Oge na-eche echiche nke iji ọgwụ eme ihe: Ihe ize ndụ nke mbu maka mgbanwe na ntanye (2017)

Chloe J. Jordan^* na Susan L. Andersen

Substancemụrụ ihe n’oge nwata toro eto n’ụzọ dị egwu na - abawanye ohere nke ịgwọ ihe eji eme ihe ogologo oge (SUD). Oge mmetụta ntorobịa sitere na nwatakịrị, wee malite ikwe ka mmepe nke agwa ndị dị ize ndụ na-enyere aka ịlanarị; taa ndị a nwere ike igosipụta dị ka ihe mbịaghị ọgwụ ọjọọ. Isi ihe eji eme ihe na-egbochi nsogbu na - aga n'ihu na - eme ka ọ na - ebute mgbanwe neurobiological nke na - emekwu ihe ize ndụ SUD. Ọ bụ ezie na ọtụtụ ndị mmadụ na-eji ọgwụ ọjọọ eme ihe n’oge ntụrụndụ, naanị obere pasent na-aga na SUD. Echiche ndị dị ugbu a na etiology nke iri mmadụ ahụ riri ya nwere ike ibinye nghọta maka ihe ọghọm nke na-eme ka ọghọm dị na ya malite n'oge ntụrụndụ n'oge. N’ịrụ ọrụ na ọrụ ndị ọzọ, anyị na-atụ aro ihe ize ndụ mmadụ maka SUD na-esite na PFC na-emebeghị agadi yana yana hyper-reactivity nke sali abaal, omume, na usoro nrụgide. Ificationmata ihe mbụ dị n’ịchọpụta nsogbu dị oke mkpa iji belata ihe SUD. Anyị na-atụ aro ihe mgbochi maka SUD nke enwere ike ịhazi ya na profaịlụ ọ bụla nke ihe ize ndụ yana / ma ọ bụ mejuputa ya obosara, tupu oge ntorobịa ahụ enwere mmetụta, iji bulie ike ị na-etolite ịdabere na ihe. Ndụmọdụ maka nchọpụta ọdịnihu gụnyere itinye uche na oge ndị ntorobịa yana oge ntorobịa yana ndịrịta iche gbasara mmekọahụ iji ghota ihe egwu dị na mbido ma mata ihe mgbochi kachasị maka SUD.

4.1. Ihe akaebe maka oge mmetụta adịghị mma nke iji ọgwụ eme ihe na mmadụ

Ihe akaebe na-egosi na ikpughe ọgwụ ọjọọ n’oge ntorobịa nwere ike ime ka ohere SUD dị ogologo (Chambers et al., 2003; Ego, 1998). Redkọwapụta ihe ga-eweta nsogbu, gụnyere ịkpa ike, ikpughe nsogbu n'oge, ma ọ bụ ọnọdụ ndị ọzọ dịbu (dịka nlebara anya hyperactivity aghara [ADHD] na omume aghara) nwere ike ibute ọgwụ ịmalite ngwa ngwa ma ọ bụrụ na ekwughi ya (Enoch, 2011; Mannuzza et al., 2008; Verdejo-Garcia et al., 2008). Agbanyeghị, ndị nwere ADHD ndị na-anata ọgwụgwọ n'oge na-egosi ọnụọgụ dị elu metụtara afọ SUD dịka njikwa obodo jikọtara afọ (Mannuzza et al., 2008; Steinhausen na Bisgaard, 2014; Wilens et al., 2003). N’aka ozo, ogwu ogwu a adighi a abawanye n'ihe ize ndu nke ihe eji eme ihe mgbe ebido n’uzo (Molina et al., 2013; Volkow na Swanson, 2008). Ọ bụ ezie na egosiputara nsonaazụ ndị a na ọmụmụ ihe ogologo oge, ọmụmụ akụkụ ga-egosi mmekọrịta dị iche n'etiti impulsivity na wii wii were, dị ka mmalite mmalite (<16 afọ) nwere ike jikọta ya na impulsivity dị elu (Gruber et al., 2014). Ọmụmụ Epidemiology na-egosikwa na iji ihe ọ alcoholụ alcoholụ na-egbu egbu, wii wii, na cocaine na-eto eto na-abawanye ihe ize ndụ nke ịdabere na ihe (Wagner na Anthony, 2002). Nchọpụta dị ka ndị a na-ewelite ajụjụ ndị ọzọ — ọgwụ ị earlyụ ọgwụ mbụ na-eduga n’inwe agụụ ike? Ọgwụ dị iche iche nwere mmetụta dị iche iche ogologo oge na ụbụrụ yana ọghọm SUD na-esote? Atụmanya ABCD nke NIH (abcdstudy.org) ga-enyere ịza ụfọdụ n'ime nsogbu ndị a metụtara ikpughe ọgwụ n'oge.

