J Behav Diri. 2018 Mar 13: 1-10. dị: 10.1556 / 2006.7.2018.20.
Lee D1,2, Ogige J3, Nnamkoong K1,2, Kim IY3, Jung YC1,2.
ABSTRACT
Ihe ndabere na ebumnuche
A na-atụ aro ịme mkpebi ihe ize ndụ / ụgwọ ọrụ iji bute ndị nwere nsogbu egwuregwu ịntanetị (IGD) ịchụso ihe ụtọ nwa oge, n'agbanyeghị nsonaazụ ọjọọ na-adịte aka. Cortex cingulate dị n'ihu (ACC) na orbitofrontal cortex (OFC) na-arụ ọrụ dị mkpa na ime mkpebi n'ihe egwu / ụgwọ ọrụ. Ọmụmụ ihe a nyochara ihe dị iche iche isi awọ dị na ACC na OFC nke ndị na-eto eto nwere ma na-enweghị IGD na-eji morphometry dabeere na elu (SBM).
ụzọ
Anyị nyochara ụmụ nwoke toro eto 45 nwere IGD yana njikwa nwoke dabara na afọ 35. Anyị mere nyocha mpaghara mmasị (ROI) maka nha cortical na olu isi awọ (GMV) na ACC na OFC. Anyị mekwara nyocha zuru oke nke ụbụrụ vertex-amamihe gbasara ọkpụrụkpụ cortical iji kwado nyocha dabere na ROI.
Results
Ndị isi IGD nwere cortices dị gịrịgịrị na rostral ACC aka nri, OFC akuku aka nri, na pars orbitalis aka ekpe karịa njikwa. Anyị hụkwara obere GMV na caudal caudal ACC na aka ekpe orbitalis na isiokwu IGD. Cortex dị gịrịgịrị nke akuku OFC aka nri na isiokwu IGD jikọtara ya na enweghị uche dị elu. Nyocha ụbụrụ dum na isiokwu IGD kpughere cortex dị gịrịgịrị na mpaghara moto mgbakwunye aka nri, oghere ihu ihu aka ekpe, lobule parietal dị elu, na cortex cingulate dị n'azụ.
Mkpebi
Ndị mmadụ n'otu n'otu nwere IGD nwere cortex dị gịrịgịrị na GMV pere mpe na ACC na OFC, nke bụ mpaghara dị oke egwu maka ịtụle ụkpụrụ ụgwọ ọrụ, nhazi njehie, na ịhazigharị omume. Na mgbakwunye, na mpaghara ụbụrụ metụtara njikwa omume, gụnyere mpaghara frontoparietal, ha nwekwara cortices dị gịrịgịrị. Ihe dị iche iche isi awọ ndị a nwere ike itinye aka na IGD pathophysiology site na ngbanwe ihe egwu/ime mkpebi ụgwọ ọrụ yana njikwa omume belatara.
OKWU: Nsogbu egwuregwu ịntanetị; ọkpụrụkpụ cortical; olu isi awọ; ime mkpebi ihe ize ndụ / ụgwọ ọrụ; morphometry dabere na elu
PMID: 29529887
Site na nwata (1998b) gosipụtara echiche ahụ ihe dị ka afọ iri abụọ gara aga, omume riri ahụ nke omume metụtara ịntanetị apụtawo dị ka ihe gbasara ahụike uche dị mkpa na ndị na-eto eto (Kuss, Griffiths, Karila, & Billieux, 2014). N'ime nsogbu omume ndị a, nsogbu egwuregwu ịntanetị (IGD) enyochala nke ọma dịka isiokwu nwere mmasị dị ukwuu (Kwụsị, 2013). A na-egosipụta mmetụta uche ụgwọ ọrụ na mbelata mfu n'okwu ikpe IGD (Dong, DeVito, Huang, & Du, 2012; Dong, Hu & Lin, 2013). Nsogbu na nleba anya njehie (Dong, Shen, Huang, & Du, 2013) na ihe isi ike n'ịchịkwa omume nke ọma (Ko et al., 2014) na-akọkwa na IGD. N'ihi ya, ahaghị nhata n'etiti ịchọ ụgwọ ọrụ na-abawanye na njikwa omume na-ebelata na IGD na-akwalite ime mkpebi ihe egwu / ụgwọ ọrụ adịghị mma (Dong & Potenza, 2014). Na IGD, ime mkpebi n'ihe ize ndụ / ụgwọ ọrụ, nke a na-egosipụta site na mperi ime mkpebi n'okpuru ọnọdụ dị ize ndụ na mmasị maka ụgwọ ọrụ ozugbo, nwere njikọ chiri anya na ịchụso ụtọ obere oge site na egwuregwu ịntanetị, n'agbanyeghị nsonaazụ ọjọọ na-adịte aka (Pawlikowski & ika, 2011; Yao et al., 2015).
