Kaha. 2013 Jan 31.
Polite M, Loane C, Wu K, O'Sullivan SS, Woodona Z, Kiferle L, Lawrence AD, Lees AJ, Piccini P.
Kumu: Division of Brain Sciences, Keʻenaʻo Medicine, Hammersmith Hospital, ka Imperial College London, London W12 0NN, UK.
Hōʻuluʻulu Manaʻo
ʻO ka moekolohe a me ka moekolohe i ke kolohe, he kumu nui ia o ka maʻi maʻamau no nā maʻi i loaʻa i ka maʻi o Parkinson i nā hoʻoponopono pani pani. Uaʻike mākou i kahi mea liʻiliʻi e pili ana i ka maʻi maʻi o ka moekolohe i ka maʻi o Parkinson, aʻaʻole iʻikeʻia i kaʻikeʻana i nā mea e like me nā hiʻohiʻona o ka moekino ma ka pānaʻi pākī nui i ka lolo a me ka hana i loko o ia mau mea paʻakikī. ka hui o nā maʻi 12 me ka maʻi o Parkinson me ka moekolohe me ka hoʻohanaʻana i kahi hoʻolālā hoʻohālike i ka hoʻohālike i ka hoʻohālikeʻana i nā mea a pau e pili ana i ka moekolohe, i nāʻikeʻike'ē aʻe a piliʻole hoʻi. Ua manaʻo mākou he hiki i kaʻikeʻana i nāʻike moe kino e hoʻonui ai i ka makemake o ka wahine i nā maʻi me ka maʻi o Parkinson me ka moekolohe e pili ana i nā loli o ka hana lolo i nā moku i pili i ka hoʻonāukiuki i ka hoʻonākauʻana.
ʻO nā maʻi i loaʻa i ka maʻi o Parkinson me ka moekolohe, ua paʻiʻia a hoʻopauʻia nā lāʻau lapaau dopamine, a ua hoʻohālikelikeʻia nā hopena o lākou me kahi hui o nā maʻi maʻi o 12 Parkinson ma waho o ka moekolohe a me nā maʻi'ē aʻe. ʻO ka hōʻikeʻana i nā moe kolohe nui nui ka makemakeʻana i ka wahine a me nā pane hedonic i loko o ka maʻi'ōkino maʻi o Parkinson i ka hoʻohālikelikeʻana i nā maʻi maʻi o Parkinson. ʻO kēia mau hoʻololi kūlike ua kūlike i ka nui o ka hoʻohālikelike o ka oxygen koko e hoʻololi i nā wahi ma loko o nā lālā limbic, parabolic, kino, occipital, somatosensory a me nā mua e pili ana i nā kaʻina hana a me nā manaʻo.
Hōʻike kaʻikepili kiʻi hoʻolālā i ka hoʻomāhuahuaʻana o ka makemake o ka moekolohe me ka hoʻonuiʻiaʻana o ka hana i ka striatum ventral, a me ka hanaʻana i nā mea e hana ai.. WMa muli o ka maʻi o Parkinson i ka poʻe maʻi me ka maʻi o Parkinson, ua hōʻikeʻia ka hōʻemiʻana o kaʻikeʻikeʻike hana i ka hoʻoukaʻana i ka hōʻikeʻana o nā leka moe e pili ana i ka rest.
ʻAʻole i mālamaʻia kēia mau hana i ke olaʻana o nā maʻi, ke manaʻo nei e hoʻokuʻu i nā lāʻau lapaʻau o ka dopamine i ka hanaʻana i loko o nā kaapuni'ōnaehana o kaʻaha i loko o kaʻeha kala ma ke kīʻaha e hiki ke hoʻohui i ka moe kolohe.
Aia nā hopena o kēia aʻo i pili i ka hopena o ka hopena o ka hōʻike ma o kaʻikeʻana i ka'ilikala nui i ka hoʻonuiʻana i ka libido, i loko o kēia pūʻulu o nā maʻi maʻi hiki ke alakaʻi i nā hopena pili i nā kānaka a i kekahi manawa, mau'ōlelo mālama.
Ma muli o ka hōʻeuʻeuʻana i nāʻikeʻike i nā mea maʻi i nā maʻi me ka maʻi o Parkinson me ka moekolohe, hiki ke hoʻoikaika nui no kaʻimiʻana i kēia hana hoʻohanohano ma o ka hoʻouluʻana a me ka hoʻopauʻana o ka corbex cerebral.
Introduction
ʻO nā pilikia o ke kaohiʻana me ka moekolohe a me ka moekolohe i ke kolohe, he kumu nui ia o ka maʻi maʻamau no nā poʻe maʻi me ka maʻi o Parkinson e loaʻa ana ka curerapamine substitutive (Weintraub ¶ AL., 2006; Evans ¶ AL., 2009; Auhea ¶ AL., 2009). ʻO ka moekolohe me ka moekolohe i ka moe kolohe me nā noi nuiʻole no ka wahine mai ka hoa wahine aiʻole i ka hoa pilikino, hoʻonui i ka pāʻani ponokala, ka pākīkī ikaika, ka palakōkika me nā kipa i nā wāhine hoʻokamakama, a ma kekahi mau mea mua muaʻole, i paraphillias (eg sadism, bestiality, transvestitism; Quinn ¶ AL., 1983; Auhea ¶ AL., 2006). ʻO ka piʻiʻana o ka moekolohe ma ka maʻi maʻi Parkinson,ʻo ia ka'3.5% ma kahi hoʻonui nuiʻana o nā maʻi e loaʻa ana ka dopamine agonist therapy me nā kāne iʻoi aku i nā wāhine keʻikeʻia he wahine maʻamau (Weintraub ¶ AL., 2010). Ua aʻoʻia kahi noi hou aʻoi aku ka liʻiliʻi i kahiʻoi aku o ka moekolohe ma ka maʻi maʻi Parkinson o 7% a me kahi loulou pū me l-DOPA (ʻO Hassan ¶ AL., 2011). Ua hōʻike pūʻia nā papahana mua i kahi pilina ma waena l-DOPA a me ka moekolohe (ʻO Ballivet ¶ AL., 1973; Palaunu ¶ AL., 1978; Uitti ¶ AL., 1989).
Ua loaʻa i ka lehulehu keʻano pilina o ka moe ma ka'apena a hiki i ka lehulehu ke hoʻolakoʻia, a hiki i nā kiʻi pīkoi ke hiki aku ma ka pūnaewele. Ua'ōleloʻia,ʻo ka pili mau i nā mea pili i ka moekolohe, hiki ke hoʻonā i nā hana kūponoʻole i keʻano o ka noho kanaka ma kekahi mau mea pilikino a me nā kānaka pilikino e lawe ana i ka lāʻau lāʻau (Nā Rees ¶ AL., 2007). Hōʻike nā haʻawina i nā'īlio e pili ana ka pilina maʻamau ma waena o nā lāʻau lapaʻau dopamine a me nāʻike moe kolohe i kaʻoihanaʻoihanaʻoihana nui (Pomerantz, 1990). ʻO ke koʻikoʻi o kaʻike e pili ana me ka uku e like me ka papahana no ke ola, no ka mea, makemakeʻia ka 'makemake' e kahi pilina maʻamau i waena o ka nohona o ka pūnaehana dopamine mesolimbic a me ke kūʻana o nā uku a iʻole nā palapala (Zhang ¶ AL., 2009; Berridge, 2012).
PET (Hōʻike ¶ AL., 2000) a me MRI hana (ʻAno ¶ AL., 2002; Hamana ¶ AL., 2004; Walter ¶ AL., 2008) uaʻike nā haʻawina o nā hana kuʻuna i nā mea iʻikeʻia ma nā mea olakino i nā kānaka olakino. He nui nā'āpana e like me ka striatum ventral, hypothalamus, amygdala, cingulate a me orbitofrontal cortex. I loko o kahi noi hou, me ka hoʻohanaʻana i ka PET a me nā mea kikoʻole o ka weheʻana o ka dopamine, ua hōʻikeʻiaʻo ka poʻe maʻi me kahi maʻi maʻi o Parkinson i ka nui o ka hōʻailona Striatum dopamine ma hope o kaʻikeʻana i nā mea iʻikeʻia ma ka nānāʻana e like me ka hui o nā maʻi maʻi o Parkinson (ʻO O'Sullivan ¶ AL., 2011). ʻO kēiaʻikeʻana e pili ana i ke kumumanaʻo hoʻonāukiho hoʻonāukiho, e manaʻo ana e loaʻa ana ka loaʻaʻana o ka hōʻailona kōkua ma muli o ka hāʻawiʻana i kaʻoluʻolu nui (aiʻole "makemake") no nā uku a me nāʻike, no ka hopena o nā neuroadaptations i nā projections dopamine i ka pili o striatum ventral ke kaʻina hana hoʻolālā (ʻO Berridge ¶ AL., 2009).