Enthapụ ọghọm nke SUD na-akpata ihe na nsonaazụ mmadụ n'ihe isi ike dị na ya bụ ihe siri ike n'ihi mkpụrụ ọnya ndị ọzọ metụtara. Ndi netiti ndi n’ile n’enweghi nsogbu nke ihe ojoo di otua ndi nke ogwu ojoo n’enwe nsogbu.Nees et al., 2012; Schneider et al., 2012; Stanger et al., 2013; Whelan et al., 2012). Cortex prefrontal etolite etolite ruo n ’etolite etolite ma obu n’oge okenye (Arain et al., 2013; Barnea-Goraly et al., 2005; Durston et al., 2001; Giedd et al., 1999; Sowell et al., 1999; lee Nkebi 5.1), ma bụrụ ihe dị mkpa maka nsogbu dị n'okpuru SUD. Iji ihe eji eme ihe n'oge uto nwere ike ime ka mgbanwe gbanwee n'ọrụ PFC yana atụmanya PFC na mpaghara subcortical nke na-adịgide n'oge okenye.Squeglia et al., 2009). Mpaghara ụbụrụ na-emetụta ihe ikpughere ọgwụ na-emetụta ọnọdụ ha tozuru oke mgbe ekpughere ọgwụ ọjọọ (Andersen, 2005; Andersen na Navalta, 2011). Dịka ọmụmaatụ, ndị na-eto wii wii na-egosi ọkpụrụkpụ cortical na etiti, ihu ihu na mkpuchi na - adị ala, mana ọnụọgụ dị elu karịa na ngalaba ndị ọzọ dịka nke kacha elu oge na adịghị ala,Lopez-Larson et al., 2011). Ọzọkwa, iji wii wii na-amalite amalite (<16 afọ) jikọtara ya na iguzosi ike n'ezi ihe na-acha ọcha na eriri afọ na corpus callosum ma e jiri ya tụnyere oge ị mariụ wii wii na-amalite (> 16 afọ; Gruber et al., 2014).

4.2. Ihe akaebe maka oge mmetụta adịghị mma nke iji ihe eme ihe na anụmanụ

Ọmụmụ anụmanụ egosila na oge ihe ga - eme ka ekpugide ọgwụ dị. Oge ihe ịba ụba iji ihe mkpali mee ihe pụtara ihe atụ dị ka ihe akaebe ga-egosi oge oge ntorobịa nwere mmetụta mmerụ ahụ (ị substanceụ ọgwụ ọjọọ)Adriani et al., 2004; Baskin et al., 2015; Brandon et al., 2001, 2003; Harvey et al., 2011; Jordan et al., 2014, 2016; Kuhn, 2015; Ruedi-Bettschen et al., 2006; Schramm-Sapyta et al., 2009; Smith, 2003; Wong et al., 2013). Dịka ọmụmaatụ, n'ụdị anụmanụ AD AD, nke na-esokarị SUD n'ime mmadụ (Mannuzza et al., 2008; Steinhausen na Bisgaard, 2014), ọgwụgwọ na ọgwụ mkpali n'oge uto (ụbọchị ọmụmụ mgbe ọ gasịrị [P] 28 – 55) kwalitere ọnụego iji nweta njikwa cocaine, ma nwekwuo arụmọrụ na mkpali nke nkwalite cocaine (Baskin et al., 2015; Harvey et al., 2011; Jordan et al., 2014). Gulley na Juraska (2013) mee nyocha ọzọ banyere mmetụta ogologo oge nke mkpughe ọgwụ ntorobịa.

