NĀ KUMU: ʻO kēia kahi mana o kā Kauka Hilton "Kaukaʻi ʻAnekalakala: Kahi Manaʻo Neuroscience", i loaʻa ma kēia ʻāpana like. Kūpono ʻo ia, e like me mākou, hiki i nā makana kūlohelohe ke lilo i mea addictive a hoʻololi i ka lolo e like me nā lāʻau. ʻO kāna pepa i nānā hou ʻia e nā hoa ʻO ka hōʻino ponokala kiʻi - kahi stimulus supranormal i manaʻo ʻia i loko o ka pōʻaiapili o ka neuroplasticity | Hilton | ʻO Neuroscience & Psychology Socioaffective (2013).
Ianuari 20, 2011
ʻO Donald L. Hilton, Jr. MD, FACS
Ke Kauka Pāʻoihana Clinical
Keʻena o ka Neurosurgery
Ke Kulanui o Texas Kula Haukino Ola ma San Antonio
Polokalamu ka lolo o ke kanaka e hoʻoulu i nā hana e kōkua i ke ola. Hāʻawi ka ʻōnaehana mesolimbic dopaminergic i ka ʻai a me ka moekolohe me nā mea hōʻoluʻolu ikaika. ʻO Cocaine, opioids, ʻalekoke, a me nā lāʻau ʻē aʻe e hoʻokahuli, a i ʻole hijack, i kēia mau ʻōnaehana leʻaleʻa, a e noʻonoʻo ka lolo e pono i kahi lāʻau kiʻekiʻe e ola. I kēia manawa ua ikaika nā hōʻike e pili ana nā makana kūlohelohe e like me ka meaʻai a me ka moekolohe i nā ʻōnaehana uku ma ke ʻano o ka hopena o nā lāʻau iā lākou, no laila ka hoihoi i kēia manawa i ka 'kūlohelohe maoli.' Hoʻopili, inā he cocaine, ʻai, a moekolohe paha ke pau kēia mau hana i ka hāʻawi ʻana i kahi kūlana homeostasis, a ma kahi o ka hopena maikaʻi ʻole. ʻO kahi laʻana, ke ʻai nei ke kumu o ka momona o ka momona e hoʻopaʻapaʻa ai kekahi mea i ke kaulike olakino. Pēlā nō, lilo nā ponokala kiʻi i mea hōʻino ke hōʻino a hōʻino paha i ka hiki i ke kanaka ke hoʻomohala i ka pili aloha.
He 2001 mau makahiki i hala aku nei ua hoʻomaka nā hōʻike e kuhikuhi i ke ʻano addictive o ka hoʻohana nui ʻana i nā hana kūlohelohe i kumu e loaʻa ai kahi makana dopaminergic i ka lolo. ʻO kahi laʻana, ua ʻōlelo ʻo Kauka Howard Shaffer, ka Luna Hoʻokele o Addication Research ma ke Kulanui ʻo Harvard, i ka makahiki XNUMX, "Ua pilikia nui wau me kaʻu mau hoa ponoʻī i ka manawa aʻu i ʻōlelo ai ʻo ka nui o nā mea hōʻalo ka hopena o ka ʻike ... repetitive, high-Emotional, high -ʻike pinepine. Akā ua akāka i ka neuroadaptation – ʻo ia hoʻi, nā loli i ke kaapuni neural e kōkua ai e hoʻomau i ke ʻano – a loaʻa pū me ka loaʻa ʻole o ka lawe lāʻau ʻana ”[1] I loko o nā makahiki he ʻumi mai kona haʻi ʻana i kēia, ua nānā nui ʻo ia i kāna noiʻi ʻana i nā hopena o ka lolo o nā ʻano maʻa maoli e like me ka piliwaiwai. E hoʻomaopopo i ka mea aʻe mai kēia like Science pepa mai 2001