Ua hōʻike nā haʻawina hoʻokolohua e pili ana i nā'eneka pūnaeweleʻenehana ma nā wahi e like me ka striatum ventral, hypothalamus, amygdala a me ka cortex medial prefrontal i kahi i ka hoʻoulu i ka wahine a me ka hahai,Pfaus, 2010; Stolzenberg a Numan, 2011). Ua hōʻikeʻia ka manaʻoʻana e nā dopamineric drugs e hoʻonui i ka loaʻaʻana o nā uku kūlohelohe, e like me nā mea hoʻonā wahine (Fiorino a me Phillips, 1999; Nocjar a me Panksepp, 2002; Afonso ¶ AL., 2009), ma muli o ka hoʻoikaika nuiʻana i ka hāʻawiʻana i nā makana i nā pane uku. Eia kekahi,ʻo ka moekolohe a me nā lāʻau lapaʻau e hoʻohui i ka heluna o nā neurons i ka striatum ventral, amygdala, hypothalamus a me ka'opiʻi kāpili o mua, e hoʻomaopopo ana i nā pūnaewele kahi hiki i nā lāʻau lapaʻau ke hoʻoikaika i ka moekino (ʻO Frohmader ¶ AL., 2010; paa ¶ AL., 2010).
E like me ka manaʻo kumu hoʻonāukiuki, hiki ke hoʻohuiʻia i ka maʻi o Parkinson i ka hoʻonuiʻana i ka hanaʻana i nā'āpana lolo i pili i ka hoʻouluʻana i ka wahine a me ka hoʻouluʻana, aʻo kēia mau mea e hiki ke hoʻohanaʻia e ka lāʻau lāʻau dopaminergic. I kēia manawa,ʻike mākou i nā poʻe maʻi me ka maʻi o Parkinson me ka moekolohe e hōʻike ana i ka pili pili i ka moekolohe i loko o kēia mau'āina e pili ana i ka hoʻouluʻana i ka wahine, a e pili ana i ka hoʻouluʻana i ka wahine. Uaʻimi mākou eʻimi i kēia mea ma ka nānāʻana i ke kūlana o ka oxygen koko-e faalagolago ana (BOLD) i nā hoʻololiʻana me ka MRI hana (ma ka hoʻohālikeʻana i nā pane i kahi hōʻike lāʻau lāʻau ON me ka wiliʻana o ka lāʻau) a hoʻoponopono i nā hopena kiʻi me nā loiloi halihali o ka hoʻouluʻana i ka wahine.
Nā maʻi a me nāʻano
Nā mea i komo ai a me nā hōʻailona pili
ʻO nā maʻi maʻi he iwakāluakūmāhāʻole me ka maʻi'ōpilikia o ka maʻi Parkinson i aʻoʻia (Nā Papahana 1 a 2). ʻO kaʻumikumamālua o kēia mau mea i hōʻoia i nā pae hōʻailona hoʻolālā i manaʻoʻia no ka pili wahine (Auhea ¶ AL., 2006; Ka Papa Hana 1). ʻO nā mea'ē aʻe o ka 12 me ka maʻi maʻi Parkinsonʻaʻole he moʻolelo o ka moekolohe a iʻole nā mea'ē aʻe o ka hoʻoponoponoʻana i ka manawanui a lawelaweʻia e like me ka pūʻulu papa. ʻO Frohmader ¶ AL. (2011) ua hōʻike e pili ana nā hopena o nā lāʻau lapaʻau ma luna o nā moekolohe kolohe i nāʻano holoholona i kaʻike like o ka lāʻau dopamineric a me kaʻike pilina. Pēlā nō,ʻo ka moekino lapaʻau i loko o ka maʻi o Parkinson kahi mea e ulu ai ma ka pōʻai o ka hoʻohanaʻana i ka lāʻau lapaʻau pinepine aʻaʻole loa eʻikeʻia. hou maʻi (Giladi ¶ AL., 2007). No laila, ua hoʻohālikelike mākou i nā poʻe maʻi me ka maʻi o Parkinson me ka moekolohe i kahi pūʻulu mālama o nā mea maʻi i loaʻa i ka maʻi o Parkinson.
Nā kūlana o ke kikowaena o nā haumāna
| Nā hōʻailona | ʻO ka maʻi o Parkinson me ka moekolohe | ʻO nā maʻi maʻi o Parkinson | P-waiwai |
|---|---|---|---|
| Ka helu o nā kumu | 12 | 12 | |
| Makahiki (mau makahiki ± SD) | 55.2 ± 9.2 | 62.3 ± 9.7 | 0.077 b |
| Sex | 11 M / 1 F | 10 M / 2 F | |
| ʻO ka lōʻihi o ka maʻi (makahiki ± SD) | 9.6 ± 5.2 | 10.1 ± 6.4 | 0.85b |
| ʻO ka UPDRS PAʻA PAHELE (Māhele III) (mean ± SD)a | 40.2 ± 10.1 | 34.9 ± 9.9 | 0.21b |
| UPDRS ON ka kaʻa (Mahele III) ka helu a me ka maikaʻi% (mean ± SD)a | 23.1 ± 8.2 (43.8 ± 9.7%) | 20.0 ± 5.5 (41.4 ± 11.7%) | 0.29 (0.59)b |
| KaʻImiʻAi Moku-Mental (mean ± SD) | 29.8 ± 0.4 | 28.9 ± 2.2 | 0.30c |
| Nā Lā LāTOTAL (mg ± SD) | 600 ± 327 | 778 ± 278 | 0.17b |
| Nā Lā LāL-DOPA (mg ± SD) | 288 ± 326 | 646 ± 264 | c |
| Nā Lā LāDA (mg ± SD) | 311 ± 183 | 132 ± 143 | c |
a Ka awelika oʻelima mau loiloi ma nā lā likeʻelima.
b Hoʻokuʻuʻoleʻia t-test.
c Hōʻikeʻo Mann-Whitney.
ʻO nā maʻi maʻi o Parkinson i nā maʻi = nā maʻi me ka maʻi o Parkinson me ka moekoloheʻole a iʻole nāʻano hoʻonāukiuki'ē aʻe; M = kāne; F = wahine; SD = ke kaulike maʻamau; UPDRS = Ka maʻi maʻi i hoʻohuiʻia i kahi maʻi pāʻani. ʻO LED = levodopa ōlike. Hoʻohālikelikeʻia ka hopena e like me ka hōʻike mua (ʻO Politis ¶ AL., 2010): LED (mg) = (1 × = levodopa) + (0.77 × levodopa + entacapone) + (1.43 × levodopa CR + entacapone) + (1.11 × ropinirole ER) + (20 × rotigotine) + (20 × bromocriptine) + (100 × apomorphine) + (30 × pergolide) + (10 × cabergoline) hanana LED, ma levodopa / carbidopa aiʻole benserazide hydrochloride:ʻo levodopa wale nō heluʻia.
ʻO nā maʻi me ka maʻi o Parkinson me ka moekolohe
| Nā Kaupapa | Sex | makahiki | Keʻano o ka moekolohe | Nā'Iina'ē aʻe | Hoʻoponopono Dopaminergic | Nā Lā LāDA | Nā Lā LāL-DOPA |
|---|---|---|---|---|---|---|---|
| HS1 | M | 46 | ʻO nā kiʻi'opikala / ka hana pinepine i nā moe kolohe a me nā koi | CS | Cabergoline | 280 | 0 |
| HS2 | M | 65 | ʻO ka moe me nā poʻe i heleʻoleʻo ia e pili i ka piliʻana i ka moekolohe a iʻole ka hana i ka moekolohe | Pramipexole | 267 | 0 | |
| HS3 | M | 72 | ʻO ka wahine me nā poʻe āna i makemakeʻole ai e hui | ʻO Ropinerole, levodopa | 180 | 700 | |
| HS4 | M | 65 | Nā hopena pilikia / pili i ka pūnaewele ponokala | Pramipexole | 200 | 0 | |
| HS5 | M | 50 | Ua hōʻole ka maʻi i ka wehe | BE, CS | ʻO Ropinerole, levodopa | 180 | 800 |
| HS6 | F | 55 | Hoʻonuiʻia ka moekolohe | CS | Pramipexole | 200 | 0 |
| HS7 | M | 53 | ʻO nā kiʻi'onikala | ʻO Pramipexole, levodopa | 240 | 260 | |
| HS8 | M | 53 | Nā hopena e pili ana / ka hilinaʻi pili i ka moekolohe | PG, BE, CS | ʻO Ropinerole | 360 | 0 |
| HS9 | M | 60 | Ua hōʻole ka maʻi i ka wehe | BE, CS | ʻO Ropinerole, levodopa | 300 | 600 |
| HS10 | M | 41 | ʻO nā kiʻi pilikino / nā hele pinepine i nā moekolohe | DDS | Cabergoline, levodopa | 530 | 500 |
| HS11 | M | 45 | ʻO nā kiʻi pumeʻoni / hoʻokomo pūnaewele pūnaewele | DDS | ʻO Pramipexole, levodopa | 200 | 600 |
| HS12 | M | 57 | ʻO ka hoʻokomo pū me ka pūnaewele ponokala | DDS, PG, BE | ʻO Ropinerole | 800 | 0 |
E BE = eʻai i kaʻai; CS = ke kūʻai kūʻaiʻana; ʻO = = agonist dopamine; DDS = ka maʻi dessregulation dopamine; HS = ka hypesexuality; ICD = ka maʻi hoʻomalu o ka mana; PG = pili pili pāʻani.
