Mphotho, dopamine komanso kulamulira chakudya: zotsatira za kunenepa kwambiri (2011)

Miyambo Yogwiritsa Ntchito. 2011 Jan; 15 (1): 37-46. onetsani: 10.1016 / j.tics.2010.11.001. Epub 2010 Nov 24.

Volkow ND, Wang GJ, Wowonongeka RD.

gwero

National Institute on Abuse, National Institutes of Health, Bethesda, MD 20892, USA. [imelo ndiotetezedwa]

Kudalirika

Kukhoza kulimbana ndi chilakolako cha kudya kumafuna kuyendetsa bwino ma circuits a neuronal omwe akuphatikizidwa kwambiri kuti athe kutsutsana ndi mayankho omwe akulosera mphotho pa kudya chakudya komanso kufuna kudya chakudya. IneKafukufuku wamatsenga amasonyeza kuti maphunziro ovuta kwambiri akhoza kukhala ndi zovuta mu njira za dopaminergic zomwe zimayendera njira zogwirizana ndi mphotho zokhudzana ndi mphoto, chikhalidwe ndi kulamulira. Zimadziwika kuti ma neuropeptides omwe amayendetsa mphamvu zamagetsi (homeostatic njira) kupyolera mu hypothalamus amachititsanso ntchito ya maselo a dopamine ndi ziwonetsero zawo m'zigawo zomwe zimakhudza njira zopindulitsa zomwe zimayambitsa kudya. Izi zimapangidwanso kuti izi zikhoza kukhala njira yomwe kudya ndi kusokoneza zizindikiro za homoeostatic kumapangitsa kuti ntchito za madera zikhale zogonjetsa mphoto, chikhalidwe komanso chidziwitso.

Introduction

Chiŵerengero cha anthu akuluakulu a ku US ali olemera kwambiri [thupi la chiwerengero cha mthupi (BMI) ≥30 kg m-2] [1]. Mfundo imeneyi ili ndi zotsatira zambiri, chifukwa kunenepa kwambiri kumayenderana ndi matenda aakulu (monga matenda a shuga, matenda a mtima, mafuta a chiwindi ndi khansa zina) [2]. N'zosadabwitsa kuti chisamaliro chokwanira chokha chifukwa cha kunenepa kwambiri ku US chimawerengedwa pafupi ndi US $ 150 biliyoni [3].

Zolinga za chikhalidwe ndi chikhalidwe mosakayikira zimapangitsa mliriwu. Mwapadera, malo omwe amalimbikitsa kudya zakudya zosafunikira (kupezeka kwapadera kwa zakudya zopangidwira komanso zopanda kanthu) ndi kusagwiritsidwa ntchito mwakuthupi amakhulupirira kuti ali ndi gawo lofunika kwambiri pa vuto la kunenepa kwambiri (Website Overweight and Obesity of Centers for Disease Control and Prevention; http://www.cdc.gov/obesity/index.html). Komabe, zinthu zina zimathandizanso kudziwa kuti ndani (kapena ayi) adzakhala ochepa mu malo awa. Malinga ndi kafukufuku wamtundu, ziwalo zoberekera zimayikidwa pakati pa 45% ndi 85% za kusiyana kwa BMI [4,5]. Ngakhale kuti kufufuza kwa majini kunavumbula mfundo zosinthika zomwe zikuimira anthu oposa ambiri [4], makamaka mbali yaikulu, kunenepa kwambiri kumaganiziridwa kukhala pansi pa ulamuliro wa polygenic [6,7]. Ndipotu, kafukufuku watsopano wa magulu a gulu lonse (GWAS) omwe adachitidwa ku 249,796 anthu a ku Ulaya adadziwika kuti 32 loci yokhudzana ndi BMI. Komabe, awa loci anafotokoza 1.5% chabe ya kusiyana kwa BMI [8]. Komanso, zikuyesa kuti maphunziro a GWAS ndi zitsanzo zazikulu ayenera kudziwa 250 yowonjezera loci ndi zotsatira pa BMI. Komabe, ngakhale ndi mitundu yosazindikiratu, amayerekezera kuti zizindikiro zosiyana ndi loci zikanangokhala ndi 6-11% ya kusiyana kwa mtundu wa BMI (malinga ndi kuyerekezera kwa 40-70%). Zochepa zofotokozera za kusiyana pakati pa mafukowa zimakhala zowonetseratu zovuta zogwirizana pakati pa zifukwa zina (monga momwe zanenedwa ndi majini) ndi momwe anthu amachitira ndi malo omwe chakudya chimakhalapo, osati kokha kokha ngati gwero la zakudya, koma komanso ngati mphotho yamphamvu yomwe yokha imalimbikitsa kudya [9].

The hypothalamus [kudzera m'magazi a khansa yotchedwa leptin, cholecystokinin (CCK), ghrelin, orexin, insulini, neuropeptide Y (NPY), komanso kupyolera mwa kuyang'ana kwa zakudya, monga shuga, amino acids ndi mafuta acids] amadziwika ngati ubongo waukulu dera lomwe limayang'anira kudya zakudya zokhudzana ndi caloriki ndi zakudya zoyenera [10-13]. Makamaka, phokoso loponyedwa kudzera m'magulu ena a hypothalamic nuclei and extra-hypothalamic zigawo za ubongo, kuphatikizapo nucleus tractus solitarius, imayendetsa chakudya cha homeostatic [12] ndipo zimakhudzidwa ndi kunenepa kwambiri [14-16] (Chithunzi 1a, gulu lakumanzere). Komabe, umboni ukuwonjezeka kuti ubongo umayendetsa kupatulapo yokhudza njala ndi satiety amagwiritsidwa ntchito pa chakudya ndi obesity [17]. Makamaka, miyendo ingapo [nucleus accumbens (NAc), amygdala ndi hippocampus] ndi ma cortical brain (orbitofrontal cortex (OFC), makina osungirako zinthu (ACC) ndi insula] komanso njira za neurotransmitter (dopamine, serotonin, opioids ndi cannabinoids) komanso hypothalamus zimakhudzidwa ndi zotsatira zopindulitsa za chakudya [18] (Chithunzi 1a, gulu lakumanja). Mosiyana ndi zimenezo, lamulo la kudya kwa hypothalamus likuwoneka kudalira mphotho ndi zokakamiza zamagetsi kuti zisinthe khalidwe la kudya [19-21].

