Pem hauv ntej hlwb. 2018 Apr 23; 9: 154. doi: 10.3389 / fpsyt.2018.00154. eCollection 2018.
Liu L1,2, Yao YW2, Li CR3,4, Zhang JT2, Xia CC5, Lan J1, Ma SS1, Zhou N1, Fang XY1.
Abstract
Kev ua si hauv Internet gaming (IGD) yog qhov paub los ntawm kev txawj ntse thiab lub siab lub ntsws. Cov kev tshawb fawb dhau los tau qhia txog qhov tshwm sim ntawm IGD thiab kev nyuaj siab. Txawm li cas los, nrug lub hlwb kev tshawb nrhiav tau nthuav dav rau kev paub lub peev xwm ntawm IGD. Ob peb cov kev tshawb fawb tau hais txog kev comorbidity ntawm IGD thiab kev nyuaj siab cov tsos mob thiab lwm lub hlwb neural mechanisms. Ntawm no, peb nquag tshawb xyuas qhov teebmeem no los ntawm kev sib tham txog kev tshawb fawb ntev, qhov kev tshawb nrhiav kev sib txuas ntawm lub xeev thiab kev pabcuam rau kev ua haujlwm. Autoregressive cross-lagged modeling nyob rau ntawm cov menyuam kawm ntawv qib siab ntawm cov tub ntxhais kawm qib siab tau qhia tias IGD qhov kev nyuab siab thiab kev nyuaj siab yog twv dua. Ntawm cov neural qib, cov neeg uas muaj IGD tuaj yeem tsim kho rsFC ntawm sab laug amygdala thiab txoj cai dorsolateral prefrontal cortex (DLPFC), inferior frontal thiab precentral gyrus, piv txwv nrog tswj cov neeg koom, thiab amygdala-frontoparietal connectivity nyob rau hauv lub hauv paus tsis zoo los txiav txim siab txo cov kev mob tshwm sim tom qab pab kho tus mob hlwb. Tsis tas li ntawd, tom qab qhov kev cuam tshuam, cov tib neeg nrog IGD pom tau tsawg dua ntawm kev sib txuas ntawm cov laug amygdala thiab sab laug nruab nrab frontal thiab precentral gyrus, piv rau cov pab pawg neeg tsis koom tes. Cov kev tshawb nrhiav no qhia tau tias IGD tuaj yeem txuam nrog kev nyuaj siab; aberrant rsFC ntawm kev xav thiab kev tswj kev ua haujlwm hauv zos yuav muaj kev ntxhov siab thiab sawv cev rau lub hom phiaj kho mob hauv cov tib neeg nrog IGD. Registry lub npe: Tus cwj pwm thiab lub hlwb ntawm IGD; URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405; Tus lej sau npe: NCT02550405.
KEYWORDS:
amygdala; kev nyuaj siab; fMRI; internet gaming teeb meem; so-state functional connectivity; subgenual anterior cingulate cortex
PMID: 29740358
PMCID: PMC5924965
DOI: 10.3389 / fpsyt.2018.00154
URL: https://www.clinicaltrials.gov/ct2/show/NCT02550405;
Tus lej sau npe: NCT02550405.
Introduction
Cov cwj pwm coj cwj pwm thiab kev quav yeeb quav tshuaj muaj ntau yam kev tshwm sim xws li kev mob comorbidities xws li kev nyuaj siab [1]. Kev tiv thaiv hauv Internet (IA) tau raug suav tias yog kev saib xyuas tus cwj pwm. Internet gaming teeb meem (IGD), raws li ib daim ntawv tshaj tawm ntawm IA, tau muab tso rau hauv qhov thib tsib tsab ntawm Diagnostic and Statistical Manual of Mental Disorders (DSM-5) raws li ib qho kev lees paub kev kawm ntxiv [2]. Cov kab mob kev puas siab puas ntsws tau raug pom tau tias yog cov chaw sib txawv. Txawm li cas los xij, nyob rau hauv qhov pib ntawm Kev Tshawb Pom Taw Tseg Cov Cai (RDoC), cov cim roj ntsha ntawm lub hlwb thiab cov kev xav ntawm lub siab ntsws xav yog qhov tseem ceeb tshaj plaws hauv kev soj ntsuam kev tshawb nrhiav thiab tej zaum yuav raug faib tawm ntawm kev mob hlwb [3]. Hauv particular, lub hlwb kev ntsuam xyuas tau muab ib qho cuab yeej siv hauv kev paub txog cov cim neural. Cov kev tshawb fawb yav dhau los kuaj xyuas cov neural hauv paus ntawm kev paub lub hlwb xws li kev tiv thaiv tsis muaj kev tiv thaiv thiab kev txiav txim siab hauv IGAD [4, 5]. Txawm li cas los xij, txoj kev xav tsis zoo (piv txwv li, kev nyuab siab) thiab lub tswv yim ntawm lub hlwb nyob hauv cov pejxeem no tseem tsis tshua paub meej txawm tias muaj cov kev comorbidity ntawm IGD thiab kev nyuaj siab.
Tus mob nyuab siab feem ntau tshwm sim rau cov neeg uas muaj IA / IGD [6]. Ib qho kev ntsuas-tshuaj tau qhia tias cov neeg mob kev nyuab siab muaj kev nyuab siab heev rau cov neeg uas muaj IA (26.3%) dua li cov kev tswj kev noj qab haus huv (11.7%) [7]. Cov kev tshawb fawb hauv IGD kuj qhia txog cov kev nyuab siab dua cov neeg muaj feem yuav raug mob los yog nrog IGD, thiab ntxiv rau kev nyuab siab thaum muaj kev tiv thaiv los ntawm IGD [8-10]. Txawm li cas los xij, cov kev tshawb fawb ntawm qhov cross-sectional no yuav tsis qhia meej qhov kev taw qhia ntawm IA / IGD thiab kev nyuaj siab [11, 12]. Ib qho kev tshawb nrhiav txoj haujlwm yuav pab qhia ntxiv txog kev sib raug zoo ntawm cov tsos mob ntawm IGD thiab kev nyuaj siab.
