Kuwonetsa biopsychological za vuto lakutchova njuga (2017)

Gabriel C Quintero

Ndemanga yapano ndikuwunikira komwe kumayeserera ntchito zakale zokhudzana ndi vuto la kutchova juga. Zimaphatikizapo mitu ya 1) kusokonezeka kwa kutchova njuga kuchokera ku malingaliro a neuroimaging and electroencephalography (EEG), 2), magwiridwe antchito, komanso mbali ya neuropsychological yokhudzana ndi kutchova juga, ndi 3) makina osokoneza bongo osokoneza bongo. Zilango ndi kutayika mu kutchova juga kumatha kusiyana pamalingaliro amtundu wa ubongo. Komanso magwiritsidwe ena amomwe ubongo umagwirira ntchito, maumboni amtundu wa muubongo, mayankho a EEG, komanso kuzindikira kwawoko ndi magwiridwe antchito amatha kusiyanitsa otchova njuga kwa omwe amatchova njuga. Komanso, otchova njuga amatha kuwonetsa kukanika m'malo a ubongo monga chikole, kutsogolo kwa lobe, ndi orbitof mbeleal cortex. Kutchova juga kwachidziwitso ndi vuto lomwe limatha kusiyanasiyana malinga ndi kuuma kwa kuzindikira, kutchova juga (kachitidwe kake kapena ayi), chiyembekezo chakuchira, matchulidwe obwereranso, komanso kutchulidwa poyambitsidwa ndi chithandizo. Pomaliza, potengera mitundu ya njuga, kuyenera kwa chisankho cha juga kumayendetsedwa ndi kupezeka kwa ma cices, zochitika za dopamine receptors, komanso zochitika zina za ubongo (infralimbic, prelimbic, or rostral agranular insular cortex). Otchova juga amasiyana pamasewera olowa kutsogolo kwa ubongo poyerekeza ndi otchova juga osaneneka (ngati kuwina kapena kutaya masewera). Otchova njuga anali ndi ntchito ya EEG. Kuopsa kwa kutchova juga kunalumikizidwa ndi kukulitsidwa ndi zopezeka zazidziwitso. Insula inali yofunikira pakupotoza malingaliro omwe adalumikizidwa ndikuwunika pazotsatira pa njuga.

Maono a Neuroimaging ndi electroencephalography (EEG)

Njira zapadera zamagulu olumikizana ndi ubongo zimalumikizidwa ndi zilango (zotayika) kapena kubwezera (phindu) la njuga.7 Ndikothekanso kusiyanitsa pakati pa otchova njuga omwe amagwiritsa ntchito nthawi yomweyo ndi otchova juga pamasewera olimbitsa thupi,8 kuchuluka kwa zinthu zaimvi,9 kukula kwa kapangidwe kakang'ono ka ubongo,9 zochitika zam'mbuyomu zowonongeka kwa ubongo, komanso mayankho olakwika a EEG.10

Chithunzi chomwe chimatha kusiyanitsa pakati pa otchova juga am'magazi komanso anthu otchova juga pamasewera olimbitsa thupi ndi kuphunzira komwe kunachitika ndi Miedl et al. Izi zidasiyanitsa ndi gulu la otchova njuga komanso ovuta pachiwonetsero pakamayeserera masewerawa akuda pogwiritsa ntchito mphamvu zamagetsi zotsatsira (fMRI).8 Makamaka, magwiridwe antchito aubongo anayeza pa kuwunika kwa ngozi (ngozi yayikulu komanso yotsika) ndikuwongolera mphotho (kuwina kapena kutaya ndalama) pogwiritsa ntchito ntchito zomwe zimafunikira kuti omasankhawo asankhe pakati poti atenge kapena ayi panjira ya nkhandwe yoopsa . Palibe kusiyana komwe kunapezeka pakati pa magulu pazikhalidwe; komabe, ma indices omwe amalumikizidwa ndi mulingo wa okosijeni wamagazi anali osiyana kwambiri pakati pamagulu mu thalamus, apamwamba akakanthawi, komanso magawo oyang'ana kutsogolo kwa ubongo. Ngakhale otchova njuga adawonetsa kuyankhidwa kwamikhalidwe yoopsa kwambiri komanso kuchepetsedwa kwa zoopsa, ena otchova njuga nthawi zina ankawayankha motsutsana. Kuphatikiza apo, pakubweza mobwerezabwereza, otchova njuga omwe amakhala ovuta komanso owonetsa kanthawi kochepa amawonetsa kuwonjezeka kwa ntchito yaubongo kumbuyo kwa cingated cingated and ventral striatum. Kuphatikiza apo, osewera ovuta adawonetsera mawonekedwe amtundu wa kutsogolo, komwe kungayimire kukumbukira kwamtsogolo komwe kumatsutsidwa ndi zomwe zimayenderana ndi masewera.8

Kufufuzanso kwina komwe kukuwonetsa kuti njira zina zochitira mu maubwenzi amtundu waubongo zimalumikizidwa ndi zilango (zotayika) kapena kubwezera (phindu) la ntchito yotchova njuga yomwe anachitidwa ndi Camara et al. Ntchitoyi idaphunzira kukonza kwa zida za neural zomwe zimakhudzana ndi kukonza kwachilango ndi kubweza.7 Makamaka, mitundu yosiyanasiyana yolumikizirana (ubongo wam'deralo ndi yotakata) idasinthidwa pogwiritsa ntchito fMRI pomwe maphunziro adachita masewera olimbitsa thupi. Kafukufuku adapeza kuti phindu la ndalama ndi kutayika zidayendetsa malo amodzimodzi muubongo (wopangidwa ndi ubongo wama kutsogolo - striatum ndi limbic system); pambali, kuyambitsa kwakukulu kudapezeka mu striatum yapansi (m'magulu onse a hemispheres). Kugwirizana kwa ntchito yolumikizana kunawonetsa mayendedwe okondweretsa kuti apeze ndi kutaya malo mu amygdala, hippocampus, ndi insort cortex yomwe imalumikizana ndi kutsegulidwa komwe kwakupezeka kumalo amtunda kwa striatum otsika kwambiri, komanso kulumikizana kwa amygdala kunawonekera kwambiri pambuyo pake pakuwonongeka.7

Kumbali inayi, ndizothekanso kusiyanitsa pakati pa otchova njuga omwe amatsutsana ndi omwe amatchova juga pamasewera olingana ndi kuchuluka kwa imvi yaubongo komanso kukula kwa kapangidwe kakang'ono ka ubongo, kutengera kafukufuku wochitidwa ndi Fuentes et al.9 Kafukufukuyu adawunika kusiyana kwa kuchuluka kwa maubongo pakati pa ochita masewera amiseche omwe ali ndi vuto la kutchova njuga (n = 30) ndi odzipereka athanzi (n = 30) pogwiritsa ntchito kusanthula kwa zithunzi zomwe zimapezeka pamakina ogwiritsira ntchito maginito (1.5 T).9 Kusiyana komwe kunapezeka kunali kovutikira kakang'ono ka zinthu zaimvi kutchoyerekeza ndi kuwongolera; Komanso, otchova njuga adawonetsa kukula kwakukulu mu thalamus (kumanja), hippocampus (kumanja), ndi putamen (kumanzere). Mapeto ake anali oti kusasinthika kwa ubongo kungalimbikitse kusintha kwa ntchito komwe kumalumikizidwa ndi chizindikiro cha kutchova juga; Komanso, kafukufukuyu amathandizira lingaliro loti njira yobwezera ziwalo zam'mimbamu ndiyofunikira ku pathophysiology yamatendawa.9

