Mmetụta Na-agwụ Mgbanwe na Njikọ Na-adịghị Mkpa na Ndị Na-enwe Mmekọrịta Mmekọahụ (2016)

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IHE: N'ime ọmụmụ ihe a, dị ka ndị ọzọ, aha a na-akpọ "Àgwà Ọjọọ Mmebi" (CSB) nwere ike ịpụta na ụmụ nwoke ahụ bụ ndị ọgwụ ọjọọ riri ahụ. Ana m ekwu nke a n'ihi na ndị CSB na-ewe ihe fọrọ nke nta ka ọ bụrụ awa 20 nke iji egwu egwu kwa izu. Njikwa ahụ ruru 29 nkeji kwa izu. N'ụzọ na-akpali mmasị, 3 nke 20 CSB nọ na-arịa ọrịa "orgasmic-erection," ebe ọ dịghị otu n'ime ndị na-achịkwa akara na-akọ nsogbu nsogbu mmekọahụ.

Ihe Nchoputa: Ihe mgbagwoju anya nke ihe ndi na-acho onu na ndi na-adi n'ime ha di iche iche gbanwere na ngalaba CSB.

Dị ka ndị na-eme nchọpụta si kwuo, mgbanwe mbụ - eme ka amygdala dị elu - nwere ike igosipụta mmezi nkwalite (nnukwu "wiring" na akara ndị na-anọghị na mbụ na-ebu amụma foto porn). Mgbanwe nke abụọ - njikọta dị n'etiti ventral striatum na cortex prefrontal - nwere ike bụrụ akara maka ikike na-adịghị ike nke ịchịkwa mkpali. Ndị nnyocha ahụ kwuru,Mgbanwe ndị a dị na nchọpụta ndị ọzọ na-eme nchọpụta banyere nsogbu mmebi ahụ na njedebe mkpali na-emetụ n'ahụ.. ” Ihe nchoputa nke amygdalar na ntinye aka (sensitization) ma belata njikọta n'etiti ụlọ ọrụ akwụ ụgwọ na preteal cortex (hypofrontality) bụ abụọ n'ime ụbụrụ ụbụrụ buru ibu nke a hụrụ na ọgwụ ọjọọ riri ahụ.

Tim Klucken, PhDederede, Sina Wehrum-Osinsky, Dipl-Psych, J an Schweckendiek, PhD, Onno Kruse, MSc, Rudolf Stark, PhD

DOI: http://dx.doi.org/10.1016/j.jsxm.2016.01.013

nkịtị

Okwu Mmalite

Enweela mmasị na-amụbawanye na nghọta nke ọma banyere etiology nke omume mmekọahụ ike (CSB). A na-eche na mmemme ahụ nwere ike ịbụ usoro dị mkpa maka mmepe na nhazi nke CSB, ma ọ dịghị ihe ọmụmụ nke dị ugbu a nyochaworo usoro ndị a.

ebumnuche

Iji chọpụta ihe dịgasị iche iche dị iche iche na arụ ọrụ na-arụ ọrụ na nkwonkwo ọkụ na njikọta na CSB na otu njikwa ahụ ike.

ụzọ

Uzo abuo (ndi 20 ndi nwere CSB na 20 njikwa) gosiputara ihe omuma ihe na-acho acho mgbe ha na-eme ihe ngosi nke magnetik, nke bu ihe mkpali neutral (CS +) buru amuma banyere mmekorita nwoke na nwanyi na mkpali abuo (CS-).

Ihe Nchọpụta Isi

Ọbara ọbara oxygen na-adabere adabere na psychophysiologic mmekọrịta.

Results

Dịka isi ihe kpatara ya, anyị chọpụtara na ọrụ amygdala dị ukwuu n'oge nkwalite maka CS + vs CS- na ibelata njikọ n'etiti ventral striatum na corpox prefrontal na CSB na otu ìgwè.

mmechi

Ihe nchoputara na egosi na enweghi ihe jikota ihe ndi mmadu na-acho ma obu ndi na-acho na CSB. Mmebanye amygdala ụba nwere ike igosi nhazi mmezi na ndị ọrịa na CSB. Tụkwasị na nke a, enwere ike ịkọwa njikọ ahụ dị ala dịka ihe nrịba maka nchịkwa mmetụta uche na-adịghị mma n'ìgwè a.

Okwu Mkpụrụ: Amygdala, Nhazi, Mmetụta, Positive, ụgwọ ọrụ, Mmekọahụ Arousal

Okwu Mmalite

Mmepe na Intaneti na iyi egwu (dịka ọmụmaatụ, site na smartphones) enyela ụzọ ọhụrụ, ngwa ngwa, na ụzọ a na-amaghị aha iji nweta ihe ọmụma gbasara mmekọahụ (SEM). Ihe ngosi na SEM na-esonyere otu isiokwu nke onwe ya, nke kwadoro onwe ya, nke omume, na nke mmeghachi omume.1, 2, 3, 4, 5, 6, 7 Nnyocha ndị dị na Britain na 2013 gosipụtara na ihe dịka 10% nke okporo ụzọ Ịntanetị nọ na saịtị ndị toro eto karịrị okporo ụzọ na netwọk mmekọrịta.8 Nnyocha na-enyocha akwụkwọ ntanetị n'ịntanetị na-enyocha ihe mkpali maka ihe ndị na-akpali agụụ mmekọahụ n'Internet chọpụtara ihe anọ-mmekọrịta, nchịkwa ọnọdụ, iji eme ihe, na efu.9 Ọ bụ ezie na ọtụtụ n'ime ụmụ nwoke na-enwekarị nsogbu na njirimara SEM ha, ụfọdụ ndị na-akọwa omume ha dịka omume rụrụ arụ (CSB) nke na-eji oke ojiji, njedebe nke njikwa, na enweghị ike ibelata ma ọ bụ kwụsị àgwà nsogbu ahụ, n'ụzọ akụ na ụba, n'ụzọ anụ ahụ, ma ọ bụ n'ụzọ mmetụta uche maka onwe ya ma ọ bụ ndị ọzọ. Ọ bụ ezie na ndị ikom a na-akọwakarị onwe ha dị ka "nwoke ma ọ bụ nwanyị na-eri ọgwụ ọjọọ," e nwere echiche ndị na-asọ mpi banyere CSB. Ụfọdụ ndị nchọpụta akọwawo omume a dịka nsogbu nchịkwa,10 nkwụsịtụ iwu nke ọnọdụ uche, nsogbu na-agwụ agwụ-mkpasu iwe,11 ma ọ bụ nsogbu ịṅụ ọgwụ ọjọọ,12 ebe ndị ọzọ na ezere mkpakọrịta mmekọrịta na-ejikọta site na iji okwu ahụ enweghi mmekorita nwoke na nwanyi di na nwanyi.13 Ndị nchọpụta ndị ọzọ agbaghawo mkpa ọ dị maka nyocha ọhụụ n'ozuzu.14, 15 Ya mere, nyocha nke neurobiological na-enyocha ngọngọ nke CSB bụ ihe dị mkpa iji ghọtakwuo usoro ndị dị n'okpuru.

