Khalidwe lachiwerewere loperekera: Prefrontal ndi limbic volume ndi kugwirizana (2016)

Tengani.JPG

MAFUNSO: Pomwe kafukufukuyu amagwiritsa ntchito mawu oti "Khalidwe Lokakamiza Kugonana (CSB)," omverawo anali osokoneza bongo (onani kusindikizidwa uku). Poyerekeza ndi kulamulira bwino CSB nkhani zawonjezeka zotsalira za amygdala ndi kuchepetsa kugwirizanitsa ntchito panthawi yopumulira pakati pa amygdala kumanzere ndi DLPFC. Olemba analemba kuti:

Zomwe tikupeza panopa zikuwunikira zowonjezereka mu dera lomwe likukhudzidwa ndi zolimbikitsana komanso zochepetsetsa zovomerezeka zogwirizana ndi makampani oyendetsa olamulira omwe ali pamwamba. Kusokonezeka kwa malo oterewa kungathe kufotokozera njira zowonongeka zomwe zimapangitsa kuti phindu lachilengedwe likhale lopanda malipiro kapena kuti zikhale zovuta kuti zikhale zolimbikitsa. Ngakhale kuti zovuta zathu zokhudzana ndi zovuta zogwirizana ndi zomwe zili ndi vuto la mankhwala osokoneza bongo (SUD), zotsatirazi zikhoza kusonyeza kusiyana pakati pa mankhwala omwe amayamba chifukwa cha mankhwala osokoneza bongo.

Kusintha kwa #1): "Kulumikizana kochepa pakati pa amygdala & dorsolateral prefrontal cortex." Amygdala amatenga gawo lofunikira pakukonzekera kutengeka, kuphatikiza poyankha kupsinjika. Amygdala imakhudzidwa kwambiri ndi zinthu zambiri monga zizolowezi, kulakalaka kuyambiranso komanso zizindikiritso zakutha. Kuchepetsa kulumikizana kwantchito pakati pa amygdala ndi preortalal cortex yolumikizana ndi zosokoneza bongo. Amaganiziridwa kuti kulumikizana kosauka kumachepetsa mphamvu ya preortalal cortex pazomwe wogwiritsa ntchito akuchita zosokoneza.

Kusintha kwa #2): "Kuchuluka kwa amygdala voliyumu" (zomwe zikutanthauza kuti imvi yambiri). Kafukufuku wambiri wogwiritsa ntchito mankhwala osokoneza bongo amafotokoza za amygdalae wocheperako (zosamveka pang'ono). Kafukufukuyu akuwonetsa kuti kuwopsa kwa mankhwala osokoneza bongo kumatha kubweretsa kuzinthu zochepa ndipo motero kumachepetsa amygdala voliyumu ya omwe amamwa mankhwala osokoneza bongo. Mosakayikira izi zimathandiza. Tiyenera kudziwa kuti amygdala imagwiranso ntchito nthawi zonse pakuwonera zolaula, makamaka mukamayamba kugonana. Mwachitsanzo, kudina kuchokera pa tabu kupita pa tabu kapena kufunafuna kanema kapena chithunzi kumatha kuyatsa amygdala. Mwina nthawi zonse kugonana Zosangalatsa komanso kufufuza ndi kufunafuna zimapangitsa kuti amygdala azitha kugwiritsira ntchito zolaula.

Mafotokozedwe amodzi kwa amygdala ochuluka kwambiri owonetsa zolaula: Zaka zambiri zakugwiritsa ntchito zolaula zitha kukhala zopanikiza. Komanso, nkhani za CSB sizinali zolaula zokha; adakumananso ndi zovuta zoyipa chifukwa chogwiritsa ntchito zolaula (kutaya ntchito, mavuto amgwirizano, kukula kwa zolaula zopangitsa ED). Nayi mfundo yofunika: Kusokonezeka maganizo pakati pa anthu ndi chikhalidwe cha amygdala:

Ngakhale kuti njira zenizeni za pulasitiki sizinamvetsetse bwino, Zikuoneka kuti kulemera kwapanikizika kwambiri kumawonjezeka m'madera ambiri a amygdala, koma zotsatira za hippocampus ndi kortteal cortex zimakhala zosiyana.

Timaganizira zapamwambazi popeza izi Kafukufuku wa 2015 yemwe adapeza kuti "ogonana" ali ndi cholumikizira cha HPA chosakhazikika (kusokoneza maganizo kwambiri). Kodi kupanikizika kosalekeza kamene kanakhudzana ndi kuwononga zolaula / kugonana, pamodzi ndi zinthu zomwe zimapangitsa kugonana mosiyana, zimayambitsa amygdala volume? Potsirizira pake, kuchepa kwa amygdala pangakhale chikhalidwe choyambirira chakumwa moledzeretsa, monga ana m'mabanja omwe ali ndi chiopsezo chachikulu chauchidakwa ali ndi amygdalae ang'onoang'ono.

LINKANI Phunziro LOPHUNZITSIRA

Casper Schmidt,1,2,3 Laurel S. Morris,1,4 Timo L. Kvamme,1,2,3 Paula Hall,5 Thaddeus Birchard,5 ndi Valerie Onani1,4,6 *

Mapu a Ubongo Waumunthu

Olemba adanena kuti alibe kutsutsana kwa zofunikanso.

Kudalirika

Background

Zizoloŵezi zakugonana (CSB) zimakhala zofala ndipo zimagwirizanitsidwa ndi zovuta kwambiri zaumunthu komanso zachikhalidwe. Zomwe zimayambitsa matenda a ubongo sizikumveka bwino. Kafukufuku wamakono akufufuza mavoti a ubongo ndi kupuma kwachangu ku CSB poyerekezera ndi odzipereka odzipereka (HV).

Njira

Dongosolo lachidule la MRI (MPRAGE) linasonkhanitsidwa mu maphunziro a 92 (23 CSB amuna ndi 69 omwe amafanana ndi a HV malemu a zaka) ndipo amalingalira pogwiritsa ntchito voxel-based morphometry. Kupuma kwa ntchito kumagwiritsidwe ntchito ka MRI pogwiritsa ntchito njira zamakono zowonongeka ndi kufufuza zida zodziimira (ME-ICA) zinasonkhanitsidwa mu maphunziro a 68 (maphunziro a 23 CSB ndi a 45 a zaka zofanana).

