Biomed Res Int. 2015; 2015: 378675. Epub 2015 Mar 24.
Volume 2015 (2015), Tshooj ID 378675, 9 nplooj ntawv
http://dx.doi.org/10.1155/2015/378675
Yunqi Zhu, 1,2,3,4 Hong Zhang, 1,2,3,4 thiab Mei Tian1,2,3,4
1Department of Nuclear tshuaj, Lub Tsev Kho Mob thib Ob ntawm Zhejiang University Tsev Kawm Ntawv Tshuaj, 88 Jiefang Road, Hangzhou, Zhejiang 310009, Suav Teb
2Zhejiang University Medical PET Center, Hangzhou 310009, Suav
3Institution of Nuclear tshuaj thiab Molecular Imaging, Zhejiang University, Hangzhou 310009, Suav teb
4Key Laboratory ntawm Kev Kho Mob Mob Nroj Tsuag Ntawm Nroog Zhejiang, Hangzhou 310009, Suav
Tau txais 18 lub Xya hli ntuj 2014; Txais 8 lub kaum hli ntuj 2014
Tawm Tsav Xwm Kev Kawm: Ali Cahid Civelek
Copyright © 2015 Yunqi Zhu li al. Qhov no yog ib tsab xov xwm qhib kev faib tawm raws li Creative Commons Attribution Licence, uas tso cai txwv tsis pub, faib, thiab luam tawm hauv txhua qhov nruab nrab, yog txoj haujlwm tseem ceeb raug muab teev tseg.
Abstract
Kev siv cov khoom siv hauv Internet hauv Internet kev siv yees (IA), uas yog txuam nrog ntau yam tsis zoo. Cov kev siv lub cev thiab cov kev siv lub cev muaj nuj nqi tau raug coj los siv rau kev ntsuam xyuas cov kev hloov ntawm cov neurobiological thiab cov paj hlwb ntawm IA. Cov kev ntsuam xyuas no piav qhia txog kev tshawb nrhiav txog cov roj ntsha (molecular and functional findings) ntawm cov neurobiological mechanisms ntawm IA, tsom ntawm kev sib nqus resonance imaging (MRI) thiab nuclear kev kuaj xws li positron emission tomography (PET) thiab ib qho photon emission computed tomography (SPECT). Cov kev tshawb xyuas MRI qhia tau tias cov kev hloov ntawm cov teebmeem nyob hauv xub ntiag cortex muaj feem xyuam nrog kev ua haujlwm txawv txav hauv Internet khoob. Nuclear ntsuam xyuas pom tau tias IA yog txuam nrog kev ua haujlwm ntawm lub hlwb dopaminergic systems. Txoj kev tsis zoo ntawm dopamine kev tswj ntawm prefrontal cortex (PFC) yuav ua rau tus nqi muaj zog thiab kev coj cwj pwm tsis zoo hauv Internet dhau ntawm kev siv cov txheej txheem. Cov kev tshawb fawb ntxiv tau ntxiv los txiav txim siab txog kev hloov hauv Internet hauv lub hlwb, nrog rau lawv qhov kev cuam tshuam rau tus cwj pwm thiab kev paub.
1. Introduction
Kev quav tshuaj yeeb dej caw lossis dej num muaj peev xwm ua rau tib neeg txoj kev noj qab haus huv thiab qee zaum ua rau muaj teeb meem loj hauv kev loj [1-3]. Piv txwv, kev siv internet ntawm kev siv internet yuav ua rau muaj kev tiv thaiv tus cwj pwm kev coj cwj pwm, ua rau kev puas tsuaj lossis kev nyuaj siab [4]. Tsis ntev los no, kev tshawb fawb txog kev tiv thaiv hauv Internet (IA), tshwj xeeb tshaj yog hauv Internet gaming teeb meem (IGD), tau nce ntau hauv qhov ntau thiab zoo [5, 6]. IA feem ntau txhais tau tias yog ib qho tsis muaj peev xwm tswj cov kev siv hauv Internet, ua rau muaj kev puas siab puas ntsws, kev sib raug zoo, thiab / los yog kev ua haujlwm [7]. IA yog txuam nrog ntau yam kev tsis zoo, xws li kev tua cov kev ua ub ua no, tsis muaj kev mloog, kev sib ceg thiab kev ua siab phem, kev nyuaj siab, kev tsis sib haum xeeb, kev kawm ntawv tsis zoo, tsis muaj kev noj qab nyob zoo, thiab kev kho siab zoo [5].
Thaum IA tau nthuav kev xav paub los ntawm kev tshawb fawb ntiaj teb, muaj tam sim no tsis muaj cov txheej txheem kuaj mob. Muaj ntau qhov kev tshuaj ntsuam xyuas tau tsim nyog rau yamntxwv IA. Cov lus qhia ntau tshaj plaws rau cov lus ntsuas yog cov lus nug Young [Diagnostic Questionnaire] [8-10]. Raws li ntawm Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), Young pib tsim tau cov lus nug luv luv uas tau soj ntsuam IA [8]. Hauv kev ua haujlwm ntawm cov txheej xwm no, koom nrog tsib lossis ntau tshaj ntawm yim yam teebmeem hauv 6 lub hli dhau los no raug cais raws li kev tsim txom los ntawm IA. Cov tub ntxhais hluas kuj tsim tau 20-khoom nug, hu ua Internet Addiction Test [10]. Hauv 20-khoom nug, txhua yam khoom muaj raws li 5-Point Likert scale ntsuam xyuas cov teeb meem ntawm Internet siv. Cov qhab-nees dhau 50 qhia qhov teebmeem hauv internet lossis qee zaus hauv internet thiab cov qhab-nees dhau 80 qhia txog teebmeem hauv lub neej muaj teebmeem [10]. Kev Tiv Thaiv hauv Internet tau muab pov thawj los ua ib qho kev siv tau thiab siv tau zoo uas siv tau los ntawm kev faib cuab IA [11]. Lwm yam kev kuaj mob thiab kev ntsuam xyuas cov cuab yeej tau tsim thiab siv los ntsuam xyuas IA [12-16].