E tinyewo ya na ime ka nkwonkwo ahụ dị mfe nwere ike ịbụ usoro dị mkpa maka mmepe na mmezi nke ịṅụ ọgwụ ọjọọ na ịbawanye nsogbu ọrịa uche.16, 17 N'ihe na-eme ka ihe na-emetụ n'ahụ, ihe mkpali na-anọpụ iche (CS +) dị na nkwalite ntụrụndụ (UCS), mgbe mkpali ntọpụ nke abụọ (CS-) na-egosi enweghị UCS. Mgbe nwatakịrị ole na ole gasịrị, CS + na-eweta nzaghachị nkwenye (CRs) dị ka mmụba nzaghachi omume akpụkpọ anụ (SCRs), mgbanwe na ntụle ọkacha mmasị, na arụmọrụ na-agbanwe agbanwe.16, 18, 19 N'ihe banyere nkwonkwo nke mmeghari ahụ, a chọpụtawo netwọk nke na-agụnye ventral striatum, amygdala, orbitofrontal cortex (OFC), insula, cortex cingulate (ACC), na cortex occipital.20, 21, 22, 23, 24 N'ihi ya, ventral striatum na-etinye aka na nkwonkwo obi ụtọ n'ihi ọrụ dị mkpa ọ na-atụ anya, nhazi ọrụ ụgwọ, na mmụta.25, 26 Otú ọ dị, n'adịghị ka ventral striatum, ọrụ nke amygdala maka ọnọdụ nkwalite na-adịchaghị mfe. Ọ bụ ezie na ọtụtụ ụmụ anụmanụ na ụmụ mmadụ na-egosi ugboro ugboro na amygdala dị ka ógbè etiti maka egwu egwu,27 etinyeghị aka na nkwonkwo na-emegharị ahụ ka ọ dị obere. N'oge na-adịbeghị anya, ụmụ anụmanụ na ọmụmụ ihe ụmụ mmadụ egosiwo na amygdala na-etinye aka na nhazi nke mmegharị ahụ ọkụ, nkwalite ngwa ngwa, na nhazi nke CSB site na iji usoro dị iche iche na atụmatụ.28, 29, 30, 31, 32, 33, 34, 35, 36 Dịka ọmụmaatụ, Gottfried et al29 achọtara amygdala dị ukwuu na CS + na CS- n'oge agụụ agụụ mmadụ na-eji isi ísì ụtọ dị ka UCS. A na-atụgharị ọrụ na OFC, insula, ACC, na cortex occipital dị ka usoro nyocha na / ma ọ bụ nke omimi nke ihe ndị ahụ.16

Ruo ugbu a, ọ bụ naanị ọmụmụ ihe abụọ na-arụ ọrụ magnetik (fMRI) ka nyochachara njikọta nke CSB wee chọpụta mmụba ndị ọzọ na amygdala na ventral striatum yana gbanwee njikọ njikọta na isiokwu na CSB n'oge ngosi nke ihe metụtara (mmekọahụ).35, 36 Lọ ndị a dị na nyocha ndị ọzọ na-enyocha usoro ntanetị nke nsogbu riri ahụ na enweghị ike ịchịkwa mkpali.37, 38 Dịka ọmụmaatụ, nchọpụta nyocha na-egosi mmekọrịta dị mkpa n'etiti ọrụ amygdala na ike nke agụụ.37 Ọmụmụ ihe ọzọ nke jiri ntanetị tensor dị iche iche chọpụta ihe na-acha ọcha bụ microstructure na-eguzosi ike n'ezi ihe na mpaghara ndị mbụ na CSB nwere na mmekọrịta na-ezighị ezi n'etiti CSB na njikọta dị na frontbe lobe.39

Na mgbakwunye na ịdị mkpa nke usoro nrụgide na-agba ume, ihe nkwụsị na nkwụsị nke omume mkparị bụ ihe dị oké mkpa maka mmepe na nzizi nke ọtụtụ ọrịa uche na àgwà nkwụsị.40, 41 Ihe isi ike ndị a na nkwụsị nwere ike ịkọwa njedebe nke ịchịkwa CSB mgbe a na-eche ya ihu. N'ihe gbasara mmekorita nke mmebi iwu na usoro iwu ya, ventral striatum na ventromedial prefrontal cortex (vmPFC) yiri ka ọ dị mkpa na-ekwu okwu: ventral striatum chere na ọ dị mkpa maka ịmalite ime omume mkparị, ebe ọ bụ na vmPFC na - njikọ.42 Dịka ọmụmaatụ, nsonaazụ ndị gara aga nwere njikọ nwere nkwarụ na nkwarụ na mbido na-enweghị isi na àgwà mkpasu iwe.42, 43

Otú ọ dị, ọ dịghị nnyocha e mere ugbu a ka nyochaa usoro mmechi nke usoro mmụta mmetụ ma ọ bụ nkwụsị nke ịchịkwa CSB na iji njikwa dị mma. Dabere na akwụkwọ ndị e depụtara na mbụ, ebumnuche mbụ nke ọmụmụ ihe ugbu a bụ ịchọpụta mmeghachi omume hemodynamic nke mmetụ na-emetụ n'ahụ n'isiokwu ndị a ma e jiri ya tụnyere otu onye na-achịkwa otu. Anyị na-eburu n'uche na ịbalite ọganihu n'ime amygdala na ventral striatum na ndị CSB na-ejikọta ya na ndị na-achịkwa. Nzube nke abuo bu ichota ihe di iche n'etiti ndi otu. Ịchọta mkpụrụ okwu dị nro nke mgbanwe ngbanwe na mgbanwe na njikọta na ihe ndị a ga-enwe mmetụta ọ bụghị nanị maka nghọta nke mmepe na mmezi nke omume a kamakwa maka usoro ọgwụgwọ, nke na-elekwasị anya na mgbanwe omume site na ngbanwe ahụmịhe mmụta (dịka, àgwà ime mmụọ ọgwụ).44