Resting-state fMRI tau tshwm sim los ua ib qho cuab tam siv los tshawb xyuas cov kev xav hauv hlwb lub hlwb [13, 14] thiab kev puas hlwb loj hauv ntau qhov mob neuropsychiatric disorders, xws li IGD thiab kev nyuaj siab loj (MDD) [15, 16]. Qhov tseem ceeb, IGD thiab MDD tshwm sim rau kev sib koom ua haujlwm hauv xeev-xws li kev sib raug zoo ntawm lub xeev (rsFC) kev hloov hauv kev xav network, uas muaj lub npe ntawm amygdala thiab subgenual anterior cingulate cortex (sgACC). Tshwj xeeb, cov amygdala muaj txiaj ntsig rau kev paub thiab kev koom ua ke ntawm cov ntaub ntawv cuam tshuam thiab kev siv nyiaj thiab cov kev xav hauv lub siab, thiab tsim thiab cia cov kev xav tsis zoo [11, 15, 17-19]. Lub sgACC plays lub luag haujlwm tseem ceeb hauv kev tswj arousal rau cov lus teb rau kev xav thiab lwm yam kev mob nkees [20, 21]. Cov kev tshawb fawb yav dhau los qhia txog kev sib raug zoo ntawm cov amygdala nrog cov cheeb tsam ntawm cov tswj kev ua haujlwm, nrog rau cov ciaj ciam tom ntej (PFC), txuas nrog cov lus teb rau ntau tshaj rau cov leeg tsis zoo hauv MDD [22-24] thiab IGD [25]. Lub sgACC yog lub hauv paus rau kev tswj cov kev cai [15, 22] thiab cov kab mob ntawm kev nyuaj siab [15, 26]. Sib txuas nrog sgACC thiab amygdala, lub PFC yog ib feem ntawm kev ua hauj lwm tswj circuit uas tswj kev xav [27]. MDD cov neeg mob tau pom kev sib raug zoo ntawm SgACC thiab dorsolateral / dorsomedial PFC, nrog koom nrog kev tswj yus tus kheej kom ntau [28, 29]. Ntxiv sgACC-PFC connectivity kuj tau pom muaj nyob hauv cov neeg uas muaj kev quav tshuaj yeeb [30, 31]. Yog li, kev tshuaj xyuas qhov kev sib txuas ntawm kev sib txuas ntawm amygdala, sgACC, thiab PFC, thiab cov kev sib raug zoo nrog kev nyuaj siab thiab kev quav tshuaj muaj peev xwm qhia tau tias tseem ceeb neural phenotypes ntawm IGD.
Tsis tas li ntawd, cov kev tshawb fawb yav tas los tau qhia tias cov kev pabcuam tus cwj pwm coj zoo hauv kev ua kom muaj kev tiv thaiv kev quav yeeb tshuaj [32, 33] thiab kev nyuab siab rau cov neeg uas muaj IGD los sis IA [34-36]. Kev ntsuam xyuas kev pabcuam kev coj cwj pwm cuam tshuam txog kev sib raug zoo hauv lub network thiab nws cov koom haum nrog kev txo cov kev nyuab siab thiab kev quav tshuaj muaj peev xwm muab tau cov pov thawj ntxiv los txhawb kev sib koom sib npaug ntawm IGD thiab kev nyuaj siab.
Hauv txoj kev tshawb nrhiav tam sim no, peb nthuav tawm kev tshawb pom los ntawm 4 xyoo longitudinal daim ntawv ntsuam xyuas los tshawb txog kev sib cuam tshuam ntawm kev mob hnyav ntawm kev nyuaj siab thiab kev quav tshuaj tiv thaiv hauv IGD. Tsis tas li ntawd, txhawm rau taw tes rau cov kev sib tshuam neural los ntawm kev nyuab siab rau cov tib neeg muaj IGD, peb tau ua txoj kev tshawb nrhiav rsFC uas yog tsom rau cov amygdala thiab sgACC. Thaum kawg, peb tau soj ntsuam seb kev coj tus cwj pwm zoo li cas yog kho tus mob kev nyuab siab thiab kho qhov teeb meem hauv kev txuas nrog kev nyuab siab rau cov tib neeg nrog IGD. Raws li cov pov thawj yav dhau los [11, 12, 37], peb pom tau tias ob txoj kev sib raug zoo ntawm yav dhau los thiab yav tom ntej ntawm kev tiv thaiv hauv Internet / kev nyuaj siab. Tsis tas li ntawd, raws li cov kev tshawb fawb neuropsychiatric yav dhau los [25, 38], peb pom tau tias cov tib neeg uas muaj IGD yuav pom cov kev mob tshwm sim thiab hloov rsFC ntawm amygdala thiab sgACC nrog cov cheeb tsam ntawm lub tswj kev sib txuas lus, uas yuav raug muab kho los ntawm kev coj cwj pwm ntawm IGD.
Ntaub ntawv thiab kev
Cov neeg koom
Rau Txoj Kev Tshawb Fawb 1, cov ntaub ntawv tau raug sau ua ib feem ntawm kev kawm ntev txog cov tub ntxhais kawm qib siab siv Internet hauv ib lub tsev kawm ntawv hauv Beijing, hauv plaub nthwv dej, pib xyoo 2011. Los ntawm kev ntsuas cov cuab yeej tshawb fawb online, ib pab pawg ntawm thawj xyoo kawm qib siab cov tub ntxhais kawm raug ntsuas xyoo. Txhua tus neeg tuaj koom tau muab daim ntawv sau qhia kev pom zoo thiab raug them nyiaj txiag rau lawv lub sijhawm, raws li cov txheej txheem tau pom zoo los ntawm Lub Tuam Txhab Saib Xyuas Tsev Kawm ntawm Lub Tsev Kawm Ntawv ntawm Psychology, Beijing University.
Cov neeg tshawb xyuas tau muab tso rau hauv txoj kev tshawb no tsuas yog lawv tau ua si hauv online games thiab siv nruab nrab dua 20% lawv cov sijhawm siv internet rau txhua qhov ntawm plaub xyoo sib law liag los ntawm cov ntaub ntawv tau txais. Ntawm tag nrho 2,182 cov tub ntxhais kawm, 1,619 (1,253 pojniam, 366 Cov Txiv Neej) tsis tau raws li cov qauv kev nkag mus kawm thiab raug tshem tawm ntawm txoj kev tshawb fawb. Txoj kev cais ntawm cov pojniam (90.99%) yog siab dua txiv neej (45.47%) (χ2 = 550.056, P <0.001). Yog li, kev tshawb fawb los ntawm tag nrho ntawm 563 cov tub ntxhais kawm (124 pojniam thiab 439 txiv neej) tau txais rau txoj kev tshawb no. Lawv lub hnub nyoog li ntawm 16 txog 21 xyoos (txhais tau tias ± SD = 18.31 ±. 89) ntawm lub sij hawm 1.
Kev kawm 2 thiab 3 yog ob qho tib si hauv ib qho haujlwm loj ntawm kev tsim kho thiab ntsuas tus cwj pwm cuam tshuam rau IGD. Cov neeg tuaj koom tau raug tshaj tawm hauv Is Taws Nem thiab cov kev tshaj tawm tshaj tawm hauv cov tsev kawm qib siab hauv nroog, nrog cov lus hauv qab no ntxiv: (1) tus qhab nia> 67 ntawm CIAS [39]; (2)> 14 teev ib asthiv koom nrog kev twv txiaj hauv Internet, yam tsawg kawg 1 xyoos. Cov ntsiab lus suav nrog kev tswj hwm kev noj qab haus huv (HC) cov neeg koom yog: (1) tus qhab nia <60 ntawm CIAS; (2) tsis txhob siv ntau dua 2 teev ib as thiv uas koom nrog kev ua si hauv Is Taws Nem. Txhua tus neeg tuaj koom yog cov muaj cai cov txiv neej. Cov kev cais tshwj xeeb yog ib qho kev siv tam sim no lossis yav dhau los ntawm kev siv yeeb tshuaj tsis raug cai thiab kev twv txiaj (suav nrog kev twv txiaj hauv online), ib qho keeb kwm ntawm kev puas siab ntsws lossis mob hlwb thiab kev siv cov tshuaj kho hlwb tam sim no, raws li tau txheeb xyuas los ntawm cov kev sib tham ib nrab. Tag nrho ntawm 76 cov tib neeg uas muaj IGD thiab 41 HCs tau koom rau Txoj Kev Kawm 2. Rau Txoj Kev Kawm 3, 63 tus neeg nrog IGD tau raug xaiv, cov uas 44 pom zoo koom nrog kev cuam tshuam txog kev coj cwj pwm phem (CBI + pab pawg) thiab seem 19 yog nyob hauv pawg tswj hwm. (CBI− pab pawg) vim yog lawv lub sijhawm ua haujlwm. Nees nkaum peb tus neeg hauv pawg CBI + koom nrog so hauv lub xeev fMRI ua ntej thiab tom qab CBI. Kaum rau ntawm 19 CBI− tau zoo sib xws rau kev ntsuas tib lub sijhawm. Cov kev kawm 2 thiab 3 tau pom zoo los ntawm Lub Chaw Haujlwm Saib Xyuas Kev Nkag Pov Tseg Hauv Xeev Tshawb Fawb Kev Tshawb Fawb ntawm Kev Txawj Ntse thiab Kev Kawm hauv Beijing Normal University.