Nnyocha meta nke ime mkpebi gosiri na orbitofrontal cortex (OFC) na mpaghara ụbụrụ cingulate cortex (ACC) na-etinyekarị aka na mkpebi metụtara ihe egwu / ụgwọ ọrụ.Krain, Wilson, Arbuckle, Castellanos, na Milham, 2006). Kpọmkwem, a na-eche na OFC ga-ekenye ụkpụrụ ụgwọ ọrụ na nhọrọ omume, dabere na nsonaazụ aghọtara ma ọ bụ echere na omume ahụ (Wallis, 2007). A na-atụ aro ACC ka o tinye koodu amụma amụma ụgwọ ọrụ (ọdịiche dị n'etiti ụgwọ ọrụ amụma na nsonaazụ n'ezie) (Hayden, Heilbronner, Pearson, & Platt, 2011) ma na-ekere òkè dị mkpa na nleba anya njehie na imezi omume (Amiez, Joseph, & Procyk, 2005). Ndị mmadụ n'otu n'otu nwere IGD akọpụtala ọrụ arụrụ arụ nke ACC na OFC gbanwere na nzaghachi nye ọtụtụ ọrụ uche, nke nwere ike imetụta ikike ha nwere ime mkpebi metụtara ihe egwu / ụgwọ ọrụ. N'ime ọmụmụ ihe onyonyo arụ ọrụ gara aga site na iji Probabilistic Guessing Task, ndị mmadụ nwere IGD gosipụtara mmụba na-abawanye na OFC n'oge ọnọdụ uru yana mbelata ịgbalite na ACC n'oge ọnọdụ ọnwụ.Dong, Huang, & Du, 2011). Ndị mmadụ n'otu n'otu nwere IGD gosikwara ngbanwe mgbanwe na ACC na OFC na nzaghachi na ọrụ STROOP, na-egosi ike belatara ime nleba anya njehie na njikwa ọgụgụ isi na omume ha.Dong, DeVito, Du, & Cui, 2012; Dong, Shen, et al., 2013). N'ụzọ doro anya, nchoputa ndị a kwekọrọ na mgbanwe nhazi a kọrọ na OFC na ACC metụtara IGD (Lin, Dong, Wang, na Du, 2015; Yuan et al., 2011). Nnyocha e mere n'oge na-adịbeghị anya, nke jikọtara akụkụ nke akụkụ na ogologo ogologo oge, gosipụtara na adịghị ike na ihe isi awọ orbitofrontal bụ akara nke IGD (Zhou et al., 2017). Mmekọrịta dị n'etiti ihe isi awọ gbanwere na ACC na njikwa ọgụgụ isi adịghị arụ ọrụ na IGD (Lee, Namkoong, Lee, & Jung, 2017; Wang et al., 2015). Nyere mmetụta nke ihe isi awọ gbanwere na ọrụ akwara na-arụ ọrụ (Mmanụ aṅụ, Kötter, Breakspear na Sporns, 2007), anyị na-eche na ihe isi awọ gbanwere na OFC na ACC na-enye aka n'ịme mkpebi na-adịghị mma / ụgwọ ọrụ na IGD.
A na-eji ọtụtụ usoro neuroanatomical iji nyochaa ihe isi awọ, gụnyere nyocha morphometric (SBM) dabere na elu, nke na-enye usoro dị nro maka ịlele njirimara morphological nke ụbụrụ site na iji ụdị geometric nke elu cortical.Fischl et al., 2004). Nyocha SBM nwere ọtụtụ uru dị na nyocha nke cortical morphology: enwere ike iji ya tụọ usoro mpịachi cortical.Fischl et al., 2007na ikpuchi anụ ahụ subcortical (Kim et al., 2005). Na mgbakwunye, nyocha SBM na-enye ozi bara uru gbasara ọkpụrụkpụ cortical, ebe usoro ndị atụnyere, dị ka morphometry dabere na voxel (VBM), bụ naanị n'ịtụle udi cortical.Hutton, Draganski, Ashburner, & Weiskopf, 2009). Agbanyeghị na ọmụmụ VBM achọpụtala mgbanwe ụda isi awọ mpaghara (GMV) na ndị nwere IGD (Yao et al., 2017), enwebeghị nyocha SBM zuru oke, gụnyere ntule nke ọkpụrụkpụ cortical, maka IGD. Ụfọdụ ọmụmụ SBM chọtara OFC dị gịrịgịrị na ndị nọ n'afọ iri na ụma nwere IGD karịa na njikwa (Hong et al., 2013; Yuan et al., 2013). Agbanyeghị, emebeghị nyocha SBM nke ndị na-eto eto nwere IGD. Ọzọkwa, ọ bụ ezie na ndị nọ n'afọ iri na ụma na ndị na-eto eto nwere IGD na-akọ na ha nwere obere GMV nke ACC.Lee et al., 2017; Wang et al., 2015), enwebeghị ọmụmụ banyere ọkpụrụkpụ cortical nke ACC. N'ihi na GMV na cortical ọkpụrụkpụ na-enye ụdị ozi dị iche iche gbasara ọrịa neuropsychiatric.Lemaitre et al., 2012; Winkler et al., 2010), anyị na-eche na nchikota nke GMV na cortical ọkpụrụkpụ nwere ike inye nkọwa zuru oke nke ihe isi awọ gbanwere na IGD.
Ebumnuche nke ọmụmụ a bụ iji tụnyere ACC na OFC isi awọ n'ime ndị ntorobịa na-enweghị IGD. N'iji nyocha SBM, anyị nyochara GMV na oke cortical na ndị egwuregwu ịntanetị. Anyị chere na ndị toro eto nwere IGD ga-enwe obere GMV na cortex dị gịrịgịrị na ACC na OFC. Anyị na-atụ anya na mgbanwe ihe isi awọ ndị a na-ejikọta ya na ọchịchọ na-arịwanye elu nke ime mkpebi ndị eguzobere na afọ ojuju dị mkpirikpi, dị ka ụtọ nke egwuregwu, kama nyocha nke ihe ize ndụ dị ogologo oge, dị ka mmetụta uche na-adịghị mma. Iji nwalee echiche anyị, anyị mere nyocha mpaghara mmasị (ROI), lekwasịrị anya na ACC na OFC, iji nyochaa GMV na cortical cortical na ndị na-eto eto nwere IGD. Anyị jiri nyocha mmekọrịta wee nyochaa mmekọrịta dị n'etiti ihe isi awọ agbanwere na njirimara ahụike nke IGD. Maka nyocha nke abụọ, anyị mere nyocha nke ụbụrụ ụbụrụ zuru oke nke amamihe nke oke cortical iji nyochaa ngbanwe nke ọkpụkpụ cortical na-abụghị nke ACC na OFC, dịka nkwado na nyocha dabeere na ROI.