Raws li ib qho tseem ceeb ntawm IA, IGD tau txais ntau thiab ntau dua los ntawm tag nrho lub ntiaj teb. IGD tau muab tso rau hauv daim ntawv ntxiv ntawm DSM-V, nrog lub hom phiaj ntawm kev txhawb nqa kev tshawb fawb ntxiv [4]. Tus DSM-V piav IGD yog "siv cov kev siv pheej yig thiab rov siv dua hauv Internet mus ua si, feem ntau nrog rau lwm cov players, ua rau muaj kev puas tsuaj lossis kev nyuaj siab raws li qhia los ntawm tsib lossis tshaj saud (cov txheej txheem) hauv 12 lub hli" 5].
Hauv ob peb lub xyoo dhau los, kev siv cov kev ua haujlwm thiab kev siv lub cev ua haujlwm tau raug coj los siv los kawm txog txoj kev kho paj hlwb ntawm IA. Molecular imaging yog ib lub lag luam uas tsim muaj kev qhia txog kev mob ntawm cov kab mob ntawm cov kev tshawb nrhiav kev tshawb nrhiav [17]. Lub sij hawm molecular imaging yuav dav dav txhais tau tias yog lub hauv vivo characterization thiab ntsuas ntawm biologic kev ntawm cov qib cellular thiab molecular [18]. Yuav kom tiv thaiv thiab kho IA, nws tseem ceeb kom muaj kev to taub meej txog nws cov tswv yim pib. Cov tswv yim tshiab tau coj los siv rau kev siv ntau yam hauv lub cev thiab kev siv lub hlwb kev kuaj, xws li magnetic resonance imaging (MRI), positron emission tomography (PET), thiab ib qho photon emission computed tomography (SPECT), los pab nrog kev kuaj mob ntawm ntau kuaj kab mob raws li kev tshawb fawb ntawm IA. Ntawm no peb tau soj ntsuam cov kev tshawb fawb molecular thiab cov kev tshawb fawb txog kev tshawb nrhiav tam sim no uas tau pab cuam tshuam txog cov tswv yim neurobiological ntawm IA, tshwj xeeb tshaj yog nyob rau ntawm MRI thiab PET imaging txojkev.
2. MRI Cov Kev Lom Zem
MRI yog ib qho kev siv ntau yam khoom siv uas siv cov hlau nplaum thiab hluav taws xob los ua kom pom tau cov qauv sab hauv thiab cov nqaij mos ntawm lub cev [19]. Qhov ua kom zoo tshaj ntawm MRI yog ib qho kev ua qauv ntawm kev tsim qauv yog qhov nws qhov kev daws teeb meem siab (micrometers), uas ua rau cov ntaub ntawv siv lub cev thiab cov ntaub ntawv keeb kwm yuav muab rho tawm mus ib txhij. Functional MRI (fMRI) yog cov txheej txheem tsis muaj kev phom sij uas siv tau los soj ntsuam kev ua kom lub cev muaj zog hauv lub hlwb [20]. Nws tau raug tshawb xyuas tias kev nce hauv cov dej neuronal hauv ib cheeb tsam hauv hlwb ua rau net nce rau cov ntshav oxygenated khiav ntawm qhov chaw ntawd [21]. Txij li thaum deoxygenated hemoglobin yog paragnetic, thiab oxygenated hemoglobin yog diamagnetic, ntshav siab-theem-nyob (BOLD) sib txawv ua rau kev kuaj xyuas ntawm cheeb tsam lub hlwb ua haujlwm nyob txawv cov ntsiab lus thiab kev paub xav.