Chithunzi 1  

Malamulo a chakudya amadalira kulankhulana kwamtundu wina pakati pa mphotho yowonjezera ndi ma homeostatic neurocircuits. (a) Chithunzi chojambula cha msewu pakati pa homeostatic (hypothalamus, HYP) ndi maulendo a mphoto omwe amayang'anira kudya. The ...

Malingana ndi zofukufuku kuchokera ku maphunziro a kujambula, chitsanzo cha kunenepa kwambiri posachedwapa chinakonzedwa kuti kudya kwambiri kumasonyeza kusalingani pakati pa maulendo omwe amachititsa khalidwe (chifukwa cha kuloŵerera kwawo mu mphoto ndi chikhalidwe) ndi ma circuits omwe amaletsa ndi kulepheretsa mayankho ambuyomu [22]. Chitsanzochi chikuwonetsa maulendo anayi akulu: (i) mphoto-saliency; (ii) kuyendetsa galimoto; iii) kuphunzira-conditioning; ndipo (iv) kuletsa kuteteza-maganizo olamulira-akuluakulu ntchito. Chochititsa chidwi, chitsanzo ichi chikugwiritsanso ntchito kuledzera.

IAnthu osatetezeka, kudyetsa chakudya chokwanira (kapena mankhwala osokoneza bongo) akhoza kukhumudwitsa kuyanjana pakati pa maulendowa, zomwe zimapangitsa kuti chakudya chikhale chamtengo wapatali (kapena mankhwala osokoneza bongo) komanso pakufooka kwa maulendo olamulira. Kusokonezeka kumeneku ndi zotsatira za kuphunzira bwino ndi kukhazikitsanso malipiro a zotsatira zogwiritsira ntchito zakudya zambiri zapamwamba (kapena mankhwala osokoneza bongo) ndi anthu omwe ali pangozi. Kuwonongeka kwa ma intaneti otetezeka kwambiri omwe amachititsa kuti mayankho asanakhale amphamvu amachititsa kuti munthu asamangokhalira kudya komanso kudya chakudya chokwanira (kapena kumwa mankhwala osokoneza bongo mowa mwauchidakwa).

Papepalali akukambirana umboni womwe umagwirizanitsa maulendo a neural omwe akuwongolera kwambiri ndi omwe ali ndi mphotho ndi zolimbikitsa komanso momwe amachitira ndi zizindikiro zogonana zomwe zimayendetsa chakudya cha homeostatic.

Pitani ku:

Chakudya ndi mphotho yamachilengedwe yowonongeka komanso zokopa

Zakudya zina, makamaka omwe ali ndi shuga ndi mafuta, ndizo mphoto zabwino [23] zomwe zimalimbikitsa kudya (ngakhale kuti palibe chofunikira chofunikira) ndipo zimayambitsa mgwirizano wophunzira pakati pa zokopa ndi mphotho (chikhalidwe). Malinga ndi chisinthiko, malowa a zakudya zokometsetsa ankagwiritsidwa ntchito pothandiza kuti zakudya zizidyetsedwa ngati zilipo, kuti mphamvu zizisungidwe m'thupi (monga mafuta) zowonjezera zosowa m'zochitika zomwe malo osowa chakudya sapezeka komanso / kapena osakhulupirika. Komabe, m'mayiko amasiku ano, kumene chakudya chikupezeka, kusintha kumeneku kwakhala koyenera.

Mapepala angapo a mitsempha, kuphatikizapo dopamine (DA), nthenda za m'magazi, opioids ndi serotonin, komanso maurosetiasiti omwe amagwiritsidwa ntchito poyambitsa homeostatic chakudya, monga orexin, leptin ndi ghrelin, amakhudzidwa ndi zotsatira zopindulitsa za chakudya [24-26]. DA wakhala akufufuzidwa bwino kwambiri ndipo ndi yabwino kwambiri. Ndi mphotho yayikulu yokhala ndi mphuno ya mthupi (madalitso achilengedwe ndi mankhwala), omwe amapangidwa makamaka pogwiritsa ntchito ventral tegmental (VTA) ku NAC [27]. Zizindikiro zina za DA zikuphatikizidwa, kuphatikizapo dorsal striatum (caudate and putamen), cortical (OFC ndi ACC) ndi zigawo zam'mimba (hippocampus ndi amygdala) ndi lateral hypothalamus. Inde, kwa anthu, kudyetsa chakudya chokoma kumasonyezedwa kuti kumasulire DA muzitsulo zozembera molingana ndi momwe zimakhalira zosangalatsa zomwe zimachokera ku kudya chakudya [28]. Komabe, kuthandizidwa kwa DA mu mphoto kumakhala kovuta kwambiri kuposa kungowonjezera kokha kwa mtengo wa hedonic. Poyamba kulandira mphotho ya chakudya (kapena mphoto yosadziyembekezeka), kuwombera kwa DA neurons mu VTA kumawonjezeka ndi kuwonjezeka kwa DA kumasulidwa ku NAc [29]. Komabe, mobwereza mobwerezabwereza ku mphotho ya chakudya, DA akuyankha chizoloŵezi ndipo pang'onopang'ono amasamutsidwa pazomwe zimakhudzana ndi chakudya (monga fungo la chakudya), chomwe chimakonzedweratu ngati kulandira mphotho (kukhala chidziwitso chomwe chilipo ku mphotho) [30,31]; DA chizindikiro chotsutsana ndi chidziwitsochi ndiye akutanthauzira "zolakwa zowonetsera mphoto" [31]. Zomwe zimagwiritsidwa ntchito kwambiri ndi madontho a DA ochokera m'madera omwe amapezeka m'madera omwe amachititsa chidwi (home insist or cortux), homeostatic (hypothalamus), mphotho (NAc), mafilimu (amygdala ndi hippocampus) ndi ma multimodal (OFC chifukwa cha kukhulupirika) mphotho ndi zolembedwera cues [32]. Mwachindunji, malingaliro ochokera ku amygdala ndi OFC kwa DA neurons ndi NAc akuphatikizidwa mu mayankho omwe ali ndi chakudya [33]. Zoonadi, kafukufuku adawonetsa kuti pamene nkhani zopanda amuna ndizosafunika kwambiri zimafunsidwa kuti zilepheretsa chilakolako chawo cha chakudya pamene zikuwoneka ndi zakudya, zimachepetsa ntchito zamagetsi ku amygdala ndi OFC [komanso hippocampus (onaninso Bokosi 1), insula ndi striatum]; kuchepa kwa OFC kunagwirizanitsidwa ndi kuchepa kwa kukhumba kwa chakudya [34].