Potenza et al adasiyanitsa gulu la amuna amuna omwe ali ndi vuto la kutchova juga ndi gulu loyang'anira pogwiritsa ntchito zithunzi za zochitika zokhudzana ndi zochitika za FMRI.11 Makamaka, zochitika za preortalal cortex (makamaka malo a podromedial) pazomwe zimachitika panthawi ya kuyeserera kwa Stroop zidawunikidwa. Ochita kutchova njuga anawonetsa mayankho otsika kumanzere kwa chimbudzi cham'mbuyo poyerekeza ndi maphunziro omwe amayesedwa ndi zotsatira zopanda pake. Komabe, magulu onse awiriwa adawonetsa kusintha kosiyanasiyana magawo osiyanasiyana a chithokomiro, kuphatikiza ma activation a rostral cingrate cortex apamwamba ndi dorsolateral frontal cortex. Kafukufukuyu adanenetsa kuti otchovera njuga komanso operekera matendawa adagawana ndi ma neuronal angapo pa Stroop-test mayeso, koma osiyanasiyana muntunda wokhudzana ndi kusokonekera.11

Chithunzithunzi choti ndizothekanso kusiyanitsa pakati pa otchova njuga omwe amadziwika kuti ndi otchova njuga makamaka potengera kuwonongeka kwa ubongo komanso vuto lonyansa la EEG kunali kufufuza komwe a et et. Kafukufukuyu adasiyanitsa gulu la otchova juga popanda vuto la kugwiritsa ntchito mankhwala osokoneza bongo komanso gulu la maphunziro abwino, pogwiritsa ntchito kuyankhulana kwa mitsempha, kuwunika kwa ma neuropsychological, ndi muyeso wa EEG.10 Kafukufukuyu adapeza kuti 81% ya opanga masewera anali ndi chikhalidwe chaumoyo wamavuto owonongeka, ndipo zidapezeka kuti opanga masewera adasokonekera kwambiri mu kukumbukira, ntchito zamphamvu, komanso ndende. Komanso, kusanthula kwa EEG kwawonetsa kuyankha kovutikira mu 65% ya osewera poyerekeza ndi 26% yowongolera. Kafukufukuyu adatsimikiza kuti otchova juga anali opuwala ubongo ndipo amawonongeka kwambiri mu ntchito za neuropsychological zomwe zimakhudzana ndi mabwalo amtsogolo ndi zina zambiri zosakhudzana ndi EEG. Ofufuzawo anena kuti vuto la kutchova juga lingakhale chifukwa cha kusokonekera kwa ubongo, makamaka machitidwe a frontolimbic.10

Pomaliza, ntchito ina yolembedwa ndi Doñamayor et imasiyanitsa phindu la ndalama ndi kutayika pamachitidwe otchova juga potengera kuwunikira kwakukulu kwa mutu wa magnetoencephalography.12 Makamaka, kutayika kwakulumikizidwa ndi kukhudzana ndi mayankho okhudzana ndi kusintha kwa malingaliro ndi kusinthasintha pamavuto a pafupipafupi a θ-frequency; komabe, zopeza zinali zokhudzana ndi kuphulika mu β-range, motengera mphamvu zokhudzana ndi chikhalidwe cha anthu am'tsogolo. Kuphatikiza apo, kusanthula kofananira ndi mutu wa mutu wonse womwe umapezeka mu mkhalidwe wa kutaya komwe maginito okhudzana ndi mayankho okhudzana ndi ndemanga adakulitsidwa pakati pa 230 ndi 465 ms. Komanso, izi zidalumikizidwa ndi jenereta yoyamba mu caudal cingrate cortex, motsatiridwa ndi rostral cingate cortex ndi insula yolondola; kukhudzidwa uku kunali kovomera kufikira kutayika kwa ndalama. Pomaliza, kusiyana kunapezekanso pakati pa kupambana ndi kutayika malinga ndi zigawo za oscillatory zomwe zikuwonetsedwa ndi mutu-wonse wa zigogoencephalography: mawonekedwe a "win" adalumikizidwa ndi kusinthasintha kwa ma α-, θ-, ndi ma β- otsika γ, koma kutayika kwakalumikizidwa ndi mawonekedwe β-apamwamba (omwe adalumikizidwa ndi kukula kwa kutayika).

Mapeto pa neuroimaging ndi malingaliro a EEG

Monga kuphatikiza kwa maphunziro omwe afotokozedwa pano mpaka pano, malingaliro akulu otsatirawa mu gawo lino akhoza kutsimikiziridwa. Kusiyana kwakukulu pakumachitika kwa ubongo pakati pa otchova juga komanso otchova juga nthawi zina ngati kuwina kapena kutaya masewerawa kunali kuti otchova njerewere amawonetsa njira ina yolowera kutsogola (izi zitha kutanthauziridwa ngati chizindikiritso cholimbikitsa chizindikirocho.8 Komabe, magulu onse awiriwa adawonetsa kuyankha kwamtundu wa caudal cingate cortex komanso striatum yotsika mtengo.8

Kafukufuku wina adafufuza kusiyana kwa machitidwe aubongo pazomwe zimachitika nthawi yonse yopambana kapena kutaya masewera. Mwambiri, kuwina kapena kutaya machitidwe ofanana poyankha patriostostatatimbimbic matrix (nsonga zazikulu mu ventral striatum), amygdala, insort cortex, ndi hippocampus potengera mphamvu zakumunda zofananira; komabe, pazotayika, kulumikizidwa kwa amygdala kunawonekera kwambiri.7 Komanso, zotayikiridwa zimalumikizidwa ndi negofitale yokhudzana ndi mayankho osinthika komanso mayankho osinthika omwe adaphulika pakapita nthawi ya θ; komabe, zopeza zinali zokhudzana ndi kuphulika mu β-range, motengera mphamvu zokhudzana ndi chikhalidwe cha anthu am'tsogolo.12

Kuphatikiza apo, pazotayika, malinga ndi mutu-wonse wa zigogo-ma-multimedia, maginito okonza magonedwe okhudzana ndi mayankho okhudzidwa pakati pa 230 ndi 465 ms. Kuphatikiza apo, adalumikizidwa ndi pulasitala woyamba wa caudal cingate cortex, wotsatiridwa ndi rostral cingulate cortex ndi insula yoyenera; Izi zidachitika pomvera kukula kwa chuma.12 Kuphatikiza apo, kupambana ndi kutaya kunasiyana pamitundu yosiyanasiyana yosonyezedwa ndi magnetoencephalography yonse. Makamaka, zopindulitsa zimalumikizidwa ndi zinthu zosinthasintha m'magawo a α-, θ-, komanso β-otsika γ, koma kutayika kudalumikizidwa ndi mtundu wapamwamba kwambiri (womwe umalumikizidwa ndi kukula kwa kutayika).12

Kusiyana kwakukulu muzochitika zamaubongo, kotengera fMRI, pakati pa zovuta ndi otchova juga nthawi zina pamikhalidwe yotsika kwambiri inali motere.8 Panthawi yomwe amakhala pachiwopsezo chachikulu, otchova njuga amawonetsa kuyankha kwakukulu pamtundu wa thalamus komanso malo ocheperako komanso osakhalitsa ochepa poyerekeza ndi omwe amatchova njuga nthawi zina. Kumbali inayi, panthawi yamavuto otsika, otchova njuga amawonetsa kuyankha kochepa pamtunda wa thalamus komanso malo ocheperako komanso osakhalitsa ochepa poyerekeza ndi omwe amatchova njuga nthawi zina.