Akụrụngwa na ụzọ
sonyere na
A na-ewebata ndị sonyere maka ọmụmụ ihe a site na mgbasa ozi ịntanetị, akwụkwọ ozi, na okwu ọnụ. Naanị ụmụ nwoke ka etinyere na ọmụmụ ihe ahụ. A tụlere ndị sonyere maka usoro ojiji ịntanetị ha wee lelee IGD site na iji ule riri ahụ ịntanetị etinyegoro na mbụ (IAT; Nwata, 1998a). Ndị sonyere nyere akara 50 ma ọ bụ karịa na IAT wee kọọ na isi ihe ha na-eji ịntanetị bụ egwuregwu bụ nkewaziri dị ka ndị na-eme ntuli aka, yana nyocha nke IGD. Ndị a na-eme ntuli aka wee gbaa ajụjụ ọnụ onye dibịa afa iji nyochaa isi ihe dị n'ime ahụ ha riri ahụ, gụnyere ndidi, nkwụsị, nsonaazụ ọjọọ, na iji oke oge na-efunahụ ihe.Block, 2008). N'ihi ya, ngụkọta nke isiokwu 80 sonyere na ọmụmụ ihe ahụ; Ndị a gụnyere ndị okenye 45 nwere IGD na 35 ndị nwoke na-ahụ maka ahụike nwoke, bụ ndị aka nri na ndị agadi n'etiti 21 na 26 afọ (pụtara: 23.6 ± 1.6).
Isiokwu niile natara ajụjụ ọnụ ụlọ ọgwụ ahaziri maka ọrịa DSM-IV Axis I (Nke mbụ, Spitzer, & Williams, 1997) iji nyochaa ọnụnọ nke nnukwu ọrịa isi mgbaka na ụdị Korea nke Wechsler Adult Intelligence Scale (Wechsler, 2014) iji nyochaa ọgụgụ ọgụgụ isi (IQ). N'iburu n'uche na IGD na-enwekarị ọrịa uche (psychiatric comorbidities).Kim et al., 2016), anyị mere Beck Depression Inventory (BDI; Beck, Steer na Brown, 1996) maka ịda mbà n'obi, Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) maka nchegbu, na Wender Utah Rating Scale (WURS; Ward, 1993) maka mgbaàmà nwata nke nsogbu uche-deficit hyperactivity (ADHD). N'ikpeazụ, n'ihi na IGD nwere njikọ chiri anya na mkpali dị elu (Choi et al., 2014), anyị jiri Barratt Impulsiveness Scale - ụdị 11 (BIS-11; Patton & Stanford, 1995) iji nwalee impulsivity. BIS-11 nwere subscales atọ: nhụta echiche, impulsivity moto, na enweghị atụmatụ impulsivity. Isiokwu niile bụ ọgwụ-enweghị isi n'oge ntule. Usoro mwepu maka isiokwu niile bụ ọrịa isi mgbaka na-abụghị IGD, ọgụgụ isi dị ala nke gbochiri ikike imezu akụkọ onwe ya, ọrịa akwara ozi, ma ọ bụ ahụike, yana mgbochi na nyocha MRI.
Nweta data na nhazi onyonyo
A nakọtara data ụbụrụ ụbụrụ MRI site na iji nyocha 3T Siemens Magnetom MRI nke nwere eriri isi ọwa asatọ. Enwetara MRI nhazi dị elu n'ime ụgbọ elu sagittal site na usoro ntụgharị nke 1D gradient emebi emebi nke T3 (oge nkwughachi = 2.19 ms, oge nkwughachi = 1,780 ms, flip angle = 9 °, ubi anya = 256 mm, matriks = 256 × 256, ọkpụrụkpụ iberi transversal = 1 mm). A na-enyocha data MRI niile n'anya maka ọnụnọ arịa. FreeSurfer 5.3.0 (http://surfer.nmr.mgh.harvard.edu/) e were ya n'ọrụ maka nyocha SBM nke oke cortical na GMV. Usoro nhazi ahụ gụnyere mkpofu anụ ahụ na-abụghị ụbụrụ site na iji usoro ngwakọ (Ségonne et al., 2004), mmezi nke ike na-abụghị ịdị n'otu (Sled, Zijdenbos, na Evans, 1998), nkewa nke anụ ahụ isi awọ-ọcha (Dale, Fischl, & Sereno, 1999), tessellation nke oke isi awọ-ọcha na mgbazi topologically (Ségonne, Pacheco, & Fischl, 2007), onu oriri elu ala na agbada (Fischl, Sereno, & Dale, 1999), mgbanwe ghọọ oghere okirikiri atlas (Fischl, Sereno, Tootell, & Dale, 1999), na nchịkọta akpaka nke ụbụrụ ụbụrụ mmadụ (Fischl et al., 2004). Ekpebiri ọkpụrụkpụ cortical site n'ịtụle anya dị n'etiti oke isi awọ-ọcha (elu ime) na elu pial (elu elu). A na-eme ka data ahụ dị nro site na iji 10-mm zuru oke na ọkara kacha elu Gaussian kernel.