Results

Masewera a CSB awonetsa zazikulu zamanzere amygdala grey matter volumes (kamvedwe kamene kamakonzedwa, Bonferroni inasinthidwa P <0.01) ndikuchepetsa kupumula kwa magwiridwe antchito pakati pa mbewu yakumanzere ya amygdala ndi mayiko awiri am'mbali yam'mbali yam'mbali (ubongo wonse, masango adakonza FWE P <0.05) poyerekeza ndi HV.

Mawuwo

CSB imagwirizanitsidwa ndi mipukutu yapamwamba m'zigawo zamagulu zomwe zikukhudzana ndi kuchititsa chidwi ndi kukakamizika, komanso kusagwirizana kwapakati pa malo oyendetsa malo omwe amachititsa kuti zisamayende bwino. Kafukufuku wamtsogolo ayenera kutsata kuyesa miyeso yaitali kuti afufuze ngati zofukufukuzi ndizifukwa zoopsa zomwe zisanachitike zoyamba za khalidwe kapena zotsatira za makhalidwe.

achidule

  • Kachipangizo kamene kali ndi kaloti
  • CSB
  • CSF cerebrospinal fluid
  • DLPFC dorsolateral prefrontal cortex
  • Mutu wamtundu wa GM
  • Mtundu waukulu wa GLM
  • HV odzipereka wathanzi
  • MPRAGE magnetti okonzedwa bwino
  • OFC orbitofrontal cortex
  • ROI dera la chidwi
  • Mapulogalamu a SPM Achidule Mapamenti
  • Nthawi yobwereza
  • TIYENANI nthawi
  • VBM voxel-based morphometry
  • Nkhani yoyera ya WM.

MAU OYAMBA

Chizolowezi chogonana (CSB), chomwe chimadziwikanso kuti matenda a hypersexual kapena chizolowezi chogonana, n'chofala (chiwerengero cha 3% -6%) [Kraus et al., 2016] komanso kugwirizanitsa ndi zovuta kwambiri ndi zovuta za maganizo, kuphatikizapo kukhala ndi chilakolako, kukhudzidwa, komanso kuvutika kwa chikhalidwe ndi ntchito [Kraus et al., 2016]. Kafukufuku waposachedwa wagwiritsa ntchito kumvetsetsa koyambitsa matenda a neurobiological correlates [Kraus et al., 2016] ngakhale kuti maphunziro osakhala bwino amachepetsa kumvetsa kwathu za njira zowonongeka ndi momwe tingaganizire zovuta izi. CSB yakhala ikuyendetsedwa ngati vuto lachidziwitso chodziletsa kapena khalidwe loipa [Kraus et al., 2016]. Komabe, ngakhale zoyenera za matenda okhudza kugonana kwa hypersexual zinakonzedweratu kwa DSM-5 ndipo zatsimikiziridwa mu zoyesayesa zam'munda [Reid et al., 2012], matendawa pamodzi ndi kugwiritsa ntchito intaneti kapena masewera a pakompyuta, sanaphatikizidwe mu gawo lalikulu la DSM-5, mbali imodzi chifukwa cha kuchepa kwa deta. Motero, kufufuza kwina ku CSB n'kofunika kuti tiwone bwino za mavutowa. Ngakhale CSB ikhoza kukhala ndi makhalidwe osiyanasiyana, apa tikuganizira za gulu lalikulu lomwe limabweretsa mavuto aakulu ndi kugwiritsira ntchito zolaula. Tagwiritsira ntchito CSB pa lingaliro lakuti "kukakamiza" kumalongosola zochitika zodzibwerezabwereza ndipo sikutanthauza kutanthauzira kulikonse komwe kumagwirizana kapena kulingalira.

Tinawerenga mabukuwa pa zizoloŵezi za khalidwe logwiritsa ntchito voxel-based morphometry (VBM) kapena cortical thickness. Tagwiritsa ntchito mawu otsatirawa pa PubMed (http://www.ncbi.nlm.nih.gov/pubmed): '[("Voxel-based morphometry" kapena "cortical thickness") ndi],' yotsatiridwa ndi "[kutchova njuga]," "[kugwiritsa ntchito intaneti]," "[intaneti]," "," kapena " [kuledzera]. ” Pazonse, maphunziro a 13 anapezeka mkati mwa zizolowezi zokhudzana ndi kutchova juga, kugwiritsa ntchito intaneti, kapena masewera amakanema omwe amayesa VBM kapena cortical thickness. Kuwunikiridwa kwa zolembedwazo kukufotokozedwa mu Table 1 ndi kukambirana pansipa.

Gulu 1. Kuwerengera zolemba za volumetric ndi cortical makulidwe pamaphunziro azikhalidwe

Title

Khalidwe labwino

Zida (P / HV)