Ua hauʻoli ka poʻe akamai i ka'ōleloʻana i ka hana kuʻiʻana i ka wā e "hijacks" ai nā'ōpuni o ka lolo no ka ukuʻana i ka hana ola ola e like me kaʻai a me ka wahine. "He mea kūpono paha inā hiki iāʻoe ke hoʻoponopono i kēia mau kaʻina me ka hana hoʻomōmaʻi, hiki iāʻoe ke hana me nā uku kūlohelohe," eʻike anaʻo Stan Knight i ka mea kālaiʻike hoʻonaʻauaoʻo Stanford University. No laila,ʻaʻole hiki i nā lāʻau lapaʻau ma ka naʻau o ka mea. "Ke hoʻomau nei ka hoʻomauʻana i ka hoʻokomo i ka hana e hoʻopōʻino ai me ka hopena o ka hopena," wahi a Steven Grant o NIDA.[2]
I loko o nā makahiki he ʻumi mai ka wehewehe mua ʻia ʻana o kēia mau manaʻo hoʻohuli kipi, ua hoʻokūpaʻa wale ʻia ka hōʻike no ka manaʻo kūlohelohe o ka uku kūlohelohe. I ka makahiki 2005 ua hoʻopuka ʻo Kauka Eric Nestler, ka luna o ke neuroscience ma Mount Sinai Medical Center ma New York i kahi pepa hoʻomanaʻo ʻāina ma Nā Nature Neuroscience me ke poʻo inoa "Aia kekahi ala maʻamau no ka hoʻāla?" Ua ʻōlelo ʻo ia: "" Hōʻike ka ulu ulu ʻana i ke ala VTA-NAc a me nā wahi limbic ʻē aʻe i ʻōlelo ʻia ma luna e like me ka waena, ma ka hapa iki, nā hopena noʻonoʻo maikaʻi o nā uku kūlohelohe, e like me ka meaʻai, ka moekolohe a me ka launa pū ʻana. Ua hoʻopili ʻia kēia mau ʻāpana like i loko o nā mea i kapa ʻia ʻo 'addicts kūlohelohe' (ʻo ia hoʻi, ka ʻai koi o nā uku kūlohelohe) e like me ka overeating pathological, piliwaiwai pathological a me nā moe kolohe. Hōʻike nā ʻike mua e pili ana nā alahele like: [ʻo kahi laʻana he] kea-sensitization i kū ma waena o nā uku kūlohelohe a me nā lāʻau o ka hana ʻino. "[3]
Ma 2002, ua paʻiʻia kahi haʻawina e pili ana i ka hana hōʻailona koko i hōʻikeʻia ka hopena o ka hopena ma nāʻano o ka lolo, e like me nā lobes mua.[4] Hoʻohana ka ʻenehana i kahi protocol i hoʻokumu ʻia e MRI i kapa ʻia he morphometry (VBM) i hoʻohālikelike ʻia (voxel-based morphometry), kahi i helu ʻia ai hoʻokahi mau mile mile o ka lolo a hoʻohālikelike ʻia. Ua paʻi ʻia kahi noi VBM hou i ka makahiki 2004 ma ka methamphetamine me nā ʻike like loa.[5] ʻOiaiʻo nā mea maikaʻi,ʻaʻole he mea kānalua kēia mauʻike i ka meaʻepekema a iʻole ke kanaka e pili ana, no ka mea,ʻo ia nā "lāʻau lapaʻau maoli."
Lilo ka moʻolelo i mea hoihoi hou aku ke nānā aku mākou i kahi kūlohelohe maoli e like me ka ʻai nui ʻana e alakaʻi ana i ka momona. I ka makahiki 2006 ua paʻi ʻia kahi noi VBM e nānā pono ana i ka momona, a ua like nā hopena me ka cocaine a me ka methamphetamine.[6] Ua hōʻike ka loiloi momona i nā wahi he nui o ka nalo ʻana o ka leo, ʻo ia hoʻi i nā lobes mua, nā wahi e pili ana i ka hoʻokolokolo a me ka kaohi. ʻOiai he koʻikoʻi kēia aʻo ʻana i ka hōʻike ʻana i nā pohō ʻike ʻia i loko o kahi kūlohelohe endogenous kūlohelohe, i kūʻē i kahi lāʻau hoʻomake lāʻau exogenous, ʻoi aku ka maʻalahi o ka ʻae maʻalahi ʻana no ka mea hiki iā mākou ke ike nā hopena o kaʻonaʻana i loko o ka mea kiko.