Nyocha data nyocha
Emere nyocha dabere na ROI iji tụnyere GMV na oke cortical n'etiti ndị nwere IGD na njikwa. A kọwapụtara ROI site na iji Desikan-Killiany cortical atlas (Desikan et al., 2006). ROI gụnyere akụkụ abụọ nke ACC (caudal/rostral ACC) na OFC (mpụta/medial OFC, pars orbitalis) (Ọgụgụ). 1). Iji nyochaa ndịiche otu (ndị nwere IGD vs. njikwa) na GMV na cortical ọkpụrụkpụ, pụtara ụkpụrụ nke GMV, na cortical ọkpụrụkpụ n'ime onye ọ bụla ROI e weputara site na iji FreeSurfer. Maka ROI ọ bụla, anyị mere nyocha nke covariance na SPSS 24.0 (SPSS Inc., Chicago, IL, USA) maka ọkwa dị mkpa. p = .05. Age, IQ, na olu intracranial (ICV) nke isiokwu ọ bụla abanyela dị ka covariates na nyocha maka GMV. A na-abanye afọ na IQ dị ka covariates na nyocha maka ọkpụkpụ cortical, ma ICV adịghị etinye ya dị ka ihe mgbagwoju anya, dịka nchọpụta ndị gara aga na-atụ aro na ICV adịghị emetụta ọkpụkpụ cortical.Buckner et al., 2004). Iji nyochaa mmekọrịta nke ụbụrụ na omume, anyị mere nyocha mmekọrịta maka mgbanwe isi awọ (GMV na cortical ọkpụrụkpụ na OFC na ACC) na ọnụ ọgụgụ nke onwe (IAT na BIS).
Nyocha 1. Mpaghara mmasị (ROI). A kọwapụtara ROI dị ka Desikan–Killiany cortical atlas siri dị. ROI maka ihu cingulate cortex (ACC) gụnyere akụkụ abụọ nke caudal ACC (green) na rostral ACC (oroma). ROI maka orbitofrontal cortex (OFC) gụnyere akụkụ abụọ nke mpụta OFC (red), medial OFC (acha anụnụ anụnụ), na pars orbitalis (edo edo)
Iji meju nyocha nke ROI, a na-eme nyocha nke ụbụrụ dum dabere na elu maka ọkpụrụkpụ cortical site na iji ụdị ahịrị izugbe na FreeSurfer's Query, Design, Estimate, Contrast module mgbe ịchịkwa afọ na IQ nke isiokwu ọ bụla. Dị ka nyocha nyocha maka ụbụrụ dum, ọnụ ụzọ na-emepụta ụyọkọ nke anaghị edozi ya. p < .005 were were maka ntụnyere amamihe na vertex. Anyị na-akọ naanị ụyọkọ nwere ọnụ ọgụgụ dị ukwuu nke vertices karịrị 200 iji belata ohere nke ịmepụta ihe dị mma (Fung et al., 2015; Wang et al., 2014).
Ethics
Emere ihe omumu a n'okpuru ntuziaka maka ojiji nke ndi mmadu sonyere na ulo oru nyocha nke ulo akwukwo na Mahadum Yonsei. Ụlọ ọrụ nyocha ụlọ ọrụ nke Mahadum Yonsei kwadoro ọmụmụ ihe ahụ. N'ịgbaso nkọwa zuru oke nke oke ọmụmụ ihe nye ndị niile sonyere, enwetara nkwenye ederede ederede.
Results
Njirimara igwe mmadụ na ahụike nke isiokwu
Ndị sonyere na njikwa ahụ na otu IGD dabara na afọ na IQ zuru oke (Table 1). Ndị nwere IGD nwetara akara dị elu na ule nke ịntanetị riri ahụ (IA) na enweghị mmasị ma e jiri ya tụnyere njikwa (IAT: p < .001; BIS: p = .012). Na mgbakwunye, ndị otu IGD gbagoro nke ọma na nnwale nke ịda mbà n'obi, nchekasị, na mgbaàmà ADHD nwata ma e jiri ya tụnyere njikwa ahụike (BDI: p = .001; BAI: p < .001; WURS: p <.001). Mkpokọta ICV adịchaghị iche n'etiti njikwa na isiokwu nwere IGD (1,600.39 ± 149.09 cm3 maka otu IA; 1,624.02 ± 138.96 cm3 maka njikwa; p = .467).
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Isiokwu 1. Ọnụọgụ mmadụ na mgbanwe ụlọ ọgwụ nke ndị sonyere
|
Otu nsogbu egwuregwu ịntanetị (n = 45) |
Otu njikwa (n = 35) |
Nwale (t) |
p uru |
|
|---|---|---|---|---|
| Afọ (afọ) | 23.8 ± 1.5 | 23.4 ± 1.7 | 1.074 | .286 |
| Ọnụ ọgụgụ zuru ezu IQa | 101.0 ± 10.3 | 102.7 ± 9.3 | 0.779 | .438 |
| Nnyocha Ụdị Ịntanetị | 65.8 ± 10.6 | 31.8 ± 12.7 | 12.990 | <.001 |
| Ọpụpụ Barratt Mmetụta | 52.6 ± 14.8 | 44.8 ± 11.6 | 2.585 | .012 |
| Nghọta impulsivity | 13.8 ± 5.1 | 12.2 ± 4.3 | 1.430 | .157 |
| Igwe ọkụ ọkụ | 18.3 ± 4.2 | 14.9 ± 3.4 | 3.949 | <.001 |
| impulsivity na-abụghị atụmatụ | 20.6 ± 7.9 | 17.7 ± 5.9 | 1.817 | .073 |
| Beck Obi Depression Ngwaahịa | 14.4 ± 7.4 | 8.8 ± 6.9 | 3.489 | .001 |
| Beck Ncheta Inventory | 13.0 ± 9.2 | 6.8 ± 5.8 | 3.695 | <.001 |
| Ọ bụrụ na ị na-anwale Ọgba Mmasị | 12.8 ± 9.6 | 9.8 ± 5.7 | 1.728 | .088 |
| Ọnụ ọgụgụ nke Wender Utahb | 42.0 ± 21.9 | 25.4 ± 16.0 | 3.759 | <.001 |
Note. A na-akọwapụta ụkpụrụ dị ka ± SD.
aA tụlere Quotient ọgụgụ isi (IQ) site na iji nha ọgụgụ isi nke ndị okenye Wechsler.
bEmere Wender Utah Rating Scale iji nyochaa mgbaàmà ADHD nwata.