Otu ụzọ isi gosipụta ọgwụ ntorobịa nwere ike ibulite ihe egwu SUD bụ site n'ịgbanwe usoro mmepe nke PFC yana njikọ ya na mpaghara subcortical. Na mkpanaka, ekpughere cocaine na nwata, ma ọbụghị okenye, na -emepụta mkpesa na-adịgide adịgide nke PFC (mPFC) ọrụ GABAergic na ngosipụta mkpụrụ ndụ parvalbumin nke na-apụta n’ihu ịbụ okenye (Cass et al., 2013). Ọzọkwa, ị exposureụ mmanya na-egbu egbu dị ka oke na -eme ka etolite etolite etolite etolite etolite etolite, thalamus, mpia corsex ma e jiri ya tụnyere njikwa ndị ọzọ.Gass et al., 2014; lee Gulley na Juraska, 2013 maka nyocha ozo). Ejikọtara ọnụ, ihe akaebe sitere na ma ụmụ mmadụ ma akụrụngwa na-egosi na iji ihe eme ihe n'oge oge ntorobịa nwere mmetụta pụrụ ịka njọ ka ọpụpụ na mmepe SUD, na-enwe mmetụta ogologo oge na mmepe cortical na subcortical.

4.3. Ihe mgbochi: na - akwalite enweghị ike ị toụbiga ihe ọ substanceụ substanceụ na-adịghị mma

N'ihe banyere iji ọgwụ eme ihe na ịdabere na ya, mmadụ nwekwara ike ịdị n'otu oge enweghị ike na mmetụta dị ogologo oge nke ọgwụ, dịka n'oge ụmụaka ma ọ bụ n'oge ndọrọ ndọrọ ọchịchị (Andersen, 2003, 2005; Stanis na Andersen, 2014). Mmụta ma na mmadụ (Biederman et al., 1999; Mannuzza et al., 2008; Wilens et al., 2003na akụrụngwa (Adriani et al., 2006b; Andersen et al., 2002a; Bolanos et al., 2003; Carlezon et al., 2003; Thanos et al., 2007) na-atụ aro na nwata ma ọ bụ itinye ihe ga - eme ka ọ bụrụ ihe mkpali na - belata ihe nkwụghachi ụgwọ nke ọgwụ ọjọọ ma nwee ike chebe SUD ọzọ. Premụaka ndị na-amụ ime amụba anaghị eme ka arụ ọrụ baara ha uru (Rapoport et al., 1978). Ọzọkwa, na tupu ụmụ nwanyị ime nke methylphenidate na-ebute mmụba na-adịgide adịgide nke ọbara na-akpali methylphenidate na -akpata na STR na thalamus, na-enweghị mgbanwe pụtara ìhè a hụrụ na isiokwu ndị okenye kpughere.Schrantee et al., 2016). Mgbanwe ụbụrụ yiri nke ahụ pụtara na ụmụ nwoke nwere oke nke ekpughere tupu pubertally (P20-35) nye methylphenidate (Andersen et al., 2008a). N'okpuru ọnọdụ ekpughere ọgwụ ndị a, ikpughere methylphenidate kpatara mmekpa ahụ maka gburugburu cocaine na ọnọdụ ntụpọ nke pụtara ìhè na okenye.Andersen et al., 2002a; Carlezon et al., 2003, ma lee Crawford et al., 2011). Nime anumanu, eji uzo eme ihe doziri onwe ya ‘covers’ ka cocaine gosiputara dika ewepu amygdala na aza maka udiri nke cocaine (Lowen et al., 2015; tụlere na Nkebi nke 5.2). Nkpughepuo nke psychostimulants nwekwara ike imetụta morphometry ụbụrụ na mpaghara dị mkpa maka SUD. N'ime ọmụmụ ogologo oge nke ụbụrụ cortex nke akwara, usoro ọgwụgwọ psychostimulant mere ka ọ dị ka ọgwụ ụbara ọbara nke etolite etolite etolite n’oge ntorobịa (Shaw et al., 2007, 2009; van der Marel et al., 2014). Mmetụta ịdabere na afọ nke ọgwụgwọ methylphenidate na ụbụrụ morphometry na ụmụ anụmanụ dabere na afọ ekpughere, na-enwe nnukwu mmetụta na corpus callosum white white na panatal olu na-esochi mkpughe uto ma e jiri ya tụnyere ndị okenye (van der Marel et al., 2014). Ọnụ, data ndị a na-egosi na enwere windo pubertal nke inọghọm dị na mkpali, na ikpughe ihe mkpali n'oge windo a nwere ike bụrụ ihe nchebe pụọ na nsonaazụ na-akwụghachi ụgwọ nke ọgwụ n'oge ndụ.