2.1. Cov Kev Hloov Txiav
Kev siv cov MRI, qee cov kev tshawb fawb tau qhia tias lub paj hlwb txawv txav nrog IA. Siv lub Stroop color-word test [22], uas tau siv los tshuaj ntsuam xyuas kev tswj kom tsis txhob muaj teeb meem, kev tshawb xyuas tau qhia tias cov hluas uas muaj IGD pom tias muaj peev xwm tswj tsis tau [23]. Cov kev kuaj pom tau pom tias lub cheeb tsam hauv lub hlwb uas muaj kev tswj hwm, piv txwv li, sab laug ntawm orbitofrontal cortex (OFC), insula cortex, thiab cathex cortex, tsom cov cortical thickness hauv IGD sib piv nrog cov tswj (1). Tsis tas li ntawd, cov sau phau ntawv kuj tau tshaj tawm tias qhov txo cortical thickness ntawm sab laug lateral OFC yog correlated nrog cov tsis paub lub peev xwm tswj kev peev xwm hauv IGD cov hluas. Zoo tib yam nrog rau qhov no, lwm txoj kev tshawb kawm kuj qhia txog kev ua kom tuab hauv OFC hauv Internet kev ua tub hluas ntxhais hluas [24]. Muab qhov kev pom zoo tias OFC tau siv rau hauv kev siv tshuaj ntawm kev siv yeeb tshuaj thiab kev coj cwj pwm [25, 26], cov sau phau ntawv tawm tswv yim tias IA cov cai zoo sib xws ntawm cov neurobiological mechanism nrog lwm yam kev siv. Sib nrug los ntawm cov pob txha cortical tsis tshua muaj, cov cortical thickness ntxiv tau pom nyob rau sab laug centrex cortex, precuneus, nruab nrab frontal cortex, thiab inferior temporal thiab nruab nrab ntu temporal cortices [23] (daim duab 1). Lub precuneus yog txuam nrog visual imagery, xim, thiab nco nco [27]. Cov kab mob ntawm lub cev tsis muaj zog ntawm lub cev thiab lub plawv frontal cortex tau pom hais tias koom rau hauv kev ntxias los ntawm cov yeeb tshuaj cuaj [28, 29]. Vim li no, cov ntsiab lus tau hais tias cov cortical thickness chaw nyob hauv IGD tej zaum yuav txuam nrog cov yees ntawm kev ua si cues.
Daim duab 1: Cortical thickness sib txawv hauv cov hluas thaum IGD nrog cov kev tswj ntawm kev noj qab haus huv. Cov cortical hnyav ntxiv tau pom hauv ntau qhov chaw hauv cov tub ntxhais hluas nrog IGD nrog rau kev tswj kev noj qab haus huv, uas yog, sab laug centrex cortex, precuneus, nruab nrab frontal cortex, thiab inferior temporal thiab nruab nrab ntawm lub cev cord. Txo cortical thickness nyob rau sab laug lateral OFC, insula cortex, thiab lingual gyrus, nrog rau txoj cai postcentral gyrus, entorhinal cortex, thiab inferior parietal cortex tau kuaj tau hauv cov hluas thaum IGD [23].
Voxel-based morphometry yog ib qho kev kawm tsis txaus ntseeg rau qhov kev sib txawv hauv lub regional cerebral ntim thiab cov nqaij txawv ntawm cov duab hauv cov duab magnetic resonance [30, 31]. Voxel-based morphometry tau pab cuam tshuam txog kev kho cov yam ntxwv tsis txawv txav hauv ntau hom kab mob kev nyuab siab. Voxel-based morphometry cov kev tshawb fawb pom tias IGD cov tub ntxhais hluas muaj qhov hnyav hnyav hnyav nyob hauv sab laug sab laug cingulate cortex (ACC), sab laug posterior cingulate cortex (PCC), sab laug plawv, thiab lingual gyrus [32]. Siv tib lub txheej txheem, tsawg zuj zus ntawm qhov hnyav tau pom nyob rau hauv ob sab dorsolateral PFC, cheeb tsam kawm ntxiv, OFC, cerebellum, thiab sab laug ACC hauv lwm pab pawg neeg hauv Internet uas muaj tub ntxhais hluas ntxhais hluas [33]. Tsis tas li ntawd, qhov kev tshawb xyuas Voxel raws li thib peb yog qhia txog qhov muaj mob ntawm atrophy hauv txoj cai OFC, bilateral insula, thiab txoj kev tsav tsheb ntawm IGD [34]. Cov txiaj ntsim ntawm cov grey matter atrophy ntawm cov kev tshawb fawb no tsis zoo ib yam, uas tej zaum yuav yog vim txoj kev ua cov ntaub ntawv sib txawv. Lub PFC tau raug tsim los ntawm kev teeb tsa kev paub txog tus cwj pwm, tus cwj pwm qhia, thiab kev txiav txim siab, uas muaj ntawm Doraryolateral PFC, ACC, thiab OFC [35]. Cov kev tshawb fawb ntau heev tau coj tuaj rau lub luag haujlwm ntawm PFC hauv kev quav tshuaj [36]. Tam sim no nws tau txais kev pom zoo tias lub OFC plays lub luag haujlwm tseem ceeb hauv kev tswj hwm thiab txiav txim siab [26, 37]. Kev tshawb pom lub hlwb kev tshawb fawb tau qhia tias dorsolateral PFC thiab rostral ACC tau koom tes hauv kev tswj tuav [38, 39]. Txo cov khoom hnyav hauv lub PFC yuav muaj kev cuam tshuam nrog kev coj tus cwj pwm tsis zoo hauv Internet khwv yees, uas piav qhia cov tsos mob ntawm IA. Lub tswv yim no tau npaj siab los ua si lub luag haujlwm tseem ceeb hauv kev quav tshuaj [40]. Muaj ntau cov kev tshawb fawb txog kev ua haujlwm muaj kev pov thawj tias tus neeg mob lub plab tseem tsim nyog rau txoj kev txhawb nqa tshuaj, thiab txoj haujlwm tseem ceeb heev ntawm cov neeg quav yeeb tshuaj [41, 42]. Yog li, cov txiaj ntsim tau los ntawm kev pom zoo dhau los thiab tshawb xyuas qhov tseeb ntawm PFC thiab insula rau kev quav tshuaj.
