Zogwiritsa Ntchito Neural za Chilakolako cha Kugonana Mwa Anthu Amene Ali ndi Matenda Oopsa a Hypersexual (2015)

MAFUNSO: Kafukufukuyu wa fMRI wa Korea amaphatikizapo maphunziro ena a ubongo pa ogwiritsa ntchito zolaula. Monga maphunziro a University of Cambridge, iwo adapeza njira zowonongeka za ubongo zokhudzana ndi kugonana zomwe zinkasonyeza miyambo ya mankhwala osokoneza bongo. Mogwirizana ndi maphunziro angapo a Chijeremani, iwo adapeza kusintha kwa kondomu yomwe imayenderana ndi kusintha komwe kunachitika m'zovuta za mankhwala osokoneza bongo.

Ngakhale izo zikufotokozera mbali zina za maphunziro ena, pepala ili la Korean limanenanso zotsatirazi:

1. Imafufuza mbali zina za ubongo zomwe zimagwirizanitsidwa ndi reactivity, ndipo zinapeza kuti zonse zinkakhala ndi mphamvu zoposa zowononga bwino. Zigawo zowonjezera za ubongo: thalamus, phokoso lamanzere lamanzere, gyrus yoyenera bwino, komanso kulumikiza bwino gyrus.
2. Chatsopano ndi chakuti zomwe zapezazi zikugwirizana ndendende ndi makina oyendetsera makina omwe amapezeka mwa omwe amakonda kugwiritsa ntchito mankhwala osokoneza bongo: Kuzindikira kwakukulu-kuyambiranso zithunzi zachiwerewere, komabe kulepheretsa kuyankha kuzinthu zina zachilendo. Mwa chizolowezi, zomwe zimagwirizana ndi zosokoneza bongo zimapangitsa kuti preortalal cortex iphulitse dera lamalipiro ndi "pitani mukapeze" ma siginolo. Zimabweretsanso chisangalalo chochepa poyankha mphotho zatsiku ndi tsiku. Ndiye kuti, chilimbikitso chochepa chotsata mphotho zanthawi zonse.

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Kutsogolo. Behav. Neurosci., 30 November 2015

LINKANI Phunziro LOPHUNZITSIRA

Ji-Woo Seok ndi Jin-Hun Sohn *

• Dipatimenti ya Psychology, Institute Research Brain, University of Chungnam, Daejeon, South Korea

Kafukufuku wokhudzana ndi mikhalidwe ya anthu omwe ali ndi vuto la hypersexual akhala akuchulukirachulukira chifukwa chakuwonjezereka kwa zovuta zamakhalidwe azovuta zachiwerewere (PHB). Pakadali pano, ndizochepa zomwe zimadziwika pazomwe zimapangitsa kuti munthu akhale ndi chilakolako chogonana. Kafukufuku wathu adafuna kuti tifufuze zolumikizana za chilakolako chogonana ndi zochitika zokhudzana ndi maginito (fMRI) zokhudzana ndi zochitika. Anthu makumi awiri mphambu atatu omwe ali ndi PHB ndi 22 omwe ali ndi zaka zowongolera zoyeserera zaka zawo adayesedwa pomwe amangoona zachiwerewere komanso zosagonana. Magulu a mitu ya chilakolako chogonana adayesedwa poyankha chilimbikitso chilichonse chogonana. Zokhudzana ndi zowongolera, anthu omwe ali ndi PHB adakumana ndi chilakolako chogonana pafupipafupi ndikamakhudzidwa ndi zolaula. Kulimbikitsanso kwakukulu kunawonedwa mumtundu wa caudate, wotsika kwambiri wa parietal lobe, wamkati wamkati wamkati wam'mimba wam'mimba wam'mimba wam'mimba wamtundu wamtundu wamtundu wamtundu wamtundu wamtundu wamtundu wamtundu wamtundu wa PHB, kuposa gulu lolamulira. Kuphatikiza apo, mawonekedwe a hemodynamic m'malo omwe adasinthidwa adasiyana pakati pa magulu. Zogwirizana ndi zomwe zapezedwa m'malingaliro amalingaliro amubongo okhudzana ndi zizolowezi zamakhalidwe ndi zizolowezi, anthu omwe ali ndi machitidwe a PHB komanso chikhumbo chowonjezeka adawonetsa kuyambitsa kusintha kwa zigawo za preortal cortex ndi subcortical. Pomaliza, zotsatira zathu zithandizira kuwonetsa machitidwe ndi njira zogwirizira za neural za anthu omwe ali ndi PHB.

Introduction

Khalidwe loipa la hypersexual (PHB) limatanthauzidwa ngati kutenga nawo mbali nthawi zonse m'machitidwe ogonana mobwerezabwereza popanda kulamulira chilakolako chogonana mopitirira muyeso komanso khalidwe ngakhale kuti anthu amadziwa zotsatira zake zoipa ( Goodman, 1993 ; Carnes, 2001 , 2013 ). Anthu omwe ali ndi PHB amatha kukumana ndi mavuto aakulu m'mabanja awo komanso momwe amagwirira ntchito. Kuphatikiza apo, ali pachiwopsezo chachikulu chotenga matenda opatsirana pogonana kapena kutenga mimba zosafunikira chifukwa cha kugonana kosayenera ( Schneider ndi Schneider, 1991 ; Kuzma ndi Black, 2008 ). Ku US, 3–6% ya ophunzira ammudzi ndi aku koleji ali ndi PHB ( Coleman, 1992 ; Black, 2000 ; Seegers, 2003 ). Ku Korea, pafupifupi 2% ya ophunzira onse aku koleji ali ndi PHB ( Kim ndi Kwak, 2011 ). Chifukwa cha kufalikira kwake kwakukulu komanso mavuto ena ofanana nawo, zoopsa zomwe zimagwirizana nazo zikudziwika kwambiri m'gulu la anthu pamene kuchuluka kwa PHB kukuwoneka kuti kukukulirakulira.

Ngakhale kuti kuopsa kwa PHB kwadziwika tsopano, sikunaphatikizidwe mu DSM-5 ( American Psychiatric Association, 2013 ) Mikangano ikupitirirabe pankhani ya ngati matenda opatsirana pogonana ayenera kugawidwa ngati matenda; chifukwa chake, palibe mgwirizano pa tanthauzo lake, magulu, kapena njira zodziwira matenda. Izi zikuwonetsa zovuta pakukhazikitsa muyezo womveka bwino wa magulu chifukwa chosowa maphunziro olondola komanso ozama pazinthu zokhudzana ndi matenda opatsirana pogonana.