Oge ụmụaka nwere ike ịnọchite anya ohere iji guzobe ihe mgbochi maka SUD. Ihe ndị a na - eme ọgwụ, dị ka mkpịwa pomortal methylphenidate pre-pubertal, nwere ike belata Ngwongwo na - akwụghachi ụgwọ nke ọgwụ mgbe emechara (Adriani et al., 2006a; Andersen et al., 2002a; Brenhouse et al., 2009; Carlezon et al., 2003; Thanos et al., 2007). Agbanyeghị, ekwesịrị ịkpachara anya dịka ọgwụ ọgwụ anaghị enwe mmerụ ahụ, na ndị na-agbanwe agbanwe dị ka afọ, mmekọahụ na oge ọgwụgwọ nwere ike imebi SUD adịghị mma (Baskin et al., 2015; Brandon et al., 2001, 2003; Brenhouse et al., 2009; Harvey et al., 2011; Jordan et al., 2014; Lambert na Hartsough, 1998; Steinhausen na Bisgaard, 2014). Karịsịa, enwere nnukwu mkpa maka nyocha n'ime ụmụ nwanyị. Nnyocha nke preclinical na-egosi na ụmụ nwanyị na-enwe mmetụta dị iche iche ogologo oge na-esochi pubertal (Brenhouse et al., 2009), pubertal, ma ọ bụ ọbụna ekpughe ọgwụ nye okenye (Dow-Edwards, 2010).

N'adịghị ka ọgwụ ọgwụ, enwere ike itinye ndị mmadụ n'ọrụ na-emetụta omume na-eto eto na-enwechaghị nsogbu maka mmetụta ndị ọzọ, enwere ike ijikọ ya na ọgwụ iji nwekwuo arụmọrụ. Anyị na-atụ aro na echiche izizi nke etiology nke SUD nwere ike ịkọwa ụzọ dị mma maka ndị nọ n'ihe ize ndụ. N’okpuru, anyị na-enyocha nchepụta SUD anọ ma na-atụ aro maka ịkpa agwa (omume)Isiokwu 1) nke enwere ike itinye ya n'ọrụ naanị ma ọ bụ jikọtara ọnụ iji kpalite ihe ndị dị ize ndụ maka ntughari na ntinye ihe.

 

Isiokwu 1

Nchịkọta nke ihe ọmụmụ etiology na mkpa maka ụmụaka.

5.1. Mmechi na etolite etolite etolite

A na-eche na ị disorderụ ọgwụ ure na-ebilite na akụkụ site na ikike dị ala nke igbochi ma ọ bụ ịchịkwa ọchịchọ ịchụso nsonaazụ na-akwụghachi ụgwọ nke ọgwụ, nke a maara dị ka nrụpụta ọrụ isi.Hester et al., 2010). Mpaghara ụbụrụ jikọtara ya na ọrụ onye isi na-agụnye PPDDP PDP, dorsomedial PFC (Curtis na D'Esposito, 2003), tupu emeju moto ala (Lau et al., 2006na PFC ventrolateral (Ridderinkhof et al., 2004; Fig. 2). N'ime ụbụrụ okenye, PFC na-arụ ọrụ dị mkpa nke inhibitory na ụgwọ ọrụ subcortical na usoro mkpali (Arnsten na Rubia, 2012; Tekin na Cummings, 2002), gụnyere mmekorita ya na inteathaum (STR) na subthalamic nucleus (STN; Diamond, 2013; Fig. 2).

