinephrine / dopamine reuptake inhibitor, ka mea i hoʻohana nui ʻia i ka mālama pono ʻana o nā maʻi me ka hōʻino kino. Ua noiʻi ʻia kahi haʻawina kūpono i ka hiki ʻana o ka bupropion, i ka noʻonoʻo ʻia o ka hana noʻonoʻo i ka pane ʻana i nā puʻupuʻu pāʻani e hoʻohana ana i ka fMRI [68]. Hōʻike ʻo IGD i ka hoʻōho kiʻekiʻe ma ka limu occipital, waiho dorsolateral PFC, a waiho i kahi gyrus parahippocampal ma mua o nā kāohi. Ma hope o nā wikiō 6 o ka mālama bupropion, he haʻahaʻa ka makemake a me ka nui o ka manawa i makemake ʻia e pāʻani ai. ʻO ka hana noʻonoʻo c c--induced in dorsolateral PFC ua hōʻemi ʻia, i hōʻike ʻia he mau pono ʻo bupropion. E like me ka mea i hōʻike mua ʻia, hōʻike ka poʻe individu ma ka IGD i ke kala ʻana i ka hoʻoneʻe ʻana ma luna o ka pors dorsolateral kūpono a waiho i ka parahippocampal gyrus [67]. No laila, ʻo ka molaging molaging i hiki ke kōkua i nā kauka lapaʻau e hoʻoholo i ka mālama kūpono loa no nā maʻi maʻi pilikino a nānā i kā lākou holomua i ka hoʻōla.
3. Loaʻa i ka ʻike ʻike ʻia ʻo Nuklei
Hōʻailona ka pale aku o Nuclear, ʻo ia hoʻi ʻo SPECT a me PET, loaʻa nā haʻawina o ke ʻano kiʻekiʻe intrinsic kiʻekiʻe, ka palena ʻole o ka hohonu hohonu, a me ka pālahalaha o nā keʻena lapaʻau e ʻike nei i nā molekule '70]. Hāʻawi ka SPECT a me PET i ka ʻikeʻike i ka hoʻoliʻi ʻana o ka ikehu ma vivo ma o ke kaomi ʻana i ka ʻai nui o ka glucose, ka poholima cerebral, a me ka make o ka oxygen. I ka noiʻi neuroscience, hiki iā ia ke aʻo ʻana i nā hana neural, a me nā kaʻina maʻi, pili ʻia i ka metabolism a me ka hana [71]. Loaʻa i ko PET nā pono keu aʻe o ka hāʻawi ʻana i ke kiʻekiʻe kiʻekiʻe o ka spatial ma mua o ka SPECT. No ka hoʻohui ʻana o ka pākīpī o ka cerebral metabolism, hiki iā PET a me SPECT ke hana hou aku i nā kikoʻī kikoʻī hou o ka neʻe ʻana o ka pae o ka neurotransmitter ma o ka hoʻohana ʻana i nā radiotracers neurotreceptor kūikawā [72].
3.1. PET Hoʻōla o nā Hoʻololi molino ʻo Brain
Ke hoʻohana nei i 18F-fluoro-deoxyglucose (18F-FDG) PET imaging, kahi noiʻi i noiʻi i nā ʻano o ka metabolism cerebral glucose i kahi hoʻomaha hoʻomaha ma waena o nā poʻe'ōpiopio me ka IGD a me ka poʻe me ka hoʻohana maʻamau [73]. Hōʻike nā hopena o ke hōʻike ʻana i hoʻonui nui ʻia ka glucose metabolism i ka waena waena o OFC, haʻalele caudate nucleus, a me ka ʻula insula a hoʻemi ʻia ka metabolism i loko o ka gyrus postcentral gyrus, nā gyrus precentral, a me nā ʻāpana bilateral occipital i hoʻohālikelike ʻia me nā mea hoʻohana maʻamau. Hōʻike nā hopena i ka IGD e pili ana me ka abnormality neurobiological i nā ʻĀina OFC, striatum, a me nā wahi sensory, kahi i hāpai ʻia ma ka kaohi o ke kolo, hoʻomaikaʻi ʻana i ka uku, a me kahi hoʻohanohano o nā ʻike mua.