Ngakhale kuti kugawa PHB ngati matenda kukupitirirabe kukangana, akuti kuchita zinthu zogonana mopitirira muyeso kuyenera kugawidwa ngati gulu la matenda osokoneza bongo chifukwa PHB imaphatikizapo zizindikiro zomwe zimafanana ndi mitundu ina ya chizolowezi ( Goodman, 2001 ; Kor et al., 2013 ). Chilakolako chowonjezeka chimagwirizana kwambiri ndi mbali zofunika kwambiri za matenda osokoneza bongo. Kafukufuku wowonetsa zithunzi wasonyeza kuti ntchito ya madera a ubongo omwe amakhudzidwa ndi chilakolako imasinthidwa mwa iwo omwe ali ndi chizolowezi chogwiritsa ntchito mankhwala osokoneza bongo ( Garavan et al., 2000 ; Tapert et al., 2003 ; Franklin et al., 2007 ; McClernon et al., 2009 ). Zizolowezi zoledzera, monga kutchova juga, masewera a pa intaneti, ndi khalidwe logonana, zomwe sizikuphatikizapo kumwa mankhwala osokoneza bongo mwachindunji, zimaphatikizaponso chilakolako chowonjezeka chomwe chikuwoneka kuti chikugwirizana ndi ntchito zosinthika m'madera oyenera a ubongo ( Crockford et al., 2005 ; Ko et al., 2009 ; Kühn ndi Gallinat, 2014 ; Voon et al., 2014 ).

Kafukufuku wokhudza chilakolako cha mankhwala osokoneza bongo ndi chizolowezi cha khalidwe wasonyeza kusintha kwa ntchito mu prefrontal cortex (PFC) ndi subcortical reward circuits mwa anthu omwe ali ndi matendawa ( Goldstein ndi Volkow, 2011 ). Makamaka, maphunzirowa apeza kufunika kwakukulu kwa PFC mu chizolowezi, kudzera mu malamulo ake a madera a limbic reward komanso kutenga nawo mbali pazinthu zolimbikitsa kugwiritsa ntchito mankhwala mobwerezabwereza komanso khalidwe lokakamiza. Kusokonekera kwa ntchito ya PFC kumabweretsa kuwonongeka kwa kuletsa kuyankha ndi kugawa mphamvu, monga kugawa mphamvu mosayenera ku chizindikiro choledzeretsa, monga momwe zimakhalira ndi zinthu ndi zizolowezi zoledzeretsa, komanso kuchepa kwa chilakolako cha zinthu zabwinobwino ( Goldman-Rakic ​​ndi Leung, 2002 ; Goldstein ndi Volkow, 2011 ).

Mogwirizana ndi zotsatirazi, zotsatira za kafukufuku wa neuroimaging pa ma PHB zinasonyeza kuti anthu omwe ali ndi ma PHB ali ndi chilakolako chachikulu chogonana poyerekeza ndi zowongolera zathanzi ndipo chilakolako chowonjezekacho chimagwirizanitsidwa ndi mitundu yosiyanasiyana ya mayankho a mitsempha mu dorsal anterior cingulate-ventral striatal-amygdala functional network ( Voon et al., 2014 ). Mu kafukufuku wa kapangidwe ka ubongo ndi kulumikizana kwa ntchito, Kühn ndi Gallinat (2014) adawonetsa kuti kuwonetsa zolaula pafupipafupi kumalumikizidwa ndi kusintha kwa kapangidwe ka ubongo ndi magwiridwe antchito m'malo a PFC ndipo kungayambitse chizolowezi chofunafuna zinthu zatsopano komanso zogonana kwambiri.

Maphunzirowa amapereka umboni wakuti chilakolako chowonjezeka ndi ntchito zosayenera zomwe zimakhudzidwa ndi chikhumbo zimagwiritsidwanso ntchito ku PHB, ngakhale kuti khalidwe lokha silinayambitsa matenda oopsa.

Mwatsoka, deta yodziwika bwino yokhudza mayankho a mitsempha yokhudzana ndi chilakolako chogonana mwa anthu omwe ali ndi PHB si yokwanira. Kafukufuku wakale pa njira za ubongo zomwe zimayambitsa kukonza chilakolako chogonana mwa anthu omwe ali ndi PHB adagwiritsa ntchito njira zachikhalidwe zochepetsera chilakolako panthawi yojambula zithunzi za magnetic resonance (fMRI) komanso kuwonetsedwa kwa nthawi yayitali kuzinthu zokopa. Mu maphunziro okhudza chilakolako chogonana, nthawi yowonetsera ikuwoneka kuti ndi yofunika kuchokera ku malingaliro a njira komanso chifukwa cha kusiyana kwa kukonza chidziwitso ( Bühler et al., 2008 ). Mu mapangidwe a block, nthawi yowonetsera chilimbikitso imatalikitsidwa, ndipo kuchitika kwa zinthu zokopa mosalekeza mu block ndi kodziwikiratu kwathunthu ( Zarahn et al., 1997 ). Chifukwa chake, mapangidwe a block mwina amachititsa madera omwe amagwirizana ndi njira zodziwira, monga kuyang'anitsitsa kosalekeza, kulamulira kuchokera pamwamba kupita pansi, komanso kuletsa chilakolako chogonana . Izi zitha kubweretsa kuchepa kwa kutenga nawo mbali m'maganizo motero kusintha ntchito ya mitsempha ( Schafer et al., 2005 ). Mwa njira, mapangidwe okhudzana ndi zochitika ndi otsika poyerekeza ndi mapangidwe a block wamba kuti azindikire madera a ubongo omwe ayambitsidwa, pomwe ndi abwino kwambiri poyesa ntchito yoyankha hemodynamic ( Birn et al., 2002 ).