Lingani

Zigawo zimakhudzidwa

  1. Mamasulidwe: HV, odzipereka wathanzi; P, odwala; r, kulondola; l, kumanzere; bl; GM, nkhani yakuda; WM, nkhani yoyera; ACC, antenior cingulate cortex; CB, cerebellum; CG, kuwonetsa gyrus; CN, nucleus yochuluka; DLPFC; HIPP, hippocampus; IC; IFG, grey yonyansa; IPC, chochepa cha parietal cortex; ITG, gyrus yochepa ya nyengo; LING, lingual gyrus; LOFC, ofananira ndi oralofrontal cortex; MFC, pakati pamtunda; MOFC, kapangidwe ka orbitofrontal cortex; MTG, gyrus yapakatikati; OFC, orbitofrontal cortex; PCC; PCG, gyrus yapakati; PCUN, precuneus; PrCG, gyrus yoyamba; PFC, korona yoyendera; PHG, parahippocampal gyrus; RACC, rostral anterior cingulate cortex; RMFC, khola lopakatikati pambali; SFC, yamtundu wapamwamba wa cortex; SMA, malo owonjezera othandizira; SPC, kaperesi wamtengo wapatali; VS, ventral striatum.
[Grant ndi al., 2015]Kutchova njuga16/17Cortical thicknessKuchepetsa kukula kwa cortical mu r-SFC, RMFC, MOFC, PCG ndi bl-IPC
[Joutsa et al., 2011]Kutchova njuga12/12Voxel-based morphometryKusiyana kwakukulu kwa GM kapena WM pakati pa HV ndi odwala
[Koehler et al., 2013]Kutchova njuga20/21Voxel-based morphometryKuwonjezeka kwa buku la GM mu bl-VS ndi r-PFC
[van Holst et al., 2012]Vuto lakutchova njuga40/54Voxel-based morphometryKusiyana kwakukulu kwa GM kapena WM pakati pa anthu otchova njuga ndi HV
[Hong et al., 2013]Kugwiritsa ntchito Intaneti15/15Cortical thicknessKuchepetsa kukula kwa cortical mu r-LOFC
[Yuan et al., 2011]Kugwiritsa ntchito Intaneti18/18Voxel-based morphometryKuchuluka kwa mphamvu ya GM ku DLPFC, SMA, OFC, CB, RACC
[Zhou et al., 2011]Kugwiritsa ntchito Intaneti15/18Voxel-based morphometryKuchulukitsitsa kwa GM mu l-ACC, PCC, IC, LING
[Lin et al., 2014]Kugonjetsa maseŵera a pa intaneti35/36Voxel-based morphometryKuchuluka kwa mphamvu za GM mu IFG, L-CG, IC, ndi r-HIPP                  

Kuchuluka kwa mphamvu ya WM ku IFG, IC, IPC, ACC

[Sun et al., 2014]Kugonjetsa maseŵera a pa intaneti18/21Voxel-based morphometryKuwonjezeka kwa buku la GM mu r-ITG, MTG, PHG                  

Kuchepetsa mphamvu ya GM mu l-PrCG

[Wang et al., 2015]Matenda a pa Intaneti28/28Voxel-based morphometryKuchepetsa mphamvu ya GM mu ACC, PCUN, SMA, SPC, ndi L-DLPFC, IC, CB
[Cai et al., 2015]Matenda a pa Intaneti27/30Vuto losawerengeka, FreeSurferZowonjezera za CN ndi VS
[Weng et al., 2013]Kusewera kwa masewera a pa Intaneti17/17Voxel-based morphometryKuchuluka kwa mphamvu ya GM mu r-OFC, SMA ndi bl-IC
[Yuan et al., 2013]Kusewera kwa masewera a pa Intaneti18/18Cortical thicknessKuwonjezeka kwa cortical mu l-PrCG, PCUN, MFC, ITG, MTG                  

Kuchepetsa kukula kwa cortical mu l-LOFC, IC, r-PCG, IPC

Kuzindikira kwa kusokonezeka kwa neural m'zoledzeretsa kumachokera ku maphunziro a vuto la kugwiritsira ntchito mankhwala (SUD). Anthu omwe ali ndi SUD amasonyeza kuchepa kwa ma cortical ubongo ndi makulidwe makamaka m'madera operesal cortical omwe amachititsa kuti anthu azikhala ndi makhalidwe abwino. Kusanthula kwaposachedwapa kwa maphunziro a 9 ndi anthu oledzera a 296 omwe adapezapo mwapang'onopang'ono kwambiri (GM), kuphatikizapo makina amtundu wambiri (ACC) [Xiao et al., 2015], ali ndi mavoti oyandikana nawo omwe amagwiritsidwa ntchito mosagwiritsidwa ntchito mopitirira muyeso [Taki et al., 2006]. Mitundu ya Prefrontal GM inachepetsedwa mofanana ndi anthu omwe amadalira cocaine, kuphatikizapo orbitofrontal cortex (OFC) [Rando et al., 2013; Tanabe et al., 2009], anterior prefrontal cortex [Rando et al., 2013] ndi ACC [Connolly et al., 2013], omalizawa amagwirizanitsa ndi zaka zamagwiritsa ntchito mankhwala [Connolly et al., 2013].

Kusiyana kwa magulu m'magulu ndi kulemera kwake sikukhala kosavuta m'zochita zowonongeka (zowonongeka mu Table 1). Kafukufuku katatu wa kutchova njuga anasonyeza kusagwirizana kumeneku ndi kuchepa kwa cortical m'madera ambiri omwe amachititsa kuti anthu azikonda komanso kutaya njuga [Grant et al., 2015], kuchulukanso kwambiri mu correx yolondola yoyendera [Koehler et al., 2013] kapena palibe kusiyana kwa gulu [Joutsa et al., 2011]. Pofufuza kwambiri anthu ochepetsera juga ochepa kwambiri, palibe kusiyana kwa gulu komwe kunawonedwa m'mabuku a ubongo [van Holst et al., 2012]. Phunziro limodzi laling'ono pa chiwembu cha intaneti linasonyeza kuchepa kwa cortical mu OFC [Hong et al., 2013], ndi lipoti lina lochepetsera malipoti mu dorsolateral prefrontal cortex (DLPFC) [Yuan et al., 2011] ndi maphunziro awiri omwe akusonyeza kuti m'munsimu mabuku angapo [Yuan et al., 2011; Zhou et al., 2011]. Maphunziro aang'ono aŵiri m'maseŵera a masewera a intaneti adalengeza kuti kuchepa kwa volume ku OFC [Weng et al., 2013; Yuan et al., 2013], komanso maphunziro awiri akuluakulu amalemba mabuku ang'onoang'ono m'kakisikiti [Lin et al., 2014; Wang et al., 2015] ndi maphunziro osakwatiwa malipoti amachepetsedwa mu DLPFC [Wang et al., 2015], otsika patsogolo [Lin et al., 2014], wapamwamba kwambiri [Wang et al., 2015] komanso parietal yochepa [Yuan et al., 2013] ma cortices. Ponena za nyumba zochepa, phunziro limodzi laling'ono linatchula zapamwamba zowonjezera za ventral (VS) mu vuto lakutchova njuga [Koehler et al., 2013] popanda zosiyana zotsutsana zomwe zafotokozedwa mu maphunziro ena. Kusewera kwa masewera a intaneti, zofukufukuzo zinali zosagwirizana ndi parahippocampal yaikulu [Sun et al., 2014], hippocampal wotsika [Lin et al., 2014] kapena kusiyana [Wang et al., 2015; Weng et al., 2013]. Kafukufuku wina ndi kukula kwakukulu kwazithunzi zomwe zimagwiritsidwa ntchito pamabuku amodzimodzi amasonyeza kuti pali zambiri zomwe zimachitika ndi VS zokhudzana ndi chidziwitso chodziletsa (Cai et al., 2015]. Kuphatikizidwa pamodzi, zotsatira za zovuta zowononga njuga kapena zogonjetsa zimakhala zosagwirizana kwambiri. Mosiyana ndi zimenezi, malipoti okhudza kugwiritsidwa ntchito kwa intaneti kapena kugwiritsa ntchito intaneti nthawi zambiri amatsitsa mavoliyumu omwe amachepetsa ndi kuchepa kwa ACC ndi OFC kuwerengedwa mobwerezabwereza ku maphunziro awiri.