3.2. Hoʻoponopono o nā Nuklearena o nā Abnormalities o Neuroreceptor
Ua hōʻike ʻia nā hōʻike hōʻike e pili ana ka lawelawe dopaminergic i ka hoʻohui i ka lāʻau [74, 75]. Ke aʻo ʻia ʻana e hoʻokele ʻia e Koepp et al. ua hoʻohana ʻia ka raclopride a inoa 11C a me nā pēpē PET e nānā i ka hoʻokuʻu dopamine endogenous i ka striatum kanaka i ka wā wikiō [76]. ʻO ka hiki ʻana o ka radioligand 11C-raclopride i nā ʻae lāʻau dopamine D2 e pili ana i nā pae o ka dopamine endogenous, hiki ke ʻike ʻia he mau loli i ka hiki ʻana o ka radioligand. Ua hōʻike aku nā mea kākau e hoʻopili ana ʻo 11C-raclopride i nā ʻoniwa dopamine i ka striatum i ka wā o ka pāʻani wikiō e hoʻohālikelike ʻia i nā pae pae o ka paʻa, ka mea i manaʻo ai e hoʻonui a hoʻopaʻa i ka dopamine i kāna mau mea pane. Eia kekahi, ua hōʻike lākou he hopena nui ma waena o ka hana o ka hana i ka wā o ka hana a hōʻemi i ka hana 11C-raclopride e hiki ai i ka striatum. Ua hōʻike ʻia nā hopena like i loko o nā poʻe me IA [77]. ʻO nā kānaka pilikino me IA i hōʻemi i ka loaʻaʻana o ka receptor dopamine D2 i ka striatum i hoʻohālikelike ʻia me nā kālai. Eia kekahi, aia i kahi hopena kino o ka loaʻa ʻana o ka dopamine receptor me ka hōʻino o IA. Kākoʻo kēia mau loiloi iā Han et al. ka mea nāna i noiʻi i ka genym polymorphism o ka ʻōnaehana dopaminergic ma kahi pūʻulu o nā mea pāʻani pāʻani hoʻoili pūnaewele Internet [78]. Ua hōʻike lākou i ka poʻe me ka nui o ka polymorphism genetic i ka hoʻopaloli genes no ka DopN D2 receptor a me ka dopamine degradation enzyme iʻoi aku ka maʻalahi ma ka pāʻani pūnaewele i hoʻohālikelike ʻia me nā mana o ka makahiki.
ʻO ka Dopamine transporter kahi protein membrane plasma e hoʻoikaika ikaika i ka unuhi i ka dopamine mai ka wahi extracellular i loko o ka presynaptic neurons [79]. Ka hoʻololi ʻia ka dopamine transporter kaomi ma ka striatum ma hope o ka hoʻokō mau ʻana i nā mana maʻi i hōʻike ʻia ma mua [80, 81]. Ke hoʻohana nei ʻo SPECT me ka radiotracer 99mTc-TRODAT-1, ua noiʻi ʻia i kā mākou hui hui striatal dopamine transporter density i loko o IA e ʻike ai i nā mana koho presynaptic [82]. Hōʻike mākou i ka hoʻohaʻahaʻa nui o ka hōʻike dopamine transporter i ka hoʻohaʻahaʻa nui loa a me ka nui, ke kaumaha, a me 99mTc-TRODAT-1 uptake ratio of corpus striatum i hoʻemi nui ʻia i ka poʻe me ka IA hoʻohālikelike me nā mana. Lawe pū ʻia kēia mau hopena e pili ana i ka pili o IA me ka disfunction o ka ʻōnaehana dopaminergic.