Kev ntsuas
Rau kev kawm 1, 2, thiab 3, peb ntsuas qhov phem ntawm kev tiv thaiv hauv Internet ntawm cov tub ntxhais kawm ntawv qib siab uas siv Suav Kev Siv Phom Suav Hauv Internet (CIAS; 40), uas muaj 26 yam khoom ntawm 4-point Likert scale soj ntsuam 5 qhov ntev ntawm cov tsos mob / qhov raug txim xws li siv compulsive, tshem tawm, kam rau siab, thiab cov teeb meem ntawm kev sib raug zoo neeg thiab kev noj qab haus huv / lub sij hawm tswj. Qhov kev ntseeg tau thiab kev siv tau ntawm CIAS tau muab tso rau yav tas los rau cov tub kawm ntawv qib siab [40], thiab hauv kev sim tam sim no, Cronbach's alpha coefficients ntawm qhov ntsuas no yog 0.933-0.950 thoob plaws plaub lub sij hawm cov ntsiab lus. Txog Txoj Kev Kawm 1, peb ntsuas kev qog tsis txaus siab siv cov kaum peb yam los ntawm Daim Ntawv Teev Cov tsos mob (SCL-90) [41]. Cov khoom no tau ntsuas rau ntawm qhov ntsuas 1 (yeej tsis yog qhov tseeb) txog 4 (ib txwm muaj tseeb). Hauv qhov kev sim tam sim no, Cronbach's alpha coefficients rau qhov ntsuas no yog 0.888–0.936 thoob plaws plaub lub sijhawm kis. Hauv kev tshawb nrhiav 2 thiab 3, cov neeg koom nrog kev nyuaj siab tshwm sim tau ntsuas siv Beck Cov Kev Nyuaj Siab Kev Nyuaj Siab (BDI) [42].
Kev Tshawb Fawb Cov Ntaub Ntawv MRI
Rau kev tshawb fawb 2 thiab 3, MRI cov ntaub ntawv tau txais thiab preprocessing tau piav qhia nyob rau hauv kev nthuav dav hauv kev kawm yav dhau los [33]. Luv luv, so-state fMRI cov ntaub ntawv tau muab rau ntawm 3.0 T Siemens Trio scanner ntawm lub Hlis Lub Chaw Saib Xyuas, Lub Tsev Kawm Ntawv Qib Siab Beijing. Parameters rau cov ntaub ntawv EPI yog: repetition lub sij hawm = 2,000 ms, ncha lub sij hawm = 30 ms, ntxeev kaum = 90 °, saib ntawm daim duab = 200 × 200 mm2, nrhiav tau qhov kev txheeb ze = 64 × 64, voxel loj = 3.1 × 3.1 × 3.5 mm3, hlais = 33, lub sij hawm taw tes = 200. Ib T1-wighted scan kuj tau txais nrog cov nram qab no tsis: rov qab ua dua lub sij hawm = 2,530 ms, ncha lub sij hawm = 3.39 ms, ntxeev kaum = 7 °, saib pom = 256 × 256 mm2, voxel loj = 1 × 1 × 1.33 mm3, daim ntawv tsawg = 144.
Craving Behavioral Intervention (CBI)
CBI raug tsim los ntawm kev tsim kho tus cwj pwm coj ua ntej dhau [33]. Txoj kev xav puas siab puas ntsws nrog intertwined nrog kev puas siab ntsws kawg [43], kev ntxias yuav ua tau lub luag haujlwm tseem ceeb hauv txoj kev txhim kho thiab kev kho ntawm IGD. Cov kev cuam tshuam uas pab cov tib neeg daws thiab txo cov kev ntxias yuav txhawb nqa cov txiaj ntsig zoo thiab tiv thaiv kev rov qab los (saib feem seem ntawm Cov Ntawv Qhia Ntxiv) kom paub meej ntxiv).
statistical Analysis
Autoregressive Cross-Lagged Modeling
Rau kev kawm 1, peb ua haujlwm rau kev ua haujlwm ntawm kev txiav txim siab ntawm ACLM (ACLM) los txheeb xyuas kev sib raug zoo thiab kev sib raug zoo ntawm kev sib daj sib deev thiab kev mob tshwm sim. Lub ACLM zoo haum rau kev tshuaj xyuas cov kev sib raug zoo ntawm ob txoj kev ua lub sijhawm dhau los. Hauv ACLM, qhov kev ntsuas autoregressive nruab nrab yog qhov ua tau zoo npaum licas yt kwv yees tom qab ntsuas y(t + 1), thiab tus ntoo khaub lig-lagged parameter nruab nrab yog li cas ib qho kev ntsuas ua ntej zt kwv yees tom qab ntsuas y(t + 1) saum toj thiab dhau qhov ntsuas yav dhau los ntawm yt [44, 45]. ACLM tau siv ntau txoj hauv kev tshawb nrhiav kev sib raug zoo ntawm kev sib raug zoo ntawm kev kuaj mob nrog rau cov kev mob npaws [37, 46, 47]. Pawg ntawm autoregressive cross-lagged qauv raug kuaj hauv Mplus 7.4 [48]. Mplus siv cov ntaub ntawv ntau tshaj plaws (FIML) ntau tshaj plaws los txheeb xyuas cov ntaub ntawv uas tsis muaj tseeb (saib Cov Ntawv Qhia Ntxiv kom paub ntxiv). SPSS 20.0 tau siv rau kev txheeb cais.
Kev Tshawb Fawb Txog Kev Xeem Sij Hawm
Lub ACLM nrog rau yim tsim duab: kev nyuaj siab thiab kev quav tshuaj tiv thaiv ntawm lub sij hawm 1, 2, 3, thiab 4. Ntawm txhua lub sij hawm taw tes, qhov kev ntsuas CIAS tsim cov latent variable ntawm kev tiv thaiv hauv Internet, thiab kev nyuab siab heev yog tau los ntawm kev nyuaj siab nyuab siab ntawm SCL-90. Kev ntsuam xyuas qhov teebmeem autoregressive thiab cross-lagged, peb tau kuaj xyuas cov teebmeem, metric (piv txwv li, cov chaw thau khoom) thiab cov qauv kev hloov ntawm cov qauv. Peb muab piv rau cov qauv kev haum ntawm plaub hom qauv ntawm qhov sib txawv (Table 1).
rooj 1. Kev sib piv ntawm cov qauv ntoo ua lag luam autoregressive.