ʻO nā pūnaewele hoʻolālāʻokoʻa,ʻo ia hoʻiʻo Hoehn a me Yahr,ʻo ka hapa kaʻa (Part III) o ka maʻi Lapaʻau no ka Hoʻomaʻamaʻaʻana i kahi maʻi (UPDRS), kaʻimiʻana i kaʻike a me ka heluʻana i kēlā me kēia lā l-DOPA hua like like (LED). ʻEwalu o nā maʻi 12 me ka moekino o ka maʻi maʻi Parkinson i hōʻikeʻia ma kahi o hoʻokahi hoʻonāʻau 'Nā Papahana 1 a 2).
Uaʻaeʻia ka hoʻonaʻauao kūpono mai ka komite PelekikenaʻoʻAmelika Hammersmith a me Queen Charlotte. Ua loaʻa kaʻae i kaʻaeʻia mai ka poʻe a pau i komo ma muli o ka Hōʻike o Helsinki.
Nā hōʻike hoʻolālā
Ma mua a ma hope o ka hōʻiliʻiliʻana, ua noiʻia nā haumāna e hōʻoia i ko lākou libido a me ko lākou makemake i kaʻenehana likeʻole (10 cm), ua kuʻiʻia ma waena o ka 'haʻahaʻa loa' (0 cm = 0) a 'ʻo ka mea loa loa' (10 cm = 10 nā helu). Ua hōʻike ponoʻia nā paleʻelua a pili a pili i ka manaʻo o nā mea i loko o ka hola i hala. Loaʻa i nā mea kaulike i nā mea kaulike hoʻokahi-pono e like me nā palapala noi ninia-nui (long-item)West a me Ussher, 2010). ʻO ka hapanui o nā maʻi me ka maʻi kāne o Parkinson i ka nui o nā maʻi o ka hoʻopiʻiʻana i ka manaʻo,ʻo ia hoʻi nā pālākiō likeʻole i hōʻikeʻia no ka pāʻani kālā, nā lāʻau lapaʻau a me nā meaʻai.
Nā papa hana hoʻolālā kūhohoʻikepili
Hoʻopiliʻia nā mea i komo iʻelua mau lā kaʻawale (ma waena o 11: 00 a me 13: 00 h) 7 lā ma keʻano hoʻohālikelika i ka hopena ma hope o ka hoʻomahaʻana i ka pōpō a me ka hōʻaiʻana i ka lāʻau ma lalo o 18 h ma mua o kaʻikeʻana. Ua nānāʻia nā mea i komo i loko o ke kaʻina o ka lāʻau hōʻailona maʻamau i hoʻokahi scan a ma ka'ōlelo lāʻau lāʻau ON ma hope o ka loaʻaʻana o ka hopena l-DOPA / benserazide (200/50 mg) dispersible 45 min ma mua o ka hoʻomaka ʻana o ka scan. Loiloi ʻia ka hana moto me nā helu moto UPDRS ma ka laina hoʻomaka a ma mua koke o ka nānā ʻana e hōʻoia i ka pane ʻana o ka mea maʻi i ka lāʻau (wehewehe ʻia e like me> 25% mau hoʻomaikaʻi ma nā helu moto UPDRS-III). Ka hoʻohana ʻana o lUa kohoʻiaʻo DOPA no ka meaʻo nā mea maʻi a pau i ka maʻi o Parkinson i lawe mua i kēia, no ka mea,ʻaʻohe o nā mea a pau i hoʻokahi o ka agonist dopamine hoʻokahi. Eia kekahi, lHiki iā DOPA ke hoʻonui i ka hoʻonāukiʻana i ka maʻi o Parkinson, a uaʻikeʻia ka halihali moe kolohe e like me nā mea like l-DOPA hoʻoponoponoʻana,ʻaʻole wale i ka hoʻoponopono dopona (agonist) (ʻO Ballivet ¶ AL., 1973; Palaunu ¶ AL., 1978; ʻO Hassan ¶ AL., 2011).
Hoʻonohoʻia nā mea i loko o ka scanner me nā pepeiao a me ka pale pale ma ke poʻo, nā poʻohiwi a me nā lima e hoʻomaopopo i kahi liʻiliʻi no ke neʻeʻana. Ua nānāʻia nā hoʻoukaʻana i nā'ōhū a i ka hihia o ka nui o ka hana, ua hoʻomaka houʻia ke kahakaiʻana a ua weheʻia nā waihona pono mai ka hōʻiliʻiliʻana (5.2% o nā'ōnaeho no ka haʻalulu a iʻole ka dyskinesias). Ua mālamaʻia ke kiʻi kiʻi kiʻi ma kahi kamepiula a puni o ka 3 T Philips Intera. Ua loaʻa nāʻikepili pūnaewele me nā voluma 199 o T2* uʻomanaʻo e hoʻonui i ka hoʻolālāʻana i ka hoʻolālāʻana o ka hōʻailona o ka hoʻonaʻauaoʻana i ka hoʻonuiʻana i ka hoʻonuiʻana i ka hoʻonuiʻana i ka hoʻonuiʻana i ka hōʻailona kūʻokoʻa o 3.25 mm; 3000 × 30). Ua hoʻokumuʻia ka'āpana hoʻokipa'āpana i -90 ° mai ka lālani papa hana mua aʻe e hoʻohaʻahaʻa i ka hōʻailona lobe mua ma muli o kaʻili o ka makani, me kahi z-e hoʻonui i ka hoʻonaʻauaoʻana i nā mea āpau ma luna o nā alapine hiki ke'ālikaiʻia (Deichmann ¶ AL., 2003; ʻO Goldstone ¶ AL., 2009). Hoʻokahi o ka manaʻo kiʻekiʻe T1Houluuluʻia ka turbo e hoʻonui i ka'ōkuhi kiʻi (ka manawa kikowaena 4.6 ms; ka manawa hou 9.7 ms; 8 ° flip angle; 240 mm nānā).
ʻO keʻano o nā hiʻohiʻona hoʻonā'ānana hana kūpono
I loko o kaʻike MRI maʻamau,ʻelimaʻano o nā kiʻi kala i hōʻikeʻia i loko o kahi hoʻolālā papa: (i) nā hōʻailona lāʻau lāʻau; (ii) nā hōʻailonaʻaiʻai; (iii) nā kālā a me nā hōʻike pili kālā pāʻani; (iv) nā moe kolohe; a (v) nā kuhikuhi palekana. Ua loaʻa ka hapanui o nāʻike iʻikeʻia a me kaʻikeʻole i ke kikowaena o ka International Picture Affect Picture Picture (ʻO Lang ¶ AL., 2008) a ua hoʻonuiʻia e nā kiʻi i loaʻa mau mai i nā pūnaewele. Ua hōʻikeʻia he'enekino kiʻi e like me ka hoʻokomoʻana i nā hōʻike o ka paʻi aloha, ka hīkī aloha, nā kiʻi a me nā kiʻi hoʻonāukiuki o nā wāhine a me nā kāne (ke kāne iʻikeʻia: uaʻike nā kāne i nā kāne a me nā wāhine i nā kāne) me ke kapaʻia o ko lākou kino. Uaʻikeʻia nā'enekeʻikepiliʻokoʻa i nā'āina a me nā hiʻona'āina, nā mea hale a me nā'ōnaeho'ōpili. ʻO ka International Picture Picture Pūnaewele i nā mea iʻikeʻia i ka wā iʻikeʻia ai ka hopena o ka wahine i ka manawa i hoʻoholoʻia a ua hōʻikeʻia e hoʻonāukiuki i nāʻano nui o ke alo o ka wahine ma mua o ka MRI / psychophysiological ma mua.Bradley ¶ AL., 2001; Conaglen a me Evans, 2006; Walter ¶ AL., 2008).
Ua hoʻokomoʻia nā kiʻi o ka manaʻo like like me nā pōka 14.7 iʻelua mau holoʻana o ka 9 min 56 a pau i kēlā me kēia. Ua loaʻa i kēlā me kēia'āpana nā kiʻi likeʻoleʻehiku mai kaʻaoʻao likeʻole, me ka heluʻeono mau papa o kēlā me kēiaʻano i hōʻikeʻia ma kahi papa kauoha pseudorandom me kahi hoʻonohonoho kiʻi ma mua o kēlā me kēia'āpana. Ua kālepa likeʻia nā kauoha holoʻokoʻa ma waena o nā haumāna a me nā mākaʻikaʻi. Ua hōʻikeʻia kēlā kiʻi kēia kiʻi no ka 2100 ms, a ua ukaliʻia kēlā me kēlā me kēia papa e kahi hōʻailona helu 4000 i hiki ai i ka mea komo ke helu mai ka 1 a hiki i ka 5 i ka nui o ka makemake o lākou i ka'āpana o nā kiʻi iʻikeʻia (me 1 ka 'inaina iaʻu' ʻO 5 ka 'makemake au iā ia'). Ua hanaʻia kēia mau manaʻo ma ka leo, a ua kākauʻia lākou i loko o kahi kamepiula. Ua ukaliʻia ka slide pākuhi e kahi 1000 ms i kahi manawa o ke keʻa paʻa. Ua nānāʻia nā kiʻi ma kahi aniani i hoʻonohoʻia ma luna o kahi pūnaewele poʻo RF he 8, a ua hōʻikeʻia nā kiʻi mai kahi papahana e hoʻohana ana i ka pūnaewele hōʻike kiʻi IFIS-SA (In Vivo) a me ka polokalamu E-Prime (Psychology Software Tools Inc).