Mpaka lero, pali umboni wochepa wa kusintha kwasintha kwa anthu omwe ali ndi CSB. Kafukufuku wa anthu abwino omwe ali ndi zolaula zosaonongeka sagwiritsiridwa ntchito ndi CSB kuwonetsa ma volume ochepa a GM pamlingo woyenera [Kühn ndi Gallinat, 2014]. Kufufuza kochepa kwa MRI kwa anthu omwe ali ndi CSB (N = 8 pagulu lirilonse) adawonetsa kuchepa kwamatenda am'mapepala oyera oyera amaso oyang'ana kutsogolo (WM) poyerekeza ndi HV [Miner et al., 2009]. Ponena za ntchito zothandizira, mawonedwe a abambo a HV amathandizira machitidwe ozoloŵera kachitidwe kachitidwe cholowera kumanzere ku BOLD chochita ku zithunzi zolimbitsa thupi [Kühn ndi Gallinat, 2014] komanso kuchepetsa mwayi wotha kuwonetsa zithunzi [Prause et al., 2015]. Mosiyana ndi zimenezi, mu zolemba za FMRI zomwe zimagwirizanitsa CSB ndi HV, mafilimu owonetsa zachiwerewere amachititsa apamwamba VS, amygdala ndi mayankho a ACC BOLD ku CSB [Voon et al., 2014]. Kugwirizanitsa ntchito pakati pa zigawo izi zogwirizana ndi ndondomeko ya chilakolako cha kugonana kapena "kufuna" koma osati "kukonda" muzochitika za CSB zomwe zimasonyeza kuti ntchito yolimbikitsa ndi yolimbikitsa, yofanana ndi mankhwala osokoneza bongo. Mofananamo, mu phunziro lina pa zolaula zolaula pa intaneti, chilakolako chogonana chogonana chinagwirizanitsidwa ndi ntchito yayikulu yowonongeka ndi kugwirizanitsa ndi zizindikiro zowononga zolaula zolaula osati ndi njira zina zogonana kapena kuvutika maganizo [Brand et al., 2016]. Kafukufuku wina waposachedwapa akuwonetsanso kuti anthu omwe ali ndi vuto la chiwerewere amakhala ndi chilakolako chogonana nthawi zambiri pamene akugonjetsedwa ndi chilakolako chogonana, komanso kuti kuwonetsetsa kwakukulu kunkachitika pang'onopang'ono, kutsika kwapakati, kutsika, ndi DLPFC mu gulu ili [Seok ndi Sohn, 2015]. Anthu a CSB amasonyezanso chidwi choyambirira chosonyeza kugonana kwachinyengo [Mechelmans et al., 2014] zomwe zimagwirizana ndi zosankha zabwino zomwe zimagwiritsidwa ntchito kuzinthu zogonana [Banca et al., 2016]. Poyankha kuwonetseratu zochitika zowonongeka, masewera a CSB anasonyezeratu chizoloŵezi choyambira mu ACC chosokoneza chiwerewere, chomwe chimagwirizana ndi zokonda zazithunzi za kugonana [Banca et al., 2016], zotsatira zomwe zikhoza kufotokozedwa ndi kachitidwe kokha koma zingakhalenso zogwirizana ndi lingaliro la kulekerera ku zizolowezi zoledzeretsa.

Kafukufuku wamakono akufufuza GM volumetric mu CSB ndikuwerenganso mabuku omwe alipo panopa pamaphunziro olemera a njuga ndi intaneti ndi masewera ogwiritsira ntchito masewera. Timayang'ananso ntchito yothandizira anthu omwe ali ndi CSB ndi ofanana ndi HV ndi dongosolo lokhazikitsa maulendo osiyanasiyana (ME-ICA) momwe zizindikiro za BOLD zimadziwika ngati zida zokhazikika zomwe zimakhala ndi kusintha kwa chizindikiro cha TE). pamene zizindikiro zopanda BOLD zimadziwika ngati zida zodziimira TE [Kundu et al., 2012]. Tikuyembekeza kusokoneza makina okhwima ndi okhudzana ndi malipiro omwe amasungidwa ndi amygdala, VS ndi dorsal ACC.