 

Fig. 2

Neural circuitry na-ebute nsogbu nke ị substanceụ ọgwụ (SUD). Echiche ndị dị ugbu a na etiology nke SUD na-egosi ihe iri mmadụ ahụ na-esite na arụmọrụ ọrụ (A), mmụba dị ukwuu nke ihe metụtara ọgwụ (B), na ...

5.2. Sentence na-akpali akpali

Usoro iwu nke abuo banyere otiology nke ịdabere na ihe na-akọwa usoro dị mkpa na iri mmadụ ahụ: mkpali dị egwu, ma ọ bụ "ọchịchọ" ma ọ bụ ọchịchọ mmụọ nke ụbụrụ kwuru na mkpali na-akwụghachi ụgwọ na gburugburu ebe obibi (Berridge na Arnsten, 2013; Berridge, 2007, 2009a). N'oge mgbanwe site na iji ihe eji eme ihe gaa na ịdabere, a na-ekwu na ebumnuche dị ukwuu maka ihe metụtara ọgwụ ọjọọ karịa ihe ndị ọzọ metụtara gburugburu ma ọ bụ ọnọdụ (dịka nri, mmekọrịta ọha na eze, wdg). N'ihi ya, ka oge na-aga, mkpali ịchụso ọgwụ ahụ na-ekpuchi mkpa ndị ọzọ na ihe ndị na-egosi ọgwụ ọjọọ na-eme ka akparamagwa na-akpalite. Achọpụtala netwọsị salience site na ịmachi ọmụmụ ihe fMRI nke njikọta steeti, ma tinye dorsal ACC, OFC, na colarex na-ejikọta ike ha siri ike na usoro subcortical na limbic (Seeley et al., 2007). Deszọ ndị ọzọ dị mkpa dị na netwọkụ salience gụnyere saịtị dị iche iche maka mmetụta uche, ụkpụrụ ime ụlọ, na ụgwọ ọrụ (lee Fig. 2; Ongur na Ahịa, 2000; Seeley et al., 2007). Amygdala kacha rụọ ọrụ dị mkpa na itinye mkpụrụedemede nzuzo, na - ejikwa mmetụta dị iche iche eme ihe mgbe ọ bụla enwere njikọta nke ọgwụ ọgwụ na mpụga gburugburu ebe obibi.Chang et al., 2012; Meil na hụ, 1997; Szalay et al., 2013). Ka oge na-aga, usoro ọgwụ ọgwụ jụrụ oyi na-enwetakwu mmetụta dị mma site na ịgbalite saịtị cortic. N'aka nke ya, saịtị cortic na-emetụta mpaghara ndị metụtara ụgwọ ọrụ nke NAc, nke jikọtara ya na ịchọrọ ọgwụ ahụ, na STR, nke jikọtara ya na omume ịchọ / ị takingụ ọgwụ ebe obibi.