Choncho, zolinga za phunziroli zinali zoyenera

(1) kubwereza zochitika zam'mbuyomu zamakono za chilakolako cha kugonana kwa anthu omwe ali ndi PHBs,

(2) kuzindikira kuti kusintha kwa ubongo kumagwira ntchito m'madera odziwika kuti akukhudzidwa ndi chilakolako chowonjezeka, ndi

(3) kumvetsetsa kusiyana kwa mayankho a hemodynamic a madera awo a ubongo m'kupita kwa nthawi kwa anthu omwe ali ndi PHB pogwiritsa ntchito fMRI zokhudzana ndi zochitika.

Tinaganiza kuti anthu omwe ali ndi ma PHB amatha kusonyeza chilakolako chachikulu chogonana poyerekeza ndi kulamulira bwino komanso kuti zigawo za ubongo, monga PFC ndi maulendo opatsa malipiro, ziwonetseratu ntchito zowonongeka komanso zowonongeka.

Njira

ophunzira

Kafukufukuyu adaphatikizapo amuna 23 omwe anali ndi amuna kapena akazi okhaokha m'gulu la PHB [zaka zapakati = 26.12, kupotoka kokhazikika (SD) = zaka 4.11] ndi amuna 22 omwe anali ndi amuna kapena akazi okhaokha m'gulu lolamulira (zaka zapakati = 26.27, SD = zaka 3.39) . Pafupifupi anthu 70 omwe angakhale nawo adasankhidwa kuchokera ku malo ochiritsira chifukwa cha vuto la kugonana komanso misonkhano ya Sex Addiction Anonymous . Zofunikira zophatikizidwa zidakhazikitsidwa pazifukwa zodziwira za PHB za maphunziro am'mbuyomu (Table S1; Carnes et al., 2010 ; Kafka, 2010 ). Zofunikira zochotsera zinali izi: zaka zoposa 45 kapena zosakwana zaka 18; matenda oopsa amisala, monga vuto la kugwiritsa ntchito mowa mopitirira muyeso, vuto la kutchova juga, vuto lalikulu la kukhumudwa, vuto la bipolar, kapena vuto la obsessive-compulsive; pakali pano akumwa mankhwala; mbiri ya kuvulala mutu kwakukulu; kugonana kwa amuna kapena akazi okhaokha; mbiri yaupandu; kapena kusayenerera kujambula zithunzi (monga kukhala ndi chitsulo m'thupi mwake, astigmatism yayikulu, kapena claustrophobia). Madokotala adachita mafunso azachipatala a anthu onse omwe angakhalepo, ndipo gulu lomaliza la amuna 23 omwe adakwaniritsa zofunikira zophatikizidwa osati zofunikira zochotsedwa adasankhidwa pagulu la PHB. Pa gulu lowongolera, ophunzira 22 omwe ali ndi makhalidwe a anthu (zaka, jenda, mulingo wamaphunziro, ndi mulingo wa ndalama) omwe adafanana ndi gulu la PHB adasankhidwa. Ophunzira onse adapereka zilolezo zolembedwa atafotokozedwa zomwe zili mu kafukufukuyu. Bungwe Lowunikira Bungwe la Chungnam National University Institutional Review Board lidavomereza njira zoyesera ndi zovomerezeka (nambala yovomerezeka: 201309-SB-003-01). Ophunzira onse adalandira chindapusa cha ndalama (madola 150) chifukwa chotenga nawo mbali.

Zida Zoyeza

Ophunzirawo adamaliza kafukufuku wokhala ndi mafunso okhudza makhalidwe awo a anthu ndi zochitika zawo zogonana kwa miyezi 6 yapitayi ndi masikelo okhazikika, monga Barratt Impulsiveness Scale-11 ( Patton et al., 1995 ), Buss-Perry Aggression questionnaire ( Buss ndi Perry, 1992 ), Beck Depression Inventory ( Beck et al., 1996 ), Beck Anxiety Inventory ( Beck et al., 1996 ), Sexual Addiction Screening Test-R (SAST-R; Carnes et al., 2010 ), ndi Hypersexual Behavior Inventory (HBI; Reid et al., 2011 ; Table 1 ). Mafunso okhudza khalidwe la kugonana anali zaka zogonana koyamba komanso momwe ubale wawo ulili pakali pano. Mkhalidwe wogonana wokhawokha unatanthauzidwa ngati ubale womwe anthu awiri okha amagonana okhaokha. Ubale wogonana wosakhala wapadera unatanthauzidwa ngati kusunga ubale wogonana ndi anthu osiyanasiyana popanda kusunga ubale uliwonse muubwenzi.

Mafunso okhudza makhalidwe okhudzana ndi kugonana anali kuphatikizapo kuchuluka kwa kugonana komwe kumachitika pa sabata, kuchuluka kwa maliseche pa sabata, kuchuluka kwa kuonera zolaula pa sabata, ndi chiwerengero cha ogonana nawo onse m'miyezi 6 yapitayi . Kuphatikiza apo, SAST-R ( Carnes et al., 2010 ) ndi HBI ( Reid et al., 2011 ) zidagwiritsidwa ntchito poyesa kuchuluka kwa PHB mwa ophunzira. SAST-R ili ndi mafunso 20 opangidwa kuti ayese kuchuluka kwa chizolowezi chogonana. Zigolizo zimayambira pa 0 mpaka 20, ndipo zigoli zapamwamba zikusonyeza chizolowezi chogonana kwambiri. HBI ili ndi mafunso 19, ndipo zigolizo zimayambira pa 19 mpaka 95. Zigoli zonse 53 kapena kupitirira apo zimasonyeza vuto la hypersexual . Kugwirizana kwamkati (Cronbach's α coefficient) kwa SAST-R ndi HBI ndi 0.91 ndi 0.96, motsatana ( Carnes et al., 2010 ; Reid et al., 2011 ).