Panali kusiyana kosiyana pakati pa otchova njuga ndi otchera. Ochita juga anawonetsa zochulukirapo ndimakutu poyerekeza ndi odzipereka athanzi, malinga ndi ukadaulo wa MRI.9 Komanso, odzipereka athanzi anali ndi ziwonetsero zazikulu za hippocampus lamanja, thalamus yakumanja, komanso lamanzere kumanzere poyerekeza ndi otchova njuga.9 Ochita masewera otsogola adawonetsa ntchito yochepetsetsa m'chigawo chaubongo chokhudzana ndi kuwongolera (ventromedial pre mbeleal cortex) poyerekeza ndi zowongolera, kutengera fMRI yokhudzana ndi zochitika;11 komabe, panalibe zosiyana m'mayankho a rostral cingrate cortex kapena dorsolateral frontal cortex.11 Ochita masewera otchova juga anali ndi ntchito yovuta ya EEG poyerekeza ndi oyendetsa bwino.

Zogwira ntchito mozindikira, magwiridwe antchito, komanso mbali zama neuropsychological zamagetsi

Otchova njuga amatha kuwonetsa zochita m'njira zazidziwitso kapena zowongolera, ndipo kusintha kumeneku kumawasiyanitsa ndi otchova njuga omwe samvera. Zina mwazovuta zomwe zimapezeka m'matumbo amisala zimadziwika kuti sizingachitike,13-17 kukhazikika kwachidziwitso,13,14,18 kuperewera pokana kuponderezana,14 kuyankha kwachinyengo,19 kusokoneza kwa zopinga,13 kuwunika pang'onopang'ono,13,14 kusokoneza ntchito,13,20 zosankha zowonongeka (zowopsa21 kapena kusankha),17 zolakwika zowunika zotsatira zamtsogolo,22 kusokonezeka kukumbukira10 kusokonezedwa10 kuyendetsa bwino ntchito,10 kusaka zodziwika,17 kuletsa kuvulaza,17 kusowa kwa mgwirizano,17 kudzilamulira koipa,17 zolakwika pakuthana ndi mavuto (kupeza njira zatsopano),23 ndi kusagwira bwino ntchito.23

Kuphatikiza apo, kusintha kosiyanasiyana kwa ma neuropsychological omwe amapezeka m'matumbo am'magazi kwalumikizidwa ndi kusokonezeka kwa ubongo m'malo monga insula (kutanthauzira kwa zochitika ndi zotsatira),24 kutsogolo lobe (kuchepa kwa ntchito yayikulu),13 orbitof mbeleal kotekisi (zosankha zopanda pake,21 kuyesa zotsatira zamtsogolo,22 kapena kukhazikika kwanzeru),18 preontial cortex (ozindikira ozindikira (malo oyenda),18 zosankha zowonongeka (dorsolateral zone),21 zolakwika kupeza njira zina mavuto,23 kugwira ntchito kotsika,23 ndi chitseko cham'mimba (chidziwitso chazovuta).23 Kuphatikiza apo, zovuta zina zamagetsi zomwe zimachitika zimakhudzana ndi maubongo a ubongo monga ma frontotemporolimbic matrix (kuchepa kwa kukumbukira, kugogomezera, komanso kuchita zantchito yayikulu)10 ndi dera la kutsogolo (zoperewera posankha chisankho, kukakamizidwa, kufunafuna zapamwamba, kupewa kupweteketsa mtima, kuchepetsa mgwirizano, komanso kudziyang'anira).17

Ngakhale mkati mwa mitu yamaphunziro omwe ali ndi njuga zam'magazi, ndizotheka kupeza kusiyana kwamkati motengera: kuchuluka kwa kuzindikira (kupotoza kolumikizidwa kumalumikizidwa ndi vuto lalikulu kwambiri);25 mtundu wamasewera otchova njuga (njira zamasewera zopanda njira; otchovera njuga omwe ali ndi mitundu yosiyanasiyana ya juga amatha kusiyanasiyana pokhudza kugonana, udindo wapabanja, komanso zaka);26 kutanthauzanso kutchova njuga (zosinthika zina zimatha kuyambitsa kubwereranso kutchova juga, monga kutalika kwa chisokonezo, kudziwitsa, kusankha kosankha, komanso mawonekedwe amkati amanjenje);13 matchulidwe ake kusiya kwa mankhwala (zinthu monga kufufuma kwambiri, kusokonekera kodzilamulira, kusokonekera kwa magwiridwe antchito, komanso kukakamizidwa kwakukulu kungachepetse kusiya kuchotsedwa);27 ndi kusiyana pakubwezeretsa ndikuyenda patsogolo kwa chithandizo (zovuta zogwiritsa ntchito zinthu zimasokoneza malingaliro ndi kuwongolera [zoletsa], chifukwa zinthu zimalepheretsa kugwira ntchito kwa preortal cortex).28 Adanenedwa kuti otchova njuga amatha kuyambitsa matenda ofanana pogwiritsa ntchito mankhwala; Kuphatikizika kwa zovuta kumatha kupangitsa kuchira komanso / kapena njira zakuchira ndizovuta kwambiri.29

Tsopano, kafukufuku wosiyanasiyana akufotokozedwa omwe amapanga gawo ili pa kuzindikira, ntchito yayikulu, ndi neuropsychology ya juga ya pathological. Choyamba, kafukufuku adayang'ana kuyanjana pakati pakupotoza komwe kumayenderana ndi kutchova juga ndi magawo osiyanasiyana a njira zotchovera juga (zotheka zamasewera, kusewera kovuta, ndi kusewera kosavomerezeka).25 Ikagwiritsa ntchito achinyamata, achinyamata, komanso achikulire ochokera ku China. Zotsatira zinawonetsa kuti kupotoza kozindikira, makamaka komwe kumakhudzana ndi kulephera kuchita kuletsa masewera ndi kuyembekezera kwabwino pamasewera, zinali zisonyezo zodziwika bwino zamasewera atatu omwe akutukuka. Makamaka, zinanenedwa kuti gulu lotseguka la m'maganizo limakhala ndi malingaliro ochulukira kuposa magulu ena ovuta kutchova juga, omwe pambuyo pake amawonetsa zodziwikiratu kuposa kuphonya kosavomerezeka kwa juga. Komabe, kuchuluka kwa misala yodziwoneka bwino kunawonetsa mtundu wosiyana malingana ndi vuto la kutchova njuga: munjira zosavomerezeka za kutchova juga, mitu yokhwima imawonetsa kuwonekera kochenjera kuposa magulu ena; mbali inayi, munkhani zovuta za kutchova juga, maphunziro okhwima adawonetsa kuperewera kolingana ndi magulu ena; ndipo m'magulu otchovera njuga, achinyamatawo adawonetsa zochenjera kuposa magulu enawo. Pomaliza, kusiyana kwakugonana kunanenedwanso mu mitundu yotsutsana: m'magulu osavomerezeka amtundu wa juga, abambo adawonetsa kusokonekera kwakukulu pakusagwirizana kwawo kuti athe kusewera mosiyana ndi akazi; mbali inayo, munjira zolaula zomwe zingayambitse vuto logonana.25