Diffusion tensor imaging (DTI) yog ib qho kev ua kom muaj peev xwm taug qab lub hlwb dawb teeb meem fibers noninvasively. Dej cev muaj zog (diffusion) tau pom tias yuav ceev npaum li cov teeb meem dawb dawb tshaj li ntawm lawv. Qhov txawv ntawm ob txoj haujlwm no yog lub hauv paus ntawm DTI [43, 44]. DTI muab lub moj khaum rau kev tshaaj, kev tsom xam, thiab kev laij lej ntawm cov diffusion properties of white matter. Ntxiv nrog rau gray teeb meem txawv txav, dawb teeb meem txawv txav kuj tau pom zoo nyob rau hauv IGD. Siv DTI, kev tshawb xyuas kev ntsuam xyuas dawb teeb meem rau cov neeg uas muaj IGD [45]. Qis dua feem ntau yog ib qho kev qhia tawm hauv thalamus thiab sab laug PCC hauv IGD ntu kom muaj kev noj qab haus huv ntawm lwm yam. Tshaj tej ntawm, ntau dua li tus kabmob thaij (thalassus) hauv thalamus yog txuam nrog ntau dua ntawm IGD. Cov teeb meem dawb dawb kuj tseem ceeb toom rau lwm lub cheeb tsam hauv hlwb los ntawm lwm cov kev tshawb fawb. Piv txwv, ob leeg kho kom zoo thiab txo cov tshuaj feem ntau yog ib qho kev tshawb fawb, nrog kev kho kom zoo nkauj zoo nkauj nyob rau sab laug posterior ntawm lub qhov capsule thiab txo cov kabmob hauv kev cai hauv parahippocampal gyrus [33]. Hauv lwm txoj kev tshawb nrhiav, nws txo qis qis dua anisotropy tau qhia thoob hauv Internet kom muaj lub hlwb, nrog rau PFC thiab ACC [46]. Txawm li cas los xij, tsis muaj qhov chaw siab dua feem ntau ntawm cov tshuaj anisotropy. Cov kev tshwm sim zoo li no kuj qhia tawm rau lwm pab pawg me nyuam hluas nrog IGD [34]. Cov kev tshawb pom no qhia tias IA tsis pom muaj cov kab mob dawb tsis meej, uas tej zaum yuav txuas rau qee tus cwj pwm tsis zoo. Nws yuav tsum raug sau tseg tias qhov kev hloov ntawm qhov kev hloov hauv cov cheeb tsam hauv lub hlwb tsis hloov raws li cov kev tshawb fawb no, thiab qhov tsis sib haum xeeb ntawm cov kev tshawb fawb no yuav tsum tau tshawb xyuas ntxiv.
2.2. Functional Abnormalities
Siv cov hlab arterial spin-labeling perfusion fMRI, Feng li al. tshawb xyuas cov teebmeem ntawm IGD ntawm so qhov cerebral ntshav ntws hauv cov hluas [47]. Sib piv nrog cov kev tswj hwm, cov hluas uas siv cov tshuaj IGD pom cov kab mob hauv hlwb loj dua ntais ntawm sab laug ntawm lub cev ntais ntawm lub cev / fusiform gyrus, sab laug parahippocampal gyrus / amygdala, sab nraud frontal lobe / ACC, sab laug insula, txoj cai insula, txoj cai nruab nrab ntawm lub cev nqaij daim tawv precentral gyrus, sab laug txuas ntxiv cheeb tsam, sab laug cingulate gyrus, thiab txoj cai inferior parietal lobe. Feem ntau ntawm cov cheeb tsam no muaj nyob hauv tus qauv npaj los ntawm Volkow et al. hauv kev quav yeeb quav tshuaj yog kev tsis txaus siab ntawm kev ua cov ntaub ntawv thiab kev koom ua ke ntawm ntau lub hlwb circuits thiab kev ua haujlwm [48]. Ntawm cov cheeb tsam ntawm lub hlwb, cov amygdala thiab hippocampus yog ib feem ntawm qhov kev koom tes hauv kev kawm thiab kev nco uas tau cuam tshuam nrog kev ywj pheej ntawm cov lus siv rau cov yeeb tshuaj cawv [49]. Ob leeg cov insula thiab PFC paub ua lub luag haujlwm tseem ceeb hauv kev quav tshuaj [36, 40]. Kev kuaj ntshav tsawg tsawg tau pom nyob rau sab laug nruab nrab ntawm lub cev nqaij daim tawv, sab laug nruab nrab ntawm lub cev nqaij daim tawv, thiab txoj cai cingulate gyrus hauv IGD cov hluas. Cov kev tshwm sim qhia tau tias IGD hloov cov hlab ntshav qis hauv cov tub ntxhais hluas lub hlwb. Txawm li cas los xij, nws tseem tsis paub meej hais tias cov kab mob cerebral ntws hloov cov teeb meem feem ntau ntawm cov hlab ntsha los yog lwm yam kev hloov los kho rau kev puas tsuaj.