I kahi noiʻi hohonu hou aʻe, ua noiʻi kā mākou hui i kēlā me ka dopamine D2 receptor a me ka metabolism glucose i nā poʻe like like me ka hoʻohana ʻana i ka PET me 11C-N-methylspiperone (11C-NMSP) a me 18F-FDG, ma nā wahi ʻelua o ka hoʻomaha ʻana a me ka hana pāʻani pūnaewele. 69]. ʻO ka emi nui o ka hoʻohaʻahaʻa glucose i mālama ʻia i loko o nā hanana prefrontal, temporal, a me nā limu i nā kumuhana IGD. Ma ka hoʻomaha hoʻomaha, ka haʻahaʻa haʻahaʻa o 11C-NMSP binding i ʻike ʻia i loko o ka gyrus temporal haʻahaʻa kūpono loa i nā kumuhana IGD e hoʻohālikelike ʻia i nā mana maʻamau (Figure 2 (a)). Ma hope o ka hana pāʻani Pūnaewele, 11C-NMSP e pili ana i ka waiwai ma ka striatum ka haʻahaʻa loa i nā kumuhana IGD i hoʻohālikelike ʻia me nā mana, e hōʻike ana i ka hōʻemi o ka ʻae o dopamine D2 (Figure 2 (b)). Ka hoʻoponopono ʻia ʻana o ka mea nānā dopamine D2 e hoʻopili ʻia i nā makahiki o ka hoʻohana ʻana i ka pūnaewele (Figure 2 (d)). ʻO ka mea nui, ma nā kumuhana IGD, haʻahaʻa haʻahaʻa o dopamine D2 receptor i ka striatum ua hoʻopau ʻia me ka hoʻohaʻahaʻa ʻana i ka hana metabolism i loko o ka OFC. Hōʻike kēia mau hopena i ka dopamine D2 receptor medireg dysregulation o OFC hiki i ka mālamina o kahi hana no ka nalowale o ka kaohi a me ka hana i hoʻopaʻa ʻia ma nā kumuhana IGD.
Hōʻike 2: 11C-NMSP PET imaging o ka dopamine D2 receptor i loaʻa i nā kumuhana IGD. (a) Ma ka hoʻomaha hoʻomaha, ka haʻahaʻa haʻahaʻa o 11C-NMSP binding i loaʻa ma ka puʻuwai kino temporal kūpono i loko o nā kumuhana IGD i hoʻohālikelike ʻia i nā mana (ʻāpana ʻoniʻoni) (uncorrected,). (b) I ka mokuʻāina o ke pāʻani pāʻani, ʻo 11C-NMSP ka mea i paʻa i ka putamen i haʻahaʻa loa i ka pūʻulu IGD ma mua o ka pūʻulu o ka mana, a ma ka ʻaoʻao ʻākau (ka kala melemele (uncorrected,). (c) ʻO nā ʻākau ʻākau (,) a me nā waiho lima no ka 11C-NMSP o ka palena lima (,) i hōʻino maikaʻi me ka kiʻi ʻōpio i nā kumuhana IGD. (d) ʻO ka hema hema o OFC i ka paina cerebellum o 11C-NMSP e hoʻopili kino ana me ka hewa me ka lōʻihi o ka hoʻohana ʻana i ka pūnaewele (,) [69].
Mai kēia mau hopena, hōʻike i ka hōʻike like ʻana o IA i nā mīkini like me nā loiloi like me ka hoʻohui ʻana i ka lāʻau lapaʻau. Eia nō naʻe, aia kahi hōʻike e hōʻike ana he nui nā kūʻokoʻa i ka hana neʻōmaʻomaʻo o nā hana ʻalani like ʻole [83]. I loko o kahi hōʻikeʻike, Badiani et al. hoʻolako i nā hōʻike e pili ana i ka addiate addiction a me psychostimulant addally he whanali a me ka neurobiologically wehe, a pili kēia mau ʻokoʻa i nā mea ʻē aʻe [83]. No laila, ʻo ka hoʻomaopopo ʻana i nā hana neurobiological i lalo o ke IA he mea pono no ka hoʻomohala ʻana i ka pili lapaʻau pono a me ka hopena.