ʻImiʻia kaʻikeʻikeʻikeʻikepili
Ua kālailai ʻia nā ʻikepili kiʻi me ka hoʻohana ʻana i ka Palapala ʻIkepili Palapala Helu Helu 5 (Ke Keʻena ʻOihana Neuroscience Imaging, UCL, UK). Ua kiola ʻia nā pae mua ʻelima o kēlā me kēia holo MRI hana e ʻae i nā hopena o ke kaulike, a ua hoʻonohonoho ʻia nā scans āpau i ka scan mua o ka holo a laila hoʻi i ke kumu o nā nui āpau no ka neʻe ʻana a me ka manawa hoʻoponopono. Loaʻa nā scans āpau i ka hoʻopili hope loa o <2 mm o ka neʻe i kēlā me kēia ala. Ua ʻimi mākou i ka ʻikepili no ke koena o nā mea i hoʻohana ʻia me ka hoʻohana TSDiffAna i hoʻokō ʻia ma ka Statistical Parametric Mapping mana 5, e hoʻopuka nei i nā kiʻi a me nā ʻano like ʻole no kēlā me kēia leo hana.http://imaging.mrc-cbu.cam.ac.uk/imaging/DataDiagnostics). Hoʻohālikelikeʻia kahi hua'ōlelo e like me kahi hui-like o ka hoʻokekēkēʻana a me ka hāʻina iho i kahi ihoʻole me ka hoʻolālā hoʻokolohua. ʻAʻole mākou iʻike i kekahi mau mea i makemakeʻia e nānā houʻia. ʻO ke kiʻi hanaʻoihana i kākau inoaʻia i ka T1 ke kūlana kiʻi. Ua hoʻokumuʻia nā kiʻi kikowaena i nā kiʻi kikowaena i ka papahana kūlana papahana kūlana kiʻekiʻeʻo Montreal Neurological Institute e hoʻohana ana i nā palena o ka T segment1 ke kūlana kiʻi a hoʻouluʻia me ka hoʻohanaʻana i ka 8 mm piha piha ka hapalua o nā kānana Gaussian.
Ua hanaʻia kaʻimi mua ma kahi kūlana papahana hoʻokahi kahi i hanaʻia ai nā mea likeʻole i loko o keʻano laina linear no kēlā me kēia kūlana hoʻopaʻi i emiʻole i ke kumuhana (kiʻi paleʻole) a no ka moeʻana i nā uku'ē aʻe (male me nā uku'ē aʻe). ʻO ka'ōnaehana pūnaewele heʻono mau mīkini a me nā mea maʻamau, ka helu no ka neʻeʻana a me nā mea hanaʻinoʻole e hanaʻia ana iʻekolu mauʻaoʻao o ka unuhi (neʻeʻana) a meʻekolu axes of rotation (x, y, z ka unuhi a x, y, z ke hoʻololi) no kēlā me kēia holo. ʻO nāʻano likeʻole o ka hoihoi i hanaʻia i kēia manawa (e like me ka male me ke kūʻole) ua hoʻohanaʻia i ka lua o nā pae, ka hōʻuluʻulu o ka hopena o nā pōpilikia. ʻO kahi pae helu helu o P <0.001 uncorrected a me ka huhui cluster ma luna o 10 voxels (2 × 2 × 2 mm) i hoʻohana ʻia no ka hoʻoulu ʻana me ka hoʻohana ʻana i ka lolo holoʻokoʻa me ka hoʻoponopono no nā hoʻohālikelike he nui e hoʻohana ana i ka helu loaʻa hewa ma P <0.05 (ʻO Genovese ¶ AL., 2002). Ua hoʻoholoʻia nā luna hui o ka peak voxel activation i loko o ka lolo i ka paeʻaina no ON a hoʻopuka i ka nānāʻana i nā maʻi me ka maʻi o Parkinson me kaʻole o ka moekolohe. Ua hana hou mākou i waena o ka pūʻulu (nā maʻi maʻi o Parkinson i ka maʻi o Parkinson me ka moekolohe) a me ka hōʻailona ma waena (PAHE ma mua o ka lāʻau) no ka nānāʻana inā uaʻoi aku ka nui o nā kaʻina mīkini ma kahi maʻi a iʻole keʻano kūlana ma mua o ka mea'ē aʻe aʻike i ka neʻeʻana ʻaʻole iʻokoʻa ma waena o nā hui a me nā kūlana (P > 0.1 i nā hihia ʻelua).
Ma keʻano he'āpana'āina a priori ua kuhia ka manaʻo kuhiakau, uaʻikeʻia kekahi mauʻike o ka hopena o ka hopena ma waena o ka lua (male i ka piliʻole a me ka wahine e pili ana i nā hoʻololi likeʻole ma ON a me nā'ōlelo hōʻailona) no nā māhele kūpono o ka hoʻohanaʻana i MarsBar (Brett ¶ AL., 2002) me ka pae helu helu hoʻokahi (ʻike hapa maʻamau i ka P <0.05). ʻO kēia mau ʻāina ʻo ka orbitofrontal cortex, anterior cingulate cortex, posterior cingulate cortex, amygdala, ventral striatum a me ka hypothalamus. ʻO nā hiʻohiʻona o ka orbitofrontal cortex, anterior cingulate cortex, posterior cingulate cortex a me amygdala i lawe ʻia mai ka waihona Automated Anatomic Labeling e pili pū me MarsBar. Ua kūkulu ʻia nā palapala ʻāina ventral striatum a me hypothalamus e ke kiʻi ʻana i kēia mau wahi hoihoi i ka ANALYZE polokalamu kiʻi olakino (mana 8.1, Mayo Foundation). Ua hoʻohana ʻia kēia mau palapala ʻāina i mea e uhi ai ke koena o ka lolo e ʻae ana i ka hoʻohālikelike ʻana i loko o nā puke kikoʻī (1850 mm3 i kēlā me kēia māhele no ka makani straltum a me ka 1380 mm3 ma kēlā me kēia māhele no ka hypothalamus). ʻO nā mea a pau e komo ana i ka hoʻohālikelikeʻokoʻa (e like me ka wahine ma ka hoʻohālike) o kēlā me kēia'āpana'āina no nā ON aʻelua a me ka weheʻana i nā mīkini lāʻau i laweʻia no ka hoʻopiliʻana me kaʻikepili.
ʻIkepili helu
Ua hoʻohanaʻia nā kuhi helu statistical me SPSS (version 16, SPSS Inc) no Macintosh. Hoʻohālikelike i loko o nā hui (e like me ka maʻi o Parkinson me ka piliʻole OFF male pāʻoihana me ke kūʻole) i hanaʻia me ka hui pūʻana tnā hōʻike a me nā hoʻohālikeʻana o nā hui (e like me ka maʻi o Parkinson me ka moekolohe PA) i hanaʻia me ka hoʻohanaʻana iʻelua mau hiʻohiʻona tnā hōʻike. No ka hōʻoiaʻana o ke kikowaena a me ka hoʻoikaika o ka hana, hoʻohālike i ka homogeneity a me ka Gaussianity me nā ho'āʻoʻo Bartlett a me Kolmogorov-Smirnov. Ua hoʻohana maikaʻiʻia nā ho'āʻo'ōmele a me nā heluʻole. ʻO Pearson corlation value r a me Spearman's rho (ρ) (i ka wā i hoʻokaʻawaleʻoleʻia ai nā'enela) e nānā i ka pilina ma waena o ka manaʻo o ka hoʻoipoipoʻana i ka wahine ma hope o kaʻikeʻana i nāʻike pilikino a me kēlā me kēia o nā'āina BOLD hope loa i nā hoʻohālikelike hoʻohālikelike no ka hoʻohalikeʻole i ka ON a me ka weheʻana i nā'ōlelo lāʻau. Ua hoʻohanaʻia ka correctferval correction e kū'ē i ka pilikia o nā hōʻike likeʻana.
Results
'Imike a me ka hoʻoikaika maʻamau
ʻO nā maʻi i loaʻa i ka maʻi o Parkinson me ka moekolohe ka mea nui eʻoi aku ka nui o ka hoʻopunipuni dopamine a me ka emi iki l-DOPA i hoʻohālikelikeʻia me nā maʻi maʻi o Parkinson. ʻAʻoleʻokoʻa nā heluʻelua ma kekahi o nāʻanoʻokoʻa o ke kino (makahiki, male, maʻi maʻi, UPDRS hapa III OFF, ON a me ka pane ma hope o l-DOPA, Kaʻi 'ana i ka Mino-Mental, ka LED o nā lā a pauTOTAL) (Nā Papahana 1 a 2).
Ma mua o ka pahūʻana o ON a me ka ON,ʻo nā maʻi me ka maʻi o Parkinson me ka moekolohe a me nā maʻi maʻi o Parkinson i kaʻole i ka heluʻana i nā kuko wahine (3 Pūnaewele). Ma hope o ka PAHE a me ka ON scan kahi i hōʻikeʻia ai nā haumāna i kaʻike moe, nā poʻe maʻi me ka maʻi o Parkinson me ka moekolohe i hōʻike i ka piʻi nui o ko lākou moekoloheʻana e like me kā lākou palani ma mua o ka nānāʻana a hōʻike pū i ka hoʻonui nui i ka hoʻohālikeʻana i ka makemake o ka ʻO nā maʻi maʻi o Parkinson,ʻo ka mea i koe i ka hoʻomau ponoʻana a me ka nānāʻana. ʻO nā maʻi i loaʻa i ka maʻi o Parkinson me ka moekolohe, ua piʻi aʻe ka piʻiʻana o ko lākou kukoʻana i ka ON ma ka hoʻohālikeʻana i ka OFF scan (3 Pūnaewele). ʻO ka maʻi o Parkinson me ka moekolohe a me nā pūʻulu maʻi maʻi o Parkinson i hōʻikeʻole i loko ma waena a ma waena o ka hui likeʻole o kaʻai, ka mea'ai'ē, a me ka makemake lama ma mua a ma hope o ka ON a me ka sc scanner (nā hōʻike i hōʻikeʻoleʻia).