NJIRA

ophunzira

Nkhani za CSB zidatumizidwa kudzera pa malonda ochokera ku intaneti komanso kuchokera kwa otsogolera. HV yamwamuna wofanana ndi zaka zokalamba analembedwanso kuchokera kumalonda a m'madera a East Anglia. Masewera onse a CSB anafunsidwa ndi katswiri wa zamaganizo kuti atsimikizire kuti zida zogwira ntchito za CSB (zokhudzana ndi matenda a hypersexual (Kafka, 2010; Reid et al., 2012] ndi chizolowezi chogonana [Carnes et al., 2007], ndikuwongolera kugwiritsira ntchito zinthu zolaula pa Intaneti. Izi zinayesedwa pogwiritsira ntchito kusintha kwa Arizona Sexual Experiences Scale (ASES) [Mcgahuey et al., 2011], pomwe mafunso adayankhidwa pamlingo wa 1-8, ndi maiko apamwamba omwe akuyimira kufooketsa kwakukulu. Chifukwa cha mtundu wa cues, maphunziro onse a CSB ndi HV anali amphongo komanso amodzi. Onse a HV anali okalamba (± 5 a zaka zapakati) ndi maphunziro a CSB. Zolinga zinawonetsedwanso kuti zikhale zofanana ndi zochitika za MRI monga momwe tachita kale [Banca et al., 2016; Mechelmans et al., 2014; Voon et al., 2014]. Njira zosafuna kuphatikizapo kukhala pansi pa zaka za 18, kukhala ndi mbiri ya SUD, kukhala wosagwiritsa ntchito nthawi zonse zinthu zopanda pake (kuphatikizapo khansa), komanso kukhala ndi matenda aakulu a maganizo, kuphatikizapo vuto lalikulu lomwe limakhalapo kwambiri kapena vuto lalikulu lopanikizika, kapena mbiri ya matenda ochititsa munthu kusinthasintha zolaula kapena schizophrenia (owonetsedwa pogwiritsa ntchito Mini International Neuropsychiatric Inventory) [Sheehan et al., 1998]. Zoledzeretsa zina kapena zosokoneza khalidwe ndizinso zofunikira. Ophunzira amamuyesa kafukufuku wogwiritsa ntchito masewera a pa Intaneti kapena masewera olimbitsa thupi, kutchova njuga kapenanso kugula zinthu zovuta, ubwana kapena akuluakulu odwala matenda osokoneza bongo, komanso matenda opatsirana pogonana. Ophunzira anamaliza UPPS-P Impulsive Behavior Scale [Whiteside ndi Lynam, 2001] kuti aone kusagwirizana, ndi Beck Depression Inventory [Beck et al., 1961] kuti aone kuvutika maganizo. Mitu iwiri ya 23 CSB inali kudwala matenda opatsirana pogonana kapena inali ndi matenda osokonezeka a comorbid komanso phobia (N = 2) kapena chikhalidwe cha anthu (N = 1) kapena mbiri yaubwana wa ADHD (N = 1). Chilolezo chodziwitsidwa chidapezeka, ndipo kafukufukuyu adavomerezedwa ndi University of Cambridge Research Ethics Committee. Omwe adalandila amatenga nawo mbali.

Neuroimaging

Kupeza data ndi kukonza

Makhalidwe.

Zithunzi zamakono zinasonkhanitsidwa kuphatikizapo maginito okonzeka kupanga maginito (MPRAGE) pogwiritsira ntchito Siemens Tim Trio 3T-scanner ndi kanema wa mutu wa 32 pogwiritsa ntchito T1 kulemera kwa MPRAGE magawo (176 sagittal magawo, nthawi za 9; nthawi yobwereza (TR) = 2,500 ms; nthawi yotsutsa (TE) = 4.77 ms; nthawi yosokoneza = 1,100 ms; kupeza matrix = 256 × 256 × 176; flip angle = 7 °; kukula kwa voxel 1 × 1 × 1 mm). Kusanthula kunachitikira pa The Wolfson Brain Imaging Center ku University of Cambridge.

Dongosolo lachikhalidwe linakonzedwa ndi Statistical Parametric Mapping (SPM8; http://www.fil.ion.ucl.ac.uk/spm) (Wellcome Trust Center ya Neuroimaging, London, UK). Zithunzi zowonongeka zinayambanso kugwiritsidwa ntchito, ndikuyika chiyambi pa kutuluka kwapansi. Zithunzi zinagawidwa (pogwiritsa ntchito gawo latsopano la SPM) mu GM, WM ndi cerebrospinal fluid (CSF) zochokera m'mapangidwe oyenera a mapepala amtundu uliwonse. Magawo atatu a minofuyi anaphatikizidwa mwachidule kuti amayerekezera kuchuluka kwa mawu osakanikirana. Kachitidwe ka template kanalengedwa pogwiritsa ntchito DARTEL [Ashburner, 2007], yomwe imafotokozera magawo ofunikira kuti akwaniritse chithunzi cha GM cha munthu aliyense pamalo amodzi, m'njira yofananira. Template iyi ya DARTEL idalembetsedwa pamapu omwe angakhale ndi kusintha kwa affine, kubweretsa zithunzi m'malo a MNI. Zithunzi zidakonzedwa mwapakatikati ndi mulifupi mokwanira theka la kernel ya 8 mm3.

Malo obwereza.

Dongosolo lopuma la fMRI linapezedwa kwa maminiti a 10 ndi maso otseguka ndi Siemens 3T Tim Trio scanner ndi kanema ya 32-kanjira pachilumba cha Wolfson Brain Imaging, University of Cambridge. Mapulogalamu ojambula mapangidwe a mapulogalamu omwe amagwiritsidwa ntchito pamagwiritsidwe ntchito pa intaneti (nthawi yobwereza, 2.47 s; flip angle, 78 °; kukula kwa matrix 64 × 64; kukonza ndege, 3.75 mm; FOV, 240 mm; 32 magawo oblique, osakaniza Chinthu chofunika kwambiri chokhala ndi kachilombo ka 3.75 mm ndi 10% gap; iPAT chiwerengero, 3; bandwidth = 1,698 Hz / pixel; nthawi yokwanira (TE) = 12, 28, 44, ndi 60 ms).