No laila pehea e pili ana i ka moekolohe? I ka makahiki 2007 kahi nānā VBM mai Kelemania i nānā kikoʻī ʻia i ka pedophilia, a hōʻike i ka ʻike like like me ka cocaine, methamphetamine, a me nā haʻawina momona.[7] ʻO ke koʻikoʻi o kēia noi ʻana e pili ana i kēia kūkā kamaʻilio ʻana e pili pono ana i ia mea e hōʻike ai i ke koi ʻana i ka moekolohe hiki ke hoʻololi i ke kino, ka anatomic i ka lolo, ʻo ia hoʻi ka ʻeha. ʻO ka mea e mahalo ai, ua loaʻa i kahi pepa hou kahi pilina kiʻekiʻe ma waena o nā kiʻi ponokala pedophilic a me nā keiki hoʻomāinoino kolohe.[8] Kuhi kēia, ua nānā ka pepa i kahi subgroup me, i waena o nā pilikia ʻē aʻe, ka hoʻoweliweli ʻana i nā ponokala. ʻOiai hiki iā mākou ke huki i nā ʻokoʻa kūpono a me ke kānāwai ma waena o nā kiʻi ʻoniʻoni a ke keiki a me nā mākua, ʻaʻole paha e loaʻa ka lolo i kahi kiko e pili ana i ka makahiki e pili ana i ka hoʻohaʻahaʻa ʻana o ka dopaminergic a me ka nalo ʻana i ka nui o ka hoʻohuoi. Mālama paha ka lolo inā paha ʻike kino ke kanaka i ka moekolohe, a i ʻole ke hana ʻana ia ma o ka waena o ka moekolohe mea, ʻo ia hoʻi, nā kiʻi ʻoniʻoni. Hoʻololi nā ʻōnaehana aniani o ka lolo i ka ʻike kamepiula o nā ponokala kiʻi i kahi ʻike maoli, a pili i ka lolo. Kākoʻo ʻia kēia e kahi noiʻi hou mai Palani e hōʻike ana i ka hoʻoulu ʻana o nā wahi e pili ana i nā neurons aniani i ka lolo o ke kāne i nā kāne e nānā ana i nā ponokala kiʻi. Pau nā mea kākau, "ʻōlelo mākou ... ʻo ke aniani-neuron ʻōnaehana e hoʻonāukiuki i nā mea e nānā ana me ke ʻano hoʻoikaika o kekahi mau kānaka ʻē aʻe e hōʻike nei i nā hiʻohiʻona o ka moekolohe."[9] ʻO ke aʻo muaʻana e kākoʻo ana i ka hōʻino mua i nā mea i hikiʻole ke mālama i kā lākou moe kolohe.[10] Ua hoʻohana kēia noiʻi i ka MRI diffusion e loiloi i ka hana o ka lawe nerve ma o nā mea keʻokeʻo, kahi o nā axons, a i ʻole nā kaula e hoʻopili ana i nā hunaola nerve. Hōʻike ia i ka hana maikaʻi ʻole ma ka ʻaoʻao kiʻekiʻe o mua, kahi e pili ana i ka compulsivity, kahi hiʻohiʻona o ka hōʻā.
Hōʻike nā noiʻi he nui i nā hoʻololi pathologic metabolically i ka neurochemistry e like me ka "aʻo" o ka lolo e lilo i kaʻaʻa. Hiki ke nānā ʻia kēia mau hoʻololi hoʻololi i ka ʻōnaehana uku dopamine me nā scans o ka lolo e like me ka MRI, PET, a me nā SPECT scans. ʻOiai mākou e manaʻo i kahi noi scan lolo e hōʻike i nā mea kūpono ʻole i ka dopamine metabolism i ka lāʻau cocaine,[11] hiki paha iā mākou ke kahaha i kaʻikeʻana i kekahi hōʻike hou i hōʻikeʻia i kēia manawa e hōʻike ana i ka hanaʻole o kēia mau'ahamele likeʻole me ka pili pāʻani.[12] ʻO kaʻaʻaʻana i ka mea nui, kekahi mea'ē aʻe i hōʻailona, ke hōʻike pū nei hoʻi i nāʻano pilikino like.[13]
He mea nui nō hoʻi kahi pepa mai ka hale mai o Mayo i ka mālamaʻana i nā mea hōʻailona pilau i naltrexone, he mea hōʻailona opioid.[14] ʻOi. Ua mālamaʻo Bostsick a me Bucci ma ka hale maʻi Mayo i kekahi mea maʻi me ka hikiʻole ke hoʻomalu i kāna hoʻohana ponokala pūnaewele.