Cov qauv 1 tau ua haujlwm raws li lub hauv paus qauv uas tsis muaj kev hloov tsis txuam nrog kev ntsuam xyuas txoj kev tsis sib nkag siab. Hauv 2, peb tau sim cov cim tsis sib thooj ntawm kev txwv kom muaj kev sib npaug los sib npaug ntawm txhua lub sij hawm (Table S2), los xyuas kom meej tias cov kev cai muaj tib lub ntsiab lus ntawm txhua lub sijhawm [50, 51]. Nyob rau hauv Model 3, peb txwv cov kab kev sib tw rau cov kev nyuab siab heev (T) 
tiv thaiv qhov hnyav (T + 1) thiab tiv thaiv qhov hnyav (T) kev nyuab siab heev (T + 1) yuav tsum sib npaug zos raws sij hawm, seb. Thaum kawg, hauv Model 4, peb txwv tsis pub txoj kev pib rov qab rau txhua qhov kev nyuaj siab thiab kev quav kev quav yeeb tshuaj nyob rau lub sij hawm kom sib npaug (Xam) 1). Peb mam li muab piv rau cov qauv ntawm cov qauv plaub ntawm cov qauv plaub los xaiv cov qauv zoo tshaj plaws. Χ2 tus nqi, qhov sib piv ntawm qhov sib haum (CFI), Tucker-Lewis Performance index (TLI) thiab hauv paus ntawm square approximation (RMSEA) tau siv los piv cov qauv haum [49].
Daim duab 1. Tus ntoo khaub lig-lag luam kev txheeb ze. Peb qhia cov cim tsis xwm yeem, tsis sib thooj, thiab tsis sib xws ntawm qhov yuam kev tsis sib thooj nyob rau lub sijhawm siv cov tsiaj ntawv ntawm txoj kev. Cov zauv muaj kev sib npaug ntawm cov qauv coefficients (*P <0.05; ***P <0.001).
Cuam Tshuam Cov Ntaub Ntawv Tshawb Fawb
Hauv kev tshawb 2, ob tus qauv t-tsis tau tshawb nrhiav kev yees thiab kev nyuab siab heev ntawm IGD thiab HC pawg. Kev soj ntsuam cov variance (ANOVAs) nrog cov kev ntsuas dua raug siv hauv 3 los tshawb xyuas cov teebmeem ntawm CBI hauv Internet gaming cov cwj pwm, nrog pab pawg (CBI + thiab CBI-) raws li kev sib tw, thiab kev sib tham (lub hauv paus thiab qhov kev xeem thib ob) qhov zoo tshaj plaws hauv qhov kev kawm.
Cov Ntawv Qhia Ua Ntej MRI
Cov ntaub ntawv muaj preprocessed thiab tshawb xyuas siv DPABI version 1.2 (http://rfmri.org/dpabi) thiab SPM8 (http://www.fil.ion.ucl.ac.uk/spm). Thawj qhov 10 tau muab pov tseg. Cov ntaub ntawv ntawm tus kheej EPI tau kho cov sij hawm hlais. Cov neeg koom nrog lub taub hau suab ntau tshaj 3.0 hli hauv kev txhais lossis 3 ° hauv kev sib hloov (2 IGD subjects) raug tshem tawm. Peb ntxiv txo cov kev tawm tsam ntawm lub taub hau suab nrog Friston-24 kho. Peb regressed tawm cov teeb meem ntawm cerebrospinal kua thiab dawb teeb meem kom txo tau cov teebmeem ntawm physiological artifacts. Cov ntaub ntawv EPI tau tshwm sim tom qab lub koom haum Montreal Neurological Institute (MNI). Ib qho chaw lim xiav ntawm 4 hli puv dav dav ntawm ib nrab ntawm Gaussian ntsiav ntau tau siv. Tom qab ntawd, ib lub hnab ntim dhau ntawm lub lim dej (0.01-0.10 Hz) tau siv los txo qis qis thiab suab nrov nrov heev.
RsFC Cov Nyiaj Tshem Tawm
Bilateral subgenual ACC thiab amygdala cov noob raug txheeb tau los ntawm kev sib txuas ua haujlwm-raws li atlas [52], thiab los ntawm atlas ntawm thaj chaw Brodmann (Brodmann cheeb tsam 34, saib Daim Duab S1). Qhov sij hawm nruab nrab-sijhawm nyob rau txhua lub noob tau tawm tsam tag nrho-lub hlwb voxels los ua cov duab kos sib txheeb. Correlation coefficients tau hloov pauv mus rau Z cov qhab nia nrog Fisher's r-rau-z hloov.
Peb sib piv IGD thiab HC pawg 'rsFC hauv sgACC thiab amygdala rau Kev Tshawb Nrhiav 2, thiab sib txawv ntawm qhov kev hloov ntawm rsFC ntawm CBI + thiab CBI− pawg ([rsFC ntawm qhov ntsuas thib ob] - [rsFC ntawm lub hauv paus]) hauv Kev Kawm 3 nrog ob -am txwv t-tsev thiab cov kev sib txawv ntawm cov pab pawg tau raug kho los ntawm kev siv Gaussian random field theory (GRFT, voxel-level P <0.001 sib xyaw nrog pawg-qib P <0.05 kho rau kev ua txhaum tsev neeg).
Hauv IGD pawg hauv Txoj Kev Kawm 2, peb tseem ua qhov kev soj ntsuam ROI-based regression los tshuaj xyuas qhov kev sib raug zoo ntawm BDI, CIAS tus qhab nia, thiab rs-FC, nrog ROI tau txheeb los ntawm tag nrho-lub hlwb ntawm-pawg sib piv. Peb tau tshaj tawm cov paj hlwb kev ua haujlwm tseem ceeb hauv ROIs raug kho raws li txhais tau los ntawm GRFT nrog voxel-theem P <0.005 thiab pawg-theem P <0.05 (PSVC-FWE <0.05).
Rau txoj kev tshawb no 3, ROI-based regression analyzes tau ua nyob rau hauv CBI + pawg los tshawb xyuas kev sib raug zoo ntawm kev hloov ntawm BDI thiab hauv CIAS qhab nia thiab hloov rsFC raws li tau teev los ntawm ob qho qauv t-tests (voxel-level P <0.005 thiab pawg-theem P <0.05; PSVC-FWE <0.05).
tau
Kawm 1: Daim ntawv ntsuam xyuas ntawm Kev Nyuaj Siab thiab Kev Sib Yaum Sib Txawv hauv Internet Gamers
Bivariate correlations qhia theem kev ruaj ntseg ntawm tib lub zog ntawm plaub qhov tsis tseem ceeb, qhov sib txuam sib luag ntawm cov kev hloov hauv txhua nthwv dej, thiab qhov ntev ntawm qhov tsis sib haum ntawm cov tsis muaj (saib S1). Tshwj xeeb tshaj, hla plaub lub vuag, qhov phem ntawm kev tiv thaiv hauv Internet tau ntxov ua rau mob siab tshaj tom qab (r 's xws li 0.19 rau 0.27, P <0.01), thiab kev nyuaj siab ntau dua ua ntej lawm tau cuam tshuam nrog kev quav ntau dua tom qab (r 's xws li 0.25 rau 0.30, P <0.01).