Kafukufuku wolemba Ledgerwood et al kusiyanitsa kukhoza kwa nzeru, kukumbukira, ndi maudindo akuluakulu (kukumbukira [kugwira ntchito], kuletsa kuyankha, kuzindikira mapulaneti, kupilira, kulingalira bwino, ndi bungwe) pakati pamagulu a maphunziro omwe ali ndi vuto la kutchova njuga ndi kuwongolera (zitsanzo za 45 maphunziro pa tsango limodzi).20 Kufufuzaku kunanenanso kuti maphunziro omwe ali ndi vuto la kutchova njuga amawonetsa zolakwika zina pamlingo wa bungwe komanso kukonzanso malingaliro poyerekeza ndi zomwe zimawongolera.20

Ntchito ina inasiyanitsa magulu awiri a maphunziro ndi vuto la kutchova njuga (n = 77) logawidwa ndi mitundu ya njuga yomwe amakonda: Strategic motsutsana nonstrategic.26 Njira yamtundu wa juga yomwe inkakhala ndi ma craps, makhadi, masewera opikisana, komanso kugulitsa masheya; njuga yopanda mafayilo ake inali ndi tepi yakukoka, makina olowetsa, ndi makanema apavidiyo. Masango adafananizidwa potengera zosintha zosiyanasiyana monga maukadaulo (kutha kwa njuga, nthawi, ndi ndalama zomwe zimagwiritsidwa ntchito), matenda amisala yofananira, komanso mayeso aubongo ndi kuzindikira (kuchuluka kwazinthu zam'mapulogalamu amtundu wa pulayenti ndi kuchepa kwa magalimoto). Kafukufukuyu adapeza kuti osewera omwe alibe magulu anali othekera kwambiri kukhala azimayi, osudzulidwa, komanso okalamba; Kuphatikiza apo, ndalama zomwe zimaseweredwa sizinasiyane pakati pa masango. Osewera omwe sanakhale ndi magawo awiriwa sanasinthe malinga ndi momwe amagwirira ntchito: magulu onse awiriwa adawonetsa kusawongolera kuwongolera ndi kusakhazikika kwachidziwitso poyerekeza ndi mitu yoyang'anira. Anazindikira kuti njira zomwe amakonda amakonda pamasewera (nonstrategic vs Strategic) zitha kulumikizidwa ndi zochitika zina zamankhwala koma sizingasiyane pang'onopang'ono chifukwa cha kuyendetsa galimoto komanso kuzindikira zovuta.26

Billieux et al30 kuwunikira ngati zinthu zomwe zingalumikizidwe ndi masewera olimbitsa thupi (mwachitsanzo, kukhudzika komwe miyambo ingathandize kuchita bwino kusewera) kungakhudze mayankho ndi mayankho anu poyesa kutchova juga. Pachifukwa ichi, gulu la maphunziro (n = 84) omwe ankasewera pafupifupi mwezi uliwonse ankachita masewera olimbitsa thupi a noncomplex. Kafukufukuyu adazindikira kuti luso lolingalira pamasewera olimbitsa thupi (mwachitsanzo, malingaliro abodza okopa omwe amalimbikitsidwa ndi kusintha kwa zinthu zina monga kukonzanso zotsatira zoyipa), koma osati miyambo yolingana ndi njuga (mwachitsanzo, malingaliro abodza okopa olimbikitsidwa ndi zina zakunja monga mwayi), adalimbikitsa zambiri zapamwamba polimbikitsira kusewera zotsatila zaposachedwa. Komabe, zidanenedwa kuti kusakhala kwawongolera pakulamulira kwamtsogolo pakulimbitsa thupi. Kafukufukuyu adatsimikiza kuti zoyambitsa zotsatira zaposachedwa zimayenderana ndi kutchova njuga kogwirizana ndi kuthekera kwa kuthekera, kutsimikizira lingaliro lakuti kutchova njuga pafupi ndi zophonya kumalimbikitsa mawonekedwe akuwongolera.30

Kafukufuku adawunika mndandanda wazamaphunziro a zaka za 18-65 zaka; Maphunzirowa anali otchova njuga ndipo anapangidwanso pantchito zotsatsa nyuzipepala.14 Ophunzirawo adalumikizidwa m'magulu atatu (popanda zoopsa, mitu yomwe ili pachiwopsezo, ndi maphunziro omwe ali ndi vuto la kutchova njuga) kutengera kufunsa kofufuza. Ntchitoyi idapeza kuti maphunziro omwe ali ndi vuto la kutchova juga anali okalamba modabwitsa ndipo amawonetsa zoperewera zamphamvu zogwirizana ndi kusunthika, kuthamanga poyankha, komanso kusinthasintha kwazinthu poyerekeza ndi maphunziro. Ntchitoyi idatsimikiza kuti kuponderezedwa kosokonekera komanso kukhudzika kwazinthu kumakhalapo pazochitika zomwe zili ndi vuto la kutchova njuga, mosiyana ndi osewera popanda ngozi komanso pangozi. Komanso, zidafotokoza kuti kuzindikira msanga kwa vutoli muzaka zachinyamata kapena zaka zocheperako kumatha kuthandizira kupewa matenda amtundu wa juga.14

Kertzman et al adasiyanitsa kulowererapo kosakanikira mumagulu a anthu omwe ali ndi vuto la masewera (n = 62) ndikuwongolera maphunziro (n = 83) pogwiritsa ntchito njira yosinthira kumbuyo ya Stroop.19 Zinapezeka kuti magwiridwe antchito omwe ali ndi vuto la kutchova njuga anali operewera komanso osachedwa kwambiri kuyerekeza ndi kuwongolera. Kuphatikiza apo, nthawi yankho mu boma losalowerera ndale (mawu mu inki yakuda) sanachedwe kuyerekezedwa ndi nthawi yankho mu boma losawonongeka (dzina la utoto ndi inki wosiyana). Ntchitoyi idatsimikiza kuti kuphedwa kwa mayeso a Stroop kudasokonekera m'matumbo oyambira.19