ụzọ

sonyere na

Ejiri ndị ikom iri abụọ nwere CSB na 20 jikọtara njikwa site na ntinye aka nke onwe ha mgbe akpọsịrị na ndị na-ezo aka na ụlọ ọgwụ na-apụ apụ maka ọgwụgwọ omume omume (Isiokwu 1). Ndị niile sonyere nwere ọhụụ nkịtị ma ọ bụ nke edozigharịrị ma debe ma debanye aha nnabata. Emere ihe omumu a dika nkwuputa nke Helsinki. Ndị niile sonyere na-agba ajụjụ ọnụ ụlọ ọrụ iji chọpụta nyocha Axis I na / ma ọ bụ Axis II. Ndị nkewapụtara dịka ndị nwere CSB ga-emezue ụkpụrụ niile maka mmekọ nwoke na nwoke gbanwere maka CSB13:

1. Maka ma ọ dịkarịa ala ọnwa 6, mgbagha mmekọahụ, agụụ, na mmekorita nwoke na nwanyị inwe mmekọahụ ga-ejikọta ma ọ dịkarịa ala anọ n'ime ise ise a:

a. Oge na-ewe oké iwe nke agụụ mmekọahụ na agbamume na-agba ma site na ime atụmatụ na itinye aka n'omume mmekọahụ

b. Imeghari uche n'echiche mmekọahụ, agbamume, na omume ndị a na-azaghachi n'ọnọdụ ọnọdụ dysphoric

c. Na-emeghari uche n'echiche mmekọahụ, agbamume, na akparamàgwà maka mmeghachi omume nke ndụ

d. Mgbalị na-emezighachi ma ọ bụ na-emeghị nke ọma iji chịkwaa ma ọ bụ jiri nwayọọ belata agụụ mmekọahụ, agbamume, na omume ndị a

e. Na-emeghachi omume mgbe niile mgbe ị na-eleghara ihe ize ndụ anya maka mmerụahụ ma ọ bụ nke mmetụta uche nye onwe gị na ndị ọzọ

2. Ahụhụ ma ọ bụ ihe nhụjuanya nke onwe gị na-ahụ maka ọrịa, mmekọrịta, ma ọ bụ akụkụ ndị ọzọ dị mkpa nke ịrụ ọrụ metụtara oge na ike nke mgbaasị mmekọahụ, agbamume, na omume

3. Echiche ndị a, agụụ, na akparamàgwà agụụ mmekọahụ abụghị n'ihi mmetụta nchịkwa physiologic kpọmkwem nke ihe ndị dị egwu, ọnọdụ ahụike, ma ọ bụ usoro ahụike nwoke

4. Ọ dịkarịa ala afọ 18

Isiokwu 1Demographic na Psychometric Measure for CSB and Control Groups*

Otu CSB

Njikwa otu

Statistics

Age34.2 (8.6)34.9 (9.7)A = 0.23 P = .825
BDI-II12.3 (9.1)7.8 (9.9)A = 1.52 P = .136
Oge eji ele oge SEM, min / wk1,187 (806)29 (26)A = 5.53 P <.001

Axis M nsogbu

 MD ihe omume41
 MDgha ọrịa MD ugboro ugboro4
 Mkparịta ụka ọha na eze1
 Nsogbu mmezi1
 Phobia akpan akpan11
 Orgasmic-erection disorder3
 Nsogbu somatoform1

Axis II nsogbu

 Narcissistic àgwà mmadụ1

Ngwọrọ ọrịa uche

 Amitriptyline1

BDI = Akuko Beck Depression II; CSB = ịkwa iko; MD = isi mba; SEM = ihe omuma nke oma.

*A na-akọwa data dị ka pụtara (SD).

Usoro nhazi

Emere usoro nhazi ahụ mgbe ị na-eme fMRI (lee n'okpuru maka nkọwa). Ejiri usoro nhazi dị iche na ule 42 mee ihe (21 kwa CS). Oghere abụọ nwere agba (otu acha anụnụ anụnụ, otu odo) jere ozi dị ka CS ma bụrụ nke na-emezighị emezi dịka CS + na CS- gafere isiokwu. CS + bụ nke 1 nke foto 21 na-esote ya (100% nkwado). Ihe osise niile gosiputara di na nwunye (mgbe niile otu nwoke na otu nwanyị) na-egosi ihe ngosi mmekọahụ (dịka, na-enwe mmekọahụ na ọnọdụ dị iche iche) ma gosipụta ya na agba na 800 × 600 pixel mkpebi. Emere ihe ndị ahụ na ihuenyo na njedebe nke nyocha ahụ (ọhụụ = 18 Celsius) site na iji ihe ngosi LCD. A na-ekiri foto site na enyo enyo n’elu eriri igwe. Oge CS bụ 8 sekọnd. Foto ndị na-akpali agụụ mmekọahụ (UCS) pụtara ozugbo CS + (100% nkwado) maka 2.5 sekọnd na-esote oge nke 12 na 14.5 sekọnd.