Bokosi 1. Udindo wa hippocampus m'zochita zodyetsa

Hippocampus sikuti ndizofunikira zokhazokha, komabe zikugwiritsanso ntchito njira yothetsera kudya mwa kuyambitsanso njira zogwirira ntchito (kuphatikizapo kukumbukira ngati wina amadya, kukumbukira mabungwe ogwirizana, kukumbukira komwe kuli chakudya, kudziwitsa momwe anthu akumvera njala ndi kukumbukira momwe kuti athetse izi). Mwachitsanzo, mu makoswe, mitsempha yosankha mu hippocampus imalephera kuthetsa pakati pa njala ndi zachisomo [99] ndipo, mu makoswe aakazi, izo zinachititsa hyperphagia [100]. Kwa anthu, kafukufuku wa ubongo wanena kuti kugwiritsidwa ntchito kwa hippocampus kuli ndi chilakolako cha chakudya, njala, yankho la chakudya ndi zakudya zokoma [101]. Hippocampus imanena za insulini, ghrelin, glucocorticoids komanso mapuloteni a CB1, omwe amasonyeza kuti dera limeneli limayambitsanso kudya zakudya zopanda mphamvu [102,103]. Kuwonjezera apo, hippocampus imakhudzidwa ndi kunenepa kwambiri, monga momwe zatchulidwira ndi kufufuza zojambula zosonyeza kuti mwazowona koma osati anthu wathanzi, hippocampus imasonyeza kusokonezeka chifukwa cha zakudya zokhazokha [104].

Zomwe zimapangidwira zimatha kudyetsa ngakhale makoswe odyetsedwa [30] ndipo, mwa anthu, kufufuza kwafukufuku kwawonetsa kuti kuwonetsa zakudya za chakudya kumapangitsa kuti DA ayambe kuwonjezeka mu statum yomwe ikukhudzana ndi chilakolako chodya chakudya [35]. Kuphatikizana ndi kuphatikizidwa kwake ndi chikhalidwe, DA akuphatikizidwanso ndi cholinga chochita zofunikira zoyenera kupeza ndi kudya chakudya. Zoonadi, kugawidwa kwa DA mu chakudya cha mphotho kwagwirizanitsidwa ndi kulimbikitsitsika kapena "kusowa" kwa chakudya kusiyana ndi 'kukonda' chakudya [36] (Bokosi 2), zotsatira zomwe zingakhale zovuta kuphatikizapo striatum ndi mwina NAC [37]. DA ili ndi mbali yofunikira kwambiri pa nkhaniyi kuti makoswe omwe samapangitsa DA kufa ndi njala chifukwa chosowa chodetsa kudya [37]. Kubwezeretsanso kwadzidzidzi kwa DNA kuntchito kumapulumutsa nyama izi, pamene kubwezeretsa ku NAC sikutero.

Bokosi 2. Kufuna kutsutsana ndi kukonda: kusiyana kwakukulu

Mapulogalamu opereka ubongo omwe amawathandiza kudya amawuniyanitsa njira yomwe imakhudzidwa ndi chilakolako cha chakudya, chomwe chimatchedwa 'chosowa,' mogwirizana ndi njira yomwe imakhudzidwa ndi zakudya za hedonic, zomwe zimatchedwa 'kukonda' [36]. Ngakhale kuti nthawi zambiri dopamine isokonezeka kwambiri (ngakhale kuti siyi yokha) yomwe imakhudzidwa ndi 'kufuna', machitidwe a opioid ndi cannabinoid ndiwo ambiri (ngakhale osati okha) okhudzana ndi zakudya 'zokonda'.

Zoonadi, kufufuza kwa ubongo mwa anthu kwasonyeza kuti kutuluka kwa dopamine kunayambitsa pamene anthu amakumana ndi correlates ya zakudya ndi malingaliro awo ofunika a chakudya [35]. Mosiyana ndi zimenezi, kuyambira kwa opioid kapena mapuloteni amatha kuchititsa kuti chilakolako chawo chikhale chokondweretsa poonjezera "kukonda" chakudya (ie palatability). Ngakhale kuti njira ziwirizi ndi zosiyana, zimagwirizana kuti azikhala ndi makhalidwe abwino.

Zakudya za hedonic ('kukonda') ziwoneka zikudalira, pakati pa ena, opioid, cannabinoid ndi GABA kutsegula magazi [36]. Zakudya zimenezi 'zimakonda' zimagwiritsidwa ntchito m'madera omwe amapereka mphoto kuphatikizapo lateral hypothalamus, NAc, ventral pallidum, OFC [9,27,38] ndi insula (malo oyambirira kukoma mu ubongo) [39].