Muaj kev cuam tshuam nrog kev sib txuas lus tseem ceeb hauv cov tib neeg nrog IA. Ib txoj kev tshawb no tsis ntev los no tau pom tias cov ntsiab lus nrog IGD tuaj yeem muaj kev sib txuas ua haujlwm hauv lub bilateral cerebellum posterior lobe thiab nruab nrab ntawm lub cev nqaij daim tawv piv nrog cov pawg tswj [50]. Qhov bilateral inferior parietal lobe thiab txoj cai inferior temporal gyrus tshaaj txo kev sib txuas. Lwm txoj kev tshawb qhia tau qhia tias cov hluas uas muaj IA pom muaj kev sib txuas nrog kev sib txuas nrog cov cortico-subcortical circuits, thiab cov kws muab sab hauv ob leeg yog qhov feem ntau txuam nrog subcortical hlwb cheeb tsam [51]. Cov kev tshwm sim no qhia tias IA yog txuam nrog ib qho loj thiab qhov tseem ceeb ntawm kev sib txuas ntawm kev ua haujlwm ntawm ib lub lag luam xa tawm.
Nws tau raug tshaj tawm tias qhov kev poob qab yog cuam tshuam nrog IA [52]. Lub peev xwm los tawm tsam cov lus teb rau cov lus teb raug tshawb fawb feem ntau tshawb nrhiav siv cov teeb liab los yog tsis mus / tsis-mus paradigms [53]. Txoj kev tshawb no tsis ntev los no tau soj ntsuam kev tsis txaus siab thiab kev ua yuam kev hauv kev kawm nrog IGD [54]. Tag nrho cov ntsiab lus tau muaj kev sib raug zoo mus / tsis-ua hauj lwm hauv qab fMRI thiab ua tiav cov lus nug txog IA thiab kev ua tsis taus. Pab pawg neeg IGD tau txais qhab nia dua rau impulsivity thiab tshaaj siab dua lub hlwb kom ua thaum ua teb inhibition rau sab laug OFC thiab ob leeg caudate nucleus tshaj ntawm cov tswj. Daim OFC tau txuam nrog kev tsis txaus siab [37, 55]. Vim li no, cov txiaj ntsig tau pab txhawb qhov tseeb tias lub koomhaum ua kev tsis sib koom nrog koom nrog kev cuam tshuam kev tsis txaus siab. Ib txoj kev zoo sib xws nquag pom cov kev sib raug zoo ntawm cov lus teb hauv cov txiv neej nrog IA uas siv cov kev sib raug zoo ntawm fMRI Stroop xim-lo lus [56]. Pawg IA qhia tau tias "Stroop effectiveness" -related ua si hauv ACC thiab PCC piv nrog kev tswj kev noj qab haus huv ntau dua. Lub ACC tau pom tias muaj kev koom tes hauv kev sib tham tsis sib haum thiab tswj kev txawj ntse [57, 58]. ACC nrhiav neeg coob dua thaum lub sij hawm Stroop xim-lo lus muaj peev xwm xav txog "kev txawj ntse" hauv pawg IA. Lub PCC yog ib feem ntawm lub hom phiaj ua lag luam thiab muaj kev cuam tshuam hauv kev ua tib zoo [59]. Kev ua haujlwm ntau dua hauv PCC tuaj yeem qhia qhov tsis muaj kev cuam tshuam tsis zoo ntawm lub hom phiaj ua lag luam tsis zoo uas ua rau tsis ua haujlwm rau kev ua haujlwm kom paub txog kev pabcuam hauv pawg IA. Cov kev tshwm sim no qhia tau tias cov neeg uas muaj IA muaj peev xwm ua tsis tau zoo ntawm qhov kev pab cuam-kev tsis sib haum xeeb.
Lub hom phiaj hauv cheeb tsam yog kev siv fmRI cov kev tshawb fawb uas ntsuas txoj kev sib haum xeeb ntawm cov voxel uas tau muab nrog nws cov neeg nyob ze tshaj plaws, thiab nws tuaj yeem siv los ntsuam xyuas lub xeev cov kev ua ub no hauv kev ua haujlwm raws li cov kev xav tias cov vox nyob ib puag ncig yuav tsum muaj cov qauv zoo xws li [ 60]. IGD cov tsom pom qhov tseem ceeb hauv lub regional homogeneity hauv plaetal lobe pieretal, sab laug posterior cerebellum, thiab sab laug nruab nrab frontal gyrus thiab tsawg homogeneity hauv temporal, occipital, thiab parietal hlwb regions piv nrog kev tswj kev noj qab haus huv [61]. Cov qhab-nees qhia tias ntev-ntev hauv kev ua si hauv internet ua si kom muaj suab paj nruag synchronization hauv kev ua haujlwm nrog lub cev muaj zog nrog lub hlwb thiab kev poob siab hauv kev pom thiab hnov txog cov hlwb hauv hlwb.
Ntau txoj kev tshawb nrhiav qhov chaw ntawm lub hlwb uas muaj kev cuam tshuam nrog kev ua si ua si [62-65]. Cov neeg koom tau nrog cov gaming duab thaum uas tseem nyob hauv cov fMRI. Cov kev tshawb fawb no tau pom muaj cov teeb meem kev ua si hauv cov cheeb tsam ntawm lub hlwb (xws li, dorsolateral PFC, inferior parietal lobe, ACC, parahippocampal gyrus, OFC, thiab PCC) nyob rau hauv pawg pab pawg sib piv nrog pawg tswj. Cov activated lub hlwb regions tau zoo zoo nrog tus kheej-qhia gaming yaum. Tej yam txawv txav hauv cov cheeb tsam hauv hlwb no tau ua rau kev tiv thaiv los ntawm ntau cov kev tshawb fawb thiab tej zaum yuav cuam tshuam nrog cov kev tswj hwm kev tswj hwm, kev xav, kev coj tus cwj pwm, thiab ua haujlwm nco hauv IGD subjects [66].