A na-enye ụdị ikpe niile n'usoro iwu: Ọ bụghị otu ugboro ka a na-enye CS otu karịa ugboro abụọ. A na-ekpughe CS abụọ ahụ n'otu oge mbụ na nke abụọ nke nnweta ahụ. Nlereanya abụọ mbụ (otu ikpe CS, otu CS-ikpe) na-ewepụghị nyocha ahụ n'ihi na enweghi ike ịmuta ihe, na-akpata nyocha 20 maka CS ọ bụla.45

Ihe Ntuzi

Tupu nnwale ahụ na ozugbo usoro nhazi ahụ gasịrị, ndị na-eso ụzọ gosipụtara valence, mkpali, na agụụ mmekọahụ nke CS +, CS-, na UCS na 9-point Likert na atụmanya UCS ha na 10-point Likert. Maka ọkwa CS, a na-enyocha nyocha ọnụọgụ site na nyocha nke ọdịiche (ANOVA) na 2 (CS ụdị: CS + vs CS-) × 2 (oge: tupu mgbe anyị nwetasịrị) × 2 (otu: CSB na otu njikwa) imewe site na nyocha ule na SPSS 22 (IBM Corporation, Armonk, NY, USA) maka ọkwa ọ bụla. A na-eduzi ule post hoc kwesịrị ekwesị iji nyochaa mmetụta ndị dị ịrịba ama ọzọ. Maka foto ndị na-akpali agụụ mmekọahụ, e mere t-sample abụọ iji nyochaa esemokwu dị iche iche.

Omume Omume Omume

A na-atụle SCR ndị ahụ site na iji Agro AgCl electrodes jupụtara na isotonic (NaCl 0.05 mol / L) electrolyte ọkara etinye na ndị na-abụghị isi n'aka ekpe. A kọwara SCR dị ka mmeghachi omume phasic naanị otu mgbe mmalite ntụrụndụ. Ya mere, ọdịiche kachasị dị n'etiti kachasị na nke kachasị elu n'ime 1 ruo 4 sekọnd mgbe CS kọwara dị ka nzaghachi mbụ nke oge (FIR), na n'ime 4 ka 8 sekọnd dịka nzaghachi nkeji abụọ (SIR), nakwa n'ime 9 ka 12 sekọnd dịka nzaghachi nkeji atọ (TIR). Emepụtara nzaghachi n'ime windo nyocha site na iji Ledalab 3.4.4.46 Nzaghachi ndị a bụ log (μS + 1) gbanwere iji dozie mmebi nke nkesa nke data ahụ. Isi okwu ise (atọ nwere CSB na njikwa abụọ) egosighi SCR ọ bụla (enweghị nzaghachi ka ukwuu na UCS) ma ewepu ya na nyocha ahụ. ANOVA nyochara ihe pụtara SCR na 2 (CS ụdị: CS + vs CS-) × 2 (otu: CSB vs group control) imepụta ihe na-esote ya site na iji SPSS 22.

Imaging Resonance Imagen

Ọrụ Hemodynamic

Enwetara onyonyo arụ ọrụ na anatomic site na 1.5-Tesla dum-tomograph (Siemens Symphony na usoro gradient; Siemens AG, Erlangen, Germany) nwere eriri isi. Ihe nnweta ihe owuwu nwere ihe oyiyi 160 T1 dị arọ (magnetization kwadebere ngwa ngwa inweta gradient nkuzi; 1-mm iberi oke; oge ikwughachi = 1.9 sekọnd; oge mgbata = 4.16 ms; ele anya = 250 × 250 mm). N'ime usoro nhazi ahụ, enwetara onyonyo 420 site na iji usoro imepụta gradent grapient echo-planar na mpekere 2 na-ekpuchi ụbụrụ dum (mpempe akwụkwọ = 25 mm; ọdịiche = 5 mm; ịgbadata iberi iberi; ugboro ugboro = 1 sekọnd; oge mgbago = 2.5 ms; tụgharịa n'akuku = 55 Celsius; echiche nke anya = 90 × 192 mm; matriks size = 192 × 64). E wepụrụ mpịakọta abụọ mbụ ya n'ihi ọnọdụ ndọta na-ezughị ezu. Nyochachara data site na iji Statistical Parametric Mapping (SPM64, Wellcome Department of Cognitive Neurology, London, UK; 8) tinye na MATLAB 2008 (Mathworks Inc., Sherbourn, MA, USA). Tupu nyocha niile, e bu ụzọ dozie data, nke gụnyere nhazigharị, enweghị nkọwa (b-spline interpolation), mgbazigharị oge, ndenye aha data nke onye ọ bụla so na ya, na ịhazi usoro ohere nke Montreal Neurological Institute ụbụrụ. A na-eji ire ụtọ Spatial smoothing eme ihe atọ nke Gaussian nke nwere akụkụ atọ zuru oke na ọkara kachasị nke 7.5 mm iji nye ohere maka ndenye aha ederede.

Na ọkwa mbụ, a tụlere ihe ndị dị iche iche maka isiokwu ọ bụla: CS +, CS-, UCS, na ndị na-abụghị UCS (akọwapụtara dị ka windo oge mgbe CS-ngosi kwekọrọ na windo oge UCS mgbe CS +47, 48, 49). A họọrọ ọrụ mkpara maka onye ọ bụla regressor. Onye ọ bụla regressor nọọrọ onwe ya na ndị ọzọ, anaghị etinye mgbanwe dịgasị iche (cosine angle <0.20), ma jikọtara ya na ọrụ nzaghachi hemodynamic. Ebugharị usoro isii nke mgbanwe ahụ siri ike nke enwetara site na usoro nhazigharị ka ewepụtara dị ka covariates na ụdị ahụ. Ejiri nza dị elu nke kpochara na usoro nke oge voxel (oge mgbe niile = 128 sekọnd). Akọwapụtara ọdịiche dị iche (CS + vs CS-; CS- vs CS +; UCS vs non-UCS; non-UCS vs UCS) akọwapụtara maka isiokwu ọ bụla iche.

Maka nyocha nke abụọ, a na-eduzi nyocha abụọ na nke abụọ-nyocha iji chọpụta isi ọrụ nke ọrụ (CS + vs CS-; UCS na ndị na-abụghị UCS) na esemokwu n'etiti otu. A na-emezi nyocha nchịkọta akụkọ maka nchịkọta mpaghara-nke mmasị (ROI) site na njedebe siri ike nke P = .05 (edozighi), k = 5, na uzo di nkpa (P = .05; edozi maka njehie nke ezinụlọ, k = 5), na nyocha nke ụbụrụ zuru oke na-eduzi ọnụ ụzọ P = .001 na k> 10 voxels. Ejiri SPM8 nyochaa nyocha niile.