Masewero Oyesera ndi Paradigm Yoyesera

Kafukufuku wapatsogolo unachitika pa amuna 130 omwe anali ndi ntchito zabwinobwino zogonana omwe sanachite nawo kafukufuku wa fMRI kuti asankhe zolimbikitsa zogonana komanso zosagonana pa kafukufuku wa fMRI (File S1). Zolimbikitsa zowoneka zinali ndi zithunzi 20 zomwe zinasonkhanitsidwa kuchokera ku International Affective Picture System (zithunzi 6; Lang et al., 2008 ) ndi mawebusayiti a pa intaneti (zithunzi 14). Zolimbikitsa zogonana zinali ndi zithunzi zosonyeza akazi amaliseche ndi zochita zogonana. Kuphatikiza apo, zithunzi 20 zomwe sizinapangitse chilakolako chilichonse chogonana zinasankhidwa ngati zolimbikitsa zogonana. Zinagwirizana ndi zolimbikitsa zogonana chifukwa cha kuchuluka kwa kukongola kwawo. Zolimbikitsa zogonana sizinawonetse zochitika zolimbikitsa kwambiri, monga masewera a m'madzi, kukondwerera kupambana, ndi skiing. Zolimbikitsa izi zinasankhidwa kuti zizindikire zochita za ubongo zomwe zinali zokhudzana ndi chilakolako chogonana pochotsa zochita zomwe zimachokera ku malingaliro osangalatsa komanso chilakolako cha kugonana.

Pa njira yoyesera ya fMRI, malangizo achidule okhudza kuyeseraku adaperekedwa kwa masekondi 6 kumayambiriro kwa kuyeseraku, komwe kunatsatiridwa ndi kuwonetsedwa mwachisawawa kwa zolimbikitsa zogonana kapena zosagonana kwa masekondi 5 iliyonse . Nthawi iliyonse ya interstimulus inali masekondi 7-13 (avereji, masekondi 10) kuti athandize wophunzirayo kubwerera ku mkhalidwe wawo woyambira. Kuti ophunzirawo apitirize kuyang'ana kwambiri zolimbikitsazo, adapemphedwa kuti akanikizire batani loyankhira pamene cholinga chosayembekezereka chinaperekedwa kwa pafupifupi 500 ms kwa nthawi 12 panthawi iliyonse. Nthawi yonse yofunikira pa kuyeseraku inali mphindi 8 ndi masekondi 48 (Chithunzi 1 ).

CHITSANZO CHA 1

Atamaliza kuyesa kwa fMRI, ophunzirawo adawonera zolimbikitsa zomwezo zomwe zidaperekedwa mu kuyesa kwa fMRI, ndipo adayenera kuyankha mafunso atatu otsatirawa kuti awone ngati ali ndi vuto la maganizo.

Choyamba, adafunsidwa kuti ayankhe "inde" kapena "ayi" akafunsidwa ngati akufuna kugonana pogwiritsa ntchito chiwonetsero chilichonse.

Chachiwiri, iwo amafunika kuyesa chilakolako chawo chogonana pa chiwerengero cha Likert zisanu kuchokera ku 1 (zochepa kwambiri) mpaka 5 (kwambiri).

Chachitatu, kuyerekezera kwa omwe akutenga nawo mbali pamiyeso ya valence ndikudzutsa chilimbikitso chilichonse kunatsimikizika molingana ndi sikelo ya Likert ya mfundo zisanu ndi ziwiri.

Zotsatirazo zinapangidwa pa miyeso iwiri. Valence, yomwe inali yabwino kapena yoipa, inachokera ku zovuta kwambiri ku 1 kuti ikhale yosangalatsa pa 7, ndipo kuwuka kwa maganizo kunachokera ku batala pa 1 kukondweretsedwa / kukweza ku 7. Pomalizira, ophunzirawo anayenera kufotokoza maganizo ena omwe adakumana nawo pambali pa chilakolako cha kugonana pamene akuwonekera pachithunzi chilichonse.

Kupeza Zithunzi

Kupeza zithunzi kunachitika pogwiritsa ntchito 3.0 T Philips magnetic resonance scanner (Philips Healthcare, Best, The Netherlands). Njira yojambulira fMRI yojambulidwa ndi echo-planar imaging single-shot [imaging variables: repetition time (TR) = 2,000 ms, echo time (TE) = 28 ms, slice thickness = 5 mm with no gap, matrix = 64 × 64, field of view (FOV) = 24 × 24 cm, flip angle = 80°, ndi in-plane resolution = 3.75 mm] idagwiritsidwa ntchito kupeza zithunzi 35 zopitilira za oxygen level-dependent blood oxygen level (BOLD). Zithunzi za anatomical zolemera T1 zidapezeka ndi 3-dimensional fluid-attenuated inversion recovery sequence ( TR = 280, TE = 14 ms, flip angle = 60°, FOV = 24 × 24 cm, matrix = 256 × 256, ndi slice thickness = 4 mm).

Zosanthula Zosati

Pofuna kufufuza momwe machitidwe ndi mitsempha zimayankhira zomwe zimachokera ku chilakolako chogonana, zithunzi ndi deta yamaganizo ya zithunzi zitatu zomwe zidayambitsa malingaliro ena, monga kunyansidwa, mkwiyo, kapena kudabwa, kupatula chilakolako chogonana sizinaphatikizidwe mu kusanthula deta. Mayeso odziyimira pawokha a ma frequency ndi mphamvu ya chilakolako chogonana pakati pa magulu awiriwa adachitidwa pogwiritsa ntchito SPSS 22 (IBM Corporation, Armonk, NY, USA). Kuchuluka kwa chilakolako chogonana kunaganiziridwa kuti ndi kuchuluka kwa zolimbikitsa zomwe wophunzira aliyense adakumana nazo chilakolako chogonana kuchokera pakati pa zolimbikitsa zonse 20 zogonana, ndipo mphamvu ya chilakolako chogonana inali kuchuluka kwa chilakolako chogonana cha zithunzi 20 zogonana.

SPM8 (Dipatimenti Yabwino Yopangiritsa Sayansi, London, UK) idagwiritsidwa ntchito kufufuza deta ya FMRI. Poyambira kutsogolo, kujambulitsa zithunzi za MRI kunachitika motere: Kukonzekera kwa nthawi yokhazikika, kukonzekeretseratu njira, ndi kuika malo pazithunzi zomwe zimaperekedwa ndi Montreal Neurological Institute (MNI). Pambuyo pake, zojambulazo zinkasinthidwa ndi 8-mm Gaussian kernel.