Ua kau ʻia ʻo ia ma naltrexone, kahi lāʻau e hana ma ka ʻōnaehana opioid e hoʻoliʻiliʻi i ka hana a ka dopamine e hoʻoulu ai i nā hunaola i loko o nā nucleus accumbens. Me kēia lāʻau i hiki iā ia ke loaʻa ka kaohi o kāna ola moekolohe.
Manaʻo nā mea kākau:
I ka hōʻuluʻuluʻana, nā hanana pūnaewele i loko o ka hopena PFC o ka mea hoʻonāukiuki i ka hoʻonuiʻana i ke ola o nā hoʻokūkū i pili i ka lāʻau, hoʻemiʻia ka mālamaʻana o nā mea ulu lāʻauʻole, a emi iho ka hoihoi i ka hahaiʻana i nā hana i mālamaʻia i ka hopena e ola ai. Ma waho aʻe o ka'āpono o ka naltrexone mai ka Administration Food and Drug Administration no ka mālamaʻana i ka waiʻona, ua hōʻike kekahi mau hōʻike loiloi i hōʻikeʻia i kona kūpono no ka mālamaʻana i ka pāʻani pili pāʻani, kaʻehaʻeha, kleptomania, a me ka moe kolohe. Manaʻo mākouʻo kēia ka mea mua o kāna hoʻohanaʻana no ka hakakāʻana i ka hōʻailona o ka nohokino.
Ua hoʻokumuʻia ka Royal Society of Lādana i ka 1660, a hoʻopuka i ka nūpepa'enekemaʻoi lōʻihi i ka honua. Ma kahi hoʻopuka hou o kēia Nā Hanahana Philosophical o ke Royal Society, ka mokuʻāina o ka ʻike o ka hoʻowahāwahā i hōʻike ʻia e like me ke kūkākūkā ʻia e kekahi o nā ʻepekema poʻokela poʻokela o ka honua i kahi hālāwai o ka Hui. ʻO ke poʻo o ka nūpepa nūhou e hōʻike ana i ka hālāwai ʻo "The neurobiology of addiction - new vistas." ʻO ka mea e mahalo ai, o nā ʻatikala 17, pili ʻelua ʻelua i ka hoʻohaʻahaʻa kūlohelohe: pāʻani petologic[15] a me kahi pepa na Dr. Nora Volkow e pili ai i nā mea likeʻole i ka lolo i ka lāʻau hōʻailona a me kaʻaiʻana[16]. ʻO kahi pepa ʻekolu a Kauka Nestler i kamaʻilio ai i nā hiʻohiʻona holoholona o ka hoʻāʻo maoli a me DFosB.[17]
ʻO DFosB kahi lāʻau i aʻo ʻia e Kauka Nestler, a ʻike ʻia e loaʻa i nā neurons o nā kumuhana addict. Me he mea lā he kuleana physiologic ka maikaʻi, akā hoʻopili nui ʻia i ka mea hōʻowai ʻO ka mea e mahalo ai, ua ʻike mua ʻia ia i loko o nā lolo o nā holoholona i hoʻopaʻa ʻia i loko o ka hoʻāʻo ʻana i ka lāʻau, akā ua loaʻa i kēia manawa i nā pūpū lolo i loko o nā nucleus accumbens e pili ana i ka ʻai nui. o nā makana kūlohelohe.[I] ʻO kahi palapala hou e noiʻi ana i ka DFosB a me kona kuleana ma ka hoʻolimalimaʻana i nā uku kūlohelohe, kaʻai a me ka moekolohe, kāki hope:
Ma ka hōʻuluʻuluʻana,ʻo ka hana i hōʻikeʻia maʻaneʻi, he hōʻoia ia, heʻokoʻa i nā lāʻau lapaʻau, nā hana kūlohelohe e hoʻokomo i nā kūlana DFosB i ka Nac ... ko mākou hopena e hoʻonui i ka hiki i ka DFosB hoʻokomoʻana i ka NAc hiki ke pāʻani i nā mea koʻikoʻi wale nō o ka lāʻau lapaʻau. nāʻano o ka mea i kapaʻia he mau mea'ānanaka maoli e pili ana i ka hōʻiliʻiliʻana i nā uku kūlohelohe.[18]
ʻO Kauka Nora Volkow ke poʻo o ka National Institute on Drug Abuse (NIDA), a ʻo ia kekahi o nā ʻepekema ʻepekema kaulana loa a kaulana hoʻi i ka honua. Ua ʻike ʻo ia i kēia ulu ʻana i ka ʻike o ka hana kūlohelohe a kākoʻo i ka hoʻololi ʻana i ka inoa o ka NIDA i ka National Institute on Diseases of Addiction. Ka puke pai Science hōʻike: "Ua manaʻo pūʻo NIDAʻo Nora Volkow he mea pono e hoʻokomo i ka inoa o kāna kumunā lāʻauʻaloʻalo e like me pornokala, ka pāʻani, a me ka meaʻai, wahi a NIDAʻo Glen Hanson. Makemakeʻo ia e hoʻouna aku i ka leka e pono ai iā mākou ke nānā i ka māina a pau. '"[19] (ua hoʻokomoʻia ka manaʻo.).