Nyocha nyocha nke ROI
Nyocha dabere na ROI nke ọkpụrụkpụ cortical chọpụtara na isiokwu ndị nwere IGD nwere cortex dị gịrịgịrị na rostral ACC aka nri, akụkụ OFC aka nri, na orbitalis aka ekpe karịa cortex na njikwa (rostral ACC: p = .011; OFC n'akụkụ: p = .021; pars orbitalis: p = .003; Tebụl 2). Nchọpụta ndị a ka dị ịrịba ama mgbe gụnyechara ọnọdụ comorbid (BDI, BAI, na WURS) dị ka covariates (rostral ACC: p = .008; OFC n'akụkụ: p = .044; pars orbitalis: p = .014). Nyocha dabere na ROI maka GMV gosipụtara na isiokwu ndị nwere IGD nwere obere GMV na caudal caudal ACC na aka ekpe orbitalis, ma e jiri ya tụnyere njikwa (caudal ACC: p = .042; pars orbitalis: p = .021). Nchọpụta ndị a ka dị mkpa na caudal ACC (p = .013) mgbe etinyere ọnọdụ comorbid (BDI, BAI, na WURS) dị ka covariates ma ọ bụghị na pars orbitalis (p = .098). N'ihe metụtara njikwa, isiokwu ndị nwere IGD enweghị GMV ma ọ bụ cortex buru ibu na ROI.
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Isiokwu 2. Mpaghara ntụnyere mmasị dabere na oke cortical na olu isi awọ n'etiti ụmụ nwoke nwere nsogbu egwuregwu ịntanetị (IGD) na njikwa (IGD otu < otu njikwa)
|
akụkụ |
Otu nsogbu egwuregwu ịntanetị (n = 45) |
Otu njikwa (n = 35) |
Nwale (F) |
p uru |
|
|---|---|---|---|---|---|
| Ọkpụrụkpụ cortical (mm) | |||||
| Rostral anterior cingulate cortex | Right | 2.86 ± 0.20 | 2.98 ± 0.19 | 6.747 | .011 |
| Mkpesa orbitofrontal cortex | Right | 2.71 ± 0.14 | 2.79 ± 0.14 | 5.540 | .021 |
| Pars orbitalis | ekpe | 2.71 ± 0.20 | 2.86 ± 0.21 | 9.453 | .003 |
| Olu okwu isi awọ (mm3) | |||||
| Caudal anterior cingulate cortex | Right | 2,353.24 ± 556.33 | 2,606.89 ± 540.76 | 4.285 | .042 |
| Pars orbitalis | ekpe | 2,298.00 ± 323.25 | 2,457.83 ± 298.86 | 5.523 | .021 |
Note. A na-akọwapụta ụkpụrụ dị ka ± SD.
N'ime isiokwu IGD, cortex nke dị gịrịgịrị na akụkụ aka nri OFC jikọtara nke ọma na akara nhụsianya dị elu, mgbe ọnọdụ mmekọrịta (BDI, BAI, na WURS) gụnyere dị ka covariates (r = −.333, p = .038; Onyonyo 2). Anyị ahụghị njikọ ndekọ ọnụ ọgụgụ n'etiti mgbanwe isi awọ, kpọmkwem GMV pere mpe na cortex dị gịrịgịrị, yana akara IAT.
Nyocha 2. Nyocha njikọ maka mmekọrịta ụbụrụ na omume. Mmekọrịta dị n'etiti ọkpụrụkpụ cortical na akụkụ aka nri orbitofrontal cortex (OFC) yana akara nhụsianya nke Barratt Impulsiveness Scale (BIS) mgbe njikwa maka covariates (afọ, IQ, BDI, BAI, na WURS). Iji gosi njikọ chiri anya, a na-emegharị mgbanwe na covariates site na iji ntughari ahịrị. A na-eji ihe mhapụrụ agbakọọ na-abụghị nke a gbakọrọ agbakọ wee mepụta ebe mkposasị. Ọkpụrụkpụ cortical nke akụkụ aka nri OFC jikọtara nke ọma na mkpali uche na isiokwu IGD (r = −.333, p = .038)
Nyocha vertex nke ụbụrụ dum-amamihe
Nyocha zuru oke nke ụbụrụ ụbụrụ nke ụbụrụ cortical gosiri na isiokwu ndị nwere IGD nwere cortex dị gịrịgịrị na mpaghara moto mgbakwunye ziri ezi (SMA; nhazi ọkwa Talairach: X = 7, Y = 21, Z = 53; Onyonyo 3A). Na mgbakwunye, isiokwu ndị nwere IGD nwere cortex dị gịrịgịrị na mpaghara anya ihu aka ekpe (FEF; nhazi kacha elu Talairach: X = −10, Y = 17, Z = 45; Onyonyo 3B), akụkụ aka ekpe cingulate cortex (PCC; nhazi kacha elu Talairach: X = −9, Y = −30, Z = 40; Onyonyo 3B), na aka ekpe elu parietal lobule (SPL; nhazi kacha elu Talairach: X = −15, Y = −62, Z = 61; Onyonyo 3C) karịa njikwa. Ndị otu IGD enweghị mpaghara ụbụrụ nwere oke cortex ma e jiri ya tụnyere njikwa.