Los kuaj cov kev sib raug zoo ntawm kev sib khi thiab kev nyuab siab heev, peb ua ntej haum Model 1 yam tsis muaj tusariariates lossis kev txwv. Cov qauv haum rau cov qauv no yog qhov zoo [χ2(210)
= 441.049, P <0.001, CFI = 0.972, RMSEA = 0.044, SRMR = 0.070]. Tus Qauv 1 tau txais kev pab raws li lub hauv paus qauv rau kev sib piv nrog ntau cov qauv uas tsis nruj, qhov twg ntawm txhua txoj hauv kev hla kev tau sib luag los ua qhov sib luag thoob plaws kev ntsuas. Txwm nrog peb cov kev xav, Tus Qauv 2 qhia tau zoo dua li Ua Qauv 1 nrog RMSEA zoo dua tab sis tsis muaj qhov sib txawv hauv χ2, CFI thiab TLI qhov tseem ceeb [Δχ2(12)
= 10.912, P > 0.05; ΔCFI <0.01, ΔTLI <0.01]. Yog li, metric invariance ntawm kev quav yeeb quav tshuaj hauv Internet tau txais kev txhawb nqa, qhia tias kev quav yeeb quav cawv raug nkag siab thiab soj ntsuam los ntawm cov neeg twv txiaj hauv online kom zoo ib yam nyob thoob plaws 4 xyoos. Thib ob, Tus Qauv 3 tau zoo dua piv rau Tus Qauv 2, nrog RMSEA zoo dua tab sis tib CFI, TLI thiab χ2 nqi. Ntawd yog, cov teebmeem ntawm kev sib tw ntawm ob txoj kev sib raug zoo [kev nyuaj siab / kev txom nyem (T) Kev quav yeeb tshuaj / kev nyuab siab heev (T + 1)] zoo ib yam dhau lub 4 xyoo. Tom ntej no, Model 4 txawv ntawm Model 3 hauv χ2 tab sis tsis muaj lwm qhov ntsuas tau zoo (ΔCFI <0.01, ΔTLI <0.01, ΔRMSEA <0.01), tawm tswv yim hais tias txhua qhov kev cuam tshuam ntawm ob qho kev hloov tau nyob ruaj khov thiab zoo tib yam thoob plaws 4 xyoos. Tus Qauv 4 yog li tau xaiv los ua tus qauv kawg rau qhov kev kawm no.
rooj 2 teev cov qauv coefficients ntawm Model 1 thiab 4, thiab qhia tau tias feem ntau ntawm kev tiv thaiv hauv Internet thiab kev nyuab siab muaj kev ntxhov siab tau zoo sib xws ntawm lub sijhawm. Txuas ntxiv, qhov kev nyuab siab ntawm kev nyuab siab rau kev hnyav (β = 0.118, 0.126, 0.127) yog siab tshaj qhov feem ntawm kev quav tshuaj tiv thaiv kev nyuab siab rau kev nyuaj siab (β = 0.070, 0.066, 0.070). Ua ke, cov txiaj ntsim tau los muab cov kev ntsuas tawm ntawm kev sib txuas ntawm lub cev ntawm kev nyuaj siab thiab kev quav tshuaj tiv thaiv.
rooj 2. Parameter kwv yees ntawm cov qauv yooj yim thiab ARCL Model 6.
Kawm 2: Neural Correlates Kev Nyuaj Siab hauv Internet Gaming Cov Kev Puas Tsuaj
Demographics thiab cov Gaming Internet Gaming ntawm IGD thiab HC Yam Kawm
IGD thiab HC cov ntsiab lus tsis txawv ntawm hnub nyoog, kev kawm, los yog cawv siv thiab luam yeeb haus luam yeeb. Raws li kev xav, IGD cov ntsiab lus tshaj tawm BDI (8.78 ± 5.54 vs. 2.85 ± 3.64; t = 6.91, P <0.001) thiab ntau dua CIAS cov qhab nia (78.46 ± 8.40 vs. 43.49 ± 9.64; t = 20.27, P <0.001), hauv kev sib piv rau HC cov ncauj lus kawm (Cov Lus S3).
rsFC Txawv Sib Txawv ntawm IGD thiab HC Yam Kawm
Piv rau HC, IGD kis tau pom ntau dua rsFC ntawm cov laug amygdala thiab txoj cai DLPFC (Daim Duab 2 thiab Rooj Lus 3). Txawm li cas los xij, tsis muaj qhov sib txawv ntawm cov pab pawg neeg sib txawv ntawm txoj cai rau txoj cai amygdala los yog ob tog sgACC noob. Los ntawm kev siv ntau qhov kev soj ntsuam (voxel level) P <0.005 thiab pawg-theem P <0.05), cov ntsiab lus kawm IGD qhia tau pom tias ntau dua rsFC ntau dua ntawm sab laug sgACC thiab sab xis DLPFC (Daim duab S2 thiab Rooj S4).
Daim duab 2. Resting-state functional connectivity nyob rau hauv IGD thiab HC compound (A) thiab koom nrog kev nyuaj siab hauv pawg neeg IGD (B).
rooj 3. Noob qhov chaw thiab cov cheeb tsam uas muaj qhov sib txawv hauv kev sib txuas ntawm IGD thiab HC cov ntsiab lus (GRFT, voxel level P <0.001 thiab pawg-theem P <0.05).
Hlwb-Cwj Pwm Kev Sib Ceg
Nyob rau hauv pab pawg neeg IGD, kev nyuaj siab yog qhov tsis sib haum nrog kev sib cuag ntawm cov laug amygdala thiab txoj cai DLPFC (MNI: 57, 9, 30; r = -0.35; Xam 2). Muaj tsis muaj kev sib txheeb ntawm kev tiv thaiv ntawm kev tiv thaiv thiab sab laug amygdala-txoj cai DLPFC kev sib txuas.
Kawm 3: Qhov Teeb Meem ntawm Kev Cuam Tshuam Txog Kev Nyuaj Siab thiab Lub Neural Bases ntawm Therapeutic Efficacy
Demographics thiab cov Gaming Internet Gaming
ANOVA nrog kev ntsuas rov qab ua dua pom ib pawg (CBI + & CBI−) los ntawm kev sib kho (thawj thiab ntsuas thib ob) kev sib cuam tshuam rau qhov mob hnyav ntawm IGD [F(1, 59) = 22.62, P <0.001] thiab BDI qhab nia [F(1, 59) = 7.89, P <0.01] (Cov Lus 4). Muab piv rau pawg tswj hwm, pawg pabcuam tau pom ntau qhov kev txiav nyiaj hauv CIAS thiab qhov kev nyuaj siab ntawm cov kev kho mob tom qab.
rooj 4. Cov sib piv ntawm cov qhabneem ntsuas ntawm CBI thiab CBI-pab pawg thaum lub sijhawm ua ntej thiab tom qab kev cuam tshuam.