Pambuyo pomaliza kukonza, mapangidwe a matrices okhala ndi mikhalidwe iwiri (mkhalidwe wogonana ndi mkhalidwe wosagonana) adapangidwa kuti aliyense azindikire madera omwe ali ndi chikhumbo chogonana. Kusanthula koyamba kwa munthu payekha kwa kufananiza kwa mkhalidwe wogonana kupatula mkhalidwe wosagonana kunagwiritsidwa ntchito poyesa zotsatira zosasinthika, ndipo zithunzi zapakati zidapangidwa pa munthu aliyense. Mayeso amodzi a t pazithunzi zapakati adagwiritsidwa ntchito poyesa zotsatira zazikulu za gulu lililonse pazithunzi zosiyana zomwe zidapangidwa mu kusanthula kwa munthu aliyense. Mayeso awiri a t adachitidwa kuti azindikire kusiyana pakati pa magulu awiriwa pa mayankho a ubongo mu mkhalidwe wogonana poyerekeza ndi mkhalidwe wosagonana. Kuphatikiza apo, kusanthula kwa ubale kunachitika kokha mu gulu la PHB kuti adziwe madera omwe amachitika omwe amagwirizana ndi kuopsa kwa hypersexuality malinga ndi SAST-R. Chifukwa kusiyana kwa zigoli za mafunso kungakhale kotsika kwambiri kuti kuwulule mgwirizano wofunikira kwambiri mu gulu lolamulira, kusanthula kwa ubale sikunachitike mu gulu lolamulira. Ma P values ​​osakwana 0.05 (False Discovery Rate, corrected, cluster size ≥ 20) kapena 0.001 (yosakonzedwa, cluster size ≥ 20) amaonedwa kuti ndi ofunika kwambiri pa ntchito ya ubongo chifukwa milingo imeneyi nthawi zambiri imavomerezedwa mu maphunziro a fMRI. Ma coordinates onse a ma voxels oyambitsidwa akuwonetsedwa ngati ma MNI coordinates mu Matebulo 3 , 4.

Kusintha kwa chizindikiro cha peresenti kunatengedwa kuchokera ku Madera Omwe Amachita Chidwi (ROIs) kutengera zotsatira za kusanthula kwa pakati pa gulu ndi ubale [monga, thalamus yapawiri, dorsolateral prefrontal cortex (DLPFC), nucleus ya caudate yakumanzere, gyrus ya supramarginal yakumanja, ndi dorsal anterior cingulate gyrus yakumanja] ndi MarsBaR ( http://www.sourceforge.net/projects/marsbar ). Ma ROI adapangidwa poyika bwalo la 5-mm kuzungulira ma coordinates omwe afotokozedwa mu Matebulo 3 , 4. Pofuna kuwona mawonekedwe a nthawi ya mayankho a hemodynamic, nthawi ya chizindikiro cha BOLD idachotsedwanso kuchokera ku ma ROI panthawi yowonetsa chilimbikitso chilichonse chogonana (zonse masekondi 12; masekondi 5 ndi masekondi 7 pambuyo pake) kwa onse omwe adatenga nawo mbali . Nthawi ya maphunziro idawerengedwa pakati pa ophunzira onse m'gulu lililonse.

Monga mayeso otsatira a ubale kuti awerengere mgwirizano, ubale pakati pa zigoli pa SAST-R ndi HBI ndi kusintha kwa chizindikiro cha peresenti mu ROI kutengera zotsatira za kusanthula ubale (Table 4 ) zidasanthulidwa mu gulu la PHB ndi SPSS 22.

Results

Zotsatira za Maphunziro a Psychological

Pa ziganizo za 20 zaumoyo wathanzi, ndi ziwiri zokha zomwe zimalimbikitsa malingaliro ena kupatulapo kugonana komwe kumadzudzula chifukwa cha zochitika zitatu zogonana. Mmodzi wogwira ntchito mu gulu lolamulira anafotokoza kuti zochitika ziwiri zokhudzana ndi kugonana pakati pa kugonana kwa 20 zimapangitsa kunyansidwa ndi kukwiya, pamene wophunzira wina mu gulu lolamulira anawonetsa kuti chithunzi chimodzi chogonana chinadabwitsa. Zithunzi zitatu zogonana zomwe zinapangitsa kuti anthu asamangokhalira kugonana ndizosiyana ndi kusanthula deta.

Wodziimira t-kuwonetseratu kuti palibe kusiyana kwa magulu muzithunzi za valence ndi kudzuka chifukwa cha kugonana [valence: t(43) = 0.14, p> 0.05, a Cohen d = 0.042; kudzutsa: t(43) = 0.30,p> 0.05, a Cohen d = 0.089]. Kuwonjezera apo, chiwerengero cha zokhuza kugonana pakati pa zithunzi za 20 zolaula zomwe zinapangitsa chilakolako cha kugonana sanadabwa kuti gulu la PHB linkalakalaka chilakolako chogonana mobwerezabwereza kuposa gulu lolamulira panthawi yogonanai [t(43) = 3.23, p <0.01, a Cohen d = 0.960]. TIye ali ndi mphamvu zokhudzana ndi kugonana anawonetsa kuti gulu la PHB linakhala ndi chidwi chogonana kwambiri kuposa gulu lolamulira chifukwa cha zithunzi zolimbikitsa kugonana [t(43) = 14.3, p <0.001, a Cohen d = 4.26]. Zotsatira za zofufuza za maganizo zikuwonetsedwa mu Table 2.

Zotsatira za fMRI

Mu gulu la PHB, kuyambitsa kunawonedwa mu bilateral middle/inferior frontal gyri [Brodmann area (BA) 9], cuneus/precuneus (BA 7, 18, ndi 19), striatum, thalamus, ndi cingulate gyri (BA 24 ndi 32) poyankha zolimbikitsa kugonana poyerekeza ndi zolimbikitsa zosagwirizana ndi kugonana. Mu gulu lolamulira, kuyambitsa kunawonetsedwa mu bilateral middle/inferior frontal gyri (BA 9), cuneus/precuneus (BA 7, 18, ndi 19), striatum, thalamus, ndi left cingulate gyrus (BA 24) (corrected False Discovery Rate, p < 0.05).