Nyocha 3. Nyocha vertex nke ụbụrụ dum-amamihe gbasara ọkpụrụkpụ cortical. Ọnụ ọgụgụ ọnụ ọgụgụ nke p < .005 (anaghị edozi ya) were were maka ntụnyere amamihe na vertex. E jiri ya tụnyere njikwa, isiokwu ndị nwere IGD nwere cortex dị gịrịgịrị na mpaghara moto mgbakwunye aka nri (SMA; nhazi ọkwa Talairach: X = 7, Y = 21, Z = 53; ọnụ ọgụgụ nke vertices: 271), (B) ogige anya ihu aka ekpe (FEF; nhazi elu Talairach: X = −10, Y = 17, Z = 45; ọnụ ọgụgụ nke vertices: 224) na cingulate cortex aka ekpe (PCC; nhazi kacha elu Talairach: X = −9, Y = −30, Z = 40; ọnụ ọgụgụ nke vertices: 215), na (C) aka ekpe elu parietal lobule (SPL; nhazi MNI kacha elu: X = −15, Y = −62, Z = 61; Ọnụ ọgụgụ nke vertices: 216)
Nkwurịta
N'iji nyocha SBM, anyị tụlere ihe isi awọ nke ACC na OFC na ndị toro eto nwere IGD na njikwa ahụike dabara adaba. Nchọpụta anyị na-akwado echiche na ndị na-eto eto nwere IGD nwere cortices dị gịrịgịrị na obere GMV na ACC na OFC karịa njikwa. Anyị mere nyocha dabere na ROI wee chọpụta na isiokwu ndị nwere IGD nwere cortex dị gịrịgịrị na rostral ACC aka nri, akụkụ OFC aka nri, na orbitalis aka ekpe karịa njikwa. Ọmụmụ ihe gara aga akọpụtala cortex dị gịrịgịrị na mpụta OFC na pars orbitalis nke ndị nọ n'afọ iri na ụma nwere IGD.Hong et al., 2013; Yuan et al., 2013). Ọmụmụ ihe a lekwasịrị anya na ndị na-eto eto wee hụ nsonaazụ yiri nke ahụ gbasara ọkpụrụkpụ cortical na OFC na na rostral ACC. N'ime isiokwu nwere IGD, cortex OFC dị n'akụkụ aka nri nke dị gịrịgịrị jikọtara ya na enweghị uche dị elu, na-egosipụta ọchịchọ ime mkpebi dabere na afọ ojuju nwa oge. Na mgbakwunye, anyị chọpụtara na isiokwu ndị nwere IGD nwere obere GMV na caudal ACC aka nri yana orbitalis aka ekpe. Nchọpụta a kwekọrọ na ọmụmụ VBM gara aga, nke kọrọ na isiokwu ndị nwere IGD nwere obere GMV na ACC na OFC (Yuan et al., 2011; Zhou et al., 2011). Dị ka ọ dị na ọmụmụ gara aga (Hutton et al., 2009; Tomoda, Polcari, Anderson, & Teicher, 2012), Nsonaazụ anyị nke GMV na ọkpụrụkpụ cortical dabara n'otu akụkụ, mana anyị hụkwara ndịiche. Nchọpụta anyị na-egosi na ọkpụrụkpụ cortical anaghị adabakọ kpamkpam na GMV, na-egosi na GMV na ọkpụrụkpụ cortical kwesịrị ịtụle ọnụ maka foto ziri ezi nke mgbanwe isi awọ.
Nchọpụta dị mkpa nke ọmụmụ a bụ na ndị na-eto eto nwere IGD nwere mgbanwe isi awọ na ACC; kpọmkwem, ndị a nwere a thinner right rostral ACC cortex, yana obere GMV na nri caudal ACC, ma e jiri ya tụnyere njikwa. Akụkụ rostral nke ACC na-etinye aka na nzaghachi metụtara njehie, gụnyere nhazi mmetụta, na akụkụ caudal nke ACC jikọtara ya na nchọpụta nke esemokwu iji nweta njikwa ọgụgụ isi.Van Veen & Carter, 2002). N'ihi na a na-ejikọta ọkpụrụkpụ cortical mpaghara na omume (Bledsoe, Semrud-Clikeman, & Pliszka, 2013; Ducharme et al., 2012), The thinner rostral ACC cortex na IGD nwere ike itinye aka na ọdịda ịzaghachi nsonaazụ ọjọọ nke egwuregwu gabigara ókè site na iji nhazi njehie adịghị mma. Ọzọkwa, obere GMV nke caudal ACC na ndị na-eri egwuregwu ịntanetị nwere ike itinye aka na mfu nke njikwa ọgụgụ isi na egwuregwu gabigara ókè. Na mgbakwunye, ihe nchoputa anyị nke ihe dị iche iche isi awọ dị n'akụkụ aka nri nke ACC kwekọrọ na ihe akaebe gara aga na nlekota na njikwa omume metụtara ya na-agbatị n'akụkụ aka nri.Stus, 2011).