Goudriaan et al adawunika kulumala kwa mitsempha ya magwiridwe antchito m'magulu omwe ali ndi vuto la kutchova njuga (n = 49), kayendetsedwe kabwinobwino (n = 49), iwo omwe ali ndi vuto la kugwiritsa ntchito mankhwala osokoneza bongo (vuto la kugwiritsira ntchito mowa, n = 46), ndi tsango ndi chisokonezo pakuwongolera zoyeserera (Tourette's, n = 46).13 Batiri lalikulu la neuropsychological lidagwiritsidwa ntchito lomwe limayeza magwiridwe antchito komanso magwiridwe antchito oyang'anira. Zinapezeka kuti magulu a omwe ali ndi vuto la kutchova juga kapena kugwiritsa ntchito mowa amawonetsa kuchepa kwa zoletsa, kuwunika nthawi, kudziwidwa bwino kwamapulogalamu, komanso kulinganiza ntchito. Mapeto akulu a kafukufukuyu anali oti maphunziro omwe anali ndi vuto la kutchova juga komanso mowa anali osiyanitsidwa ndi kuchepa kwa oyang'anira; Izi zikusonyeza kuwonongeka kwakukhudzana ndi kulumikizana kwa lobe kutsogolo. Kufanana pakati pa kutchova juga ndi vuto la kugwiritsa ntchito mowa kumapereka lingaliro lodziwika bwino la matenda amanjenje.13

Kafukufuku wina adasiyanitsa kagulu ka amuna omwe ali ndi vuto la kutchova njuga (n = 25) ndi gulu laowongolera amuna (n = 25) pogwiritsa ntchito masewera-a-kete.21 Kafukufukuyu anapeza kuti anthu omwe ali ndi vuto la kutchova njuga amawonetsa zofooka pamasewera oyendetsa masewera; Kuphatikiza apo, zidapezeka kuti zochitika zosintha zowopsa zinali zokhudzana ndikuwunika mayankho komanso magwiridwe antchito akuluakulu. Kafukufukuyu adamaliza kuti zisankho zowopsa zomwe ophunzira omwe ali ndi vuto la kutchova juga atha kusokonezedwa ndi kusokonekera kwa kutsogolo komanso kusokonekera kwa chimbudzi.21

Kumbali ina, Cavedini et al22 adasiyanitsa njira zowongolera zisankho zomwe zimachitika ndi ntchito ya inferomedial pre mbeleal cortex pagulu la akatswiri otchovera njuga (n = 20) ndi maphunziro olamulira athanzi (n = 40) pogwiritsa ntchito njuga. Kafukufukuyu akuwonetsa kukhalapo kwa ubale pakati pa vuto la kutchova njuga ndi matenda osiyanasiyana (monga, kugwiritsa ntchito mankhwala osokoneza bongo ndi vuto lochita kukakamiza) lomwe linawonetsa kuchepetsedwa kuyesa zotsatira zamtsogolo, komanso kuti izi zitha kuwerengedwa pang'ono pang'ono mwa atypical machitidwe a orbitofrontal kotekisi.22

Boog et al adaphunzira kusazungulira mu gulu la otchova njuga pogwiritsa ntchito ntchito: woyamba wokhazikika wodziwa kuzindikira ndi gawo lobwezeretsanso (mwachitsanzo, kusinthanso kuphunzira), ndipo chachiwiri chilinganizo chowunikira kuzindikira kwazonse m'zinthu zotere. ).18 Chifukwa chaichi, miyeso ya zolipiritsa zozolowera zolumikizana zolimbitsa thupi (zolimbitsa thupi zolimbitsa thupi) ndi mayeso a Wisconsin Card Sorting (WCST) adasiyanitsidwa pakati pa gulu la maphunziro omwe amafunafuna chithandizo chokhala ndi vuto la kutchova njuga ndi tsango loyendetsa (lofanana Ndi zaka komanso zogonana). Zotsatira zake zidawonetsa kuti maphunziro omwe ali ndi vuto la kutchova juga adasokoneza kuperekedwa kokha pakulankhula kwa mitsempha yowunikira kubwezeretsedwa kozindikira. Zomwe zapezazi zikuwonetsa kuti kusinthasintha kwazinthu zomwe zili ndi vuto la kutchova njuga ndizotsatira zamaphunziro olimbitsa thupi osazolowereka, ndipo osakhazikitsidwa pachiwopsezo chambiri chazovuta. Kuphatikiza apo, ofufuzawo adawona kuti zovuta zomwe adaziwona zinali chizindikiro cha kusowa kwa kolowera kwapambali pake, orbitof mbeleal cortex, komanso dera laling'ono la striatum mitu yomwe ili ndi vuto la kutchova njuga.18

Maraziti et al amafufuza za pathophysiology yamavuto otchova juga.23 Kafukufukuyu adasanthula gulu la maphunziro omwe ali ndi vuto la kutchova njuga (n = 20) pogwiritsa ntchito mayeso a neuropsychological ndicholinga chofufuza madera omwe ali ndi matenda. Mayeso omwe adagwiritsidwa ntchito anali mayeso amawu ogwiritsira ntchito mawu, WCST, ndi Wechsler Memory Scale (kukonzedwanso). Poyerekeza ndi gulu lolamulira, omwe ali ndi vuto la kutchova njuga amawonetsa zosiyana mu WCST zokha; mwachindunji, adawonetsa zoperewera pakuzindikira njira zosankha zothetsera mavuto ndikuwonetsa kuchepa kwamphamvu pamene akupita patsogolo magawo a ntchitoyo. Ziyerekezo zapakati za mayeso ena zinali mkati mwa mulingo woyenera. Kafukufukuyu adatsimikiza kuti maphunziro omwe ali ndi vuto la kutchova juga anali ndi zolakwika zochokera ku WCST; mwachindunji, sanathe kuphunzira kuchokera pazolakwitsa zawo ndikufufuza mayankho ena. Inanenanso kuti kuchita zachiwerewere kumayendedwe oyambilira kungayambitse zovuta za kutchova njuga zomwe zingawapangitse kuti azitha kutengera kutengera kwazovuta komanso / kapena mokakamiza, monga zomwe zimapezeka muvuto la kutchova juga.

Mbali inayi, pogwiritsa ntchito fMRI, Coricelli et al adanena kuti kuyambiranso kuyankha mu amygdala ndi orbitofrontal cortex kunachitika pa nthawi yosankhidwa, pomwe chithokomiro chimayembekezera zotsatira zoyeserera.31 Kuphatikiza apo, mapangidwe awa amawonetsera kuphunzira pokhazikika pamalingaliro omwe anakumana kale. Zotsatira zam'maganizo zimatha kupanga njira zowunikira zomwe zimachitika posankha njira, ndikupangitsa kulimbikitsa kapena kupewa zomwe mwakumana nazo.

Bechara ndi Martin adasanthula ngati kudalira zinthu kungasokoneze kukumbukira kukumbukira kutengera masewera olimbitsa thupi komanso zomwe sizingafanane ndi masewera olimbitsa thupi.28 Kutengera ndi zotsatira zawo, olemba adanena kuti preortal cortex ndiyomwe imayendetsa njira zosiyanasiyana zakusankha komanso zoletsa. Komanso adati malingaliro omwe ali ndi vuto la kugwiritsa ntchito mankhwala osokoneza bongo amakhudzidwa ndi mtundu uliwonse kapena kuphatikiza kwawo. Zotsatirazi zinali zofunika, chifukwa ndizofala kupeza omwe amatchova matendawa akuwonetsa zovuta zomwe amagwiritsa ntchito, ndipo izi zitha kuyambitsa njira zochiritsira komanso kuchira.29