ʻO ka moekolohe ma mua a ma hope o ka hopenaʻana i nā hanuʻana o ka wahine
| Mamua o nā hanana hiʻohiʻona | Ma hope o nā hana hoʻokūkū | P-eʻike | |
|---|---|---|---|
| E paʻi ka nānā | |||
| Kaohi maʻi PD (mean ± SE) | 1.98 ± 0.59 | 2.25 ± 0.45 | 0.31a |
| PD HS (mean ± SE) | 2.67 ± 0.56 | 3.70 ± 0.50 | a |
| P-eʻike | 0.40b | b | |
| ON scan | |||
| Kaohi maʻi PD (mean ± SE) | 1.32 ± 0.28 | 2.12 ± 0.60 | 0.18d |
| PD HS (mean ± SE) | 2.01 ± 0.39 | 5.24 ± 0.41 | a |
| P-eʻike | 0.15c | b | |
| E paʻi ka nānā | ON scan | ||
|---|---|---|---|
| Ma hope-ma mua o nā hana hoʻoili kino | |||
| Kaohi maʻi PD (mean ± SE) | 0.28 ± 0.26 | 0.80 ± 0.52 | 0.34d |
| PD HS (mean ± SE) | 1.04 ± 0.32 | 3.23 ± 0.51 | a |
| P-eʻike | 0.08b | b | |
a Paired t-test.
b Hoʻokuʻuʻoleʻia t-test.
c Hōʻikeʻo Mann-Whitney.
d Wilcoxon ua hoʻohālikeʻia nā hoaʻelua.
HS = kūkākūkā; PD = Ke maʻi o Parkinson.
ʻO nā maʻi i loaʻa i ka maʻi o Parkinson me ka moekolohe ke makemake i nāʻikeʻike moe i hōʻikeʻia i loko o ka MRI hana nuiʻoi aku ma mua o ka poʻe maʻi maʻi o Parkinson (ka maikaʻi o kaʻike = 85.2%; 3.4 ± 1.2 a me 2.1 ± 0.6, mean ± SD; P <0.05, pālua ʻole t-test me ka Welch correction), akā,ʻaʻole heʻokoʻa i kā lākou helu no nā uku hōʻailona e pili ana i nā lāʻau lapaʻau, kālā a me ka pāʻalī, aiʻole meaʻai (P > 0.1 i nā hihia āpau, pālua ʻole t-test me nā hoʻoponopono Welch). ʻAʻoheʻike i loaʻa ma waena o ON a me Scans.
Māhele o ka hoʻolālā kiʻi hoʻonāʻana i kaʻenehana waiwai
Ua hōʻike ka māhele o ka hōʻailona waiwai i nā poʻe maʻi me ka maʻi o Parkinson me ka moekolohe iʻoi aku kaʻoi aku kaʻoi aku o kaʻoihana (e hoʻonui i ka hōʻailona BOLD) ma mua o ka maʻiʻana o ka maʻi Parkinson i ka wā eʻikeʻia ai i nāʻike iʻikeʻoleʻia ma kaʻikeʻana i ka maʻi. : P <0.001, ʻākau: P <0.005), mua cingulate cortex (hema: P <0.005, ʻākau: P <0.001), hope cingulate cortex (hema: P <0.001, ʻākau: P <0.001), amygdala hema (P <0.05), ventral striatum (hema: P <0.05, ʻākau: P <0.05) a me hypothalamus (hema: P <0.005, ʻākau: P <0.01) (Laau. 1C-H). No keʻano likeʻole i ka moku'āina lāʻau ON, ua mālamaʻia kekahiʻano likeʻole o ka hoʻouluʻana o ka lolo, aʻaʻole he mauʻokoʻa koʻikoʻi i ka hoʻoikaikaʻana ma waena o ON a me Scans. Ke hoʻohālikelike mākou i ka hopena o OFF ma mua o ke kaona o ka lāʻau lāʻau ma ka hui wale nō o nā maʻi me ka maʻi o Parkinson me ka moekolohe,ʻaʻole mākou iʻike i keʻano likeʻole o ka hoʻoukaʻana.
Nā palapala transverse, coronal a magitalima o nā palapalaʻilima helu palapala e hōʻike ana i ka hoʻonuiʻana o ka hōʻailona hōʻailona (mau'āpana kalaʻula-kala) e pili ana i kaʻikeʻana i nā hiʻohiʻona maʻamau maʻamau i nā maʻi (A a me B) ma ka maʻi 12 a ma ka maʻi 12. nohokino (PD HS) (C-H) i ka ON a hoʻopau i nā hōʻailona. E hōʻikeʻia ana ka hōʻailona hōʻailona ma (A a B) ma ka'ākau a me ka waena pono o ka'ōpū kino (MTG) a me ka gyrus āpau waena (MOG) (x = -48, y = -59, z = 9), (C) ventral striatum (VS) (x = 18, y = 15, z = - 11), (D) hypothalamus (x = -5, y = -4, z = -9), ((E) ka piko mua mua (aPFC), ka'opiʻi kalaʻau mua (ACC), ka lobuleʻaha kiʻekiʻe (SPL) a me ka pehu'ōpū (PCC) hope loa (x = 8, y = -16, z = 33), (F) ma kaʻaoʻao hema a me ka waena pono o ka'ōkiko a me ke kaukena waena a me ka hui mua mua (x = -8, y = 56, z = 4), a me (G a H) aiʻole ka'alikaluko cortex (OFC), ka lobule nuiʻoi aku, ka'opiʻi kāpiliʻi hope, a me ka'ākau a me ka waena pono o ke kino āpau a me ka hapalua waena (x = -24, y = 48, z = -8). Hōʻike ka pālākiu znā hāʻina.
Ua hōʻike ka māhele o ka hōʻailona waiwai i nā poʻe maʻi me ka maʻi o Parkinson me ka moekolohe iʻoi aku kaʻoi aku o kaʻoihana i ka wā iʻikeʻia ai i ka moekolohe e like me nā mea'ē aʻe iʻikeʻia i loko o ka holoiʻana o ka wānana i nā'āpana ma lalo nei: orbitofrontal cortex (hema: P <0.001, ʻākau: P <0.001), mua cingulate cortex (hema: P <0.001, ʻākau: P <0.001), hope cingulate cortex (hema: P <0.001, ʻākau: P <0.001), ventral striatum (hema: P <0.001, ʻākau: P <0.001) a me hypothalamus (hema: P <0.001, ʻākau: P <0.001). Ua mālama ʻia nā hana like like i ka wā o ka lāʻau lapaʻau ON, a ʻaʻohe ʻokoʻa nui o ka hoʻoulu ʻana ma waena o OFF a me ON scans.
Hoʻopāʻau kiʻi hoʻonāʻana i ka hoʻonāʻana o ka naʻau
ʻO ka hana maʻamau ma waena o nā maʻi me ka maʻi maʻi Parkinson me ka moekolohe a me nā maʻi o Parkinson
ʻO nā maʻi i loaʻa i ka maʻi o Parkinson me ka moekolohe a me nā mea maʻi maʻi o Parkinson i ka hōʻike likeʻana i ka nui o ka hōʻailona hōʻailona ma kaʻikeʻana i nāʻikeʻikeʻike kino me ka nānāʻole i loko o ka ON a me ka weheʻana i nā lāʻau maʻi e hōʻike ana i ka pāpālua ma waena o nā 'Laau. 1A a me E; Nā Papa Kūkākūkā 2A a me I, Kaʻikepili houA a me I). No kēlāʻano likeʻole i ka PAHEA,ʻo nā maʻi me ka maʻi o Parkinson me ka moekolohe a me nā mea maʻi maʻi o Parkinson i hōʻike i ka hōʻailona likeʻole o BOLD i ka hoʻohālikelikeʻana i ka bilatinui ma loko o ka pulupulu [Brodmann (BA) 29 a me 30), gyrus brassppocal and cuneus (BA 17 ) (Laau. 2A a me E; Nā Papa Kūkākūkā 2B a me D, Kaʻikepili houB a me D).