Kev hloov hauv rsFC hauv CBI thiab CBI Pawg
Piv nrog rau CBI-pawg, pawg CBI + pom tias tau txo qhov rsFC ntawm sab laug amygdala nrog sab laug precangel gyrus thiab DLPFC, tom qab qhov kev cuam tshuam (daim duab 3A thiab Rooj Lus 5). Txawm li cas los xij, tsis muaj qhov sib txawv ntawm cov pab pawg neeg sib txawv ntawm txoj cai rau txoj cai amygdala los yog ob tog sgACC noob. Muaj ntau qhov kev soj ntsuam (voxel level) P <0.005 thiab pawg-theem P <0.05), CBI + cov ntsiab lus qhia pom tsis tshua muaj kev cuam tshuam kev ua haujlwm sib txuas ntawm sab laug sgACC thiab sab laug postcentral gyrus (Daim Duab S3 thiab Rooj S5).
Daim duab 3. Tau hauv kev tshawb 3. Sib piv ntawm kev hloov rsFC ([rsFC ntawm ob qhov xa khoom] - [rsFC ntawm qhov pib]) ntawm CBI + thiab CBI-pab pawg hauv sab laug amygdala nrog MFG, precentral gyrus thiab SFG (A); Kev tsis sib haum ntawm FC ntawm sab laug amygdala thiab txoj cai DLPFC ntawm lub hauv paus uas hloov pauv ntawm kev nyuaj siab hauv pawg CBI + (B); Scatterplot pom ntawm correlation ntawm hloov pauv ntawm BDI thiab beta qhov tseem ceeb rau pawg nyob hauv lub hauv paus rsFC ntawm amygdala-DLPFC (C).
rooj 5. Noob qhov chaw thiab cov cheeb tsam uas muaj qhov sib txawv hauv kev sib txuas ntawm CBI thiab CBI pawg (GRFT, voxel level P <0.001 thiab pawg-theem P <0.05).
Hlwb-Cwj Pwm Kev Sib Ceg
Txawm hais tias tsis muaj cov koom haum tseem ceeb ntawm kev hloov ntawm rsFC thiab theem kev nyuab siab lossis kev quav tshuaj muaj yees raug cai hauv pawg CBI, qhov kev sib txuas ntawm cov laug amygdala thiab txoj cai DLPFC ntawm qhov pib yog qhov cuam tshuam nrog kev hloov pauv ntawm kev nyuaj siab ([Post-Pre], MNI: 42, 15, 27, r = 0.63; SVC; Cov duab 3B, C) hauv pawg CBI. Txawm li cas los xij, lub koom haum tsis muaj qhov teeb meem loj dua thaum tswj rau qhov kev nyuab siab.
kev sib tham
Peb soj ntsuam qhov kev sib raug zoo ntawm cov kev mob tshwm sim ntawm kev nyuaj siab thiab kev quav yeeb thiab kev siv cov cuab yeej siv neeb los ntawm txoj kev tshawb nrhiav qhov kev tshawb nrhiav ntev, qhov kev tshawb nrhiav kev sib txuas ntawm lub xeev thiab kev tshawb nrhiav kev pab cuam. Feem ntau, kev tiv thaiv hauv Internet thiab kev nyuab siab muaj kev sib raug zoo ntawm kev sib tw ntawm Internet gamers vim kev tiv thaiv thiab kev nyuab siab sib txawv sib cuam tshuam lwm sib thooj hauv 4 xyoo. Los ntawm kev sib piv ncaj qha rau cov tib neeg nrog IGD thiab HC, peb pom tias pawg IGD tsom siab tshaj kev nyuab siab thiab amygdala-DLPFC rsFC, nrog lub zog ntawm kev sib cuag tsis zoo nrog kev nyuaj siab hauv pawg neeg IGD. Tsis tas li ntawd, cov tib neeg muaj IGD pom tias muaj kev nyuab siab heev thiab rsFC ntawm lub amygdala thiab DLPFC tom qab tau txais kev pabcuam tus cwj pwm ntawm IGD. Cov kev sib tshuam ntawm Aberrant ntawm cov kev xav hauv lub siab ntsws thiab tswj kev ua haujlwm yuav ua rau kom muaj kev nyuaj siab tshwm sim hauv IGD, thiab cov kev cuam tshuam cov teeb meem no yuav ua rau ob tus yeeb yam ntawm kev tiv thaiv hauv Internet thiab kev nyuaj siab. Ua ke, cov kev tshawb nrhiav tau muab kev txhawb zog uas cov kev ua si hauv Internet gaming thiab kev nyuaj siab tshwm sim yog sib cuam tshuam.
Cov txiaj ntsig tau ua raws li kev xav hais tias Internet gamers cov kev mob tshwm sim thiab kev nyuaj siab tau txais txiaj ntsig los ntawm ib leeg. Tshwj xeeb, kev nyuaj siab / kev quav yeeb quav tshuaj hauv Is Taws Nem nyob rau lub sij hawm nyuam qhuav pib muaj txoj kev xav tias txoj kev quav / quav yeeb tshuaj heev nyob rau lub sijhawm tom qab. Yog li, kev quav yeeb tshuaj thiab kev nyuaj siab loj hauv cov neeg twv txiaj hauv online yog ob-txoj hauv kev, ua ke nrog kev tshawb pom hauv lwm cov kev quav ntxiv [53, 54]. Txawm hais tias yav dhau los cov kev tshawb fawb tau qhia siab dua kev nyuab siab ntawm cov neeg hauv internet gamers [5, 16, 55, 56], as Well as reciprocal kev sib raug zoo ntawm kev nyuaj siab thiab kev quav tshuaj hnyav siv longitudinal cov ntaub ntawv [57], cov kev tshawb nrhiav tam sim no yog thawj zaug uas qhia txog kev sib haum xeeb ntawm kev sib raug zoo ntawm cov tsos mob ntawm kev nyuaj siab thiab kev tiv thaiv hauv Internet gamers. Bidirectional kev sib raug zoo yuav hloov vim hais tias (1) cov tib neeg tiv thaiv lawv cov kev nyuaj siab ntxhov siab los ntawm kev ua si hauv Internet [2, 58]; (2) tau siv lub sijhawm ua si hauv Internet ua rau kev nyuaj siab vim yog tsis muaj lossis tshem tawm ntawm kev sib raug zoo ntawm lub neej [58, 59]. Tsis tas li ntawd, qee qhov sib faib khoom xws li roj ntsha, kev sib raug zoo los yog lub neej thaum ntxov yuav ua rau kom muaj kev nyuab siab thiab IGD, nrog rau lawv cov koom haum [58, 60]. Tsis tas li ntawd, qhov kev nyuab siab ntawm kev nyuab siab rau kev hnyav hnyav heev siab tshaj qhov cuam tshuam ntawm kev quav tshuaj rau kev nyuaj siab, qhov teeb meem uas yuav tsum tau tshawb nrhiav ntxiv.