Kumbali ina, Goudriaan et al32 anafufuza zinthu zomwe zimayambitsa kubwereranso m'mavuto a juga. Pachifukwa ichi, adagwiritsa ntchito maphunziro omwe ali ndi vuto la kutchova juga (n = 46), ndikufufuza zomwe zimayambitsa chidwi, kupatsa chidwi, kusokoneza, komanso njira zosankhira (pazochitika zotsutsana) pakubwezeretsanso njuga. Ntchitoyi idapeza kuti matendawa amakhala nthawi yayitali, ma neurocognitive alama a disinhibition (nthawi yothandizira kuti aimitse), komanso kusankha njira yothetsera vutolo (mayesedwe a makadi) anali olosera zakubwezeretsanso (kuwerengera kwa pafupifupi 53% ya kusiyana) . Momwemonso, kubwezera chidwi ndi chidwi sichinanenere kuti kubwereranso m'mbuyo kungayambenso kutchova njuga. Kafukufukuyu adatsimikiza kuti kutalika kwa matendawo, miyeso yodulira matendawa, komanso kusankha kwazosankha kunali koyeserera mwamphamvu kubwereranso. Kuphatikiza apo, zomwe zapezazi zinalozera ku mawonekedwe amkati am'mimba kukhala odalirika kwambiri pakuwonetseranso kubwereranso poyerekeza ndi mawonekedwe akunja.32

Det et adasiyanitsa gulu la osewera opanda vuto logwiritsa ntchito mankhwala osokoneza bongo (n = 21) ndi gulu la maphunziro athanzi (n = 19) pogwiritsa ntchito kuyankhulana kwamalingaliro a neurologic (ozikidwa pa kusokonekera kwa ubongo), EEG, ndi kuwunika kwa neuropsychological. Kafukufukuyu anapeza kuti 81% ya otchova juga anali ndi thanzi labwino pazowonongeka kwa ubongo; Komanso, otchova njuga adasokonezeka kwambiri poyerekeza ndi zowongolera, kukumbukira, ndi magwiridwe antchito. Komanso, EEG yawonetsa mayankho osayenera mu 65% ya osewera, mosiyana ndi 26% yowongolera. Kafukufukuyu adatsimikiza kuti osewera adawonongeka ndi ubongo ndipo adachititsanso zovuta za mitsempha yakutsogolo ya bongo ndi zowonjezera zokhudzana ndi EEG. Ofufuzawo anena kuti vuto la kutchova njuga ndi lomwe linayambitsa matenda a ubongo, makamaka oyang'anira mabwalo a frontolimbic.10

Kafukufuku wina waposachedwa anayerekezera odwala omwe ali ndi vuto linalake mu ubongo (amygdala, insula, kapena inferomedial prefrontal cortex), maphunziro olamulira bwino, komanso maphunziro omwe ali ndi zotupa zama ubongo osiyanasiyana.24 Monga gawo la phunziroli, ophunzirawo adayenera kuchita masewera mu zida zamakono ndi makina osatsira. Tinaona kuti kusintha kosinthika kwakumachitika kwa zophonya pafupi ndi zochitika zina kumachitika mozindikira. Kuphatikiza apo, kafukufukuyu adatsimikiza kuti njira zochizira zomwe zimachepetsa kubwezeretsanso zitha kukhala zothandiza pochotsa mavuto a juga.24

Kafukufuku wina kwa amuna aku China adasiyanitsa otchova njuga (n = 37) ndikuwongolera (n = 40) pofotokozera ubale pakati pa vuto la kutchova juga ndi kusakhazikika.15 Kafukufukuyu adapeza kuti omwe ali ndi vuto la masewera anali osadabwitsa poyerekeza ndi owongolera. Ngakhale zili choncho, palibe kusagwirizana komwe kunapezeka pakati pa magulu omenyera kapena mayeso a mawu a Stroop. Tinaona kuti vuto la kutchova juga limalumikizidwa ndi kusakhudzidwa, m'malo mokopeka ndi boma. Makamaka, vuto la kutchova njuga limalumikizidwa ndi mtundu wa kusokonekera kochokera ku umunthu wautali womwe umawongolera ochita masewerawa kuti azigwiritsa ntchito phindu la posachedwa (mkhalidwe wofikira), m'malo mozindikira kwakanthawi kapenanso kungodzibweretsa zakukhosi. Kuphatikiza apo, kafukufukuyu adalimbikitsa kuti chithandizo chamankhwala chisinthidwe ndi kuphedwa kwa otchova juga mwa kulimbikitsa machitidwe owongolera komanso kupereka gawo pobwezeretsa kwakanthawi.15

Alvarez-Moya et al27 adafufuza ubale pakati pa kudzidziwitsa nokha, mapangidwe amisala, komanso chithandizo chamankhwala zimayambitsa vuto la kutchova juga. Kufufuzaku kunagwiritsa ntchito mitu yambiri yamatenda omwe ali ndi matenda otchova njuga (zitsanzo za maphunziro a 88), koma idalibe gulu lowongolera. Mituyi idawunikidwa pogwiritsa ntchito mayeso omwe amayesa ntchito zazikulu, kusankha zochita, komanso chidwi. Njira yochizira yomwe amagwiritsa ntchito inali yothandiza pozindikira. Kufufuzaku kunapeza kuti panali chiwerengero chachikulu cha zotsatira zachilendo (muzochita za ophunzira) zomwe zimalumikizidwa ndi kuyenda kotsika pa mayeso a Iowa Njuga. Kuphatikiza apo, kukwezedwa kopitilira muyeso, kukwezeka kopitilira muyeso, kusakwanira kosinthika, ndi kuchepa kwa mayeso a Iowa Gask Task (EFGH). Palibe mndandanda womwe ukudziwitsa wekha kapena cholozera mwatsatanetsatane unalibe zokhudzana ndi zovuta kapena kuchuluka kwa mankhwalawa. Tinaganiza kuti kubwezera m'mitsempha yamaubongo kumalumikizidwa ndi omwe adachita nawo kafukufuku payekha zomwe adazipanga pakuwonetsa zochuluka pakugwiritsa ntchito ndalama. Kudzisokoneza modziletsa (makamaka kupweteketsa chidwi komanso kusakhudzidwa) komanso kuwonongeka kwa chiwongolero. Anadziwikanso kuti umunthu wosiyana ndi momwe mitsempha imasinthira imayenderana ndi zomwe otchova juga amathandizidwa ndi zamisala, kutengera mtundu womwe wasinthidwa.27

Fuentes et al16 ndinayerekezera maphunziro a 214 ndi vuto la kutchova njuga (24.3% yopanda vuto linalake ndi 75.7% yokhala ndi vuto lofananirana) ndi kuwongolera kwa 82 kutengera nthawi yankholo, pafupipafupi zolakwitsa (zolimbitsa thupi / zolimbitsa thupi), ndi makonda a Barratt Impulsiveness Scale. Omwe anali ndi vuto la kutchova juga adalakwitsa kwambiri pakuchita masewera olimbitsa / osapita ndipo adawonetsa masitepe apamwamba pa Scratt Impulsiveness Scale. Komanso, olemba adanena kuti kuyesa kwa neuropsychology ndi Barratt Impulsiveness Scale kuphatikiza mapangidwe opanga zinthu zosiyanasiyana omwe amasiyanitsa maphunziro ndi vuto lakusewera kuchokera kwa iwo omwe alibe vuto lakusewera; Kuphatikiza apo, mawonekedwe awa anali bwino kuposa mapangidwe ena okhala ndi mtundu umodzi wa muyeso. Malinga ndi zotsatira zake, kusokonekera kunali chochitika chamitundu yambiri, ndipo otchova njuga anali gulu lalikulu komanso losiyanasiyana losiyanasiyana.16