5.2.2. Ihe akaebe sitere na anumanu

N’adịghị ka ọrụ ndị isi, enwere ike ịtụle iji ike eme ihe ngwa ngwa n’oge nwa obere. Ndị nọ n’afọ iri na ụma na-ekwu na ike ga-eme ka mmadụ na-eme ihe ga-eme ka ihe na-akpali ya pụta, gụnyere ihe metụtara ọgwụ, ma e jiri ya tụnyere ụmụ aka ma ọ bụ ndị okenye. Ogwe ntorobịa na-etolite oke maka gburugburu metụtara cocaine dị ala karịa ụmụaka ma ọ bụ okenye (Badanich et al., 2006; Brenhouse et al., 2008; Zakharova et al., 2009b) na -ekwusi ike ka ikpochapu ihe choro nke cocaine, ma weghachite uzo ichota ihe di oke karia ndi okenye (Brenhouse et al., 2010; Brenhouse na Andersen, 2011). Ndị na-eto eto na-etolite etolite ọnọdụ maka gburugburu metụtara nicotine mgbe njikọkọ ọgwụ na gburugburu, ebe ngwụcha nwa na oke okenye nwere ike ọ gaghị etolite mmasị ọbụlagodi mgbe ha jikọrọ ọnụ (Adriani et al., 2002; Belluzzi et al., 2004; Vastola et al., 2002). N’otu aka ahụ, usoro ngosipụta onwe onye na-egosi na, ma e jiri ya tụnyere ndị okenye, oke na-eto eto na-enweta nchịkwa cocaine ngwa ngwa (Perry et al., 2007) iritekwu uru cocaine, na -ebibi mbibi ma nwekwaa iweghachi ọgwụ cocaine ngwa ngwa.Anker na Carroll, 2010; Wong et al., 2013; Wong na Marinelli, 2016). Ọzọkwa, ụmụ oke na ụmụ oke na-eto eto nwere onwe ha na-achịkwa nicotine karịa ndị okenye (Levin et al., 2003, 2007, ụmụ oke na-eto eto na-eji aka ha na-achịkwa nnukwu heroin karịa ndị okenye (Doherty na Frantz, 2012). N'uche, nchoputa ndị a na-egosi na mkpali dị elu ma ọ bụ mkpali dị elu n'oge oge uto na-atụnye ụtụ maka njirimara dị mkpa nke ịdabere na akụrụngwa, gụnyere ọgwụ a na-achọ ịnwụ anwụ, mbibi mbibi, na omume ịlaghachi azụ.

Imepe ihe akara na dopaminergic ihe akara nwere ike inye aka ịkọwa iji mkpali nwere ume dị elu n'oge uto (Brenhouse et al., 2008; Sonntag et al., 2014). Ọmụmụ Lesion na inacering na-egosi ịdị mkpa nke NAc na itinye ọdịnaya mmalite nke mkpụrụedemede metụtara ụgwọ ọrụ, ebe BLA yiri ka ọ dị mkpa maka idobe ntinye ederede n'oge.Chang et al., 2012; Szalay et al., 2013). Ngosipụta nke mkpali sitere n'ihe metụtara ọgwụ ọjọọ bụ nke onye nabatara D1 dị elu na-egosipụta na ntinye gafere na PFC rue NAc (Kalivas et al., 2005; Robinson na Berridge, 1993b; Sonntag et al., 2014). Ka oge na-aga, echiche ndị metụtara ọgwụ ọjọọ na-ahapụ ọgwụ dopamine na NAc ọbụlagodi na enweghị ọgwụ ị (ụ (Ito et al., 2002; Willuhn et al., 2010).

Njikọ PFC ← - → BLA na PFC → NAc njikọta n'oge uto na - enye usoro ndị ọzọ nke mgbakwunye metụtara ụgwọ ọrụ na - enweta nnabata siri ike, na - emetụta oge ụmụaka. Ogologo ihe nyocha axonal na-abawanye na afọ na BLA → PFC (Cunningham et al., 2002, 2008na PFC → NAc (Brenhouse et al., 2008) okporo ụzọ rue oge uto / etolite etolite. N'ime BLA n'onwe ya, dendritic spine njupụta, ogologo, na ịdị mgbagwoju anya na-abawanye mpaghara site na oge ụmụaka site na ngwụsị oge uto, ma kwụsie ike n'oge okenye.Koss et al., 2014). Ihe njuputa Dendritic na-abawanye na nkwupụta ogologo oge sitere na BLA → mPFC site na ụmụ ndị okenye site na mgbe ha toro.Johnson et al., 2016). Inhibitory GABAergic interneurons na mPFC bụ ebumnuche ebumnuche BLA (Cunningham et al., 2008), na-atụ aro ịrị elu BLA FC mPFC na-eto eto na-emechi oge mmepe oge maka mmepe maka PFC. Ntinye uche BLA na-abawanye elu cortical interneuron excitation ma mechakwaa mgbakwunye PFC inhibitory, nke nwere ike nweda nsonaazụ na ịkwọ ụgbọala NAc na ọrụ subcortical ndị ọzọ. Ihe nyocha nke Axonal sitere na PFC → BLA prune mgbe omumu (Cressman et al., 2010), na-atụ aro inwekwu mmezi nke ọrụ.