Hauv neural qib, piv rau HC, pab pawg IGD pom tshwm sim ntau dua rsFC ntawm sab laug amygdala thiab txoj cai DLPFC, uas raug cuam tshuam nrog kev nyuab siab heev hauv pawg neeg IGD. Lub amygdala plays lub luag haujlwm tseem ceeb hauv txoj kev xav, kev paub, thiab kev nco [11, 17, 19]. Qhov tseem ceeb, cov amygdala reactivity yuav raug hloov los ntawm PFC, thiab aberrant neural kev sib raug zoo ntawm cov cheeb tsam ob hauv no tau tshwm sim hauv kev nyuaj siab. Ntxiv mus, cov amygdala reactivity yuav hloov los ntawm PFC, thiab aberrant neural kev sib raug zoo ntawm cov cheeb tsam ob hauv cov kev nyuab siab no. Piv txwv li, rsFC weaker ntawm amygdala thiab PFC tau muab tso rau hauv cov kev tshawb xyuas yav dhau los hauv xeev hauv kev nyuaj siab [23, 24, 61], IGD [25], thiab haus dej cawv [62]. Txo PFC-amygdala muaj kev sib raug zoo thaum lub sijhawm xav txog kev xav hauv siab ntsig kuj tau qhia tawm hauv MDD [27, 38, 63]. Lub DLPFC txhawb kev paub thiab kev tswj hwm tus cwj pwm [64], thiab hloov kev sib txuas ntawm DLPFC thiab amygdala tej zaum yuav cuam tshuam nrog kev nyuaj los yog kev cuam tshuam ntawm txoj kev xav tsis zoo. Hauv kev sib piv nrog cov kev tshawb fawb yav dhau los hauv MDD, cov kev tshawb nrhiav tam sim no tau pom tias muaj kev tiv thaiv zoo ntawm amygdala-DLPFC. Ib qho Ad-hoc kev piav qhia yog tias IGD cov neeg tuaj yeem khaws cia hauv kev ua si xws li kev daws kev txhawj xeeb kom dim ntawm tsis pom tus cwj pwm [58, 61], koom nrog DLPFC hauv kev tswj cov kev xav tsis zoo, uas tej zaum yuav tsis zoo rau cov neeg uas muaj IGD [65], txheeb ze rau cov neeg muaj MDD. Nws yuav tsum raug sau tseg tias IGD cov ntsiab lus nrog cov tsos mob siab dua yog pom cov kev sib txuas ntawm amygdala thiab DLPFC, qhia tias kev sib raug zoo ntawm kev nyuab siab thiab kev sib raug zoo ntawm Amygdala-DLPFC yuav tsis yog linear. Yog li, IGD cov kev mob uas muaj cov tsos mob siab mob siab tuaj yeem ua rau kom muaj kev tswj hwm ntawm qhov teeb meem ntawm amygdala los tswj cov teeb meem kev ntxhov siab, tiam sis qhov kev kho no tsis yog ua kom zoo lossis cuam tshuam rau cov neeg muaj kev nyuab siab heev. Ua ke, qhov kev taw qhia ntawm kev hloov ntawm kev sib txuas lus hauv amygdala-centered yuav tsum muaj kev tshawb fawb ntxiv, nrog ceev faj xav txog kev vib this, kev nyuab siab ntawm kev nyuab siab, kev ua haujlwm zoo ntawm thaj tsam ntawm thaj tsam ntawm prefrontal, thiab cov kev kho mob ntawm cov tshuaj kho mob. "
Zoo ib yam li cov neeg ntawm kev ntsuas ntawm kev coj cwj pwm coj hauv IGD [34], txoj kev tshawb xyuas tam sim no tau pom kev txo qhov kev tiv thaiv hauv Internet thiab kev nyuab siab hauv cov CBI + tom qab tau txais kev cuam tshuam nrog rau pawg CBI. Txuas ntxiv, pawg CBI + tau pom tias tsawg ntawm rsFC ntawm amygdala nrog thaj tsam cortical frontal. Li no, CBI zoo li normalize cov amygdala-DLPFC connectivity los ntawm kev txo cov kev sib raug zoo ntawm cov kev xav tsis zoo siab, kom cov IGD yuav tsum tau txais kev pab tsawg los ntawm kev tswj hwm tus kheej. Ua ke, cov kev tshawb pom no qhia tias kev sib koom tes ntawm amygdala thiab DLPFC tej zaum yuav yog ib qho kev qhia txog kev nyuab siab ntawm cov kev nyuaj siab nyob rau hauv IGD thiab cov neeg sib tw rau kev kho mob.
Contrary to tshawb pom los ntawm MDD [15, 29, 64], tsis muaj teeb meem sgACC-centered rsFC hloov tau nyob hauv cov tib neeg muaj IGD, los yog cov kev cuam tshuam ntawm CBI hauv kev kho rsFC ntawm cov sgACC thiab prefrontal cortex. Ib qho kev piav qhia tau yog, hauv kev tshawb 2 thiab 3, peb tsis muaj IGD cov kev mob uas muaj kev nyuab siab heev los tswj cov cwj pwm tsis txaus ntseeg, thiab sgACC dysconnectivity yuav tsis tshwm sim rau cov neeg uas muaj kev nyuab siab heev. Lwm qhov kev txhawj xeeb txog cov tswv yim sib txawv ntawm qhov sib txawv ntawm cov kev mob nyuab siab hauv IGD cov ntsiab lus thiab MDD cov neeg mob, qhov teeb meem yuav tsum tau soj ntsuam ntxiv los ntawm cov kev tshawb fawb ntawm cov tib neeg uas muaj ib leeg thiab mob comorbid diagnoses. Txawm li cas los xij, nws yuav tsum tau sau tseg tias cov ntsiab lus tau pom cov qauv zoo sib xws ntawm cov sgACC thiab amygdala, uas zoo ib yam nrog cov kev tshawb fawb hauv MDD uas aberrant rsFC ntawm affective network overlapped hauv prefrontal cortex [23, 29].
Txoj kev tshawb no tau qhia ib txoj kev sib raug zoo ntawm kev nyuaj siab thiab kev quav tshuaj tiv thaiv thiab nws cov tswv yim zoo nkauj hauv IGD. Ntawm qhov tsawg tshaj plaws, cov kev tshawb pom tau muab pov thawj rau ib qho tseem ceeb neural phenotype - tej zaum RDoC [3] -Nws IGD. Cov kev tshwm sim no tseem tuaj yeem tso tau lub teeb tshiab rau txoj kev tsim cov kev pabcuam ntxiv rau IGD. Kev xav nrog kev nyuaj siab xws li kev nyuaj siab yog suav hais tias yog ib qho tseem ceeb hauv lub hom phiaj kev tiv thaiv vim nws txoj kev koom nrog kev rov qab [66]. Raws li cov kev tshawb nrhiav tam sim no, kev nyuab siab, thiab lwm cov kev ua rau lub siab yuav tsum raug coj mus rau hauv tus account thaum tsim cov kev pabcuam thiab ntsuam xyuas cov kev ua rau kev siv tshuaj tua kabmob IGD. Piv txwv li, cov lej xws li lub sij hawm ntawm lub sijhawm fMRI neuro-tawm tswv yim [67] los hloov kho rsFC ntawm amygdala thiab sgACC yuav pab tau zoo rau cov kab mob IGD thiab kev nyuab siab thiab txhawb nqa lwm cov kev tiv thaiv kom ua tau zoo dua.