I ka hōʻuluʻulu manaʻo, i nā makahiki he 10 i hala aku nei ke kākoʻo ikaika nei ka hōʻike i ke ʻano addictive o nā uku kūlohelohe. Ua hōʻike ʻo Dr. ʻO Malenka lāua ʻo Kauer, i kā lāua pepa palena ʻāina e pili ana i ke ʻano o nā loli kemika e kū nei i loko o nā lolo o nā kānaka i hoʻohui ʻia, "ʻo ka mea hōʻalo ke ʻano o ke aʻo a me ka hoʻomanaʻo."[20] Kāhea mākou i kēia mau hoʻololi i nā lolo lolo "potentiation wā lōʻihi" a me "kaumaha lōʻihi," a kamaʻilio e pili ana i ka lolo he palakiko, a i ʻole kumuhana e hoʻololi ai a me nā uea hou. ʻO Kauka Norman Doidge, kahi neurologist ma Columbia, i kāna puke ʻO ka Brain e Hoʻololi iā ia iho ho'ākāka i ka hopena o nā ponokala kiʻi i nā kelepona hou o nā neural circuit. Hoʻomaopopo ʻo ia i kahi noiʻi e pili ana i nā kāne e nānā nei i nā ponokala pūnaewele a lākou i nānā aku ai "ʻano maʻamau" e like me nā ʻiole e hoʻokau nei i ka lever e loaʻa i ka cocaine i loko o nā pahu hoʻokolohua Skinner. E like me ka ʻiole hoʻowīwī, ke ʻimi nui nei lākou i ka hoʻoponopono hou, ke kaomi ʻana i ka iole e like me ka ʻoki ʻana o ka iole i ka lever. ʻO ka hōʻino ponokala kiʻi hele ke aʻo ʻana, a ʻo ia nō paha ke kumu o ka hapa nui o ka poʻe i hakakā me nā ʻano mea ʻano ʻāpiki he nui ʻo ia ka mea ʻoi loa o ka hoʻowahāwahā na lākou e lanakila ai. ʻO nā mea hōʻalo lāʻau, ʻoiai ka mana, ʻoi aku ka passive i ke ʻano "noʻonoʻo", akā ʻo ka nānā ʻana i nā ponokala kiʻi, ʻo ia hoʻi ma ka Pūnaewele, kahi hana ʻoi loa neurologically. ʻO ka ʻimi mau a me ka loiloi ʻana i kēlā me kēia kiʻi a i ʻole ke kiʻi wikiō i hana ʻia no ka ikaika a me ka hopena he hana i ke aʻo neuronal a me ka rewiring.
Hoʻomaopopo ka pilina kanaka i nā ala likeʻole e like me ka ho'ālaʻana i ka wā o ka heroin.[21] Inā ʻaʻole maopopo iā mākou i nā hopena o ka hiki i nā ponokala kiʻi ke polokalamu hou i ka lolo me ke ʻano, neurochemically, a me metabolatic, ke hoʻomau nei mākou e hoʻomau i ka hana ʻole i kēia maʻi koʻikoʻi. Eia nō naʻe, inā mākou e ʻae i kēia makana kūlohelohe mana i ka nānā kūpono a me ke koʻikoʻi hiki iā mākou ke kōkua i nā mea he nui i kēia manawa i hoʻopaʻa ʻia i loko o ka hoʻōla a me ke kaumaha e loaʻa ka maluhia a me ka manaʻolana.