Kafukufuku wina adawonetsa kulosera kwa kusiyanasiyana kwamunthu ndi ma neuropsychological m'mitu yomwe ili ndi vuto la kutchova juga.17 Nkhani zomwe zili ndi vuto la kutchova njuga (n = 25) ndi gulu lolamulira (n = 34) zidasiyanitsidwa ndi njira ya Barratt Impulsiveness Scale, Temperament ndi Character Inventory, komanso mayeso a neuropsychological. Omwe ali ndi vuto la kutchova njuga amawonetsa kuwonongeka kwa kutsogolo koyerekeza ndi mayeso a neuropsychological, ndikuwonetsa zoperewera zokhudzana ndi kusankha (Kuyesa Maseweredwe a Iowa), kuchuluka kwa chidwi, kufunafuna mafunso apamwamba, kupewa kuvulaza kwambiri, kuchepa kwa mgwirizano, ndi kuchepa kwa kudzidalira kuwongolera. Kafukufuku wokhudzana ndi kukonzedwa kwa zinthu kunawonetsa kuti zochitika za neuropsychological sizinakulitse kwambiri kusiyanasiyana kwa mawonekedwe a umunthu polosera zamtundu wa njuga; Komabe, zinthu za umunthu zomwe zidakulitsa kusintha kwakukulu pamwambapa pazinthu za neuropsychological polosera kutchova juga. Mapeto ake anali akuti mikhalidwe ya anthu inali yoyeneradi zowonetsa za vuto la kutchova juga poyerekeza ndi machitidwe a neuropsychological.17

Kutsimikiza pamachitidwe ogwirira ntchito, magwiridwe antchito, ndi zochitika zokhudzana ndi mitsempha yokhudzana ndi kutchova juga

Kukulitsa ndi zomwe zili m'mabodza okhudzana ndi kutchova juga ndizokhudzana ndi kuopsa kwa vuto la kutchova juga. Makamaka, mphamvu yakukondera kwazindikiritso inali yokhudzana ndi kuopsa kwa matenda amtundu wa juga (mwachitsanzo, gulu lomwe limasewera)> gulu losewera pamavuto> gulu losasewera) malinga ndi kafukufuku waku China.25 Achinyamatawo anali m'badwo wazomwe amtundu wazamiseche omwe amakhala ndi chidwi chambiri (poyerekeza ndi achinyamata ndi achikulire okhwima), ndipo panalibe umboni wotsutsana pa kugonana.25 Kumbali inayi, kuzindikira kutengeka ndi luso la kutchova njuga (koma osati chidziwitso chokhala ndi miyambo) kunaneneratu kufuna kusewera kutsatira zotsatira zaposachedwa; Kupitilira apo, kulephera kwa kudziwongolera kwakaneneratu kulimbikira pa kuyesa kwa makina owerengedwa (kutengera momwe zingakhalire zolemba labu).30

Potengera momwe magwiridwe antchito wamba amagwiritsidwira ntchito, zosankha zaumunthu sizabwino komanso zimakhazikitsidwa mwamphamvu.31 Makamaka, kudzanong'oneza (momwe mukumvera) kumawongolera mayendedwe amasankho, ndipo zokumana nazo zimasinthidwa ndi zochitika za orbitof mbeleal cortex.31

Kafukufuku yemwe adawunikira mgwirizano pakati pa zochitika zaubongo, momwe amagwirira ntchito, ndi magwiridwe antchito adapereka lingaliro la orbitofrontal cortex, amygdala, ndi insula ngati zida zofunika kwambiri. Makamaka, kuyambitsa kwa amygdala ndi orbitofrontal cortex kunachitika panthawi yosankha: kambukuyu adawunika zomwe zingachitike pazisankho ndikuyembekezera kudandaula.31 Kuphatikiza apo, mawu ofunikira anali ofunikira kutanthauzira mosazindikira zotsatira zakuphonya komanso kuyeserera koyeserera pantchito zokhudzana ndi juga.24

Kafukufuku osiyanasiyana adathandizira kusiyana kwa neuropsychological pakati pa maphunziro omwe ali ndi vuto la kutchova njuga ndi maphunziro owongolera. Makamaka, maphunziro omwe ali ndi vuto la kutchova njuga anali achikulire, ali ndi zoperewera zambiri pakulamulira kwamphamvu zamagalimoto, kuchepa kwa mayankho kuthamanga, kuchepa kwa kuzindikira kwamunthu.14 mavuto mabungwe, zoperewera posankha njira,20 Zoletsa zaumphawi, kuwerengera kwakanthawi kwakanthawi, zotsatira zoyipa zimayambitsa mayeso okonzekera,13 zolakwika mu masewera a-dayisi,21 kuchepa mphamvu yakuwunika zotsatira zamtsogolo,22 anali ocheperako, olondola, komanso olemetsa pa Stroop.19 Kuphatikiza apo, iwo omwe ali ndi vuto la kutchova njuga (poyerekeza ndi maphunziro owongolera) nawonso anali opuwala poyesa mayeso a neurocognitive omwe amawunika okhwimitsa zinthu mozindikira,18 anawonetsa zoperewera pakupeza njira zina zothetsera mavuto (mayeso a WCST), anali atachepa mphamvu (mayeso a WCST), sanathe kuphunzira kuchokera pazolakwika ndikuyang'ana mayankho ena,23 adasokonekera modabwitsa pakuwongolera, ndipo adasokonezeka poyang'ana ndi kukumbukira.10

Kafukufuku wa Neuropsychological pa maphunziro omwe ali ndi vuto la kutchova njuga akuwonetsa kuti maphunzirowa atha kukhala ndi vuto panjira ya kutanthauzira (kutanthauzira kosinthika kwa zotsatira zaposachedwa ndi kupambana kwachiyeso),24 kutsogolo lobe (kuchepa kwa ntchito yayikulu),13 ventral striatum (kusokonezeka kwa kuthekera kwazosinthika kozindikira pa mphotho),18 frontotemporolimbic circuits (kusokonekera mu ndende, kukumbukira, ndi ntchito yayikulu),28 preortalal cortex (kuzindikira kovuta, kufunikira, komanso kukakamizidwa),23 dorsolateral prefrontal cortex (zosankha zowopsa),21 ventrolateral prefrontal cortex (kusokonekera mu kuthekera kozindikira panjira),18 ndi orbitofrontal cortex (zosankha zowopsa,21 kulemala kuwunika zotsatira zamtsogolo,22 ndi kusokonekera mu kuthekera kwazosinthika kochokera mu mphotho).18

Kusokonekera chinali chimodzi mwazomwe zimayambitsa vuto la kutchova juga; M'malo mwake, maphunziro osiyanasiyana adafotokoza maphunziro omwe ali ndi vuto la kutchova juga monga akuwonetsa chidwi15,17 ndi kuchuluka kwamphamvu kwambiri (Barratt Impulsivity Scale).16 Komanso, kafukufuku wina adafotokoza maphunziro omwe ali ndi vuto la kutchova juga monga akuwonetsa mkhalidwe (osati mtundu wamtundu)15 ndikupanga zolakwika zambiri pakuchita masewera olimbitsa thupi.16