A na - agbanwekwa ọgwụ ọgwụ n'oge oge uto na - enyere aka ịkọwa ọdịiche dị iche iche na njiri agwa (Brenhouse na Andersen, 2011). Dịka ọmụmaatụ, ọrụ anyị (Andersen na Teicher, 2000; Teicher et al., 1995), na ndị ọzọ (Tarazi et al., 1998) gosiputara na ndi na-anabata dopamine kariri ma mekwaa ya dika nwa oge oghahu site na nmekorita-na nmekorita nwoke na nwanyi nke yiri ka ogha n’onweghi nsogbu nke homonụ nke pubertal (Andersen et al., 1997a,b, 2002b). Karịrị, dopamine D1 na ndị na-anabata D2 na STR na-ebili n'ọkwa dị elu na ụmụ nwoke karịa ụmụ nwanyị n'oge oge ntorobịa, na D1 ka dị elu na ụmụ nwoke n'oge ntorobịa n'agbanyeghị agam ike ụfọdụ (Andersen et al., 1997b). N'ụzọ dị iche, dopamine D1 na ndị na-anabata D2 na NAc egosighi otu usoro a, na-atụ aro ka plastic nke NAc nwere ike ịnwekwu mgbanwe maka mkpa mgbanwe nke usoro ụgwọ ọrụ (Teicher et al., 1995).

Ndi na-anabata ndị na-anata Dopamine na mPFC na-egosipụtakwa iche n'ụzọ dịgasị iche n'etiti nwata, oge ntorobịa na ntorobịa (Andersen et al., 1997a,b; Lyss et al., 1999; Teicher et al., 1998). Dịka ọmụmaatụ, ndị na-anabata D2 na-agbanwe site na inhibitory gaa na excitatory na parvalbumin interneurons na mPFC n'oge ntorobịa (Tseng na O'Donnell, 2007). Dị ka o siri dị, usoro mgbaàmà na-emepe emepe abụghị otu na mpaghara ụbụrụ niile, dịka esi kwuo na mbụ na primates na-abụghị mmadụ (Lidow et al., 1991). Kama nke ahụ, usoro akara ngosipụta n’ime sekit n’otu n’otu na-etolite n’onweghị. Dịka ọmụmaatụ, anyị chọpụtara na ndị na-anabata ndị na-anabata D1 na glutamatergic, mana ọbụghị GABAergic, neurons na atụmanya mPFC → NAc (Brenhouse et al., 2008). D1 dị elu na mPFC prication neurons nwere njikọ metụtara ọgwụ ịba ụba, ị ,ụ ọgwụ, na iji ọgwụ eme ihe riri ahụ, yana omume ndị metụtara iri ahụ dị ka ịchọ ihe ọhụụ, inwe mmekọahụ, mmasị maka ụtọ dị ụtọ, na agụụ ihe (Freund et al., 2016; Nair et al., 2011; Sanchez et al., 2003; Sonntag et al., 2014). Dị ka Fig. 3, anyị na-ebu amụma na isiokwu ndị nwere oke ume dị elu n'oge ha dị obere nwere ike ịgabiga nsogbu SUD.

 

Fig. 3

Egwu maka mbufe na nsogbu a disorderụ ọgwụ (SUD). Ejiri ihe eji eme ihe tupu oge 14 nwere ihe jikọrọ ya na nnukwu ihe ize ndụ nke ịmalite imebi ihe ma ọ bụ ịdabere na ndụ n'ọdịnihu. Agbanyeghị, ebe ọtụtụ ndị mmadụ na-anwale ọgwụ, ọ bụ naanị ntakịrị mgbanwe ...

Ha jikọrọ ọnụ, nchọpụta ndị a na-egosi na mmụba na akara PFC ← - LA BLA na PFC → NAc na njikọta n'oge uto nwere ike bụrụ ihe ga - eme ka ihe ndị metụtara ọgwụ pụta. Anyị na-ebuputa na nkuzi nke iji ike eme ihe na-enyere aka weghara mmalite nke ọgwụ nwa na-eto eto, ebe ọghọm ya na mmepe mmepe (Nkebi 5.3) na-egosi ihe egwu dị egwu na ntughari na riri ahụ.