Ọ bụ ezie na a hụghịrị iche iche iche iche na UCS Fim na BDI, anyị na-eduzi nyocha ndị ọzọ gụnyere UCS Fim na BDI ọnụ dị ka ndị na-atụle maka akaụntụ maka mmetụta nwere mgbagwoju anya nke ahụmahụ UCS na njigide. Nsonaazụ nọgidere na-adịgide adịgide (enweghị esemokwu dị iche iche; Ihe nkpuchi ihe ntanetị maka nyocha nke ROI nke amygdala (2,370 mm3), mmiri ọkụ (10,908 mm3), cortex occipital (39,366 mm3), na OFC (10,773 mm3) e si na Harvard-Oxford Cortical and Subcortical Structural Atlases (http://fsl.fmrib.ox.ac.uk/fsl/fslwiki/Atlases) (25% ihe gbasara nke puru omume) nke Harvard Center for Analysis Clinical na ventral striatum mask (3,510 mm3) site na ebe nchekwa mmadu nke Brain Project Repository nke dabere na nchekwa data BrainMap. Atlas nke Harvard-Oxford bụ atlas puru iche nke sitere na onyogho T1 nke 37 dị mma (N = ụmụ nwanyị 16). Ihe nkpuchi vmPFC (11,124 mm3) e kere MARINA50 ma jiri ya mee ihe n'ọtụtụ ọmụmụ ihe gara aga.51, 52, 53, 54

Mkparịta ụka mmekọrịta mmekọrịta psychologys

Mkparịta ụka Psychophysiologic (PPI) nyocha,55 nke na-enyocha modulation nke njikọta n'etiti mpaghara mkpụrụ na mpaghara ụbụrụ ndị ọzọ site na ọrụ nchọpụta, nke a na-akpọ mgbanwe uche uche (CS + vs CS-), duziri. A na-akọwa mpaghara mpaghara, ventral striatum na amygdala, nyocha abụọ dị iche iche dabere na mgbọrọgwụ ROI (lee n'elu). Na nke mbụ, anyị wepụtara ihe mbụ dị iche iche maka mpaghara mkpụrụ ọ bụla dị ka emejuputara na SPM8. Mgbe ahụ, a na-eme ka okwu mmekọrịta ahụ site n'ịba ụba nke na-agbanwe agbanwe (CS + vs CS-) maka isiokwu ọ bụla na ikpe ya ikpe na arụmọrụ haemodynamic. A na-eme nyocha nyocha nke mbụ maka isiokwu ọ bụla gụnyere okwu mmekọrịta ahụ dị ka onye nchịkwa mmasị (regimeress PPI) na onye dị iche iche yana onye nchịkwa ọrụ dị ka nsogbu nchịkwa.55 Na ọkwa nke abụọ, anyị nyochara ọdịiche dị iche iche nke otu njikọta (PPI regressor) n'etiti otu CSB na otu njikwa na-eji t-test abụọ na vmPFC dị ka ROI. Ndozi onyonyo onyonyo yiri nke nyocha fMRI gara aga.

Results

Ihe Ntuzi

ANOVA gosiputara nnukwu mmetụta nke ụdị CS maka valence (F1, 38 = 5.68; P <0.05), mkpali (F.1, 38 = 7.56; P <.01), agụụ mmekọahụ (F1, 38 = 18.24; P <.001), na UCS na-atụ anya ọkwa (F1, 38 = 116.94; P <.001). Na mgbakwunye, achọpụtara ụdị mmekọrịta CS oge dị mkpa maka valence (F.1, 38 = 9.60; P <.01), mkpali (F1, 38 = 27.04; P <.001), agụụ mmekọahụ (F1, 38 = 39.23; P <.001), na UCS na-atụ anya ọkwa (F1, 38 = 112.4; P <.001). Nlere ule hoc gosipụtara nkwenye na-aga nke ọma (ọdịiche dị iche n'etiti CS + na CS-) na ìgwè abụọ ahụ, na-egosi na e gosiri CS + dị ka ihe dị mma karị, na-akpali akpali karị, na-akpali agụụ mmekọahụ karịa CS- mgbe (P <.01 maka atụnyere niile), mana ọ bụghị tupu oge nnweta, na-egosi ọnọdụ ịga nke ọma na otu abụọ ahụ (Nyocha 1). Nyocha ndị ọzọ gosipụtara na esemokwu ndị a dabeere na mụbaa CS + ọnụ na ibelata CS- ọtụtụ oge (P <.05 maka atụnyere niile). Achọpụtaghị ọdịiche dị iche iche gbasara ịba ụba (P = .92) na obi ụtọ (P = .32) Ama nke UCS (ihe omumu nke nwanyi).

Tọmbneelụ onyonyo nke Ọgụgụ 1. Mepee nnukwu onyonyo

Nyocha 1

Isi mmetụta nke ihe mkpali (CS + vs CS-) na nyocha nke onwe dị iche iche maka ìgwè abụọ ahụ. Ogwe njehie na-anọchi anya njehie ọkọlọtọ nke pụtara. CS- = ihe nkwalite ọnọdụ -; CS + = ihe nkwalite ọnọdụ +; CSB = omume mmekọahụ rụrụ arụ.

Lee nnukwu foto | Download PowerPoint Slide

Mmezi Omume Akpụ

ANOVA gosipụtara mmetụta dị ukwuu nke ụdị CS dị na FIR (F1, 33 = 4.58; P <.05) na TIR (F1, 33 = 9.70; P <.01) na omume na SIR (F1, 33 = 3.47; P = .072) na-egosi ọnụọgụ SCR ka ukwuu na CS + na UCS, karị, jiri ya tụnyere CS-. Enweghị mmetụta dị ukwuu nke otu mere na FIR (P = .610), NKE (P = .698), ma ọ bụ TIR (P = .698). Na mgbakwunye, ọ nweghị ụdị mmekọrịta CS otu-otu enwere na FIR (P = .271) na TIR (P = .260) mgbe a gbaziri maka otutu ihe atụ (FIR, SIR, na TIR).

fMRI Analysis

Mmetụta nke Task (CS + vs CS-)

Mgbe ị na-enyocha mmetụta bụ isi nke ọnọdụ oyi (CS + vs CS-), nsonaazụ ụbụrụ niile gosipụtara nzaghachi ka ukwuu na CS + n'aka ekpe (x / y / z = -30 / -94 / -21; kacha z [z)max] = 5.16; gbazie P [Pụ] <.001) na aka nri (x / y / z = 27 / −88 / −1; zmax = 4.17; Pụ <.001) ihe ndi ozo. Tụkwasị na nke ahụ, nyocha ROI gosipụtara mmụba ka ukwuu na CS + ma e jiri ya tụnyere CS- na ventral striatum na cortex na occipital na ọnọdụ dị na insula na OFC (Isiokwu 2), na-egosi ọnọdụ obi ụtọ nke hemodynamic mmeghachi omume gafee ndị niile sonyere.

