Mapulogalamu a ubongo okhudzana ndi kugwiritsidwa ntchito ndi chilakolako chofuna kutchova njuga, otuta kwambiri ndi kulamulira bwino: fMRI yophunzira (2010)

Nkhaniyi yakhala wotchulidwa ndi nkhani zina mu PMC.

Kudalirika

Kusasinthika kwa cue ndi gawo lodziwika bwino la chizolowezi, cholumikizidwa ndi zochita zowonjezereka, chidwi ndi kukumbukira kwamaubongo. Pakafukufukuyu kabwinobwino, kubwezeretsanso kwa cage mu zovuta zotchova njuga (PRG) kuyerekezedwa ndi kuchulukitsa kwa cue kwa omwe amasuta kwambiri (HSM) komanso maulamuliro athanzi (HC). Magulu ogwiritsira ntchito maginito a resonance imaging okhudzana ndi zochitika zokhudzana ndi cue reactivity, ophatikizidwa ndi juga, zithunzi zokhudzana ndi kusuta komanso kusalowerera ndale, adagwiritsidwa ntchito mu 17 pakufunafuna chithandizo chosafuna kusuta PRG, 18 yopanda njuga HSM, ndi 17 yosachita njuga komanso yosasuta fodya HC. Kuwona zithunzi zamtundu wa juga (zokhudzana ndi zithunzi zosaloŵerera) zimagwirizanitsidwa ndi kutsegulitsidwa kwa ubongo kwambiri m'malo a occipitotemporal, posterior cingulate cortex, parahippocampal gyrus ndi amygdala ku PRG poyerekeza ndi HC ndi HSM. Kufunafuna kwa PRG kosakanikirana bwino ndi kutseguka kwa ubongo mu kolowera kolowera kolowera kolowera kumanzere komanso kumanzere kumanzere. Poyerekeza gulu la HSM ndi magulu ena awiriwo, palibe kusiyana kwakukulu mu zochitika zaubongo zomwe zimayambitsa ndi kusuta kwa fodya komwe kunapezeka. Pakufufuza kosinthika, gawo la HSM lomwe lili ndi mayeso okwera a Fagerström a Nicotine Dependence scores (FTND M = 5.4) adawonetsa kukhathamiritsa kwa ubongo mu ventromedial prefrontal cortex, rostral anterior cingulate cortex, insula ndi pakati / apamwamba okonda masisitere akuyang'ana zithunzi zokhudzana ndi kusuta ( zokhudzana ndi zithunzi zosalowererapo) kuposa gulu la HSM lomwe lili ndi ma FTND ochepa (FTND M = 2.9) komanso kuposa HC yosasuta. Nicotine wofunafuna wolumikizidwa ndi kutsegulira kumanzere kumanzere ndikumanzere amygdala pamene akuwona zithunzi zokhudzana ndi kusuta mu HSM. Kuyankha kwachilengedwe kukuwoneka ndi kutchova juga m'magawo aubongo omwe amalumikizidwa ndi kusunthira ndi kupezeka kwa zinthu zomwe zilipo mu PRG, zofanananso ndi kaimidwe kazinthu kakang'ono kamene kamathandizanso pakukhulupirira zinthu. Kuchulukitsa kwa ubongo m'malo ophatikizana ndi ubongo wa fronto-limbic kunalipo mu HSM ndi zambiri FTND zambiri poyerekeza ndi HSM yokhala ndi ziwonetsero zotsika za FTND.

Keywords: Chidwi, kusokonekera kwa cue, fMRI, chisokonezo chowongolera, kudalira kwa chikotini, kutchova njuga

MAU OYAMBA

Kutchova juga kwachidziwitso (PG) ndichisokonezo chomwe chimafalikira pafupifupi 1% (Welte Et al. 2001). PG nthawi zambiri imabweretsa mavuto akulu m'maganizo (Petry & Kiluk 2002; Potenza Et al. 2002). Pakadali pano, PG imatchulidwa ngati vuto la kuwongolera zinthu, koma njira zowunika zimafanana kwambiri ndi kudalira kwa zinthu. Kuphatikiza apo, kafukufuku waposachedwa wasonyeza kufanana kwa mitsempha pakati pa PG ndi kudalira kwa zinthu (Petry & Kiluk 2002; Potenza Et al. 2002; Goudriaan Et al. 2004). Zotsatira zake, olemba ena akufuna kusinthanso PG ngati chizolowezi cha DSM-V (Petry 2006; Potenza 2006).