Ib qho kev tshawb nrhiav nthuav piv IGD nrog cov ntsiab lus hauv kev tawm ntawm IGD thiab cov hauv kev tswj ntawm qhov cue hawb yees ua si hauv online [67]. Ob sab dorsolateral PFC, precuneus, sab laug parahippocampal gyrus, PCC, thiab ACC txoj cai raug qhib rau cov lus teb gaming cues nyob rau hauv IGD pawg piv nrog pawg tswj xyuas. Cov activated lub hlwb no yog piv txwv ntawm lub hlwb kev sib txuas ua ke rau cov cuab yeej ntawm kev quav tshuaj yeeb tshuaj [38, 39, 59]. Tsis tas li ntawd, pab pawg neeg uas tau txais remission tau txo kev ua kom dhau txoj cai dorsolateral PFC thiab sab laug parahippocampal gyrus dua li cov pab pawg neeg IGD. Yog li, tus sau phau ntawv hais tias ob qhov chaw yuav yog tus neeg sib tw rau cov kev tiv thaiv tam sim no rau online gaming.
MRI kuj tau siv los soj ntsuam kev kho mob ntawm cov tshuaj khomob ntawm IA. Bupropion yog ib qho kev tso cai rau tus neeg tsis muaj zog / dopamine inhibitor, uas tau muab siv rau kev kho mob ntawm cov neeg mob uas muaj kev quav yeeb tshuaj. Ib txoj kev tshawb nrhiav tau qhov kev ua tau zoo ntawm cov tsiaj nyhuv, ntsuas lub hlwb hauv kev ua teb rau cov lus cues siv fMRI [68]. IGD pom ntau dua nyob rau sab laug ntawm lub cev, lub plab dorsolateral PFC, thiab sab laug parahippocampal gyrus tshaj ntawm cov tswj. Tom qab 6 lub limtiam ntawm kev kho bupropion, lub yees thiab tag nrho cov sij hawm siv gaming tau qis dua. Lub cue vim raug mob hlwb hauv dorsolateral PFC kuj tau poob, uas qhia tias bupropion yog qhov zoo. Raws li tau hais dhau los, IGD cov neeg nyob hauv kev so ib qho kev ua kom tsawg dua cov kev cai dorsolateral PFC thiab sab laug parahippocampal gyrus [67]. Yog li, molecular imaging muaj peev xwm los pab cov neeg kuaj mob txiav txim xyuas cov kev kho mob zoo tshaj plaws rau cov neeg mob thiab saib lawv txoj kev kawm tau zoo rov los.
3. Nuclear Imaging Findings
Nuclear imaging le caag, uas muaj SPECT thiab PET, muaj qhov zoo ntawm cov kev xav hauv siab, qhov tob ntawm qhov tob, thiab ntau yam ntawm cov neeg siv tshuaj molecular saib xyuas [70]. SPECT thiab PET muab kev nkag siab rau hauv kev siv zog metabolism hauv vivo los ntawm kev ntsuas cov kua qab zib, cerebral perfusion, thiab cov pa oxygen. Nyob rau hauv kev tshawb fawb neuroscience, qhov no ua rau kev kawm txog kev ua neural, thiab cov txheej txheem kab mob, raws li lub hlwb cov metabolism thiab kev ua haujlwm [71]. Tus tsiaj muaj qhov zoo ntxiv ntawm kev muab kev daws teeb meem dua li SPECT. Ntxiv rau kev ntsuam xyuas ntawm cov kab mob cerebral metabolism, PET thiab SPECT kuj pab kom muaj ntau yam kev ntsuam xyuas ntawm cov neurotransmitter thev qhov ntawm qhov ceev ntawm kev siv cov neuroreceptor radiotracers [72].
3.1. Tus PET Imaging ntawm Hlwb Metabolic Hloov
Kev siv 18F-fluoro-deoxyglucose (18F-FDG) PET imaging, kev tshawb nrhiav tshawb xyuas qhov txawv ntawm cerebral glucose metabolism hauv resting xeev ntawm cov neeg hluas nrog IGD thiab cov neeg uas siv [73]. Cov kev ntsuam xyuas pom tau tias IGD tau ntxiv cov kabmob glucose metabolism nyob hauv nruab nrab ntawm OFC, sab laug caudate nucleus, thiab txoj cai insula thiab poob metabolism hauv ob sab postcentral gyrus, laug precentral gyrus, thiab ob lub cheeb tsam ntawm ob thaj tsam piv rau cov neeg siv li niaj zaus. Cov txiaj ntsim tau qhia tias IGD tuaj yeem txuam nrog neurobiological abnormality hauv daim OFC, striatum, thiab lub hlwb, uas muaj kev cuam tshuam hauv kev tswj hwm, kev ua nqi zog, thiab sawv cev ntawm kev sib raug zoo ntawm cov kev paub yav dhau los.