Chizindikiro cha opioid ku NAc (mu chipolopolo) ndi palralum ya ventral ikuwoneka kuti ikugwirizana ndi chakudya 'chokhumba' [40]. Mosiyana ndi zimenezi, chizindikiro cha opioid mu basolateral amygdala chimaphatikizapo kutumiza zakudya zomwe zimakhudza thupi, zomwe zimapangitsa kuti phindu la chakudya ndi kufunafuna mphotho likhale lofunika, moteronso zimapatsa chakudya chofuna '41]. Chochititsa chidwi n'chakuti, makoswe omwe akhala akudya zakudya zowonjezera shuga, vuto la mankhwala omwe ali ndi naloxone (mankhwala osokoneza bongo osagwiritsira ntchito mankhwala osagwirizana ndi makoswe olamulira) amachititsa kuti odwala matenda ochotsera opiate asamangidwe ngati ofanana ndi omwe amapezeka pamatenda omwe amapezeka mankhwala opioid [42]. Kuonjezera apo, kufotokoza kwa anthu kapena nyama za ma laboratori ku shuga kumapangitsa kuti awonongeke [43], zomwe zimasonyeza kuti shuga (ndipo mwinamwake zakudya zina zabwino) zimakhala ndi mphamvu zowonjezera kuti zikhale zovuta kwambiri. Funso lofufuzira limene limapezeka kuchokera ku datali ndiloti, mwa anthu, kudya kumayambitsa matenda ochepetsako pang'ono omwe angachititse kuti abwererenso.

Matendawa, makamaka pogwiritsa ntchito mankhwala ovomerezeka a CB1 (kusiyana ndi CB2 receptors), akuphatikizidwa ndi njira zowonjezera kunyumbaostatic komanso zopindulitsa zogwiritsira ntchito chakudya ndi mphamvu zamagetsi [44-46]. Makhalidwe a Homeostatic amalembedwa mwa magawo ena kudzera m'maganizo otetezeka komanso osasunthika mu hypothalamus ndi kupyolera pamutu wa pepala lokhalokha mu ubongo, ndipo njira yothetsera mphoto imayanjanitsidwa mwa zina mwa zotsatira mu NAC, hypothalamus ndi ubongo. Choncho, njira ya cannabinoid ndichinthu chofunika kwambiri pa chithandizo cha mankhwala kuti chithandizo cha kunenepa kwambiri ndi matenda a kagayidwe kake kamveke. Mofananamo, kufotokoza kwa serotonin za makhalidwe odyetsa kumaphatikizapo mphotho zonse ndi malamulo a homeostatic ndipo zakhala zowunikira kuti chitukuko cha mankhwala oletsa kunenepa kwambiri [47-50].

Pogwirizana, pali umboni wochuluka wosonyeza kuti pulojekiti ya homeostatic yomwe imayambitsa mphamvu, monga leptin, insulini, orexin, ghrelin ndi PYY, imayambitsanso makhalidwe omwe sali a homeostatic komanso imapatsa chakudya chopatsa thanzi [50]. Mankhwalawa amatha kukhala ndi chidziwitso chodziŵika pa kudya ndi zakudya komanso zakudya zokhazokha [51]. Mwachindunji, amatha kuyanjana ndi mapulogalamu ozindikira omwe ali pakati pa VTA DA neurons, omwe sikuti amangogwira ntchito ku NAc, komanso kumadera a prefrontal ndi limbic; Ndipotu ambiri a iwo amavomereza zolaula m'madera akutali ndi hippocampus ndi amygdala [50].

Insulini, yomwe ndi imodzi mwa mahomoni ofunikira omwe amagwiritsidwa ntchito poyambitsa matenda a shuga, imasonyezedwa kuti iyang'anize kuyankha kwa ziwalo (kuphatikizapo zigawo za mphotho za ubongo) ndi zigawo zamakono mu ubongo waumunthu kuti zisonyeze chakudya. Mwachitsanzo, polamulira bwino, insulin inachititsa kuti mazira a hippocampus ayambe kugwira ntchito.52]. Mosiyana ndi zimenezi, matenda opatsirana ndi insulini (odwala omwe ali ndi matenda a shuga a 2) amasonyeza kuwonjezeka kwambiri m'magulu (amygdala, striatum, OFC ndi insula) atakhala ndi zakudya zopatsa thanzi omwe sanali odwala matenda a shuga [53].

Iubongo wa munthu, hormone leptin yotengedwa ndi adipocyte, yomwe imachita mbali ngakhale leptin receptors mu hypothalamus (pansi pamtunda) kuti achepetse kudya, awonetsedwanso kuchepetsa kuyankhidwa kwa madera opindula a ubongo kukhala chakudya cholimbikitsa. Mwachindunji, odwala omwe ali ndi vuto la congenital leptin amachititsa kuti DA ayambe kugwiritsira ntchito zakudya zowonongeka, zomwe zimakhudzana ndi chakudya chofunikira, ngakhale pamene nkhaniyo idangodyetsedwa. Mosiyana ndi zimenezi, masolimbic activation sanachitike pambuyo 1 sabata la leptin mankhwala (Chithunzi 2a, b). Izi zinatanthauziridwa kuti leptin inachepetsa mayankho opindulitsa ku chakudya [19]. Phunziro lina la FMRI, lomwe linagwiritsidwa ntchito ndi odwala omwe ali ndi vuto la congenital leptin, linasonyeza kuti mankhwala a leptin amachititsa kuti zigawo za njala (insula, parietal komanso cortices) zisinthe. pazowonjezera zakudya zokhazokha [20]. Choncho, maphunziro awiriwa amapereka umboni wakuti, mu ubongo waumunthu, leptin imayendetsa ntchito za m'madera a ubongo zomwe sizikukhudza kokha ndi homeostatic ndondomeko, komanso ndi mayankho opindulitsa komanso oletsa kuteteza.