N'ebe a, anyị chọpụtara na ụmụ nwoke toro eto nwere IGD nwere cortex dị gịrịgịrị na akụkụ aka nri OFC ma e jiri ya tụnyere njikwa. N'ozuzu, OFC na-atụnye ụtụ na nlekota nke ụkpụrụ ụgwọ ọrụ e kenyere na mkpebi dị iche iche; ọkachasị, akụkụ akụkụ aka nri nke OFC etinyela aka na usoro mgbochi nke na-egbochi nhọrọ ndị akwụgoro ụgwọ mbụ (Elliott & Deakin, 2005; Elliott, Dolan, na Frith, 2000) ma kwalite nhọrọ nke ụgwọ ọrụ ego na-egbu oge karịa ụgwọ ọrụ ozugbo (McClure, Laibson, Loewenstein, & Cohen, 2004). Ọzọkwa, n'oge na-adịbeghị anya, a tụrụ aro ka ọrụ nke akụkụ OFC ziri ezi gụnyere ntinye nke ozi dabere na nsonaazụ ya na ozi nghọta ugbu a iji mee akara n'atụ anya gbasara nhọrọ ndị na-abịanụ (Nogueira et al., 2017). N'ozuzu, ihe akaebe a na-egosi na akụkụ ziri ezi OFC na-achịkwa ime mkpebi site na iji ozi dị n'ime na nke mpụga n'ụzọ na-agbanwe agbanwe na ngbanwe. Ọnya na mpụta OFC na-emebi mkpebi nke metụtara ụgwọ ọrụ na-egbu oge, na-eduga na mkpebi dị mkpirikpi na nke mkpasu iwe (Mar, Walker, Theobald, Ugo na Robbins, 2011). N'ebe a, ọkpụkpụ cortical nke akụkụ OFC aka nri na isiokwu IGD jikọtara nke ọma na enweghị uche, nke akọwara dị ka "ime mkpebi ngwa ngwa" (Stanford et al., 2009). N'oge na-adịbeghị anya, mmetụta uche nwere njikọ chiri anya na mmụta dabere na ụgwọ ọrụ na ime mkpebi (Cáceres & San Martín, 2017). Ya mere, dabere na nchikota nke nchoputa anyị na akwụkwọ ndị dị ugbu a, anyị na-eche na cortex OFC nke dị gịrịgịrị na-egbochi ndị mmadụ nwere IGD ijikọ ozi nke ọma iji tụọ ụkpụrụ ụgwọ ọrụ, si otú a na-enye aka na mmasị maka ihe ụtọ dị mkpirikpi na ime mkpebi siri ike. .
Nchọpụta ọzọ dị mkpa bụ na isiokwu ndị nwere IGD gosipụtara obere GMV na cortex dị gịrịgịrị na pars orbitalis aka ekpe ma e jiri ya tụnyere njikwa. The pars orbitalis dị na akụkụ ihu nke gyrus n'ihu nke dị ala, na gyrus n'ihu nke dị ala na-achọkwa imekọ ihe na mpụta OFC (Zald et al., 2012). Ọzọkwa, pars orbitalis, yana mpaghara orbitofrontal ndị ọzọ, ejirila nhazi ozi na ime mkpebi metụtara ụgwọ ọrụ.Dixon & Christoff, 2014). Karịsịa, akụkụ aka ekpe nke pars orbitalis egosila na ọ nwere njikọ chiri anya na gyrus nke etiti oge ma na-etinye aka na mgbake ebe nchekwa na-achịkwa nke ọma.Badre, Poldrack, Paré-Blagoev, Insler, & Wagner, 2005). Nyere na nhọrọ nzaghachi mgbanwe gụnyere njikwa usoro nke usoro ebe nchekwa (Poldrack & Packard, 2003), Mgbanwe ihe isi awọ n'ime aka ekpe pars orbitalis nwere ike ime ka ọ sie ike iduzi omume dabere na ozi mbụ (Badre & Wagner, 2007). Ya mere, n'ihi akwụkwọ, nchoputa anyị na-atụ aro na obere GMV na thinner cortex na ekpe pars orbitalis nke IGD isiokwu nwere ike itinye aka na iji Ịntanetị na-achịkwaghị achịkwa site na imebi ikike ha imezi omume ha dabere na ozi mbụ.
Na nyocha nke ụbụrụ ụbụrụ zuru oke, anyị chọpụtara na isiokwu ndị nwere IGD nwere cortex dị gịrịgịrị na SMA aka nri, FEF ekpe, SPL ekpe, na PCC aka ekpe ma e jiri ya tụnyere njikwa. SMA ziri ezi na-ekere òkè na ijikọ cognition na omume (Nachev, Kennard, na Husain, 2008) ma bụrụ mpaghara dị mkpa maka mgbochi nzaghachi (Picton et al., 2007). A na-agbanwe ọrụ akwara ozi na PCC site na mgbanwe gburugburu ebe obibi dị na mpụga, yana enwere ike ijikọ mgbanwe a na ngbanwe ntọala maka mgbanwe omume (Pearson, Heilbronner, Barack, Hayden, & Platt, 2011). FEF na SPL bụkwa mpaghara ụbụrụ dị oke mkpa nke na-etinye aka na njikwa nlebara anya elu-ala.Corbetta & Shulman, 2002). A na-atụ aro nhazi nhazi nke ọma nke mpaghara ihu na parietal ka ọ dị mkpa maka atụmatụ ime mgbanwe (Andersen & Cui, 2009). Agbanyeghị na mpaghara FEF ma ọ bụ SPL bụ ROI na ọmụmụ a, anyị na-atụ aro na cortex dị gịrịgịrị na mpaghara ụbụrụ ndị a, ọkachasị na mpaghara frontoparietal, na-arụ ọrụ dị mkpa n'ịbelata njikwa omume na ndị nwere IGD. Njikwa omume a na-ebelata nwere ike ịgbanwe mkpebi ihe ize ndụ/ụgwọ ọrụ, na-ebute ihe isi ike n'igbochi ọchịchọ na ịchụso afọ ojuju nwa oge.