Mu kusanthula kwa pakati pa gulu, gulu la PHB linawonetsa kutseguka kwakukulu mu dorsal anterior cingulate cortex yakumanja (dACC; BA 24 ndi 32), bilateral thalami, left caudate nucleus, right DLPFC (BA 9, 46), ndi right supramarginal gyrus (BA 40) poyerekeza ndi kutseguka mu gulu lolamulira panthawi yokumana ndi zolimbikitsa zogonana poyerekeza ndi zolimbikitsa zosagonana. Palibe madera a ubongo mu gulu lolamulira omwe adawonetsa kutseguka kwakukulu kuposa gulu la PHB . Ma coordinates onse a ma voxels oyambitsidwa akuwonetsedwa ngati ma coordinates a MNI mu Matebulo 3 , 4. Chithunzi 2 chikuwonetsa kusintha kwa chizindikiro cha peresenti mu magulu olamulira ndi a PHB mu mkhalidwe uliwonse woyesera (ndiko kuti, mikhalidwe yogonana ndi yosagonana) ya ma ROI osankhidwa, ndipo Chithunzi 3 chikuwonetsa mndandanda wa nthawi yapakati pa gulu lililonse la kusintha kwa chizindikiro cha peresenti pa nthawi iliyonse mu ma ROI panthawi yowonetsa zolimbikitsa zogonana (zonse masekondi 12; masekondi 5 ndi 7 pambuyo pake) kutengera zotsatira za kusanthula kwa pakati pa gulu.

Kufufuza kwa mgwirizano wa zigawo zomwe zinali zogwirizana ndi zigawo za SAST-R zinasonyeza kuti thalamus yolondola ndi DLPFC (BA 9) inagwirizana ndi maphunziro a SAST-R (p <0.001, osakonzedwa) mu gulu la PHB panthawi yomwe amakumana ndi zolaula, monga momwe tawonetsera mu Table 4. TZotsatira za kufufuza kwake zasonyeza kuti chizindikiro cha peresenti chinachokera ku thalamus yolondola komanso DLPFC ikugwirizana kwambiri ndi kugonana kwachiwerewere, monga momwe tawonetsera pa Chithunzi 4. Peresentiyo imasintha mu thalamus yolondola ndipo DLPFC yolondola imagwirizana bwino ndi maphunziro a SAST-R mu gulu la PHB pamene akuwonetsedwa ndi zolaula (chabwino thalamus: r = 0.74, n = 23, p <0.01; DLPFC kumanja: r = 0.63, n = 23, p <0.01). Kuphatikiza apo, chiwonetsero cha peresenti chimasinthidwa mu DLPFC yolondola ndi thalamus yakumanja zinali zogwirizana bwino ndi kuchuluka kwa HBI mgulu la PHB (thalamus yolondola: r = 0.65, n = 23, p <0.01; DLPFC kumanja: r = 0.53, n = 23, p <0.01), monga zikuwonetsedwa pa Chithunzi 4.

Kukambirana

Kafukufukuyu adafufuza ngati panali kusiyana pakati pa chilakolako chogonana pakati pa anthu omwe ali ndi PHB ndi olamulira athanzi, ndipo ngati ndi choncho, ngati kusiyana kumeneku kunali kogwirizana ndi kusintha kwa magwiridwe antchito m'mitsempha ya chilakolako chogonana mwa anthu awa. Monga momwe kunanenedweratu, gulu la PHB linawonetsa kuchuluka kwa chilakolako chogonana komanso kusintha kwa magwiridwe antchito m'malo a PFC ndi subcortical poyerekeza ndi olamulira. Zotsatirazi zikusonyeza kuti kusintha kwa magwiridwe antchito m'mitsempha ya mitsempha komwe kumathandizira chilakolako chogonana chomwe chimachokera ku cue kunali kofanana ndi komwe kumayankhidwa ndi kuwonetsedwa kwa cue mwa anthu omwe ali ndi chizolowezi chogwiritsa ntchito mankhwala osokoneza bongo kapena chizolowezi chochita zinthu mopitirira muyeso ( Garavan et al., 2000 ; Tapert et al., 2003 ; Crockford et al., 2005 ; Franklin et al., 2007 ; Ko et al., 2009 ; McClernon et al., 2009 ). Voon et al. (2014) adanenanso za kusintha kwachilendo kwa chilakolako ndi magwiridwe antchito m'madera okhudzana ndi chilakolako chowonjezeka mwa anthu omwe ali ndi khalidwe logonana lokakamiza. Tinabwereza ndikuwonjezera zotsatira izi pofufuza nthawi zomwe zidachitika mkati mwa masekondi 12 onse m'malo okhudzana ndi chilakolako chogonana.

Monga momwe kunanenedweratu, kusanthula kwa zotsatira za kuwunika kwa maganizo kunawonetsa kuti gulu la PHB linkawonetsa chilakolako chogonana chochuluka kuposa gulu lolamulira panthawi yomwe linkakumana ndi chilakolako chogonana, zomwe zinasonyeza kuti gululi linali ndi malire ochepa a chilakolako chogonana . Pamene chilakolako chogonana chinayambitsidwa, gulu la PHB linawonetsa chilakolako chogonana champhamvu kwambiri kuposa gulu lolamulira. Zotsatirazi zinali zogwirizana ndi zomwe zapezeka kale pa anthu omwe ali ndi gulu la PHB ( Laier et al., 2013 ; Laier ndi Brand, 2014 ; Voon et al., 2014 ), makamaka zikusonyeza kuti chilakolako cha zolaula chingakhale ndi gawo lofunika kwambiri pa chizolowezi chogonana pa intaneti.

Zotsatira za ubongo zomwe zimayankha ku zolimbikitsa kugonana zimagwirizana bwino ndi zomwe zapezeka kale pa neuroimaging zomwe zimasonyeza kuti zochita zimachitika m'madera a ubongo omwe amakhudzidwa ndi chilakolako chogonana kapena chilimbikitso/chiyembekezo, komanso kukonda kugonana kapena kudzuka/kutha, pamene onse omwe akutenga nawo mbali akumana ndi chilimbikitso chogonana ( Georgiadis ndi Kringelbach, 2012 ). Zotsatira za kufananiza kwa gulu la zithunzi za ubongo zawonetsa kusintha kwa magwiridwe antchito m'madera akumanja a DLPFC (BA 9) ndi subcortical, kuphatikiza dACC yakumanja (BA 24 ndi 32), nucleus ya caudate yakumanzere, gyrus yakumanja ya supramarginal (BA 40), ndi thalamus yakumanja, ndipo kusinthaku kungagwirizane ndi makhalidwe a gulu la PHB. Kuphatikiza pa kuyambitsa ubongo, tinayang'ana mndandanda wa nthawi wa mayankho a hemodynamic m'madera awa panthawi komanso pambuyo pa kudzuka kwa chilakolako chogonana m'madera awa.