3.2. Nuclear kev kuaj ntawm Neuroreceptor Abnormalities
Cov pov thawj tau tshwm sim tau qhia tias lub tshuab dopaminergic muaj kev tiv thaiv yeeb tshuaj [74, 75]. Ib txoj kev tshawb fawb los ntawm Koepp li al. siv 11C-labeled raclopride thiab kev tsom tus tsiaj los soj ntsuam cov tshuaj dopamine endogenous tawm hauv tib neeg thaum lub yees duab video [76]. Kev tiv thaiv ntawm lub radioligand 11C-raclopride rau dopamine D2 receptors yog rhiab rau theem ntawm dopamine endogenous, uas tuaj yeem kuaj raws li cov kev hloov hauv kev txav ntawm qhov radioligand. Cov sau phau ntawv qhia tias qhov kev tiv thaiv ntawm 11C-raclopride mus rau dopamine receptors nyob rau hauv striatum tau raug txo kom tsawg lub sij hawm hauv kev ua si yees duab piv nrog cov theem pib ntawm kev ruaj ntseg, uas tau pom zoo ntxiv tso tawm thiab kev txav ntawm dopamine mus rau nws cov receptors. Ntxiv mus, lawv pom tau hais tias muaj kev sib raug zoo ntawm kev ua tau zoo nyob rau lub sij hawm ua hauj lwm thiab txo 11C-raclopride los ntawm kev sib tw nyob rau hauv qhov tseeb. Cov kev tshwm sim zoo li no tau raug qhia nyob rau hauv tib neeg nrog IA [77]. Cov neeg uas muaj IA tau txo cov dopamine D2 tus neeg tau txais kev pabcuam rau hauv qhov ntsuas phoo nrog rau ntawm lwm yam. Tsis tas li ntawd, muaj qhov tsis zoo sib xws ntawm dopamine receptor uas muaj IA hnyav. Cov kev tshawb pom no yog txhawb nqa ntawm Han et al. leej twg tshawb xyuas qhov genetic polymorphisms ntawm dopaminergic system nyob rau hauv ib pawg ntawm ntau hauv Internet game players [78]. Lawv tau qhia tias cov neeg uas muaj cov kab mob genetic polymorphisms hauv genes coding rau dopamine D2 lub chaw txais tos thiab dopamine degradation enzyme tau ntau dua rau hauv Internet gaming ntau dua nrog lub hnub nyoog ntawm cov leeg tswj.
Dopamine transporter yog plasma membrane protein uas nquag hloov tawm cov dopamine los ntawm qhov chaw seem rau hauv qhov chaw ua kom tsis muaj zog [79]. Kho dopamine transporter concentration nyob rau hauv striatum tom qab mob tshuaj tswj xyuas tau tau qhia yav tas los [80, 81]. Siv SPECT nrog cov radiotracer 99mTc-TRODAT-1, peb pab pawg neeg tshawb xyuas qhov mob dopamine xa mus ceev hauv IA cov ntsiab lus txhawm rau txheeb xyuas qhov txawv txav tsis zoo [82]. Peb pom tau hais tias dopamine transporter qhia tau zoo npaum li cas thiab qhov ntim, qhov hnyav, thiab 99mTc-TRODAT-1 nce nqi ntawm corpus striatum tau zoo heev rau cov neeg uas muaj IA piv nrog rau ntawm lwm yam. Tawm ua ke, cov txiaj ntsig tau hais tias IA yog txuam nrog kev ua haujlwm ntawm lub paj hlwb dopaminergic.
Nyob rau hauv kev tshawb nrhiav ntau, peb pawg neeg tshawb nrhiav dopamine D2 reseptor thiab cov ntshav qab zib metabolism hauv tib tus neeg uas siv tus tsiaj nrog 11C-N-methylspiperone (11C-NMSP) thiab 18F-FDG, hauv ob lub xeev kev so thiab ua si hauv internet gaming [ 69]. Ib qho kev txo qis hauv cov ntshav qab zib metabolism hauv qhov prefrontal, temporal, thiab limbic systems hauv IGD cov kev kawm. Nyob hauv lub xeev so, 11C-NMSP thwj toob muaj kev ruaj khov nyob hauv txoj kev nqes tes ntawm lub cev ntawm lub cev tsis sib xws hauv IGD cov ntsiab lus piv rau cov kev tswj ntawm qhov qub (Daim duab 2 (a)). Tom qab ua si hauv Gaming, 11C-NMSP los ntawm kev sib tw muaj peev xwm nyob rau hauv qhov kev sib tshuam yog tsawg dua hauv IGD cov sib piv nrog cov tswj, qhia tias txo qib dopamine D2 reseptor (Daim duab 2 (b)). Dysregulation ntawm dopamine D2 tus neeg tau txais kev pom zoo muaj feem xyuam nrog xyoo tas los hauv Internet (2 (d)). Tseem ceeb heev, hauv IGD cov ntsiab lus, qis qis ntawm dopamine D2 reseptor nyob hauv qhov tseeb yog nrog correlated tsis qab zib metabolism hauv daim OFC. Cov kev tshwm sim no qhia tau tias dopamine D2 tus neeg tau txais kev pab kho kom haum ntawm OFC yuav ua rau hauv txoj kev tswj hwm thiab kev coj tus cwj pwm ntawm IGD cov kev kawm.