4. Nā hopenaʻike a me nā kūlana mua
Ua hōʻike ʻia nā hōʻike hōʻike ʻōiwi e pili ana i nā loli i ka ʻōnaehana o ka lolo a me ka hana e pili ana i ka IA i pili i nā wahi lolo i komo i ka uku, hoʻowalewale, a me nā hoʻomanaʻo ʻana, a me nā pūnao cognitive. Ua hoʻonui ʻia nā hana loea molecular a me ka hana ʻana i ka noiʻi IA, e hāʻawi nui ana i ko mākou ʻike i ka hana neʻōmaʻomaʻo. ʻO ka hapa nui o nā nīpepa mua i aʻo ʻia i nā kānaka IA ma lalo o ke kūlana hoʻomaha, hōʻoia i ka hanana a me ka hana pono i loko o ka OFC, dorsolateral PFC, ACC, a me PCC. Hiki i kēlā mau wahi ke kuleana nui i ka hoʻohanohano salience, pale paʻa, a me ka hoʻoholo ʻana i nā hoʻoholo. Ma kēia manawa, hoʻokahi wale nō aʻo ʻia ʻo PET me 11C-NMSP a me 18F-FDG i mālama ʻia ma lalo o ka hoʻomaha ʻana a me ka hana ʻana ma ka pāʻani pūnaewele ma ka poʻe hoʻokahi (a me IGD a ʻaʻole paha) a ʻike ua hiki i ka dopamine D2 Hoʻopuka mediated disregulation o ka OFC hiki ke hoʻomālamalama. ka hoʻokele no ka nalowale o ka hoʻokele a me ka hana pono i nā kumuhana IGD.
E lilo ana ʻo IA i pilikia koʻikoʻi ma ka honua holoʻokoʻa, he nui ka pono no ka mālama pono ʻana. Ua noi ʻia nā hoʻolālā lapaʻau a me ke ʻano lāʻau lapaʻau e mālama iā IA. Ua hōʻike ʻia he nui o nā lāʻau lapaʻau e hoʻohiki ana i ka mālama ʻana i ka IA, e like me antidepressants, antipsychotics, a me ka opioid receptor antagonist [84]. Ua hoʻokaʻawale ʻia ke ʻano hoʻomālamalama ʻana i hana ʻia e mālama i ka hōʻino o ka waiwai [85]. Mai ka ʻike ʻana o IA e ka like like me ka hana hōʻino kino, ua hōʻoia ʻia i ke ʻano cognitive-behavioral i hopena ma ka mālama ʻana iā IA [86]. ʻO ka noiʻi hou aʻe me ka hoʻohana ʻana i nā radiotracers kikoʻī e kuhi i nā ʻōnaehana neurotransmitter i hoʻopili ʻia e ka IA e hāʻawi i kahi kiʻi o ka mana o ka hana neurobiological i hoʻomoe ʻia e IA. Eia kekahi, hiki ke hoʻohana ʻia nā radiotracers e loiloi i nā hopena therapeutic o ka lāʻau lapaʻau lapaʻau kūikawā, no ka laʻana, me ka hoʻohana ʻana i 11C-carfentanil e nānā i ka loaʻa ʻana o ka mu-opioid a me ka wānana i nā hopena lapaʻau o nā antagonist reseptor opioid a me nā kōkua i nā kauka lapaʻau e hoʻoholo i ka hana kūpono loa no nā maʻi maʻi pilikino. . ^ E Ha yM.
Kū'ē o nā koho
Hōʻike nā mea kākau mea ʻaʻohe hakakā o ka makemake e pili ana i ka hoʻolaha ʻana o kēia pepa.
mau hoomaikai ana
Ua kākoʻo ʻia kēia hana e Kākoʻo mai ka National Key Basic Research Program o Kina (2013CB329506), National Science Foundation of China (NSFC) (81271601), a me ke Kuhina ʻepekema a ʻenehana ʻo Kina (2011CB504400).
E hoʻomaopopo '
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