Pakati pa madera awa, nucleus ya caudate yakumanzere ndi ACC yakumanja (BA 24 ndi 32) ndi DLPFC yakumanja zimaganiziridwa kuti zimagwirizanitsidwa ndi gawo lolimbikitsa chilakolako chogonana. Kuphatikizidwa kwa nucleus ya caudate mu chilimbikitso ndi kukonza mphotho kungayambitse yankho lake ku zolimbikitsa zogonana ( Delgado, 2007 ). Dorsal striatum imayatsidwa panthawi yoyembekezera mphotho ( Delgado, 2007 ), zomwe mwina zimasonyeza chikhumbo chomwe chimagwirizana ndi kuyembekezera kotere. Mu kafukufuku wa mayankho a mitsempha okhudzana ndi kugwiritsa ntchito zolaula, kuyambitsa pafupipafupi chifukwa cha kuwonetsedwa kwa zolaula kungayambitse kufooka ndi kuchepa kwa striatum, kuphatikiza nucleus ya caudate, mu zowongolera zathanzi ( Kühn ndi Gallinat, 2014 ). Komabe, mu kafukufuku wapano, kuyambitsa kwakukulu kunawonedwa mu nucleus ya caudate mu gulu la PHB, ngakhale gulu la PHB linkaonera zolaula pafupipafupi . Kusiyana kumeneku pakati pa zotsatira za kafukufukuyu ndi za Kühn ndi Gallinat (2014) kungafotokozedwe ndi kusiyana kwa ophunzira. Izi zikutanthauza kuti, mosiyana ndi kugwiritsa ntchito amuna athanzi mu kafukufuku wakale, kafukufuku wathu adachitika pa anthu omwe ali ndi PHB. Umboni wochuluka ukusonyeza kuti caudate nucleus ndi yofunika kwambiri pakuphunzira chizolowezi cholimbikitsa komanso kusunga khalidwe loledzera ( Vanderschuren ndi Everitt, 2005 ). Kuyambitsa caudate nucleus mu kafukufukuyu kungasonyeze kuti kugonana kwa cue-reactivity kumakhazikitsidwa pambuyo pokumana ndi zochitika zogonana mobwerezabwereza.

DACC imadziwika kuti ikugwirizana ndi njira zokhuza kugonana (Redouté et al., 2000; Arnow et al., 2002; Hamann et al., 2004; Ferretti et al., 2005; Ponseti et al., 2006; Paulo ndi al., 2008). Zomwe taphunzira za kuyambitsa dACC zimasonyeza kuti zimakhudza chilakolako cha kugonana, ndipo zotsatirazi zinali zofanana ndi zomwe zaphunzira pa zofuna zokhudzana ndi chilakolako chokhudzana ndi chilakolako pazochitika zokhudzana ndi chiwerewere (Voon et al., 2014). Kuwonjezera pamenepo, dACC imadziwika kuti ndi yofunikira pa kukonza koyambirira kwa khalidwe lokhazikitsa malingaliro poyang'anira kutsutsana pakati pa chilakolako cha khalidwe ndi kusokoneza chilakolakochi (Devinsky et al., 1995; Arnow et al., 2002;Karama et al., 2002; Moulier et al., 2006; Safron et al., 2007). Neuroanatomically, dACC imapanga ntchito ku DLPFC ndi parietal lobe (Devinsky et al., 1995; Pizzagalli et al., 2001). Mu phunziro lino, kukambitsirana mu dACC mu gulu la PHB kungasonyeze mkangano wamkati pakati pa chilakolako chofotokozera zofuna za kugonana monga zochita komanso chilakolako choletsa zifukwa chifukwa cha zochitika zogonana.

Kuyambitsa kwa gyrus ya supramarginal kumagwirizanitsidwa ndi chidwi chowonjezeka ku zolinga zomwe zimawonedwa ngati zizindikiro zogonana ( Redouté et al., 2000 ; Stoléru et al., 2012 ). Kafukufuku wakale wanena kuti chidwi chowonjezeka ku zolimbikitsa kugonana chimagwira ntchito yofunika kwambiri pakusunga chilakolako chogonana ( Barlow, 1986 ; Janssen ndi Everaerd, 1993 ) ndipo chikugwirizana ndi kufunafuna chilakolako chogonana ( Kagerer et al., 2014 ). Mu kafukufuku wapano, kuyambitsa kwa supramarginal kungawonetse chidwi chachikulu chomwe anthu a PHB adapereka ku zolimbikitsa zogonana ndipo zomwe zingayambitse chilakolako chogonana chokwera poyerekeza ndi gulu lolamulira.

Pakati pa madera omwe adayambitsidwa kwambiri pakati pa zotsatira za magulu, DLPFC ndi thalamus zidagwirizana mwachindunji ndi kuopsa kwa chizolowezi chogonana mwa anthu omwe ali ndi PHB. Tinawona kuyambitsidwa kwakukulu kwa thalamus, komwe kunali kogwirizana ndi zomwe zidapezeka kale pa kafukufuku wokhudza chilakolako chogonana ( Redouté et al., 2000 ; Moulier et al., 2006 ). Malinga ndi kafukufuku wakale pa chilakolako chogonana, kuyambitsidwa kwa thalamus kumagwirizana ndi mayankho a thupi (monga, kukonzekera kuchita zogonana) omwe amayambitsidwa ndi chilakolako chogonana ndipo amagwirizana bwino ndi kukhazikika kwa mbolo ( MacLean ndi Ploog, 1962 ; Redouté et al., 2000 ; Moulier et al., 2006 ). Chochititsa chidwi n'chakuti, tapezanso mawonekedwe apamwamba komanso otakata a hemodynamic mu thalamus poyerekeza ndi omwe ali mu zowongolera. Kuyankha kwakukulu komanso kotakata kwa hemodynamic kungasonyeze kuti chilakolako chogonana chinali champhamvu komanso chokhalitsa mwa anthu omwe ali ndi PHB.