Chithunzi 2   

Leptin imachepa pamene ghrelin imachulukitsa kuwonjezeka kwa zakudya zomwe zimakhudza ubongo m'madera. (a, b) Zithunzi za ubongo zimasonyeza malo omwe leptin inachepetsera kuyambitsa (NAc-caudate) m'mitu iwiri ndi kuchepa kwa leptin. (b) Histogram ya kuchitapo kanthu ...

Kutentha mahomoni kumawonekeranso kuyankhidwa kwa madera a mphotho ku chakudya chomwe chimakhudza ubongo wa umunthu. Mwachitsanzo, peptide YY3-36 (PYY), yomwe imamasulidwa kuchokera m'matumbo a m'matumbo pambuyo pake ndikuchepetsa kuchepetsa zakudya, inasonyezedwa kuti iwonetsetse kusintha kwa chakudya choyenera kudzera m'madera otchedwa homeostatic circulits (ie hypothalamus) ku chigawo chake ndi madera a mphotho pa kusintha kwa njala kupita ku satiety . Makamaka, pamene ma plasma PYY anali aakulu (monga pamene satiated), kuchitidwa kwa OFC ndi chakudya chimene chimapangitsa kuti zakudya zisawonongeke; pamene ma plasma PYY anali otsika (monga pamene chakudya chinkachotsedwa) hypothalamic activation positive ananeneratu kudya chakudya [54]. Izi zimasuliridwa kuti ziwonetsetse kuti PYY imachepetsa mbali zopindulitsa za chakudya kudzera mu kufanana kwa OFC. Mosiyana ndi zimenezi, ghrelin (hormone yomwe imachokera m'mimba yomwe imawonjezereka m'madera otentha ndipo imapangitsa kuti anthu adye chakudya) inasonyezedwa kuti iwonjezeke chifukwa cha zakudya zomwe zimakhudza mphotho za ubongo (amygdala, OFC, insula yamkati ndi striatum) ndipo kuyambitsidwa kwawo kunali zogwirizana ndi zozizwitsa za njala (Chithunzi 2c, d). Izi zimasuliridwa kuti ziwonetsetse kuti mauthenga a hedonic ndi othandizira alimbikitseni pazinthu zokhudzana ndi zakudya ndi ghrelin [55]. Zowonongeka, izi zowonjezera zikugwirizananso ndi kusiyana kwa chigawo cha ubongo m'magulu poyankha zakudya zomwe zimakhudza anthu omwe ali osakaniza; Kutsegulidwa kwa mphoto madera chifukwa cha zakudya zowonongeka kumachepetsedwa panthawi yomwe yatsala poyerekeza poyerekeza ndi dziko losala kudya [15].

Izi zikuwonetsa kuti pakati pa neurocircuitry yomwe imayendetsa mphotho ndi / kapena kulimbikitsa ndi zomwe zimayambitsa mphamvu yokoka kwa mphamvu (Chithunzi 1b). Zizindikiro zapadera zomwe zimayendera chizindikiro cha homeostatic kuti chakudya chiwoneke kuti chiwonjezere mphamvu za ziwalo za ubongo kuti chakudya chikhale chokoma ngati ali orexigenic (ghrelin) ndi kuchepetsa mphamvu yowonjezera kuti ikhale yowonjezereka ngati aliorexic (leptin ndi insulini). Mofananamo, kukhudzidwa kwa ubongo kumapereka madera kudya chakudya pamene chakudya chikusowa, komabe chichepere pa nthawi yochepa. Potero, oyang'anira oyendetsa pakhomo ndi omwe amapereka mphoto amayesetsa kuchita zinthu zolimbitsa thupi pazinthu zowonongeka komanso kulepheretsa kudya chakudya panthawi yomwe akudwala. Kusokonezeka kwa mgwirizano pakati pa homeostatic ndi mphotho zoyendayenda zingalimbikitse kudya kwambiri ndikuthandizira kulemera kwambiri (Chithunzi 1). Ngakhale peptide ena [glucagon-ngati peptide-1 (GLP-1), CKK, bombesin ndi amylin] imayambitsanso kudya chakudya kudzera m'maganizo awo, zotsatira zawo za extrahypothalamic zasamalidwa pang'ono [12]. Choncho, pali zambiri zomwe ziyenera kuphunzitsidwa, kuphatikizapo kugwirizana pakati pa njira za homeostatic ndi zosakhala pakhomo zomwe zimayambitsa kudya ndi kudya kwawo.

Pitani ku:

Kusokonezeka kwa mphotho ndi chikhalidwe chokhala ndi chakudya mwa anthu olemera kwambiri komanso olemera kwambiri

Kafukufuku wamakono ndi zachipatala apereka umboni wa kuchepa kwa DA kuzindikiritsa m'madera oterewa (kuchepa kwa DAD2 (D2R) receptors ndi DA release], zomwe zimagwirizanitsidwa ndi mphoto (NAc) komanso ndi zizoloŵezi (routed striatum) mu kunenepa kwambiri [56-58]. Chofunika kwambiri, kuchepa kwa D2R yopweteka kwagwirizanitsidwa ndi kudya chakudya chokwanira mu makoswe olemera [59] ndi kuchepa kwa ntchito yamagetsi ku OFC ndi ACC mu anthu ovuta kwambiri [60] (Chithunzi 3a-c). Chifukwa chakuti kufooka kwa OFC ndi ACC kumakhala kovuta kuyankhulana [kuyambiranso 61], izi zikhoza kukhala njira imene chizindikiro chodziwika bwino cha D2R chimawonetsera hyperphagia [62]. Kuchepetsa kufotokozera kwa D2R kungakhalenso kuchepetsa kukhudzidwa kwa mphotho zachilengedwe, vuto lomwe anthu ambiri angayese kulipiritsa kanthawi mwa kudya kwambiri [63]. Mfundo imeneyi imagwirizana ndi umboni wodalirika wosonyeza kuti kuchepa kwa ntchito ya DA mu VTA kumabweretsa kuwonjezeka kwakukulu kwa zakudya zamtengo wapatali [64].