Isiokwu 2 Nkọwapụta na Nkọwapụta nke Peak Voxels maka Mmetụta Na-enweghị Mmetụta nke Mmetụta na Esemokwu Otu maka iche CS + vs CS- (nyocha mpaghara-mmasị)*

Nnyocha nke otu

Structure

akụkụ

k

x

y

z

Oke z

Aghazi P uru

Mmetụta dị ukwuu nke mkpaliVentral striatumL19-15-1-22.80.045
Ọkpụkpụ nke ogeL241-24-88-84.28<.001
Ọkpụkpụ nke ogeR23024-88-54.00.002
OFCR491241-22.70.081
InsulaL134-3617173.05.073
CSB na-achịkwa otuAmygdalaR3915-10-143.29.012
Control vs CSB otu††

CSB = ịkwa iko; k = ụyọkọ ụyọkọ; L = aka ekpe; OFC = orbitofrontal cortex; R = ebe ugwu aka nri.

*Ọnụ ụzọ ahụ bụ P <.05 (emezigharị maka ezighi ezi nke ezinaụlọ; mmezi olu dị ka SPM8). A na-enye nhazi niile na ohere Montreal Neurological Institute.

†Enweghi mmeghari ihe omuma.

Esemokwu nke Group (CS + vs CS-)

Banyere iche iche iche, nyocha abụọ-sample gosipụtara enweghị iche na nyocha ụbụrụ dum ma gosipụtara mmeghachi omume hemodynamic na-arịwanye elu na ngalaba CSB ma e jiri ya tụnyere ìgwè na-achịkwa na amygdala ahụ kwesịrị ekwesị (Pụ = .012) maka CS + vs CS- (Isiokwu 2 na ọnụ ọgụgụ 2A), ebe otu onye na-achịkwa egosiputa mmemme a na-emewanye nke ọma ma e jiri ya tụnyere òtù CSB (Pụ > .05 maka atụle niile).

Tọmbneelụ onyonyo nke Ọgụgụ 2. Mepee nnukwu onyonyo

Nyocha 2

Panel A na-egosi mmụba hemodynamic na-aza n'ime isiokwu ndị nwere mmekọahụ mmekpa ahụ jiri ya tụnyere isiokwu ndị na-achịkwa ọdịiche CS + vs CS-. Panel B na-egosi nkwụsịlata usoro hemodynamic na-agbatị n'etiti ventral striatum na cortex mbụ na-achịkwa n'isiokwu ndị metụtara mmekọahụ na-agwụ ike ma e jiri ya tụnyere ihe na-achịkwa. Ogwe osisi ahụ na-egosi t ụkpụrụ maka ọdịiche a.

Lee nnukwu foto | Download PowerPoint Slide

UCS na ndị na-abụghị UCS

Banyere UCS na ndị na-abụghị UCS, a na-enyocha esemokwu dị iche iche site na iji nyocha abụọ-sample. Enweghị ọdịiche dị n'etiti otu dị iche iche mere maka ọdịiche a, na-egosi na ọdịiche dị na CR na-adabere na esemokwu na-enweghị atụ.

Mmekọrịta Psychophysiologic

Na mgbakwunye na nsonaazụ agụụ agụụ, anyị jiri PPI iji chọpụta njikọta n'etiti ventral striatum, amygdala, na vmPFC. PPI na-achọpụta ụbụrụ akụkụ njikọta na mkpụrụ ROI n'ụzọ ọrụ dabere. A na-eji ventral striatum na amygdala eme ihe dị ka mpaghara mkpụrụ n'ihi na a na-ejikọ mpaghara ndị a na ụkpụrụ mmetụta na usoro nke impulsivity. Nsonaazụ ụbụrụ dum gosipụtara nbelata njikọta n'etiti ventral striatum dị ka mpaghara mkpụrụ na ihu aka ekpe (x / y / z = -24/47/28; z = 4.33; Pamaghị ihe <.0001; x / y / z = −12 / 32 / −8; z = 4.13; Pamaghị ihe <.0001), n'akụkụ aka nri, na n'ihu (x / y / z = 57 / -28 / 40; z = 4.33; Pamaghị ihe <.0001; x / y / z = −12 / 32 / −8; z = 4.18; Pamaghị ihe <.0001) cortices na CSB na otu njikwa. Nyocha ROI nke vmPFC gosipụtara njikọta dị ala n'etiti ventral striatum na vmPFC na isiokwu ndị nwere CSB ma e jiri ya tụnyere njikwa (x / y / z = 15/41 / -17; z = 3.62; Pụ <.05; Isiokwu 3 na ọnụ ọgụgụ 2B). Enweghi mgbanwe di iche iche na njikọ amygdala-prefrontal.

Ntọala 3 Nkọwapụta na Ọnụọgụ nke Peak Voxels maka mmekọrịta Psychophysiologic (mpaghara mkpụrụ: ventral striatum) maka esemokwu otu (nyocha gbasara mmasị)*

Nnyocha nke otu

Mmekota

akụkụ

k

x

y

z

Oke z

Aghazi P uru

CSB na-achịkwa otu††
Control vs CSB otuvmPFCR1371541-173.62.029

CSB = ịkwa iko; k = ụyọkọ ụyọkọ; R = ebe ugwu aka nri; vmPFC = cortex nke na-ebute ventromedial.

*Ọnụ ụzọ ahụ bụ P <.05 (emezigharị maka ezighi ezi nke ezinaụlọ; mmezi olu dị ka SPM8). A na-enye nhazi niile na ohere Montreal Neurological Institute.

†Enweghi mmeghari ihe omuma.