Kuchulukanso kwa cue kuphatikizidwa ndi chidwi chapamwamba chokhudzana ndi zosokoneza bongo kumayimira njira yofunika kwambiri pakukhalira kwamakhalidwe oyenera (Goldstein & Volkow 2002) ndipo ingalimbikitse kuyambiranso kudalira mankhwala (Cooney Et al. 1997; ndalama Et al. 2006; Marissen Et al. 2006). Ntchito zongoyerekeza zogwiritsa ntchito ma cue-exposed paradigms mu chikonga, mowa ndi kudalira kwa cocaine zanenanso kuchuluka kwa preralal preularal, insular, amygdala, striatal, and thalamic zochitika, zigawo zamaubongo zomwe zimagwirizanitsidwa ndi kusinthidwa kwa malingaliro ndi machitidwe othandizira. Kuphatikiza apo, kuyang'anira ndi kuzindikira koyendetsa kayendedwe kazinthu zakhala zikuwoneka bwino mu maphunziro a kubwezeretsa kwa cue, kuwonetsedwa ndikuwonjezereka kwa dorsolateral pre mbeleal, anterior cingulate cortex ndi activation ya parietal (Kilts Et al. 2001; Tapert Et al. 2004; David Et al. 2005; ndalama Et al. 2006; McBride Et al. 2006; Franklin Et al. 2007).

Pafupifupi 50% ya otchovera juga omwe amayesa kusiya kusiya amakumana ndi zovuta zoyipa (Hodgins & el Guebaly 2004), ndi kafukufuku wina akuwonetsa kubwerezabwereza kwa omwe amatchova njirayi.Ledgerwood & Petry 2006). Chifukwa kudziwikanso kwa cue ndi njira imodzi yofunika kwambiri pakukhazikitsa zovuta zowonjezera, komanso chifukwa chokhudzana ndi chiopsezo chobwereranso pakudalira kwa zinthu (Cooney Et al. 1997; ndalama Et al. 2006; Marissen Et al. 2006), kufufuza njira zamatsenga za kuchuluka kwa cue mwa anthu awa ndikofunikira kwambiri. Pakadali pano, kafukufuku wokhazikika wokhazikika wa maginito (fMRI) wokhudzana ndi kutchova njuga omwe amadziwika kuti amatchova juga wazomwe adafalitsa (Potenza Et al. 2003; Crockford Et al. 2005). Kafukufuku onsewa adagwiritsa ntchito zidutswa za kanema zokhudzana ndi njuga komanso zowongolera zingapo, koma zidakhala ndi zotsutsana. Mu kafukufuku woyamba pakati pa otchova juga a 10 ndi ma 11 olamulira wamba, maphunziro a PG adawonetsa kuchepa, m'malo kuwonjezera chiwonetsero chazambiri mu ventral anterior cingulate cortex, orbitofrontal cortex, basal ganglia ndi thalamus panthawi yamagetsi okhudzana ndi njuga. Kuchulukitsa kwakanema pakuwonera zinthu zokhudzana ndi juga kunapezeka mu occipital lobe yokha (Potenza Et al. 2003). Mu kafukufuku wachiwiri mu masewera otchova juga a 10 ndi ma 10 oyendetsa bwino (HC) (Crockford Et al. 2005), Mitu ya PG idawonetsa kuyendetsa ubongo kwakutali poyankha kutchova juga kumanzere kumanzere kwamanzere, kumanzere kwamanzere, kumanzere kwa parahippocampal ndi malo oyambira kutsogolo, poyerekeza ndi HC.

Chifukwa chake, pomwe izi za kafukufuku wa PG zikuwonetsa kuchuluka kwa magawo aubongo omwe akukhudzidwa ndi chidwi, kukumbukira ndi kuwona, palibe umboni wazowonjezereka zochitika mu ziwalo zamiyendo pakuwongolera njuga zamtunduwu zimapezeka (mwachitsanzo kuwonjezeranso ku amygdala), mosiyana ndi maphunziro owonjezera pa intue kuvomerezanso kudalira mankhwala (Kilts Et al. 2004; Tapert Et al. 2004; ndalama Et al. 2006; McBride Et al. 2006; Franklin Et al. 2007). Zomwe zingakhale chifukwa cha kusinthaku ndikugwiritsa ntchito makanema m'malo mwa zithunzi ndi kusowa kwa mphamvu chifukwa cha zitsanzo zazing'ono. Kuphatikiza apo, onse kafukufuku omwe adalemba omwe amatchova njuga amaphunzitsidwa zotsatsa, ndipo sanafufuzenso ngati zotchova njuga (PRGs) zingasiyane pamalingaliro osavomerezeka. Mu kafukufuku wa fMRI yemwe amayang'ana kwambiri pakupanga mphoto kwa otchovera njuga (Zosintha Et al. 2005), yankho lolakwika pazotayika zotsutsana ndi zomwe zidatayika zidapezeka m'malo opatsa mphoto mzochita zotsutsana ndi HC. Mukamawonetsa otchova njuga pamavidiyo amtundu wa juga, machitidwe a miyendoyo amatha kukhala osakwaniritsidwa chifukwa chakuchepa kwa kuchitapo kanthu komwe kutchova njuga kumapezeka ndalama. Popeza izi zidawonekeratu pazopeza zachuma, kufufuza kwa kayendedwe ka mphamvu zokhudzana ndi njuga ndi malingaliro osaloledwa omwe samaphatikizapo phindu la ndalama kungatipatse chidziwitso pakuwonekeranso kwa cue kwa zomwe zikuchitika njuga zambiri.