Chithunzi 3  

Hyperphagia itha kubwera kuchokera pagalimoto yolipirira mphotho yofooka (yokonzedwa kudzera mu dopamine yoyendetsedwa ndi mabwalo a corticostriatal) kuphatikiza kukhudzika kwakumverera kwamphamvu (chakudya cha hedonic cha chakudya chomwe chimakonzedwa mwa gawo kudzera ...

Zoonadi, poyerekeza ndi anthu olemera, anthu olemera omwe amaperekedwa ndi zithunzi za zakudya zamtundu wapamwamba (zomwe zimapangidwira) zimasonyeza kuwonjezeka kwa neural activation m'madera omwe ali mbali ya mphoto ndi maulendo oyendetsa (NAc, dorsal striatum, OFC , ACC, amygdala, hippocampus ndi insula) [65]. Mosiyana ndi izi, kulemera kolemera, kuchitidwa kwa ACC ndi OFC (madera omwe akugwira nawo ntchitoyi ku NAC) pakuwonetsa chakudya chokwanira kwambiri kunapezeka kuti sakugwirizana kwambiri ndi BMI [66]. Izi zikusonyeza kugwirizana kwakukulu pakati pa kuchuluka kwa chakudya chomwe chikudyetsedwa (chomwe chikuwonetsedwa ndi gawo la BMI) ndi kuyanjanitsa kwa madera a mphotho ku chakudya cha calorie (chomwe chikuwonetsedwa mu kutsegulidwa kwa OFC ndi ACC) mwa anthu olemera, omwe ataya kunenepa kwambiri.

Chodabwitsa n'chakuti, anthu olemera kwambiri, poyerekeza ndi anthu oonda, sanagwiritse ntchito zochepa zowonjezera madyerero ochokera ku chakudya chomwecho (chakudya chodetsa nkhaŵa), pamene iwo akuwonetseratu zowonjezereka za zigawo zomwe zimagwiritsidwa ntchito poyang'ana [67] (Chithunzi 4). Zotsatirazi zikugwirizana ndi phunziro lomwe linanena kuti chinawonjezereka m'magazi opangira thupi (chizindikiro cha ubongo) m'zigawo zina zomwe zimapangidwira, kuphatikizapo insula.68] (Chithunzi 3d, e). Ntchito yowonjezereka ya madera omwe amachititsa kuti zikhale zovuta zimapangitsa kuti anthu ambiri azidya zakudya zina zowonjezereka, koma kuchepetsa kutayika kwa zakudya za dopaminergic ndizofunikira kwambiri zogwiritsa ntchito zakudya zomwe zingachititse kuti anthu azidya moyenera ngati njira yothetsera zizindikiro za DA zofooka [69].

Chithunzi 4    

Ophunzira omvera ali ndi kuchepa kwa mayankho ku madera omwe akuwunikira a DA pamene amapatsidwa chakudya poyerekeza ndi zomwe zalembedwa mwatsatanetsatane. (a) Gawo la Coronal lopanda mphamvu kuchitapo kanthu kumbali ya kumanzere yomwe ili kumanzere potsata kulandira mkaka motsutsana ndi njira yothetsera; ...

Zotsatira zojambula izi zimagwirizana ndi mphamvu yowonjezereka ya mphotho yomwe imadalitsika (kuyerekezera chakudya chapamwamba) chomwe chimalosera mphotho, koma kuchepetsa kuchepa kwa zotsatira zowonjezera za chakudya chenicheni mu njira za dopaminergic mu kunenepa kwambiri. Timaganiza kuti, poti pali kusiyana pakati pa mphoto yomwe ikuyembekezeredwa ndi kubereka kumene sikukwaniritse chiyembekezero ichi, izi zidzalimbikitsa kudya mokakamiza ngati kuyesa kukwaniritsa mphoto yomwe ikuyembekezeredwa. Ngakhale kulephera kwa malipiro oyembekezeka kumaphatikizapo kuchepa kwa DA cell kuwombera nyama zamatenda [70], chikhalidwe chofunika cha kuchepa kotere (pamene mphotho ya chakudya ndi yaing'ono kuposa momwe ikuyembekezeredwa) ili, kudziwa kwathu, osati kufufuzidwa.

Pogwirizana ndi kusintha kumeneku kumasintha muzowonjezereka mphoto mu maphunziro ovuta kwambiri, kafukufuku wogwiritsira ntchito zojambula adawonetseranso kuchepa kosasinthika kwa reactivity ya hypothalamus ndi zizindikiro zogonana m'mabuku ovuta kwambiri [71,72].

Pitani ku:

Umboni wa kusokonezeka kwa chidziwitso kwa anthu olemera kwambiri komanso olemera kwambiri

Pali umboni wochulukirapo wakuti kunenepa kumakhudzana ndi kuwonongeka kwa ntchito zina zomvetsetsa, monga ntchito yogwira ntchito, chidwi ndi kukumbukira [73-75]. Zoonadi, kuthetsa kukhumudwa kudya chakudya chofunikira kumasiyana pakati pa anthu ndipo kungakhale chimodzi mwa zifukwa zomwe zimapangitsa kuti azitha kudya kwambiri [34]. Zomwe zimakhudza kwambiri kunenepa kwa kudziwitsidwa zimasonyezanso kuti kuchuluka kwa chisokonezo cha matenda osokoneza bongo (ADHD)76], Matenda a Alzheimer ndi dementias ena [77], cortical atrophy [78] ndi matenda amtundu woyera [79] muzovuta kwambiri. Ngakhale kuti matenda omwe amagwiritsidwa ntchito monga mankhwala oopsa (monga matenda a shuga, matenda a shuga ndi shuga) amadziwika kuti amakhudzidwa kwambiri, palinso umboni wakuti BMI, yokha, ingawononge madera osiyanasiyana, makamaka ntchito yoyang'anira [75].