Nā huahana transverse a me ke keʻekeʻona o nā palapala'eneʻina palapala helu e hōʻike ana i ka hōʻemiʻana o ka hōʻailona BOLD (pouli a me nā'ōuliuli) e pili ana i ka hoʻonaniʻana i nā hiʻohiʻona maʻamau maʻamau i ka maʻi maʻi o 12 Parkinson (PD)A a B) a me nā maʻi 12 me ka maʻi o Parkinson me ka moekolohe (HS) (C a D) i ka manawa o ka holoiʻana o ka wānana PA. E hōʻikeʻia ana nā hāʻuleʻana o ke kahakahaʻana o nā hōʻailona hōʻemi ma (A a B) i ka'ākau hema a me ka'āpana pono polipocampal (PHG), keʻano o kaʻoki mele (ICG) a me cuneus (x = -9, y = -47, z = 2), (C) ma ka hema a me ka'āpana pono polvocampal gyrus, cuneus, keʻano o ka'ōpala, ka'ulawai, a me ka pono claustrum (x = -42, y = 14, z = 8), a me (D) ma ka hema a me ka'āpana polikocampal pono (x = 22, y = 38, z = -14). I ka moku'āina NĀ ON, ma ka hui o nā 12 poʻe maʻi me ka maʻi o Parkinson me ka moekolohe,ʻaʻoleʻikeʻia he hōʻailona BOLD hōʻemi. Hōʻike ka pālākiu znā hāʻina.
ʻO ka hana maʻamau no nā maʻi me ka maʻi o Parkinson me ka moekolohe
Ua hōʻoiaʻia ka hōʻoia o ka helu i ka'āina o nā hualoaʻa waiwai a ua hōʻike i ka piʻiʻana o ka hōʻailona hōʻailona o ka poʻe maʻi me ka maʻi o Parkinson me ka moekolohe me ka nānāʻana i nā maʻi maʻi o Parkinson i ka wā eʻikeʻia ai i nāʻikeʻikeʻikeʻole i loko o ka holoi a me ON. e like me nāʻaoʻao: ka hui kūikawā mua o ka mua (BA 10) a me ka lobule lā'ī kiʻekiʻe (BA 5 a me 7), a me ka hoʻouluʻana i ka lobule lalo iho (BA 40)Laau. 1C-H; Nā Papa Kūkākūkā 2A a me I, Kaʻikepili houA a me I). No keʻano likeʻole i ka moku PAKE,ʻo nā maʻi me ka maʻi o Parkinson me ka moekolohe e pili ana i nā mea maʻi maʻi o Parkinson i hōʻike nuiʻia ka hōʻailona BOLD hōʻemiʻia ma kaʻaila a me ka pololei claustrum (Laau. 2C a me D; Nā Papa Kūkākūkā 2B a me D, Kaʻikepili houB a me D). ʻAʻoleʻaʻohe kūlana BOLD'ē aʻe i ka manawa iʻikeʻia ai nāʻikeʻike makahoʻawa iʻikeʻoleʻia i nā poʻe maʻi me ka maʻi o Parkinson me ka moekolohe ma waena o nā'ōlelo lāʻau lāʻau hemo a me ON.
Ua hoʻokūpaʻaʻia ka'āpana o ka maʻi o Parkinson i ka hapanui o ka hopena i nā maʻi me ka maʻi o Parkinson me ka moekolohe ke hoʻohālikelike i ka pilina me nā uku'ē aʻe i nā kiʻiʻike a hōʻikeʻia i ka hōʻailona nui o ka hōʻailona BOLD ma kahi o ka wili a me ON i loko o ka cortex prefrontal bilateral (BA 9) a me ka hoʻouka kūponoʻana i ka lālani mua ma mua o ka cortex mua (BA 10) a me ke keleawe polima keleawepona.
Ka hopena o l-DOPA lāʻau i loko o ka lolo i nā maʻi me ka maʻi o Parkinson me ka moekolohe
I loko o ka hui o nā maʻi me ka maʻi o Parkinson me ka moekolohe ma ka moku'āina ON, nā hāmeʻa i mālamaʻia ma ka moku OFF a me ka moku OFF a me ka Moku'āina o ka maʻi maʻi o Parkinson (hōʻike hoʻohaʻahaʻa BOLD i ka wā eʻikeʻia ai i nāʻike iʻikeʻoleʻia i nā'ōlohelohe maʻamau. ua hoʻopauʻia ka pīpī pēpē, ka polipahipampal gyrus, cuneus, insula a me claustrum) (Nā Papa Kūkākūkā 2B a me D, Kaʻikepili houB a me D).
ʻO ka hanaʻana i ka'ōpū e pili ana i nā uku'ē aʻe i nāʻike iʻikeʻia i nā maʻi me ka maʻi o Parkinson me ka moekolohe
ʻAʻole i loaʻa iā mākou he mea nui ma waena a ma waena o nāʻokoʻa o nā hui no nā maʻi me ka maʻi o Parkinson me ka moekolohe a me nā maʻi maʻi o Parkinson i kekahi uku'ē aʻe ma keʻano o nā kumu pale (kiʻi paleʻole) (e like me nā helu lāʻau hōʻailona dopaminergic) me ka ON screw.
Nā hoʻoponopono
Ma ka pūʻulu o nā maʻi me ka maʻi o Parkinson me ka moekolohe, makemake i ka moekolohe ma hope o ka hoʻokuʻuʻana i nāʻike kuʻuna maʻamau i hoʻohuiʻia ma ka moku o ka lāʻau wiliʻole, me ka hoʻohālike hana (ke kāne me ka kūʻole)r = 0.78, P <0.01) a me ka striatum ventral (r = 0.80, P <0.01) (Laau. 3A a me B), a ma ka nohoʻana o ka lāʻau ON ma ka hana ma ka hui hoʻopili o mua (r = 0.87, P <0.001) a me ka medial orbitofrontal cortex (r = 0.65, P <0.05) (Laau. 3C a me D). ʻAʻole i loaʻa nā hoʻoponopono i ka poʻe maʻi me ka maʻi maʻi Parkinson me ka hui pūkolohe ma waena o ka 'makemake' i nā leka wahine a me ka lolo i ka wā eʻike ai i nāʻikeʻikeʻike kino iʻikeʻoleʻia i loko o ka ON a me ka weheʻana i nā hōʻailona lāʻau. ʻAʻole i loaʻa nā hoʻololi ma waena o ka makemake i nā helu a me nā mea likeʻole i loko o ka pūʻulu maʻi o Parkinson i ka ON a me ka holoiʻana i nā'ōlelo lāʻau (P > 0.1 i nā hihia āpau).
Ma nā maʻi i loaʻa i ka maʻi maʻi Parkinson me ka moekolohe, makemakeʻia ka makemake i ka wahine ma hope o ka hoʻokuʻuʻiaʻana i nā kiʻi pilina me ka hoʻonuiʻia o ka hoʻoukaʻana i (A) ka hope o ka'opiʻi a me (B) ke kuhi o ka makani ma kahi o ka holoiʻana a me ka hoʻonuiʻana i ka hoʻoukaʻana i (C) ka pīpē kinui mua a me (B) a me ka cortex medial orbitofrontal i ka manawa o ke kauwela lāʻau ON.
kūkākūkā
ʻO ka moekolohe he hana maʻamauʻole ia o ka mālamaʻana i ka dopaminergic i ka maʻi o Parkinson, a hiki i kekahi manawa ke hopena i nā hopena pili kaiapili e like me ka hemo, ka hoʻohaunaeleʻana i ka inoa o ke kanaka a me ka hopu pūʻana. ʻO kā mākou noiʻiʻana e nānā i nā hana e kau ana i ka lāʻau o ka dopamineric pili i ka moekolohe i nā maʻi me ka maʻi o Parkinson. Ua hoʻohana mākou i nā loiloi kūpono o ka hoʻouluʻana i ka wahine a hoʻohana i kekahi hiʻohiʻona MRI hana me nā kiʻi likeʻole o ka moekino (e like me nā mea i hoʻolahaʻia e ka media media) e like me nāʻikeʻike, a ua hōʻoia mākou i kaʻikeʻana i nāʻike e like me ka hoʻomāhuahuaʻana i ka makemake o ka poʻe maʻi ʻO ka maʻi o Parkinson me ka moekolohe ma ka hanaʻana i nā lolo i pili i ka hoʻouluʻana i ka wahine (e nānā 4 Pūnaewele no ka hōʻuluʻulu o nā hopena).