Kusanthula kambiri pazipangizo zodziimira (ME-ICAv2.5 beta6; http://afni.nimh.nih.gov) adagwiritsidwa ntchito pofufuza ndi kusokoneza maulendo opuma ma fMRI. ME-ICA imatha kusiyanitsa ma fMRI deta m'zipangizo zosiyana ndi Fastica. Mbendera ya BOLD peresenti yawonetsa kusintha ndi yeniyeni kudalira TE, chikhalidwe cha kuvunda kwa T2 *. Kudalira kwa TE ukuyesedwa pogwiritsa ntchito nthano-F-statistic, kappa, ndi zigawo zikuluzikulu zomwe zimatsutsana kwambiri ndi TE kukhala ndipamwamba kappa [Kundu et al., 2012]. Zachilumikizo zopanda BOLD zimadziwika ndi chidziwitso cha TE choyesedwa ndi nthano-F-statistic, rho. Zomwe zimagwiritsidwa ntchito ndizolembedwa monga BOLD kapena BOLD chifukwa cha kappa ndi rho value valueings, motero [Kundu et al., 2012]. Zida zomwe sizili za BOLD zimachotsedwa ndi ziyerekezo, zododometsa zoyenda, zolimbitsa thupi ndi zowunikira mwamphamvu molingana ndi mfundo zathupi. Zithunzi zojambulidwa za munthu aliyense zomwe zidasinthidwa zidasungidwa ku MPRAGE yawo ndikuzisintha kukhala template ya Montreal Neurological Institute (MNI). Kuwongolera malo kunkachitika ndi kernel ya Gaussian (m'lifupi mwake theka lokwanira = 6 mm). Nthawi ya voxel iliyonse idasefedwa kwakanthawi kochepa (0.008 f <0.09 Hz). Kusanthula kwa anatomical kwamunthu aliyense kudagawika kukhala GM, WM, ndi CSF. Zofunikira kwambiri pazizindikiro za WM ndi CSF zidachotsedwa.

Kusanthula kugwirizanitsa ntchito kunagwiritsidwa ntchito ndi dera lochita chidwi (ROI) -kufika pafupi ndi bokosi logwiritsa ntchito CONN-fMRI lothandizira. [Whitfield-Gabrieli ndi Nieto-Castanon, 2012] kwa SPM (http://www.fil.ion.ucl.ac.uk/spm/software/spm8/).

Chiwerengero cha Kusanthula

Makhalidwe a omvera ndi kuchuluka kwamafunso amafananizidwa pakati pamagulu okhala ndi michira iwiri t-zinthu popanda kuganiza zofanana. Kuwerengera konse kwa chiwerengero kunachitika pogwiritsa ntchito R version (3.2.0) [RC Team, 2014].

Makhalidwe

Poyerekeza magulu, kuchuluka kwa GM kwamaphunziro a CSB ndi HV adalowetsedwa munthawi yayitali (GLM). Zambiri zidakonzedwa kuti voliyumu yonse yaomwe ophunzira sachita nawo pogwiritsa ntchito makulidwe ofanana ndi chigoba chodziwikiratu mu SPM. Kufananiza kwamagulu kunasinthidwa pazaka zonse zakubadwa ndi kukhumudwa ngati ma covariates. Tidayang'ana kwambiri a priori zigawo zosonyeza chidwi zomwe zatchulidwa mu phunziro lathu lapitalo [Voon et al., 2014] komanso meta-analyzes of mankhwala cue reactivity maphunziro [Kühn ndi Gallinat, 2011], omwe ali kumanzere ndi kumanja kwa VS, amygdala kumanzere ndi kumanja, ndi ACC accorption pogwiritsa ntchito mphulupulu yochepa (SVC) ya banja-wise error (FWE) yotsutsidwa P <0.01 (Bonferroni adakonzedwa poyerekeza angapo). Pakuwunika kwa SVC, tidagwiritsa ntchito VS anatomical ROI, yomwe idafotokozedwa kale [Murray et al., 2008] lomwe linaloledwa kugwiritsa ntchito MRIcro pogwiritsa ntchito tanthauzo la VS ndi Martinez et al. [2003]. The amygdala ROI inapezedwa ku Atalomatic Anatomical Labeling (AAL) atlas. Kachipangizo ka ACC chinasinthidwa mwa kugwiritsa ntchito bokosi la zida la MarsBaR ROI [Brett et al., 2002] komanso pogwiritsa ntchito cortex yamtundu wa ROI kuchokera ku AAL atlas. Anasinthidwa motero kuti malire amtundu wapansi anali pampando wa genu wa corpus callosum [Cox et al., 2014; Desikan et al., 2006] ndipo pambuyo pake panali mapeto omaliza a genu ya corpus callosum [Desikan et al., 2006]. Zowonjezera zowonjezera kusintha kwa maphunziro a BDI zinachitidwa.

Malo obwereza

Poyerekeza kulumikizana pakati pa maphunziro a CSB ndi HV, mapu olumikizirana ndi ubongo a ROI-to-voxel adapangidwira gawo lamanzere la amygdala lomwe limachita chidwi potengera kusiyanasiyana kwamagulu. Mamapu olumikizana ndi zotsatira zake adalowetsedwa mu ma GLM athunthu kuti athe kuyerekezera kulumikizana kwaubongo wathunthu pakati pamagulu osintha zaka ndikuwunikanso komwe kumachitika zaka zonse ndi kukhumudwa. Gulu lonse laubongo linakonza FWE P <0.05 imadziwika kuti ndi yofunikira pakusiyana kwamagulu.

ZINTHU

makhalidwe

Amuna makumi awiri ndi atatu omwe amagonana amuna kapena akazi okhaokha omwe ali ndi CSB (zaka 26.9; SD 6.22 zaka) ndi zaka 69 (zaka 25.6; SD 6.55 zaka 2), zomwe nkhani za 19 CSB ndi 55 HV zinamaliza mayankho a makhalidwe. Masewera a CSB anali ndi BDI yapamwamba (P = 0.006) ndi UPPS-P (P <0.001) zambiri poyerekeza ndi HV. Zotsatira zina zamakhalidwe kuphatikiza mawonekedwe ndi kuopsa kwa zolaula komanso kugwiritsa ntchito intaneti zidanenedwa kwina [Mechelmans et al., 2014; Voon et al., 2014].

Gulu 2. Chiwerengero cha anthu komanso zamakhalidwe azomwe anthu amachita mokakamizidwa pankhani zachiwerewere komanso odzipereka athanzi

gulu

Age

BDI

UPPS-P

  1. Malipoti olekanitsa zofanana ndi P-kufunika kwa magawo awiri t-zinthu ziri muzitsulo.
  2. a

Osowa a 4 omwe achokera ku 23.

  1. b

Osowa a 14 omwe achokera ku 69.