Daim duab 2: 11C-NMSP PET kev soj ntsuam ntawm dopamine D2 lub cev nyob hauv IGD cov ntsiab lus. (a) Nyob hauv lub xeev so, 11C-NMSP los ntawm kev sib tw tau pom muaj nyob hauv txoj cai tsis sib xws ntawm lub cev nqaij daim tawv mus rau hauv IGD cov khoom piv rau cov tswj (xim daj) (tsis kho,). (b) Nyob rau hauv qhov kev ua si haujlwm hauv Xeev, 11C-NMSP los ntawm kev tsim cov kabmob twb tau qis dua hauv pawg IGD ntau dua li cov pab pawg neeg tswj, tshwj xeeb tshaj yog nyob rau sab xis (xim daj) (tsis kho,). (c) Ob leeg txoj cai (,) thiab kab tshuav 11C-NMSP los ntawm kev sib tw (,) sib cuam tshuam nrog Young Young hauv IGD cov ntsiab lus. (d) Daim OFC sab laug mus rau qhov sib piv ntawm 11C-NMSP los cuam tshuam nrog lub sijhawm dhau internet (,) [69].
Los ntawm cov ntsiab lus no, nws pom tau tias IA tau zoo ib yam li cov khoom siv neurobiological nrog kev quav tshuaj yeeb. Txawm li cas los xij, muaj pov thawj qhia tau tias muaj ntau yam sib txawv hauv cov txheej txheem kev quav yeeb tshuaj [83]. Hauv tshooj cai, Badiani li al. muab pov thawj tias kev quav tshuaj tiv thaiv kev quav yeeb quav tshuaj thiab kev quav kev quav yeeb quav tshuaj yog kev coj cwj pwm thiab kev nyuab siab, thiab cov kev sib txawv no kuj tseem siv tau rau lwm yam kev siv [83]. Yog li, nkag siab txog cov tswv yim kho lub hlwb ntawm IA yog qhov tseem ceeb rau txoj kev loj hlob ntawm cov kev kho thiab cov kev kho mob zoo.
4. Cov kev txiav txim siab thiab yav tom ntej
Cov ntaub ntawv pov thawj qhia tau hais tias cov kev hloov hauv lub hlwb thiab cov kev ua muaj feem xyuam nrog IA muaj feem xyuam rau cov cheeb tsam hauv lub hlwb uas koom nrog rau nqi zog, kev txhawb zog, thiab kev nco, thiab kev tswj kav. Cov kev siv phom sij thiab cov qauv kev ua haujlwm tau raug nce mus rau IA kev tshawb fawb, pab cuam tshuam rau peb qhov kev nkag siab ntawm lub hlwb kev tswj hwm. Feem ntau ntawm cov ntaub ntawv dhau los tau kawm IA tib neeg tsuas yog nyob hauv lub xeev xwb, kuaj xyuas thiab tsis muaj kev hloov hauv cov OFC, dorsolateral PFC, ACC, thiab PCC. Cov cheeb tsam no yuav ua tus cwj pwm tseem ceeb hauv kev ntxub ntxaug, kev tswj tus txheej txheem, thiab kev txiav txim siab. Tam sim no, tsuas yog ib qho kev tshawb ntawm PET nrog 11C-NMSP thiab 18F-FDG tau ua nyob rau hauv ob qho chaw thiab Internet gaming hauj lwm hauv tib tus neeg (xws li IGD los tsis) thiab pom tias dopamine D2 reseptor kho nruab nrab ntawm OFC yuav ua rau mechanism rau txoj kev tswj tsis tau thiab tswj hwm tus cwj pwm ntawm IGD cov kev kawm.
Raws li IA tau ua teeb meem loj thoob plaws lub ntiaj teb, xav tau kev kho mob zoo dua qub yog qhov mob ceev ceev. Ob leeg kev kho kev xav ntawm kev xav ntawm lub paj hlwb thiab kev siv tshuaj kho mob tau siv los kho IA. Muaj ntau cov tshuaj tau pom tias muaj kev cog lus hauv kev kho IA, xws li antidepressants, antipsychotics, thiab opioid receptor antagonists [84]. Kev paub kev coj cwj pwm kev coj cwj pwm tau siv rau kev quav tshuaj yeeb tshuaj [85]. Vim tias IA tau pom zoo sib xws nrog txoj kev siv tshuaj yeeb dej caw, kev paub txog tus cwj pwm kev coj cwj pwm kuj tau tshawb xyuas kom ua tau zoo rau kev kho IA [86]. Cov kev tshawb fawb ntxiv uas siv ntau hom xov tooj cua mus rau lub hom phiaj rau lwm lub paj hlwb uas cuam tshuam los ntawm IA yuav muab ib daim duab ntau dua ntawm cov neurobiological mechanism uas underlie IA. Ntxiv mus, cov radiotracers yuav raug siv los soj ntsuam txog kev kho mob ntawm cov tshuaj pharmacological, piv txwv li, siv 11C-carfentanil los kawm cov mu-opioid receptor txaus thiab kwv yees kho cov kev tshwm sim ntawm opioid receptor antagonists thiab pab cov clinicians xyuas qhov kev kho mob zoo tshaj rau cov neeg mob .
Teeb meem ntawm Cov Ntxhais
Cov sau phau ntawv tshaj tawm tias tsis muaj teebmeem txog kev xav txog daim ntawv no.
ACKNOWLEDGMENTS
Cov hauj lwm no tau txais kev txhawb nqa los ntawm Cov Kev Pab Cuam Tshuam Los Ntawm Lub Teb Chaws Tuam Tshoj ntawm Kev Tshawb Fawb Tuam Tshoj (2013CB329506), National Science Foundation ntawm China (NNFC) (81271601), thiab Ministry of Science thiab Technology ntawm Tuam Tshoj (2011CB504400).
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