Nkwurịta

Ihe ndị e chepụtara tupu ha ekwuo na nkwonkwo ahụ dị mkpa bụ usoro dị mkpa maka mmepe na mmezi nke nsogbu ndị na-abịaru nso na nsogbu ndị nwere uche gbasara ọrịa psychiatric.16 Ya mere, ebumnuche nke ọmụmụ ihe ugbu a bụ iji nyochaa ngọngọ dị na nkwonkwo ọkụ na isiokwu ndị CSB jiri ya tụnyere otu njikwa na ịchọpụta ọdịiche dị iche na njikọta nke ventral striatum na amygdala na vmPFC. Banyere mmetụta dị ukwuu nke ọnọdụ nkwonkwo, anyị chọpụtara na ọtụtụ SCRs, ntụle nke onwe ha, na ọbara oxygen na-adabere na ventral striatum, OFC, cortex occipital, na ịdọrọ na CS + vs CS-, na-egosi inwe ihe ịga nke ọma n'ogologo ihe niile .

Banyere ọdịiche dị iche iche, CSB na-achị gosipụtara mmeghachi omume hemodynamic nke CS + vs CS- na amygdala ma e jiri ya tụnyere njikwa. Nchọpụta a kwekọrọ na nchịkọta nchịkọta na-adịbeghị anya nke gosipụtara na mmalite nke amygdala na-arịwanye elu na ndị ọrịa nwere nsogbu ahụ riri ahụ ma e jiri ya tụnyere njikwa37 na maka ọrịa ndị ọzọ psychiatric, nke a na-atụle na ọnọdụ CSB. N'ụzọ dị ịrịba ama, meta-analysis nyekwara ihe àmà na amygdala nwere ike igosi ọrụ dị oke mkpa maka ịchọta ndị ọrịa.37 Tụkwasị na nke ahụ, amygdala bụ ihe dị mkpa iji mee ka ihe mgbaàmà mụta.16 Ya mere, ihe amygdala a na-ahụ anya nwere ike ịtụgharị dịka ihe nhazi nke usoro ịchọta nke a na-eme ka ọ dị mfe, bụ nke na-emepụta ihe ndị na-anọghị na-emepụtakwa n'ime ya (CS +) iji mee ka omume CSB bụrụ ihe na-eme ka ọ dị mfe. N'ikwekọ n'echiche a, amygdala mụbaa ka a na-ekwu na mmeghachi omume dị ka ihe na-enye aka n'ọtụtụ nsogbu ọrịa psychiatric metụtara ọgwụ na ndị na-abụghị ọgwụ ọjọọ.56 Ya mere, otu nwere ike iche na ụbụrụ amygdala nwere ike ịmalite mgbe ọ na-eme ihe ike nwere ike ịdị mkpa maka mmepe na nhazi nke CSB.

Ọzọkwa, ihe ndị na-eme ugbu a na-enye ohere ịkọ nkọ banyere ọrụ dị iche iche nke amygdala na egwu nakwa na nkwonkwo obi ụtọ. Anyị na-eche na arụ ọrụ dị iche iche nke amygdala na ụda egwu na nrụgide dị ọkụ nwere ike ịbụ n'ihi itinye aka na CRs dị iche iche. Dịka ọmụmaatụ, mmụba ụba na-arịwanye elu bụ otu n'ime CRs kachasị mma n'oge egwu egwu ma amygdala na-agbazi ya. N'ihi ya, mmegharị amygdala bụ ihe siri ike nchọta n'oge egwu egwu na ọnya amygdala na-eduga nkwụsị nke njedebe dị egwu na egwu egwu.57 N'adịghị iche, enwere ike ịmalite ụda nrịgo n'oge ụbụrụ na-emegharị ahụ, na ọkwa mmeghachi omume ndị ọzọ dịka mmeghachi omume nke okike (nke amygdala anaghị emetụta) yiri ka ọ bụ ihe akara kwesịrị ekwesị maka ọnọdụ mmekọahụ.58 Tụkwasị na nke ahụ, dị iche iche amygdala nuclei nwere ike itinye aka na egwu na nhịahụ dị ọkụ ma si otú ahụ nwee ike ije ozi dịgasị iche iche maka nhịahụ na egwu egwu.16

Ọzọkwa, anyị chọpụtara njikọta dị n'etiti ventral striatum na vmPFC na ndị na-achị CSB jiri ya tụnyere ndị na-achịkwa. Ejikọtara njikọta dị n'etiti ventral striatum na ebe ndị dị na mbụ na mkparịta ụka nke mmetụta uche, nsogbu ahụ, na ịchịkwa impulsivity na a hụla na ịgba chaa chaa nke ọma.43, 59, 60, 61 Ọtụtụ nchọpụta na-atụ aro na usoro mmekorita dysfunctional nwere ike ịbụ ihe na-adịghị mma nke mgbochi na njikwa igwe.41, 43 Ya mere, njikọ ahụ na-ebelata nwere ike igosipụta usoro nchịkwa dysfunctional, nke dabara adaba na nsonaazụ ndị gara aga gosipụtara njikọta gbanwere na ndị ọrịa nwere nsogbu na nchịkwa nchịkwa.62