Qee qhov kev txwv yuav tsum tau muab sau tseg. Ua ntej, Kawm 1 siv qhov kev tshawb xyuas ntawm SCL-90, whereas Kev Kawm 2 thiab 3 siv BDI los ntsuas kev nyuaj siab. Txawm hais tias ob qho tib si yog siv cov kev ntsuas nrog cov kev puas siab puas ntsws zoo, cov kev tshawb nrhiav tseem yuav raug lees paub los ntawm kev tshawb fawb los siv cov kev ntsuam xyuas zoo ib yam. Qhov thib ob, IGD yog ib qho ntawm feem tshawb nrhiav subtypes ntawm IA. Txawm li cas los xij, ib tug yuav tsum ceev faj txog cov kev tshawb pom no mus rau lwm lub subtypes ntawm IA (piv txwv li, kev tiv thaiv cybersexual) [68]. Qeb peb, txoj kev tshawb nrhiav tam sim no yog npaj rau cov tub ntxhais hluas. Kev loj hlob yog ib qho tseem ceeb rau txoj kev loj hlob ntawm ob leeg IGD thiab ntau qhov teeb meem kev xav, xws li kev nyuaj siab [69]. Muaj kev xav tau rau yav tom ntej cov kev tshawb fawb los soj ntsuam xyuas cov comorbidity ntawm IGD thiab kev nyuaj siab thiab cov tswv yim zoo hauv cov laus thaum cov hluas. Plaub, qhov kev tshawb nrhiav tam sim no tsis qhia meej txog kev sib raug zoo ntawm kev nyuaj siab thiab kev sib daj sib deev. Ob leeg-dig muag, randomized, cov kev tshawb fawb tshuaj placebo uas siv cov tshuaj FMRI thiab antidepressant tshuaj tuaj yeem hais ncaj qha rau qhov teeb meem no. Thib tsib, nyob rau hauv kev tshawb 3, IGD cov ntsiab lus tsis raug xaiv rau pawg CBI thiab CBI pawg. Yog li, peb tsis tuaj yeem tshem tawm tau yam xwm txheej xws li kev txhawb nqa kom tau txais kev kho mob ntawm cov kev tshawb pom kev coj cwj pwm thiab kev kuaj pom tam sim no. Thaum kawg, peb tau txiav txim siab IGD raws li CIAS cov qhab nias thiab lub limtiam gaming lub sijhawm. Txawm li cas los xij, xws li cov tsos mob ntawm lub cev yuav tsis muaj lub ntsiab lus theoretical thiab ua tau qhov kev pheej hmoo ntawm kev tawm tsam cov yeeb yam dav dav [70]. Yog li, cov cuab yeej cuab zog tshiab raws li kev tsim nyog txhais ntawm IGD thiab xav tias cov kev xav tshwj xeeb yog cov lus pom zoo rau yav tom ntej kev tshawb fawb.
Thaum xaus, siv kev sib txuas ntawm longitudinal daim ntawv ntsuam xyuas, fMRI thiab cov kev tshawb fawb, peb tau qhia tias cov tsos mob ntawm kev tiv thaiv hauv Internet thiab kev nyuab siab muaj kev sib raug zoo nrog kev cuam tshuam ntawm cov neeg siv Internet. Cov tib neeg nrog IGD pom tau zoo dua amygdala-DLPFC kev sib txuas, uas tau cuam tshuam nrog cov kev mob nyuab siab, thiab kev hloov li ntawd thiab kev cuam tshuam txog kev ua lag luam raug tsawg dua tom qab ib qho kev coj cwj pwm ntawm IGD. Ua ke, cov kev mob siab siab thiab kev mob kev nkeeg hauv plab ntswj ntsug-hauv kab mob hauv plab-ntswj-amgydala yuav tsum raug suav nrog rau kev tshawb nrhiav ntawm IGD thiab kev tsim kho kev pab cuam rau IGD.
Sau cov tswv yim
J-TZ thiab X-YF yog lub luag haujlwm rau txoj kev kawm thiab kev tsim qauv; LL, C-CX, JL, thiab S-SM tau pab cuam rau cov kev pab cuam thiab cov ntaub ntawv nrhiav tau; Y-WY, LL, J-TZ, thiab CL tau kev pab nrog cov ntaub ntawv ntsuam xyuas thiab kev txhais cov ntsiab lus; LL thiab Y-WY tau sau cov ntawv sau tseg. J-TZ, CL, thiab X-YF tau muab qhov tseem ceeb ntawm phau ntawv sau rau cov lus qhia kev txawj ntse. Txhua tus neeg sau ntaub ntawv tseem ceeb thiab pom zoo rau qhov kawg ntawm phau ntawv xa tuaj rau cov ntawv tshaj tawm.
Teebmeem ntawm Cov Lus Qhia Txaus
Cov sau phau ntawv tshaj tawm tias qhov kev tshawb fawb tau ua thaum tsis muaj kev lag luam los yog nyiaj txiag kev sib raug zoo uas yuav raug txwv tsis pub muaj kev cuam tshuam ntawm kev txaus siab.
ACKNOWLEDGMENTS
Peb ua tsaug rau txhua yam kev kawm rau hauv peb txoj kev kawm. Cov hauj lwm no tau txais kev txhawb los ntawm National Natural Science Foundation ntawm Tuam Tshoj (Nres 31170990, No. 81100992, No. 31700966); cov Nyiaj Tshawb Fawb Txog Kev Tshawb Fawb rau Cov Tsev Kawm Ntawv Nruab Nrab (tsis muaj 2017XTCX04); ib qho kev pab NIH (tsis muaj K02DA026990); thiab kev pab los ntawm Tuam Tshoj Postdoctoral Science Foundation (Tsis yog 2017M620655).
Cov Ntaub Ntawv Ntxiv
Cov ntaub ntawv ntxiv rau daim ntawv no muaj nyob hauv online ntawm: https://www.frontiersin.org/articles/10.3389/fpsyt.2018.00154/full#supplementary-material
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Keywords: amygdala, kev nyuaj siab, fMRI, internet gaming teeb meem, so-state functional connectivity, subgenual anterior cingulate cortex
Citation: Liu L, Yao YW, Li CR, Zhang JT, Xia CC, Lan J, Ma SS, Zhou N thiab Fang XY (2018) Lub Comorbidity ntawm Internet Gaming Teeb thiab Kev Nyuaj Siab: Sib Txawv thiab Neural Mechanisms. Pem hauv ntej. Psychiatry 9: 154. doi: 10.3389 / fpsyt.2018.00154
Tau txais: 26 Lub Ib Hlis 2018; Tau txais: 04 Plaub Hlis 2018;
Luam tawm: 23 Plaub Hlis Ntuj 2018.
Edited by:
Yasser Khazaal, Lub teb chaws Geneva, Switzerland
Rov los:
Qinghua Nws, Southwest University, Suav
Aviv M. Weinstein, Ariel University, Israel
Copyright © 2018 Liu, Yao, Li, Zhang, Xia, Lan, Ma, Zhou thiab Fang. Qhov no yog ib tsab xov xwm qhib-nthuav tawm raws li cov nqe lus ntawm Creative Commons Attribution Licence (CC BY). Kev siv, faib los yog muab luam tawm rau lwm lub rooj sab laj raug tso cai, yog tus thawj tus neeg sau thiab tus tswv ntawm tus tswv yuav raug muab tshaj tawm thiab daim ntawv tshaj tawm thawj zaug hauv phau ntawv no yog raug teev lus, raws li kev lees paub kev kawm. Tsis pub siv, faib lossis muab luam tawm uas tsis ua raws li cov ntsiab lus no.
* Kev xa xov: Jin-Tao Zhang, [email tiv thaiv]
Xiao-Yi Fang, [email tiv thaiv]
†Cov sau phau ntawv no tau pab txhawb rau txoj haujlwm no.
;