Ngakhale kusagwirizana pakati pa kafukufuku, deta yolingalira za ubongo imaperekanso umboni wa kusintha kwa kayendetsedwe kake ndi kayendetsedwe kogwirizanitsidwa ndi mkulu wa BMI mwa kulamulira kwathanzi. Mwachitsanzo, kafukufuku wa MRI wochitidwa ndi akazi achikulire pogwiritsa ntchito vophel-wise wisdom morphometry anasonyeza kusagwirizana pakati pa BMI ndi mitu yoyera (kuphatikizapo m'madera akutali), omwe, mu OFC, ankagwiritsidwa ntchito opanda mphamvu [80]. Pogwiritsira ntchito positron emission tomography (PET) kuti awononge ubongo wa shuga m'thupi mwachangu, kuwonetsana kolakwika kunayanjananso pakati pa BMI ndi ntchito zamagetsi mu PFC (dorsolateral ndi OFC) ndi ACC. Mu phunziro lino, ntchito yamagetsi mu PFC inaneneratu zomwe zikuchitika pa mayesero a executive function [81]. Mofananamo, maphunziro a NMR ofunika kwambiri a zaka zapakatikati ndi maulamuliro achikulire adasonyeza kuti BMI inagwirizanitsidwa ndi N-acetyl-aspartate (chizindikiro cha neuronal integrity) pambali yamakono ndi ACC [79,82].

Kafukufuku woganizira ubongo poyerekeza ndi anthu omwe ali ovuta komanso oonda adanenanso kuti m'munsi mwazigawo (frontal operculum ndi gyrus)n [83]. Phunziro lina, lomwe silinapezepo kusiyana pakati pa nkhani za imvi pakati pa nkhani zowopsya komanso zowopsya, zinalemba mgwirizano pakati pa zoyera za ubongo m'magulu a ubongo ndi chiuno: chiuno cha hip; chizoloŵezi chomwe chinasinthidwa pang'ono mwa kudya [84].

Potsirizira pake, udindo wa DA mu kulepheretsa kuyendetsa bwino ndikudziwika bwino ndipo kusokonezeka kwake kungapangitse kusokonekera kwa khalidwe, monga kunenepa kwambiri. Mgwirizano wolakwika pakati pa BMI ndi D2R yowonongeka yawonetsedwa mokwanira [58] komanso nkhani zopitirira mphamvu [85]. Monga tafotokozera pamwambapa, kupezeka kwapafupi kwapadera kwa D2R mu striatum ya anthu odzaza kwambiri kunkagwirizana ndi kuchepetsa ntchito zamagetsi mu PFC ndi ACC [60]. Zomwe zapezazi zimakhala zovuta kwambiri ku DA kuwonetsa kuti zikuthandizira kusokonezeka kwa madera otsogolera omwe ali okhutira kwambiri ndi kunenepa kwambiri. Kumvetsetsa bwino za kusokonezeka uku kungathandize kuthandizira njira zothandizira, kapena kusintha, kuwonongeka kwapadera pa madera akuluakulu a chidziwitso.

Mwachitsanzo, kuchepetsa kubwezeretsa, chomwe ndi chizoloŵezi chokhazikitsa mphotho monga ntchito ya kuchedwa kwa nthawi ya kubwezeretsa, ndi chimodzi mwa ntchito zofufuzidwa kwambiri zofufuzidwa mogwirizana ndi zovuta zomwe zimagwirizana ndi kukhudzidwa ndi kukhudzidwa. Kuchepetsa kuchepetsa kwafufuzidwa kwapadera kwambiri mwa owonetsa mankhwala osokoneza bongo omwe amakonda mphotho-koma-yomweyo pamlingo wawukulu koma wochedwa [86]. Kafukufuku wochepa omwe adachitidwa mwa anthu okhwima amasonyezanso kuti anthu awa amawonetsa zokonda zapamwamba, mwamsanga, ngakhale mwayi wochulukirapo wotsalira zam'tsogolo [87,88]. Komanso, mgwirizano wabwino pakati pa BMI ndi kuwongolera kwa hyperbolic, komwe phindu la m'tsogolomu lidzachotsedwa pang'onopang'ono kusiyana ndi zomwe zidzachitike m'tsogolo, posachedwa [89]. Kuchepetsa kuchepetsa akuoneka kuti kumadalira ntchito ya ventral striatum (kumene NAc ilipo) [90,91] ndi PFC, kuphatikizapo OFC [92], ndipo amamvera DA manipulations [93].

Chochititsa chidwi, zilonda za OFC zinyama zikhoza kuwonjezera kapena kuchepetsa zosankha zazing'ono zomwe zimapindula chifukwa cha kuchepa kwa madalitso aakulu [94,95]. Izi zikuoneka kuti zotsutsana ndi khalidwe labwino zimakhala zosonyeza kuti zochitika ziwiri zimagwiritsidwa ntchito kudzera mu OFC; imodzi ndiyikulingalira, motsogoleredwa ndi mphamvu yolimbikitsana, ndipo ina imayang'anira zofuna zowonjezera [96]. Kulephera kwa OFC kumagwirizanitsidwa ndi vuto lotha kusintha malingaliro olimbitsa mtima a mphamvu zowonjezera monga momwe zimakhalira (mwachitsanzo, kuchepetseratu kufunika kwa chakudya ndi matenda), zomwe zingabweretse chakudya chokwanira [97]. Ngati zolimbikitsa zimalimbikitsa kwambiri (monga chakudya ndi zakudya zomwe zimaperekedwa pa nkhani yowonjezera) zowonjezera mphamvu za reinforcer zidzakwaniritsa cholinga chochipeza, chomwe chimawoneka ngati chilolezo chochedwa kuchepetsa (monga kutenga nthawi mu mizere yayitali kugula ayisikilimu).