  1. Zambiri za 0-13 zimasonyeza kuvutika kwakukulu, 14-19 kuvutika maganizo, 20-28 kuvutika maganizo, ndi 29-63 kupsinjika kwakukulu.
  2. Maphunziro a UPPS-P amasiyana pakati pa 59 ndi 236 monga ziyeso zosayenerera (59 = zosafuna zambiri; 236 = zosafuna zambiri) zowerengedwera kuchokera ku zinthu za 59, iliyonse yotsatiridwa pakati pa 1 ndi 4 ndikuyimira zigawo zosiyana za kukhudzidwa.
  3. Machaputala: HV, odzipereka athanzi; CSB, zizolowezi zakugonana; BDI, Beck's Depression Inventory; UPPS-P, UPPS-P Makhalidwe Abwino.
CSB (N = 23)26.9 (6.22)14.82 (11.85)a152.21 (16.50)a
HV (N = 69)25.6 (6.55)6.03 (7.20)b124.87 (20.73)b
T-kusowa (P-chikondi)0.88 (P = 0.380)3.04 (P = 0.006)5.81 (P <0.001

Makhalidwe

Mutu wa ROI wa amygdala wa kumanzere ndi wolondola, wa VS komanso wachinsinsi wa ACC, wanena kuti kuseri kwa amygdala nkhani ya grey yowonjezera mu CSB poyerekeza ndi HV (SVC FWE-corrected, P = 0.0096, Z = 3.37, xyz = -28, −4, -15) (Bonferroni adakonzedweratu SVC FWE P <0.01) (Chith. 1). Zina zonse zofufuza za ROI sizinali zofunikira. Kusintha kwa kupsinjika sikusinthe kusintha kwa gulu.

Chithunzi 1.

Chithunzi 1.

Mayi otchedwa voxel-based morphometry muzochita zachiwerewere. Kuchuluka kwa buku la amygdala likuwonetsedwa pamakhalidwe okhudzana ndi kugonana kwa anthu odzipereka omwe ali ndi thanzi labwino. Chithunzicho chimasungidwa P <0.005 sinakonzedwenso fanizo. [Chithunzi cha utoto chitha kuwonedwa pa wileyonlinelibrary.com]

State Resting

Malingana ndi zotsatira za zomangamanga, tinayesa kupuma kwa mgwirizano wa boma ndi mbewu kumanzere. Tapeza kupezeka kwakukulu kwa DLPFC (DLPFC Yolondola: P = 0.012, Z = 4.11, xyz = 31 42 16; Kumanzere DLPFC: P = 0.003, Z = 3.96, xyz = -27 52 23) (mkuyu. 2). Kusintha kwa BDI sikunasinthe tanthauzo la zotsatirazi (DLPFC Yolondola: P = 0.001, Z = 4.54, xyz = 31 61 23; Kumanzere DLPFC: P = 0.003, Z = 4.26, xyz = −29 49 35).

Chithunzi 2.

Chithunzi 2.

Kupuma kwa boma kumagwirizanitsa ntchito kwa amygdala kumanzere. Mchitidwe wogonana mwachangu umagwirizanitsa ndi kuchepa kwa boma kutseguka kwachitsulo cha amygdala kumanzere (mbewu, kumanzere) ndi makina ozungulira omwe ali pambali (kumanja ndi kumanja), poyerekeza ndi odzipereka odzipereka. Chithunzicho chimasungidwa P <0.005 sinakonzedwenso fanizo. [Chithunzi cha utoto chitha kuwonedwa pa wileyonlinelibrary.com]

KUKANGANANI

Tinafufuza zosiyana ndi zomangamanga zachitsulo kwa anthu omwe ali ndi CSB poyerekeza ndi HV yofanana. Masewera a CSB adachulukanso kumapeto kwa amygdala komanso kuchepetsa kugwirizanitsa ntchito panthawi yopumula pakati pa amygdala kumanzere ndi DLPFC.

Amygdala imakhudzidwa ndi kusinthika kwa chilengedwe komwe kumayendetsa khalidwe. Cholinga cha amygdala chikugwirizanitsa zochitika zapachilengedwe kapena zochitika zapakati pazomwe zikugwirizana ndi oyanjanitsa a mtengo wapatali, kufalitsa zovuta zokhudzidwa ndi zokakamiza [Everitt et al., 2003], kuphatikizapo kukonzanso mphamvu za maganizo [Cardinal et al., 2002; Gottfried et al., 2003]. Kupeza kwawonjezeka kwa amygdala volume kumatsutsana ndi maphunziro angapo okhudzana ndi vuto la kugwiritsa ntchito mowa [Makris et al., 2008; Wrase et al., 2008], momwe kafukufuku wa mtundu uwu wa chizoloŵezi choledzeretsa anachepetsera mavoliyumu ambiri, pamene mayendedwe a volumetric ayesedwa. Zomwe zingamveke potsutsana ndi izi ndizakuti nthawi yaitali mankhwala ogwiritsira ntchito mankhwala amachititsa kusintha kosasintha kwa khunyu ndi poizoni [Kovacic, 2005; Reissner ndi Kalivas, 2010] zomwe zingapangitse kupirira kwa khalidwe lofunafuna mankhwala [Gass ndi Olive, 2008]. Nthenda yotchedwa neurotoxicity yotereyi imathandizira kuti phokoso lofala lotchuka liwonongeke m'zinthu zovuta kuzimitsa [Bartzokis et al., 2000; Carlen et al., 1978; Mechtcheriakov et al., 2007]. Zokhudzana ndi mankhwalawa ndizofunika kwambiri ku SUD koma zochepa pazochitika zowonongeka. Mu kafukufuku wa CSB waposachedwapa pogwiritsa ntchito fMRI, kufotokozera ziganizo zogonana mu CSB poyerekeza ndi zomwe sizinali CSB zinagwirizanitsidwa ndi kukhazikitsa amygdala [Voon et al., 2014]. Kaya kusiyana kwa amygdala voliyumu ndi chikhalidwe chisanayambe kukhalapo kwa anthu omwe ali ndi CSB kapena chokhudzana ndi kufotokozera kwambiri kumakhalabe kukhazikitsidwa.