Ka hōʻuluʻulu o nā hualoaʻa e hōʻike ana i nāʻokoʻa a me nā mea maʻamau i ka'āpana o ka'āpana'āina E hōʻike ana i ka hoʻonuiʻana o ka hōʻailona a hōʻemi i nā maʻi me ka maʻi o Parkinson a me kaʻole o ka moekolohe ma ON a OFF
| ʻO ka maʻi o Parkinson me ka moekolohe | ʻO nā maʻi maʻi o Parkinson | |||
|---|---|---|---|---|
| E hoʻohui a ON ON i hoʻonui | E emi iho ana ka'eneke | Loaʻa ka hekeʻana o ka ON | E hoʻohui a ON ON i hoʻonui | KĀHEHE a me ON ka emi iho |
| ʻO ka pilau kino kino | ʻO Isthmus o ka'ōhumu mele | ʻO ka pilau kino kino | ʻO Isthmus o ka'ōhumu mele | |
| ʻO ka manawa mua | ʻO Parahippocampal gyrus | ʻO ka manawa mua | ʻO Parahippocampal gyrus | |
| Cuneus | Cuneus | |||
| Ka nui o ka makani | ʻO Claustrum | |||
| Amygdala | Hoʻokū | |||
| ʻO Hypothalamus | ||||
| ʻO ke kino o ka'okihue | ||||
| ʻO ka mea i hoʻopiliʻia | ||||
| ʻO Orbitofrontal cortex | ||||
| ʻO ke kūpuni mua mua o Anterior | ||||
| ʻO ka lobule kiʻekiʻe | ||||
| ʻO ka lobule hauʻoli lalo | ||||
Ma ka'elikeʻana me nā hiʻohiʻonaʻike hana hana no ka hoʻouluʻana i ka moekolohe i nā mea ola kino (Hōʻike ¶ AL., 2000; ʻAno ¶ AL., 2002; Walter ¶ AL., 2008), kaʻikeʻana i nāʻike pilinaʻikepili i hoʻoiliʻia ma waena o nā kaʻina o nā mea e like me ka hapalua waena o ka maʻi a me ke kino o ke kino ma waena o nā poʻe maʻi me ka maʻi o Parkinson me ka moekolohe a me nā maʻi maʻi o Parkinson. Ma nā maʻi i loaʻa i ka maʻi o Parkinson me ka moekolohe,ʻikeʻia kaʻikeʻana i nāʻikeʻike i ka wahine ma kaʻaoʻao ON a me ka wānanaʻana i ka hoʻouluʻana i ka cortex orbitofrontal, cortex cingulate anterior, posterior cingulate cortex, striatum ventral, cortex front forefront, amygdala ke hypothalamus, ke hoʻohālikelikeʻia me ka maʻi o Parkinson. ʻO nā maʻi i loaʻa i ka maʻi o Parkinson me ka moekolohe, hōʻike nui lākou i ka makemake i ka wahine a me ka makemake i ka moekolohe ma hope o kaʻikeʻana i nāʻike moe kolohe. Ua hoʻomāhuahua nuiʻia ko lākou kukoʻana i ko lākou nohoʻana l-DOPA i hoʻohālikelikeʻia me ka paleʻana i ka mīkini ma hope o ka hoʻoukaʻana i ka pilina. ʻO keʻano koʻikoʻi o ka'opiʻi mua o ke kino, ka pīkoʻi o ka hope o ka hope, ka straltum ākea a me ka hopena o ka hopena ma ka hoʻonāukiuki i ka hoʻohālikelikeʻana i ka hoʻouluʻana i kēia mau'āina me ka hoʻonuiʻana i ka makemake i ka wahine. Eia naʻe,ʻaʻole i loaʻa kahi palekana ma waena o ka hana o ka lolo a ma waena a me ka helu 'liking'.
Ua hōʻike nā haʻawina holoholona i ka piliʻana o ka dopamine i ka hoʻonākau a me ka hoʻonāukiukiʻia e nā moe kolohe ma nā wahi e pili ana i ka striatum ventral, hypothalamus, cortex medial pretyal, amygdala a me mua o ka pīpī kinipona, a hiki i ka hoʻouluʻana i ka wahine. a me ke predation (Fiorino a me Phillips, 1999; Nocjar a me Panksepp, 2002; Afonso ¶ AL., 2009; Pfaus, 2010; Stolzenberg a Numan, 2011). ʻO kaʻike kūikawā me nā lāʻau lapaʻau a me ka hana moe kolohe e koiʻia no ka hoʻouluʻana i ka moekolohe i ka moekolohe (ʻO Frohmader ¶ AL., 2011), e hoʻohālikelike i ka hoʻokae pinepineʻana o ka moekolohe i ka maʻi o Parkinson ma hope o ka lawelaweʻana i nā lāʻau lapaʻau lāʻau (Giladi ¶ AL., 2007). Eia kekahi, ua hōʻikeʻia nā hana hou e hiki ai i nā lāʻau lapaʻau ke hoʻoulu i nā pūnaeweleʻano likeʻole me ka uku pilina, me ka uluʻana i nā hapalā e like me ka hypothalamus a me ka wāwae cingulate o mua (ʻO Frohmader ¶ AL., 2010). ʻO kā mākou mau hopena i lawe pūʻia me nā hana holoholona holoholona mua e kākoʻo ana i ke kumumanaʻo kumu hoʻoikaika makani e like me ke kikola no ka hoʻomaopopoʻana i nā hana o ka lāʻau lapaʻau dopamineric i hoʻokomo i ka moekolohe ma ka maʻi o Parkinson. Keʻike nei ka manaʻoo ke kumuhana e hoʻopuka ka dopamine i ka loaʻaʻana o nā uku ma o ka hāʻawiʻana i ke ola o ka hoʻohoihoiʻana i nā hanana i pili i ka uku (e like me nāʻike pilikino), kaʻimiʻana ('makemake)' o ka wahine a ma ka hihia o ka moekolohe, me keʻano hōʻailona hoʻokipa (ʻO Berridge ¶ AL., 2009). Ke hoʻomau hou nei kaʻike i ka '' makemake 'no nā uku, hiki ke hoʻopiliʻia e ka neurocircuitry ventral striatum dopamine, e hiki ke ulu ma mua o ka manawa a me ka uku' makemake 'e like me ka mea e hoʻonui ai i ka uku uku eʻimi ana (ʻO Berridge ¶ AL., 2009), a he mea kaulana ia i ka hoʻopiʻi nuiʻana o ka DNamine i ka makemake i ka wahine ('makemake'), akā,ʻaʻole i heluʻia 'makemake' o nā kiʻi kiʻi kiʻi i nā maʻi me ka maʻi o Parkinson me ka moekolohe.
ʻO ka mea nui loa (8 o 12) o nā maʻi me ka maʻi o Parkinson me ka moekolohe, he ma kahiʻoi aʻe kekahi o ka hoʻoponoponoʻana o ka manaʻo hoʻopiʻi (e like me ka pāʻani pāʻani, kaʻaiʻana, a me nā mea'ē aʻe), makemake mākou e hōʻoia i ka loli o nā loiloi a me ka lolo i ka uku ʻO ka hōʻikeʻana he kiko'ī i ka wahine aiʻole i hōʻeuʻeuʻia i nā uku'ē aʻe. ʻO ka makemake o ka mea i hōʻikeʻia e ke kanaka me ka makemake i ka pāʻani kālā, nā lāʻau lapaʻau a me kaʻai,ʻaʻole iʻole i loko a ma waena o nā pūʻulu o ka maʻi o Parkinson me ka moekolohe a me nā maʻi maʻi o Parkinson i mua a ma hope o ka ON a OFF. Eia kekahi,ʻaʻole mākou iʻike i nā mea likeʻole ma waena o nā maʻi me ka maʻi o Parkinson me ka moekolohe a me ka maʻi o Parkinson i nā mea maʻi i ka paneʻana o ka neural i kekahi mauʻike iʻikeʻia i loko o ka hōʻike MRI hana pono'ī e hōʻike ana i ka hopena o kā mākou kiʻi kiʻi i pili i ka wahine. Eia naʻe, makemake mākou eʻimi i ka hana o ka lolo maʻamau e pili ana i nāʻikeʻike moe kino e like me nā uku'ē aʻe. Ua hōʻikeʻia nā mea iʻikeʻia i ka ikaika ma ka ON a me ka wehe i nā kaomi o ka moku i ka cortex orbitofrontal, ka pehu o ke kino i mua, ka pehu'ōpili o mua, ka straltum ventral, ka cortex mua mua, ka'apena mua mua, ka brassotocampal gyrus a me hypothalamus, e hōʻoiaʻiʻo ana i ka nui o kēia mau ka hoʻonāukiuki a me ka makemake, ma ka liʻiliʻi o ka moekolohe.
ʻO kēia hoʻonui hoʻonuiʻana no kaʻike pilikino he kaulana. E hana i nā'ōʻai holoholona e Berridge a me nā hoa hana (Mahler lāuaʻo Berridge, 2009, 2012; DiFeliceantonio a me Berridge, 2012) ua hōʻike e hoʻonani i ka opioid kaapuni ma ka amygdala a me ka striatum hiki ke hoʻohālikelike i ka 'makemake' loa i kahi o nā mea lanakila. Ma lalo o ia mau kumu, loaʻa kahi uku uku hoʻokahi iʻoi aku ka 'ʻoihana hoʻonāukiuki' e huki ai i nā mea āpau a pau iā ia iho, ma ka uku o nā hōʻailona uku'ē aʻe,ʻo nā holoholona hoʻi iʻikeʻia i kēlā mau uku'ē aʻe (Mahler lāuaʻo Berridge, 2009, 2012; DiFeliceantonio a me Berridge, 2012). Pela no hoi, ua pili na pili pili i ka moe kolohe me ka hana hoomahuahua o ka amygdala e pili ana i na hoike e pili ana i na kanaka me ka moekolohe, a ua kohoia paha me ka oluolu i hoohoihoi ia ma ke ano o ka "winner-take-all" nā pilikia kaohi.
Hoʻonuiʻia ka hoʻouluʻana i ka striatum ventral e pili ana i ka hoʻonuiʻia o ka dopamine i loko o ka ventral striatum (ʻO Schott ¶ AL., 2008), e like me nāʻike PET (ʻO O'Sullivan ¶ AL., 2011) a me nā hōʻike mua e hōʻike ana i ka hoʻopiʻiʻana o ka dopamine e pili ana i nā leka wahine i loko o ka pūʻulu o nā holoholona nui (Fiorino a me Phillips, 1999). ʻO nā liona ma ka hypothalamus a me ka amygdala uaʻikeʻia e hōʻemi i ka hoʻouluʻana i ka wahine i nā kolo a me nā wahine, a me ka hana hypothalamic a me ka hana amygdala e hoʻonani i ka moe kolohe ma nā haʻawina MRI hana (Hamana ¶ AL., 2004). Ua hōʻikeʻia ka hypothalamus i ka mea koʻikoʻi i ka moekolohe a ua manaʻoʻia ua komo i loko o kahi hoʻokaʻawale o kahi hānai wahine (Allen ¶ AL., 1989; Kupfermann ¶ AL., 1991; ʻO Meisaʻela lāuaʻo Sachso,ʻo 1994; Georgiadis ¶ AL., 2010).