Komabe, panthawi yomwe chakudya chimapezeka mosavuta, zomwezo zimayambitsa khalidwe lopambanitsa (monga kugula ndi kudya chokoleti chapafupi ndi kashiyo ngakhale popanda kuzindikira kale za chikhumbo cha zinthu zotere). Kulephera kwa OFC (ndi kwa ACC) kumapangitsa kuti munthu asayambe kuchita zofuna zowonjezera, zomwe zimapangitsa kuti asamangokhalira kuchita zinthu mofulumizitsa.

Pitani ku:

Chakudya choganiza

ITingawonekere kuchokera ku umboni womwe ulipo pano, kuti kachigawo kakang'ono ka anthu ochepa kwambiri amasonyeza kusamvana pakati pa kukhudzidwa kowonjezereka kwa mphotho yoyendetsera mphoto yomwe ikugwirizana ndi chakudya chokwanira cha mphamvu ndi mphamvu zochepa zogwiritsira ntchito kayendetsedwe ka kayendedwe ka mphamvu zomwe zimafooketsa kayendedwe ka mphamvu pa zizoloŵezi zokhutiritsa. Mosasamala kanthu kuti kusalinganika kumeneku kumayambitsa, kapena kumayambitsidwa ndi, kudyetsa kudya kwambiri, chodabwitsa ndicho kukumbukira mkangano pakati pa maulendo, chikhalidwe ndi maulendo oyendetsa ndi dera loletsa kulepheretsa dera limene lakhala likuledzeretsa [98].

Chidziwitso chomwe chinawonjezeka pazaka makumi awiri zapitazo, chibadwa cha nthenda komanso zachilengedwe za kunenepa kwambiri zimatsimikizika kuti vutoli lakhalapo chifukwa cha kugwiritsidwa ntchito pakati pa matenda a ubongo omwe amachititsa kuti tizidya zakudya zamoyo komanso mitundu yambiri ya zakudya zomwe zimapangidwira machitidwe ndi zachuma. Uthenga Wabwino ndikuti kumvetsetsa kumakhazikika kwa makhalidwe omwe kumapangitsa kuti mliri wa kunenepa kwambiri ukhale ndi chinsinsi cha kuthetseratu kwake (onani Mabokosi 3 ndi 4).

Bokosi 3. Zotsatira zamakono zofufuzira

  • Kumvetsetsa bwino kuyanjana kwa maselo, maselo, ndi madera pakati pa homeostatic ndi mphoto zomwe zimalamulira chakudya.
  • Kumvetsetsa gawo la majini poyendetsa homeostatic ndi mayankho a chakudya.
  • Kumvetsetsa bwino momwe magulu ena opatsirana pogonana amathandizira, monga odwala matendawa, opioids, glutamate, serotonin ndi GABA, kusintha kosatha komwe kumachitika chifukwa cha kunenepa kwambiri.
  • Kufufuza za chitukuko cha matenda a neurobiology omwe amachititsa kudya zakudya (homeostatic ndi zopindulitsa) komanso kumvetsetsa kwa chakudya cha chilengedwe.
  • Kumvetsetsa epigenetic kusintha kwa ma cirurits neuronal kumakhala ndi homeostatic komanso kupatsa mphamvu kudyetsa chakudya mu fetal ubongo poyankha kuwonjezera chakudya ndi kusowa chakudya panthawi yoyembekezera.
  • Kufufuza kafukufuku wa chipatala m'mapiritsi a homeostatic ndi mphotho zokhudzana ndi kupezeka kwa zakudya zokoma kwambiri komanso / kapena chakudya chokwanira cha calorie.
  • Kufufuza za mgwirizano pakati pa homeostatic ndi hedonic njira zomwe zimayambitsa kudya ndi zochitika.

Bokosi 4. Zotsatira zamakono zafukufuku

  • Zofufuza kuti azindikire ngati kulimbikitsidwa kwakukulu kwa madera okhudzana ndi mphotho kumayenderana ndi zokhudzana ndi chakudya mwa anthu olemera kwambiri akuvutika ndi chiopsezo chawo chodyera kapena akuwonetsa kachilombo koyambitsa matendawa kuti adye chakudya chambiri.
  • Izi zikupangidwira kuti kupititsa patsogolo dopaminergic neurotransmission kumathandizira kuti munthu azikhala ndi khalidwe loyendetsa bwino pogwiritsa ntchito kukonza ndi / kapena kulimbikitsa zidziwitso zomwe zimagwiritsidwa ntchito kudzera mwa PFC; Komabe, kufufuza kwina kuli kofunikira mu njira zomwe sizikudziwika bwino.
  • Zakudya zokha sizimangokhala njira yopambana (ie yosatha) kulemera kwa thupi. Zingakhale zothandiza kuyankha ngati: (i) kudya kungayambitse matenda obwera chifukwa chowombera; ndipo ii) kuchepa kwa leptin zomwe zimagwirizanitsidwa ndi zakudya zowonongeka zowonongeka zimayambitsa kuwopsa kwa madera oyendetsera mphotho komanso zoperekera zakudya zoyenera.
  • Kafufuzidwe kafukufuku wokhudzana ndi matenda a ubongo omwe akugwera akuchepetsa chilakolako cha chakudya ndi njala yotsatira opaleshoni ya batiatric.
Pitani ku:

Zothandizira

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