Mndandanda wa zosintha zomwe zinanenedweratu kuti zibwererenso ndikusiya chithandizo muzochitika ndi vuto la kutchova njuga. Makamaka, olosera zam'mbuyomu anali atadwala kwa nthawi yayitali-matenda, ma neurocognitive zolembera zowonongeka pa disinhibition ndi kusankha kosankha, komanso mawonekedwe a endophenotypic neurocognitive.32 Kumbali ina, ena olosera zakuchotsa chithandizo anali osakhudzika, kufunsa kwapamwamba, zotsatira zoyipa pakubweza kwaposachedwa, komanso zotsatira zoyipa mu mayeso a Iowa Njuga (EFGH scores).27 Kuphatikiza apo, kulumala kwazomwe zimalepheretsa munthu (kupupuluma mwachangu ndi kuthekera kwachilango) ndi chiwonetsero chazovuta zodziwikiratu zomwe zasiya kugwiritsidwa ntchito kwachidziwitso.27

Pazithandizo za vuto la kutchova juga, ndikofunikira kuganizira ngati nkhaniyo ili ndi vuto lofananira ndi kugwiritsa ntchito mankhwala osokoneza bongo, chifukwa izi zitha kukulitsa vuto la kutchova juga. M'malo mwake, maphunziro omwe ali ndi vuto logwiritsa ntchito mankhwala osokoneza bongo amatha kudwala mu njira iliyonse ya chisankho komanso kuwunikira kuwunikira komwe kumaikidwa patsogolo pa cortex.28 Chifukwa chake, kufanana komwe kumachitika muvuto la kutchova juga komanso vuto lokhala kugwiritsa ntchito mankhwala osokoneza bongo kumapangitsa kuti mankhwalawo akhale ovuta.

Chidule cha ntchito yoyeserera pamitundu yampikisano yotchovera juga

Mitundu ya Rodent yanena kuti zinthu zina zimatha kusintha zosankha zoyenera kapena zoika pachiwopsezo, monga kupezeka kwa mawu omvera,33 The agonism of dopamine receptors (D₃ mtundu),33 ndikuchepetsa zochitika m'malo aubongo monga infralimbic (IL) kapena prelimbic (PrL) cortex.34 Komabe, zinthu zina monga inactivation of rostral agranular insular cortex (RAIC) zimakondweretsa kusankha kochita bwino.35 Tsopano, timasanthula maphunziro omwe amathandizira kutsutsana kwapita.

Kafukufuku osiyanasiyana adafufuza momwe ubongo umagwirira ntchito kutchova juga pogwiritsa ntchito mitundu ya njuga.33-35 Kafukufuku yemwe anachitika mu mbewa zachimuna cha Long Evans adayang'ana kufunikira kwa makanema ojambula pamayendedwe otsogola pakuthandizira kusankha kosokoneza ntchito zamtundu wa juga.33 Pachifukwa ichi, ntchito ya njuga ya rata (rGT; mafoni otayika komanso osavomerezeka) idagwiritsidwa ntchito, yomwe imakhala yothandiza kwa Iowa Kutchova Juga Task. Monga chidziwitso, mu rGT makondawo amayenera kusankha pakati pazoyankha zinayi zomwe zinali zosiyana malinga ndi pafupipafupi ndi mphamvu ya mphotho ndi chilango. Kupeza kwakukulu ndikuti kuwonjezera njira zowonetsera zowoneka bwino pantchitoyo kumapangitsa kusankha zosankha zowopsa (ngakhale makonzedwe olimbikitsira amafanananso). Komanso, zidapezeka kuti D₃-receptor agonism adathandizira kusankha njira zosasangalatsa pazokhazo zomwe zidangokhala ntchito. Kumbali ina, D₃-rcoror antagonism anali ndi zolakwika. Barrus ndi Winstanley adati njira zodabwitsazi ndizothandiza pakuwongolera njira zomwe zingapangitse kuti nyama zisankhidwe (posankha njira zosasangalatsa) ndikuchepetsa vuto logwiritsa ntchito mankhwala osokoneza bongo.33

Kafukufuku wina adawunika kufunika kwa zigawo zosiyanasiyana za cortical ndi D₂-kugwira ntchito popanga zisankho pogwiritsa ntchito njira ya RGT.34 Makamaka, PrL, IL, orbitof mbeleal, ndi anterior cingulate cortices adayesedwa. Pambuyo pophunzitsidwa mu rGT, makoswe aamuna a Long Evans adalandira infusions wa kuphatikiza kwa baclofen ndi muscimol kapena D₂-tikuyesa okana. Zinapezeka kuti kutsegula IL kapena PrL cortex kumakondwera ndi zosankha zabwino komanso kukhumudwitsa zokonda pazabwino. Komabe, kuwonetsa kwa orbitofrontal cortex kapena anterior cingrate cortex sikunasinthe kupanga chisankho. Pomaliza, kulowetsedwa kwa D₂-tikutsutsana naye sanakhale ndi vuto lililonse popanga chisankho.34

Pomaliza, kafukufuku wowonjezereka wa Pushparaj adasiyanitsa zomwe zimachitika mu macapacacacatation kapena kutumiza kwa RAIC ndi caudal granular insular cortex ya amuna a Long Evans amagwira ntchito pa rGT.35 Zinapezeka kuti kulengedwa kwa RAIC (pogwiritsa ntchito infusions ya γ-aminobutyric acid pambuyo pophunzitsidwa ndi rGT kapena kutumiza RAIC musanaphunzitsidwe rGT) kumapangitsa makoswe kusankha njira zina zowonjezera pamalipiro apamwamba komanso chilango chochepa.

Zimaliziro pazakuyesa ntchito pamitundu yotsogola

Kutengera mitundu ya rGT, zikuwoneka kuti zinthu zotsatirazi zitha kuyambitsa chisankho pazosasangalatsa kapena zowopsa: kuphatikiza pamawu omvera,33 D₃-receptor agonism (pokhapokha pamaso pa zochitika zowonera),33 ndi inactivation ya IL kapena PrL (non-D₂-receptor-amadalira) cortices.34 Kumbali inayi, zikuwoneka kuti kuyambitsa RAIC pogwiritsa ntchito infusions wa γ-aminobutyric acid kapena zotupa za RAIC zitha kukomera kusankha njira zina ndi zilango zochepa kapena zowopsa.35 Zikuwoneka kuti D₂-receptor antagonists (osachepera PrL, IL, orbitof mbeleal, kapena anterior cingulate cortices) samasonkhezera pakupanga zisankho.34

Ntchitoyi idathandizidwa ndi SNI (Sistema Nacional de Investigacion - National System of Investigation) contract 106-2015 (yoperekedwa kwa GCQ). SNI ndi dipatimenti yomwe ndi SENACYT (Secretaria Nacional de Ciencia, Tecnologia e Innovacion - National Secretariat of Science, Technology and Innovation). SENACYT ilipo mu Republic of Panama.

Kuwulura

Wolembayo sanena kuti pali zovuta zokhudzana ndi ntchitoyi.