[1] Constance Holden, "Behavioral Addictions: Aia anei lākou? Science, 294 (5544) 2 Hōʻawina 2001, 980.
[2] Ibid.
[3] ʻO Eric J. Nestler, "Aia he ala alapila maʻamau no ka mea i hōʻaia?" Nā Nature Neuroscience 9(11):1445-9, Nov 2005
[4] ʻO Teresa R. Franklin,ʻo Paul D. Acton,ʻo Joseph A Maldjian,ʻo Jason D. Gray,ʻo Jason R. Croft,ʻo Charles A. Dackis,ʻo Charles P. O'Brien, aʻo Anna Rose Childress, "Ka Hoʻoemiʻana i ka Hua'ōlelo Pīpī i ka Haʻaweʻe, Orbitofrontal, Cingulate, a me nā kino o ke kino o ka poʻe maʻi kokena, " ʻO ke olakino'ōpiopio (51) 2, Ianuali 15, 2002, 134-142.
[5] Paul M. Thompson, Kikralee M. Hayashi, Sara L. Simon, Jennifer A. Geaga, Michael S. Hong, Yihong Sui, Jessica Y. Lee, Arthur W. Toga, Walter Ling, a me Edythe D. London, "Nā'Aninoola Kūlohelohe i loko o nā'ōpū o nā Kuleana Kānana e hoʻohana ana i ka Methamphetamine, " ʻO ka Journal of Neuroscience, 24 (26) Iune 30 2004; 6028-6036.
[6] ʻO Nicola Pannacciulli, Angelo Del Parigi, Kewei Chen, Kōkena NT Le, Eric M. Reiman a me Pietro A. Tataranni, "Nā maʻi nui o ke kino kanaka: Ke aʻoʻana i nāʻano morphometry." ʻO Neuro 31 (4) Iulai 15 2006, 1419-1425.
[7] ʻO Boris Schiffer,ʻo Thomas Peschel, Thomas Paul, Elke Gizewshi, Michael Forshing, Norbert Leygraf, Manfred Schedlowske, a me Tillmann HC Krueger, "Nā Brain Structural inn in the Frontostriatal System and Cerebellum in Pedophilia." Ka Nupepa o ka Hulikala Hoʻonaʻauao (41) 9, Nowemapa 2007, 754-762.
[8] ʻO M. Bourke, A. Hernandez, KeʻenaʻUla Hou 'Redulu: He Hōʻike no ka hopena o nā lima lima ma luna o ke keiki i hōʻinoʻia e ke keiki kiʻiʻoniʻoni hewa. Ka Nūpepa o ka HaʻewaʻeiʻAi 24(3) 2009, 183-191.
[9] H. Mouler, S. Stole4ru, V. Moulier, M Pelegrini-Issac, R. Rouxel, B Grandjean, D. Glutron, J Bittoun, Hoʻoukaʻiaʻana o ka'ōnaehana kamepiula e nā wikiō wikiwiki ākea o ka hale i kūkuluʻia. . ʻO NeuroImage 42 (2008) 1142-1150.
[10] ʻO Michael H. Miner, Nancy Raymond, BryonA. Meuller, Martin Lloyd,ʻO KelvinʻO Olim, "Kaʻimi muaʻiaʻana o nā manaʻo ikaika a me nā neuroanatoma o ka moe kolohe." ʻO Neuroimaging Neroimaging Research Psychiatry Volume 174, Helu 2, Nowemapa 30 2009, ʻAoʻao 146-151.
[11] ʻO Bruce E. Wexler,ʻo Christopher H. Gottschalk,ʻo Robert K. Fulbright,ʻo Isak Prohovnik,ʻo Cheryl M. Lacadie,ʻo Bruce J. Rounsaville, a me John C. Gore, "Hoʻonā Hoʻohālikelike Hoʻohālikelike Hanaʻiaʻo Cocaine Craving," Ka PepekemaʻAmelikaʻo'Akepila, 158, 2001, 86-95.
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