Ọmụmụ ihe a nwere njedebe ndị ekwesịrị ịtụle. Nke mbu, nchoputa nke cortex thinner na ACC na OFC site na nyocha nke ROI ekwenyeghi na nyocha nke ụbụrụ dum. Anyị na-eche na ihe kpatara esemokwu a bụ ụzọ dị iche iche na usoro. Dịka ọmụmaatụ, a na-eme nyocha nke dabeere na ROI site n'ịgbakọ ọnụ ọgụgụ cortical dị n'ime mpaghara ejiri aka akọwapụta ya na ndịiche dị iche iche na-enyocha site na nchịkọta ọnụ ọgụgụ na-esote; N'ụzọ dị iche, nyocha nke ụbụrụ dum na-eji usoro ahịrị n'ozuzu ya wee tụọ ndịiche dị iche iche nke nwere amamihe na oke cortical. N'ihi na usoro ROI na-abịaru nso na ụbụrụ dum na-enye ụdị ozi dị iche iche, a na-atụ aro ka ụzọ abụọ a bụrụ ihe nkwado (Giuliani, Calhoun, Pearlson, Francis, na Buchanan, 2005). A ga-akọwapụta ihe nchoputa anyị ugbu a site na nyocha ọzọ iji belata njehie na nyocha nke ROI na ụbụrụ ụbụrụ zuru oke, karịsịa, njehie sitere na nhazi nhazi oghere. Nke abụọ, ọ bụ ezie na ọmụmụ ihe a kọwapụtara ROIs n'echiche bụ na mgbanwe nhazi na OFC na ACC na-eme ka mkpebi ihe ize ndụ / ụgwọ ọrụ na-adịghị mma na IGD, ọ dịghị kpọmkwem nha nke ikike ime mkpebi site na ule neuropsychological. Ya mere, ekwesịrị iji nlezianya kpachara anya mgbe ị na-ejikọta nchoputa onyonyo anyị na mkpebi adịghị arụ ọrụ / nkwụghachi ụgwọ na IGD. Nke atọ, ọ bụ ezie na achọpụtara IGD n'ọmụmụ ihe a site na iji ọnụ ọgụgụ IAT na ajụjụ ọnụ ụlọ ọgwụ, a naghị etinye usoro nchọpụta DSM-5 maka IGD. A na-eji usoro nyocha DSM-5 IGD eme ihe n'ọtụtụ ebe, ebe DSM-5 chọpụtara IGD dị ka otu n'ime ọnọdụ chọrọ nyocha ọzọ (Petry & O'Brien, 2013). Iji kpokọta ihe akaebe a pụrụ ịdabere na ya maka IGD, ọ dị mkpa itinye ngwa nyocha na-agbanwe agbanwe. Yabụ, ọmụmụ IGD n'ọdịnihu kwesịrị itinye usoro nyocha DSM-5. Nke anọ, n'agbanyeghị na anyị kpachiri ọmụmụ ihe a na isiokwu ndị nwere IGD bụ ndị kọrọ na egwuregwu ịntanetị bụ isi ojiji ha na-eji ịntanetị, ọtụtụ isiokwu sokwa na mmemme ịntanetị ndị ọzọ, gụnyere ịkparịta ụka n'Ịntanet. Ya mere, nhazi ọmụmụ ihe nhazi na arụ ọrụ ejikọtara n'ọdịnihu nke na-atụ ihe omume akwara na nzaghachi maka mkpali egwuregwu ga-eme ka nchọpụta anyị dịkwuo elu. Nke ise, anyị na-eji ihe n'ofe akụkụ na ọmụmụ ihe a. Nnyocha n'ọdịnihu nke jiri atụmatụ ọmụmụ ogologo oge tụọ mgbanwe ọkpụkpụ cortical n'oge uto na nwata ga-enyocha ma enwere mmekọrịta kpatara n'etiti nsonaazụ onyonyo anyị na egwuregwu ịntanetị gabigara ókè. Nke isii, ihe nlele anyị maka ọmụmụ ihe a dị ntakịrị ma gụnye naanị isiokwu nwoke. A na-akọ ọdịiche dị n'ụdị nwoke na nwanyị gbasara atụmatụ ahụike nke IGD (Ko, Yen, Chen, Chen, & Yen, 2005). Ọmụmụ ihe buru ibu nke gụnyere ma nwoke na nwanyị ga-adị mkpa iji gbasaa nghọta anyị banyere IGD.
mmechi
Anyị mere nyocha SBM nke ụmụ nwoke toro eto nwere IGD iji nyochaa mgbanwe isi awọ na ACC na OFC, nke metụtara mkpebi ihe egwu/ụgwọ ọrụ. Ntụle nke dabere na ROI na njikwa gosipụtara na ndị isi IGD nwere cortex dị gịrịgịrị na rostral ACC aka nri, akụkụ OFC aka nri, na pars orbitalis aka ekpe, yana GMV pere mpe na caudal aka nri ACC na orbitalis aka ekpe. Cortex dị gịrịgịrị n'akụkụ aka nri OFC jikọtara ya na mkpali uche dị elu na isiokwu IGD, na-enye nghọta enwere ike ime mkpebi dabere na afọ ojuju nwa oge na IGD. Nyocha ụbụrụ dum nke isiokwu IGD chọpụtara na ha nwere cortex dị gịrịgịrị na mpaghara ụbụrụ metụtara njikwa omume, gụnyere mpaghara frontoparietal. Ihe nchoputa anyi na-egosi na ngbanwe ihe isi awọ nwere ike inye ozi gbasara IGD pathophysiology, site n'igosipụta ihe ize ndụ/ime mkpebi nkwụghachi ụgwọ na mbelata njikwa omume.
Ihe ndị odeakwụkwọ nyere
DL na Y-CJ chepụtara ma chepụta ọmụmụ ihe ahụ. DL weghaara ndị sonyere ma depụta ihe odide ahụ. JP nyochara ma kọwaa data ahụ. IYK na KN weputara ntughari ntughari nke ihe odide a na ihe di nkpa nwere ọgụgụ isi. Ndị edemede niile nwere ohere zuru oke na data niile na ọmụmụ ihe ahụ wee buru ọrụ maka iguzosi ike n'ezi ihe nke data na izi ezi nke nyocha data. Ndị odee niile nyochara nke ọma wee kwado ụdị ikpeazụ nke ihe odide a maka ibipụta. Enyere IYK na Y-CJ n'otu aka ahụ n'ọmụmụ ihe a dịka ndị ode akwụkwọ na-emekọrịta ihe.
Esemokwu mmasị
Ndị na-ede akwụkwọ ekwupụtaghị mmasị ọ bụla.
References
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