5.3. Ntọala

Usoro ozo na-enye echiche na iri mmadụ ahu riri ahụ gosiputara ngbanwe neme ihe nke neme ka omume guzosie ike site na usoro omumu nke ihe omuma di na ya.Everitt et al., 2008). Learningmụta ihe mgbaru ọsọ na ime mkpebi na-akọwa nhọrọ emere dabere na ntinye gburugburu ebe obibi yana uru na-emetụta ihe a na-atụ anya ya (Hogarth na Chase, 2011; Voon et al., 2015). N'ụzọ dị iche, usoro ekike na-edobe akparamagwa na agbanyeghị mgbali ma ọ bụ ebumnuche (Juda et al., 2013; Rothman et al., 2009), ndị na-eme omume ahụ na-ebido karịa ma ọ bụ “na-akpaghị aka” (Gardner et al., 2012). N'ime ndị na-eji ọgwụ ọjọọ eme ihe, a na-ebugharị ọgwụ ọgwụ na mbụ site n'ọchịchọ maka nsonaazụ na-akwụghachi ụgwọ nke ọgwụ ahụ, omume na-ebute ebumnuche. Mgbe njikọta ọgwụ ọjọọ ugboro ugboro, ihe omume metụtara ọgwụ na-abụ ihe omume na-eduga n'ikpeazụ ịkpa ike na mmekpa ahụ. Dị ka iji ntụgharị were mee ihe n'ụzọ mkparị, nyocha site na limbic ruo na njikọta ruo na sensorimotor cortex ji nwayọ were nweta nsonye site na ọnọdụ ịgbado ụkwụ gaa na ntinye aka nke ukwuu site na mpaghara ọghọmFig. 2; Belin na Everitt, 2008; Burton et al., 2015; Everitt na Robbins, 2013; Gremel na Cunningham, 2008; Haber et al., 2006).

5.4. Nrụgide nrụgide na nrụgide na-adịghị mma

Ihe akaebe n’oge na-adịbeghị anya na-egosi na nrụgide na-eme ka njigide mkpali dị mfe na iwebata ihe na-emetụta ihe omume mgbe a na-amụ ihe, nke na-eme ka ọ dịkwuo njọ imerụ ahụ riri ahụDias-Ferreira et al., 2009; Sadowski et al., 2009; Schwabe et al., 2008, 2011; Taylor et al., 2014). Nkwupụta nke anọ na etiology SUD na-atụ aro na iji ihe ike na-eme ihe ike gụnyere nkwado na-adịghị mma, ma ọ bụ iwepụ ọnọdụ na-enweghị isi (n'ụzọ anụ ahụ ma ọ bụ nke uche na-adịghị mma), dị ka nrụgide. Ka oge na-aga, usoro nrịbawanye nke usoro ụgwọ ọrụ nke ụbụrụ na-akpata site na ị drugụ ọgwụ ọjọọ nke usoro ụgwọ ọrụ ụbụrụ na-arịwanye elu. Koob na Le Moal, 2001). Usoro a na –eme ka nrụpụta ohuru a na - eme na ọnọdụ a ga - akwụghachi ụgwọ (ya bụ, mmụba n'ihe a na - ahụta ka ọ na - akwụghachi ụgwọ) dị oke mkpa ịkwado mgbakwunye iji nọgide na - arụ ọrụ, na - eduga na ị abuseụbiga ihe ọ andụ andụ na mmepe nke SUD. Ngosiputa onyinye a ka kariri elu alloy guzosiri ike karie ike umuaka ma obu nsogbu nke oge mbu.Hanson et al., 2016). Nkpughepu anya nye ndi nwere ike idi ihe ndia bu ihe nlebara anya di nkpa maka nbughari site na ihe eji eme ihe rue na ndi mmadu.

Ndị ọrụ mba nke Instrụ Ọgwụ nke DA DA XXX na DA-10543 (SLA) na John A. Kaneb Young Investigator Award (ka CJJ) kwadoro ọrụ a. Anyị na-ekele Dr. Heather Brenhouse maka data ewepụtara na 3A.

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