Anyị hụrụ ọdịiche dị iche n'etiti CS + na CS na nke onwe ya na SCR na ìgwè abụọ ahụ, na-egosi ọnọdụ obi ụtọ, mana ọ bụghị otu dị iche iche na usoro nzaghachi abụọ a. Nchọpụta a kwekọrọ na nchọpụta ndị ọzọ na-akọ ọkwa dịịrị ya dị ka ihe a pụrụ ịdabere na ya maka mmetụta nchịkwa (ya bụ, ọdịiche dị n'etiti CS + na CS-), mana ọ bụghị maka ịchọpụta iche iche iche na nkwonkwo. Dịka ọmụmaatụ, ọ dịghị otu esemokwu dị iche iche dị na ntụrụndụ nke onwe na na SCR n'oge mkpali22, 23, 24 ma ọ bụ mgbagha48, 53, 54, 63, 64, 65 nkwenye dị iche iche dị iche iche, ebe a hụrụ ọdịiche dị iche iche na usoro mmeghachi omume ndị ọzọ dịka nzaghachi na-adabere na nkwụsị ọbara ma ọ bụ ọbara.22, 23, 24, 63 N'ụzọ dị mkpa, ntinye aka nke onwe na ọ bụghị nanị na ọ bụ ihe na-ezighi ezi nke esemokwu dị iche iche kamakwa o yiri ka ọ bụ na ọtụtụ ndị ọzọ na-emegharị ahụ, dịka ikpochapu ma ọ bụ kpuchie.66, 67 Anyị na-ahụ otu ihe ahụ na-arụpụta na SCR, nke nwere ọdịiche dị n'etiti CS + na CS- mana ọ bụghị mmetụta nke otu. Ihe nchọpụta ndị a na-akwado echiche ahụ na ntụle nke onwe na SCR nwere ike weere dịka ihe nrịti siri ike maka nchịkwa, ebe ọzọ ntụgharị dị mma maka ichepụta ọdịiche dị iche iche. Otu nkọwa nwere ike ịbụ na ntụle nke onwe na SCR na-amanye ọtụtụ amygdala-onwe (dịka, cortical ma ọ bụ ACC) ebe ụbụrụ dị iche na usoro nzaghachi dịka ụda nrịgo, nke kachasị ihe amygdala na-azaghachi.68 Dị ka ọmụmaatụ, egosila na SCR ndị nwere nsogbu, ma ọ bụghị ọnọdụ a na-atụghị anya ya, enwere ike chọpụta na ndị ọrịa nwere ọnya amygdala.69 Ọmụmụ ihe n'ọdịnihu ga-enyocha usoro ndị nwere ike ịdabere na nkwụsị nke usoro mmeghachi omume n'ụzọ zuru ezu nakwa na ha kwesịrị ịgụnye mmụba egwu dị ka ihe dị mkpa iji chọpụta ọdịiche dị iche iche.

Tụkwasị na nke a, ọ ga-adọrọ mmasị iji tụnyere CSB na usoro nchịkwa nke na-egosi nnukwu ihe mwepụ SEM ma ọ dịghị ihe ọzọ na-adịghị mma. Ụzọ a ga - enyere aka inweta nghota ka mma banyere ọnụọgụ nke ọtụtụ ọnụọgụ SEM dị ukwuu n'iwepụta usoro SEM.

-agaghị emeli

A ghaghị iburu nsogbu ụfọdụ. Anyị achọpụtaghị ọdịiche dị na ventral striatum n'etiti ìgwè abụọ ahụ. Otu nkọwa maka nke a nwere ike ịbụ na nsogbu ụlọ nwere ike egbochi esemokwu nke otu. Otutu ihe omuma akuko kwuru na enwere ike ime ka ndi mmadu nwekwuo mmetuta karia ihe ndi ozo.1, 58, 70 Ọzọkwa, ekwesiri iburu n'uche na vmPFC abụghị mpaghara akọwapụtara nke ọma ma nwee ike ịnwe akụkụ dịgasị iche iche dị iche iche na-arụ ọrụ dị iche iche. Dị ka ọmụmaatụ, ngwakọta vmPFC mmemme ndị ọzọ na nchọpụta ndị ọzọ bụ ihe mpụta na azụ ka anyị rụpụta.43 Ya mere, ịchọta ugbu a nwere ike igosipụta ọtụtụ usoro n'ihi na vmPFC na-etinye aka n'ọtụtụ ọrụ dị iche iche dị ka nlebara anya ma ọ bụ nhazi ọrụ nkwụghachi ụgwọ.

Mmechi na Mmetụta

N'ozuzu, ọrụ ahụ amygdala ahụ mepụtara wee na-eme ka ọnụ ọgụgụ nke ventral na-eme ka ọnụ ọgụgụ na-eme ka ọ ghara ịkọ banyere etiology na ọgwụgwọ nke CSB. Ndị CSB na-achị yiri ka ọ na-adịkarị mfe ịmepụta mkpakọrịta n'etiti etiti ndị na-anọghị na-anọpụ iche na mkpapụta gburugburu ebe obibi nke mmekọahụ. Ya mere, isiokwu ndị a nwere ike ịchọta ihe ndị na-eme ka mmadụ nwee mmekọahụ. Ma nke a na-eduga na CSB ma ọ bụ ihe sitere na CSB aghaghị ịza ya site na nyocha n'ọdịnihu. Na mgbakwunye, usoro iwu na-adịghị mma, bụ nke gosipụtara na nkwonkwo ventral striatal-prefrontal, nwere ike ịkwado nkwado nke nsogbu nsogbu ahụ. N'ihe gbasara ntụgharị uche pụtara, anyị chọpụtara ọdịiche dị iche iche na usoro ọmụmụ na ibelata njikọta n'etiti ventral striatum na vmPFC. Ịmepụta usoro ọmụmụ ihe ngwa ngwa na ngụkọta mmetụta uche dysfunctional nwere ike imeri ọgwụgwọ nke ọma. N'ikwekọ na echiche a, nchọpụta ndị a na-adịbeghị anya ekwuola na mgbanwe nkwonkwo ventral-PFC nwere ike ime ka ọ dịkwuo njọ na nlọghachi.71 Nke a nwere ike igosi na ọgwụgwọ ndị na-elekwasị anya na ụkpụrụ mmetụta uche nwekwara ike ịdị irè maka CSB. Ihe akaebe na-akwado echiche a egosila na ịkpa àgwà omume, nke dabere na usoro mmụta na usoro mmetụta uche ndị a, bụ ọgwụgwọ dị irè maka ọtụtụ nsogbu.72 Ihe nchoputa ndia na eme ka o doo anya banyere usoro nke CSB ma kwuo ihe puru ime ya.

Nkwupụta nke onye edemede

Category 1

  • (a)

Echiche na Kere

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Rudolf Stark
  • (B)

Inweta Data

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek
  • (c)

Nyocha na Ịkọwa Data

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Onno Kruse; Rudolf Stark

Category 2

  • (a)

Idezi Nkeji edemede

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Onno Kruse; Rudolf Stark
  • (B)

Nyochagharị ya maka Ọdịnaya ọgụgụ isi

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Onno Kruse; Rudolf Stark

Category 3

  • (a)

Njedebe kwadoro nke Nkeji edemede

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Onno Kruse; Rudolf Stark

References

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Esemokwu Mmasị: Ndị na-ede akwụkwọ ekwupụtaghị mmasị ọ bụla.

Ego: Nyocha nke German Research Foundation (STA 475 / 11-1) kwadoro ọmụmụ ihe a.