ʻO ka'opiʻi kāpili āpau mua kahi wahi kūlike e pili ana i nāʻaoʻao ma mua a me ka hoʻonāʻana i kahi mau hana autonomi a me nā neuroendocrine (Stoléru ¶ AL., 1999). Ua hoʻohuiʻia nāʻike mua i ka hoʻonāʻana o ka cortex cingulate mua me ka lōʻihi o ka tumoe o penile (Hōʻike ¶ AL., 2000) a me ka manaʻo hoʻoikaika o ka huhū a me ka makemake (Hōʻike ¶ AL., 2000; ʻAno ¶ AL., 2002; Kalama ¶ AL., 2002; Walter ¶ AL., 2008). Ua hoʻohui pūʻia hoʻi nā'āpana pāʻani a me ka'ōpili'ōpili o hope i ka hoʻohālikelike pono i ka makemake maikaʻi (ʻO Garavan ¶ AL., 2000). Ua hoʻohuiʻia ka'ōnaehana poʻokela a me nā manaʻo kūpono o ka leʻaleʻa a me ka makemake i ka wā i manaʻoʻia ai, a ua manaʻoʻia aia he kuleana i ka piliʻana i kaʻike kumuhana pilikino (Kringelbach, 2005). Eia kekahi, ua hoʻonāʻia ka hoʻouluʻana o ka cortex orbitofrontal a me ke cortex prefrontal i mea e pili pū me keʻano o ke kino o ke kino i hoʻokomoʻia i loko o ka manawa o ka hoʻonā wahine (Stoléru ¶ AL., 2003). Uaʻike mākou ua hōʻoiaʻia ka manaʻoʻana i ka moekolohe me ka hana ma nā wahi o ka'āpana (e like me ka peʻahi mua a me ke kapa kila) ma waho o ka striatum ventral, e like me ka manaʻo e hoʻonāukiuki i ka '' makemake 'ʻaʻole i maopopo i kaʻike, a 'o ia ka' ike 'makemake' makemake i ka 'ʻO Berridge a me Robinson, 1995).
I loko o kā mākou haʻawina, ua hoʻoikaikaʻia ka hanaʻana o ka lolo ma hope o kaʻikeʻana i nāʻike moe kolohe i ka lawelaweʻana l-DOPA e like me ka mea i hōʻikeʻia e ka hōʻailona BOLD like i hoʻonui i ka ON a hoʻohemo i nā mīkini lāʻau. Eia naʻe, ka nele o kahiʻeke l-DOPA hoʻopauʻole i ka hopena o ka hulina synergistic o ka moku a me ka dopamine state mesolimbic a me ke komoʻana o nā leka wahine ma ka hoʻouluʻana i ka 'makemake' no ka uku pilikino ma ka hui o nā maʻi me ka maʻi o Parkinson me ka moekolohe (Berridge, 2012; Oei ¶ AL., 2012). ʻO nā maʻi me ka maʻi o Parkinson me ka moekolohe, a ma ka moku PAHE,ʻaʻole lākou iʻaeʻole i ka lāʻau lapaʻau a hiki i ka hilinaʻiʻana, a me nā haʻawina holoholona,ʻoiai ua hiki i ka amphetamine nui a me nā hopena hilinaʻi ke hoʻohuiʻia (Hoʻopau ¶ AL., 2005),ʻo ke kohoʻiaʻana e ka amphetamine mua e hāʻawi i ka uku no ka hoʻomakaʻana i ka hahai nuiʻana i kā lākou uku pili, keʻikeʻia kaʻikeʻana o nāʻiole i ke kīnāʻole (ʻO Wyvell lāuaʻo Berridge, 2001).
ʻO ka mea mahalo, i ka hui o nā maʻi me ka maʻi o Parkinson me ka moekolohe ma hope o ka nui l-DOPA paʻakikī, i ka emiʻana o ka paʻiʻana i ka lāʻau lapaʻau a me ka moku ON a me ka ON ma ka maʻi maʻi o Parkinson (hōʻailona BOLD i hoʻohālikelikeʻia i kaʻikeʻana i nāʻike iʻikeʻoleʻia ma kaʻike maʻamau i loko o ka'ōpala o ka pīpī pīpī, ka pīpona copperppocampal, cuneus, insula a claustrum) ua hoʻopauʻia (no ka like like me ka hopena o ka lāʻau lapaʻau i ka hana kuʻi koko, nānā Volkow ¶ AL., 2010). Hōʻike kēia mau hualoaʻa hiki i nā lāʻau lapaʻau dopamine ke hoʻopau i ka hoʻopauʻiaʻana o nāʻaoʻao lolo, e pili ana i nā hoʻololi pāliki i loko o ka ho'āʻoʻana e kāohi i ka hoʻonani i ka wahine. ʻOiai ua paʻakikī ke unuhiʻana i ka hauʻoli a iʻole ka hanaʻana i nā kani uila i loko o BOLD hōʻailona hōʻemi a emi iho paha i nā hua'ōlelo i hanaʻia (ʻO Georgopoulos ¶ AL., 1982; ʻO Batini ¶ AL., 1984), hiki i nā lāʻau lapaʻau dopamine ke hoʻokuʻu i kēia inhibition ma o ka hana o nā internalurons inhibitory e hana ana i loko o nā kaapuni o nā neuronal i loko o ka hui o ka cerebral. ʻO ka hoʻokuʻuʻiaʻana o ka hanaʻana i nā neuronal i loko o ke kahe o ka pīpī gyrus, gyrusampy gyrus, cuneus, insula a claustrum i ka wā o ka poʻe maʻi ke ON a pili i nā loiloi hoʻoholo likeʻole e like me kēia haʻawina i hoʻonuiʻia ka hopena o ka makemake i ka wahine. Ke kākoʻoʻia kēia manaʻo e ka hoʻopau hope loaʻana o ka moekolohe ma hope o ka haʻaleleʻana i nā lāʻau'aeʻau agonist dopamin (Mamikonyan ¶ AL., 2008; Munhoz ¶ AL., 2009).
ʻO ka pāpāʻana o ka hoʻopauʻana o ka insula ma o nā lāʻau lapaʻau o ka DAMED e hiki ke alakaʻi i ka'ōlelo o ka moekino pili kino, no ka mea,Oppenheimer ¶ AL., 1992), pili i nāʻikeʻike iʻikeʻia me nā manaʻo hoʻonāukiuki (Stoléru ¶ AL., 1999) a, me ka hui pūʻana me ka cortex secondary somatosoryory, ua manaʻoʻia e komo i loko o ka manaʻo eʻike i ka hōʻeha i ka moe kolohe (ʻO Mouras ¶ AL., 2003). Ua hōʻikeʻia ka claustrum e pili ana i nā pane a me nā manaʻo hoʻoikaika i nā holoholona (Hamamura ¶ AL., 1997) a me nā kānaka (ʻO Reiman ¶ AL., 1989) a ua manaʻoʻia e pili ana me ka hoʻouluʻana i ke kolohe (Nā Rees ¶ AL., 2007). Hoʻopukaʻia ka hoʻopauʻana ma nā'āpana copperppocampal ma hope o ka hōʻikeʻiaʻana o nā wikiō maʻamau; akā naʻe,ʻaʻole i maopopo ponoʻia ka hana kūpono o kēia hoʻopauʻana (Hōʻike ¶ AL., 2000).
I ka hopena,ʻo kēia ka haʻawina mua e nānā ai i nā hana e pili ana i ka moekolohe ma ka maʻi o Parkinson, a me nāʻike e loaʻa ai i kahi moʻokōki e pili ana i ka hoʻonuiʻiaʻana o nā mea i hoʻonāukiukiʻia. Eia kekahi,ʻo kā mākou mau hopena he mau manaʻo e pili ana i ka hiki keʻikeʻia i kaʻikeʻana ma o kaʻikeʻana i ka leka uila e hoʻopōʻino ai i ka moekolohe pili kino i ka maʻi o Parkinson. Ma muli o kaʻikeʻana o nā kānaka i ka moekolohe, hiki iā lākou ke hāʻawi i kahi manaʻo hoʻonāukiuki no kaʻimiʻana i ka waiwai pili kālā ma o ka hoʻonuiʻana a me ka hoʻemiʻiaʻana o ka hana o ka cerebral cortex, ka mea e hiki ai ke alakaʻi i nā hopena a me nā maʻi. ʻO ka hoʻohanaʻana i nā palena o kaʻano a me ka nui o kaʻikeʻana i nāʻikeʻikeʻikepili, hiki i ka palena o ka hana kūponoʻole a iʻole ka hana pilina maʻamau i nā lāhui i pilikiaʻole e like me ka poʻe e loaʻa ana i nā lāʻau'apaʻau.
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