Mofanana ndi zomwe zapezeka mu kafukufuku wokhudza ntchito ya mitsempha mwa anthu omwe ali ndi chizolowezi chogwiritsa ntchito mankhwala osokoneza bongo panthawi ya chilakolako choyambitsidwa ndi cue, tapeza kusintha kwa ntchito ya PFC mu gulu la PHB. PFC imagwira ntchito yofunika kwambiri pakukonza mtsogolo ndi kukumbukira ntchito ( Bonson et al., 2002 ). Mu Neuroanatomically, PFC imalumikizidwa kumadera osiyanasiyana, kuphatikiza dACC, caudate nucleus, ndi parietal lobe ( Devinsky et al., 1995 ; Pizzagalli et al., 2001 ; Goldman-Rakic ​​ndi Leung, 2002 ). Kafukufuku wakale wokhudza chizolowezi wasonyeza kuti kusagwira ntchito bwino kwa netiweki iyi, kuphatikiza PFC, kukugwirizana ndi kayendetsedwe ka PFC ka madera opereka mphotho ya limbic komanso kutenga nawo mbali mu ntchito yapamwamba, kuphatikiza kudziletsa, kupatsa mphamvu anthu, ndi kuzindikira ( Goldman-Rakic ​​ndi Leung, 2002 ; Feil et al., 2010 ; Goldstein ndi Volkow, 2011 ; Kühn ndi Gallinat, 2014 ). Makamaka, maphunzirowa apeza kuti ntchito ya DLPFC yosokonezeka ndi yofooka mu luso la kuzindikira, zomwe zimapangitsa zizindikiro, monga kuwonjezeka kwa chidwi cha chinthu choledzeretsa monga momwe zilili ndi zinthu ndi makhalidwe osokoneza bongo komanso kuchepa kwa chidwi cha zinthu zabwino zomwe zimapindulitsa ( Goldman-Rakic ​​ndi Leung, 2002 ; Goldstein ndi Volkow, 2011 ). Mu kafukufuku waposachedwa, kuwona kwa DLPFC yogwira ntchito kwambiri mu gulu la PHB poyerekeza ndi gulu lolamulira kungasonyeze kufunikira kwakukulu kwa luso la kugonana.

Mwachidule, gulu la PHB linasonyeza chilakolako chachikulu chogonana chomwe chinkagwirizana ndi kusintha kwa ntchito ya ubongo. Zomwe zapezekazi zikusonyeza kuti gulu la PHB likhoza kuyang'anitsitsa kwambiri zolimbikitsa kugonana ndipo likhoza kukhala ndi yankho lokha chifukwa yankho lokhazikika ku zolimbikitsa kugonana silingathe kuthandizidwa bwino. Zolepheretsa za kafukufukuyu zinali motere. Choyamba, mtundu wa anthu omwe adafunsidwawo unali wa ku Asia. Chachiwiri, kafukufukuyu anali okhudza amuna okhaokha, ndipo maphunziro amtsogolo okhudza akazi ndi amuna ogonana amuna kapena akazi okhaokha ayenera kukhala othandiza kumvetsetsa bwino PHB. Anthu omwe ali ndi matenda amisala omwe amabwera limodzi sanalembetsedwe mu kafukufukuyu, motero kuonetsetsa kuti kafukufuku wa matenda a mitsempha akuchitika pogwiritsa ntchito PHB yokha. Komabe, malinga ndi kafukufuku wa Weiss (2004) , 28% ya amuna omwe ali ndi PHB amavutika ndi matenda aakulu a maganizo. Kutenga zinthuzi pamodzi kumachepetsa kuthekera kwa zotsatira za kafukufukuyu kwa anthu onse padziko lonse lapansi. Pomaliza, magulu awiriwa mwina adasiyana pankhani yodzidziwitsa okha komanso/kapena kukhudzidwa ndi malingaliro chifukwa cha chithandizo cha omwe adatenga nawo mbali pa PHB. Tinayesa kuchepetsa kusiyana pakati pa magulu olamulira ndi magulu a PHB pogwirizanitsa zinthu zofunika kwambiri za anthu, kuphatikizapo zaka, maphunziro, ndi momwe munthu alili, kuti tiyerekezere komanso kugwiritsa ntchito njira zoletsa anthu, monga kukhalapo kwa matenda amisala komanso kugwiritsa ntchito mankhwala amisala, m'magulu onse awiri. Kenako, tikukonzekera kufufuza momwe zinthu zomwe zimagwirizana ndi nthawi ya chithandizo kapena mtundu wa chithandizo zimakhudzira mayankho amalingaliro, kuphatikizapo mayankho ku zizindikiro zogonana, za anthu omwe ali ndi PHB.

Ngakhale zolepheretsa izi, zotsatira za phunziroli zimapereka zothandiza kwambiri ku mabukuwa ndipo zimakhudza kwambiri pa kafukufuku wamtsogolo. Tinazindikiranso zigawo zina za ubongo zomwe zimagwirizana ndi chilakolako cha kugonana ndi kusintha kwa nyengo pazochitika za madera amenewa pakati pa maphunziro ndi PHB. Monga momwe phunziro la ubongo limagwiritsira ntchito zovuta ndi khalidwe lachizoloŵezi, PHB yokhudzana ndi kusintha kwa ntchito mu PFC ndi malo osagwirizana, ngakhale popanda mankhwala ozunguza bongo. Zotsatira zathu zimakhala zothandiza pofotokozera makhalidwe ndi njira zogwirizana ndi njira zapamwamba za anthu omwe ali ndi PHB, ndikuyendetsanso magawo opitirira mafotokozedwe monga momwe zinaliri m'maphunziro apitalo.

ndalama

Ntchitoyi inathandizidwa ndi Korea Basic Science Institute (No. E35600) ndi kafukufuku wa 2014 Chungnam National University.

Kutsutsana kwa Chidwi

Olembawo akunena kuti kufufuza kunkachitika popanda mgwirizano uliwonse wa zamalonda kapena zachuma zomwe zingatengedwe kuti zingatheke kukangana.

Kuvomereza

Olembawo akufuna kuthokoza Korea Basic Science Institute kuti alole phunziroli kuti lichitike ku Dipatimenti ya Human Imaging Center pogwiritsa ntchito 3T MRI scanner (Phillips).

Zowonjezera Zowonjezera

Nkhani Zowonjezera za nkhaniyi zikupezeka pa intaneti pa: http://journal.frontiersin.org/article/10.3389/fnbeh.2015.00321

Zothandizira