Kugwira ntchito kwa DLPFC kumadziwika bwino kuti kumagwirizanitsidwa ndi mbali zazikulu zokhudzana ndi chidziwitso [MacDonald et al., 2000] ndikugwira ntchito kukumbukira [Petrides, 2000]. Kupeza kwathu kuchepa kwasinthidwe pakati pa amygdala ndi DLPFC kumagwirizana ndi mabuku omwe alipo pokhudzana ndi zigawo izi. Kugwirizana kotereku ndikofunikira kwa lamulo la kutengeka, lomwe laperekedwa kale mu kugwirizanitsa kochepa pakati pa amygdala ndi DLPFC mwa anthu omwe ali ndi vuto la kusewera kwa intaneti likukhudzana ndi machitidwe apamwamba a kukhudzidwa [Ko et al., 2015]. Kufufuza kwina komwe kumatha kuthetsa maganizo okhumudwitsa pogwiritsa ntchito njira zamaganizo zimasonyeza kuti zochitika m'madera ena a frontal cortex, kuphatikizapo DLPFC, zimagwirizanitsa ndi ntchito ya amygdala, ndipo kugwirizanitsa ntchito pakati pa zigawozi kunadalira kugwiritsa ntchito njira zamaganizidwe mu malamulo okhumudwitsa [Banks et al., 2007]. Chigwirizano cha Amygdala ndi DLPFC chikugwirizana kwambiri ndi kuvutika maganizo kwa unipolar [Siegle et al., 2007]. CSB yakhala ikugwirizanitsidwa ndi zipsinjo zachisokonezo ndi nkhawa ndi zovuta zomwe zingayambitse ntchito zotere; Komabe, zomwe tinazipeza sizinali zosiyana ndi zilembo zachisokonezo. DLPFC inathandizidwanso pophunzira za HV yamwamuna imene zithunzi zolaula zimagwiritsidwa ntchito ndi kugwirizanitsa pakati pa DLPFC ndi striatum poona zithunzi zolaula [Kühn ndi Gallinat, 2014].

Timachenjeza kuti izi zowonjezera zimapatsidwa kukula kwazing'ono za masewera a CSB ngakhale kuti ife tikuzifanizira gululi ndi kukula kwakukulu kwasankhulidwe ka HV. Chiwerengero chimodzi cha phunziroli ndi homogeneity of the population. Monga sitinaphatikizepo maphunziro omwe ali ndi vuto linalake lomwe limatha kugwira ntchito, zotsatirazi ziyenera kusamalidwa mosamala ku maphunziro a CSB ndi zovuta zina. Kuwonjezera apo, zochitika zosaoneka bwino komanso zogwira ntchito pakati pa maphunziro a CSB zingakhale zokhudzana ndi zikhalidwe zomwe zakhalako kale kapena zikhoza kukhala zotsatira za zotsatira za CSB, ndipo kotero phunziro ili silingapangitse mafotokozedwe a zotsatira za CSB. Kafukufuku wamtsogolo ayenera kutsata kuyesa miyeso yaitali kuti athetse kusiyana pakati pa zikhalidwe za dziko komanso makhalidwe omwe angayambe kusokoneza ubwino wa nkhanza zazitsamba zazikulu komanso osakanikirana.

Zomwe tikupeza panopa zikuwunikira zowonjezereka mu dera lomwe likukhudzidwa ndi zolimbikitsana komanso zochepetsetsa zovomerezeka zogwirizana ndi makampani oyendetsa olamulira omwe ali pamwamba. Kusokonezeka kwa malo oterewa kungathe kufotokozera njira zowonongeka zomwe zimapangitsa kuti phindu lachilengedwe likhale lopanda malipiro kapena kuti zikhale zovuta kuti zikhale zolimbikitsa. Ngakhale kuti zofufuza zathu zapadera zikusiyana ndi zomwe zili mu SUD, zotsatirazi zikhoza kusonyeza kusiyana pakati pa zotsatira za mankhwala osokoneza bongo. Umboni wotsutsa ukuwonetsa kuthekera komwe kumayambitsidwa ndi ndondomeko ya mowa makamaka kumathandizira ziphunzitso zolimbikitsa. Ife tawonetsa kuti ntchitoyi mu intaneti yowonjezera imakhala ikulimbikitsidwa pambuyo poyang'ana kwa olemera kwambiri kapena omwe amawakonda zizindikiro zogonana [Brand et al., 2016; Seok ndi Sohn, 2015; Voon et al., 2014] komanso kukhala ndi chidwi chambiri [Mechelmans et al., 2014] ndikukhumba zokhudzana ndi kugonana koma osati chilakolako chogonana chogonana [Brand et al., 2016; Voon et al., 2014]. Kuonjezera chidwi pa zochitika zokhudzana ndi kugonana kumagwirizananso ndi zokonda zokhudzana ndi kugonana kotero zimatsimikizira mgwirizano pakati pa chikhalidwe chogonana ndi chisamaliro [Banca et al., 2016]. Zotsatira za ntchito zowonjezereka zokhudzana ndi zochitika zokhudzana ndi kugonana zimasiyanasiyana ndi zomwe zachitika (kapena zosangalatsa zosagonjetsedwa) zomwe zizoloŵezi zowonjezereka, mwinamwake zogwirizana ndi lingaliro la kulekerera, zimachulukitsa zokonda zogonana zogonana [Banca et al., 2016]. Zonsezi zomwe zapeza zikuthandizira kuthetsa vuto la sayansi ya sayansi ya chilengedwe la CSB kutsogolera kumvetsetsa kwambiri za matendawa ndi kuzindikira momwe angathere odwala.

ZIZINDIKIRO

Tikufuna kuyamika antchito a WBIC chifukwa cha luso lawo komanso thandizo lawo polemba deta, komanso otsogolera athu pa nthawi yawo ndi kudzipereka kwawo. Komanso, tikufuna kuthokoza Thaddeus Birchard ndi Paula Hall pofuna kutumiza odwala pa phunziroli. Institute of Ethics and Clinical Neuroscience Institute (BCNI) imathandizidwa ndi Wellcome Trust ndi Medical Research Council.

ZOKHUDZA