Mu kafukufuku wapano, tinkafuna kuthana ndi mavuto awa pofufuza njira zotengera ku ubongo kutchova juga kapena kusuta fodya m'ma PRG omwe amafunafuna chithandizo, osuta kwambiri (HSM) komanso osasuta fodya (HC) osasuta fodya. Tinagwiritsa ntchito zithunzi zokhudzana ndi zochitika (George Et al. 2001; Myrick Et al. 2004; Smolka Et al. 2006) chifukwa izi zimapereka kusinthasintha koyenera pokhudzana ndi nthawi yolimbikitsira komanso kupewa mavuto achitsanzo omwe angabuke pofufuza data ya paradigm fMRI. Kuti tiyerekeze kuyambiranso kwa cue mu PRG ndikuwonetsa kukonzanso kwa gulu lodalira zinthu, gulu lofananiza la HSM linaphatikizidwanso. Gulu lolamulira la HSM lidasankhidwa chifukwa zovuta zomwe zimachitika mu chikonga cha nicotine ndizochepa poyerekeza ndi zina za mankhwala ozunguza bongo, monga mowa (Sullivan 2003; Mudo, Belluardo & Fuxe 2007). Kutengera maphunziro apakale a cue-reacaction kudalira kwodalira zinthu, tidayerekezera kuti kutchova juga ku PRG ndikusuta kosuta ku HSM kungapangitse ubongo wamphamvu kwambiri poyerekeza ndi kubwezeretsanso kwa ubongo m'magulu olamulira osasuta fodya m'malo ogwirira ntchito motengera malingaliro. the amygdala, ventral striatum ndi ventral preortal cortex, komanso chidwi ndi kuzindikira komwe kumayenderana ndi ubongo monga dorsal prefrontal cortex ndi anterior cingulate cortex (ACC). Kuphatikiza apo, ubale wapakati pa ubongo wokhudzana ndi cue ndikufunitsitsa kwa PRG ndi HSM adaphunziridwa. Tidawerengera kuti kukhumbira komwe kumagwirizana kungalumikizidwe ndikuwonjezereka kwa magwiridwe azinthu zama ubongo komanso zolimbikitsa-zogwirizana ndi PRG ndi HSM.

ZIDA NDI NJIRA

Ophunzira

PRintenen-PRG (anthu akumanzere kumanzere), 19 HSM (atatu kumanzere) ndi 19 wosasuta HC (wamanzere kumanzere), amuna onse nawo nawo nawo kafukufukuyu. Kwa PRG awiri, HSM imodzi ndi HC ziwiri, data resonance imagine (MRI) yamagetsi sakanakhoza (kupezeka) chifukwa cha zolephera za scanner. Chifukwa chake, 17 PRG, 18 HSM ndi 17 HC adapanga magulu atatu omwe amagwiritsidwa ntchito pakuwunika. PRG adasankhidwa kuchokera kuzipatala ziwiri zaku Dutch zomwe zidagwiritsa ntchito mankhwala osokoneza bongo. Gulu la HSM ndi gulu la HC adalembedwa kudzera pazotsatsa m'manyuzipepala.

Njira yayikulu yophatikizira PRG inali chithandizo chomwe chikuchitika pakubwera kwa mavuto a njuga. PRG adafunsidwa ndi gawo la T la Diagnostic Mafunso schedule (Ma Robins Et al. 1998) kuwunika njira zodziwira matenda a DSM-IV-TR a PG. Kuphatikiza apo, South Oaks Gging Screen (SOGS; Lesieur & Blume 1987) idagwiridwa ngati gawo la vuto la kutchova juga. Awiri a PRG alephera kukwaniritsa njira yomwe DSM-IV-TR PG yapeza pano. Komabe, chifukwa anakwaniritsa njira ziwiri za PG pakadali pano, anakumana ndi njira za PG m'mbuyomu ndipo zambiri za SOGS (7 ndi 8, motsatana) zinali zofanana ndi PRG yomwe inakwaniritsa njira zoyesera za PG (onani Gulu 1; tanthauzo la SOGS = 9.6 ± 2.6), PRG izi zidaphatikizidwa pazosanthula. Onse a PRG anali kupewa njuga kwa sabata la 1 osachepera. HSM adaphatikizidwa ngati amasuta ndudu ya 15 kamodzi patsiku, ndipo samachita nawo njuga zopitilira kawiri pachaka. HSM anali pano omwe amasuta omwe amayesa kuyesa kusuta monga gawo la kafukufukuyu. Mayeso a Fagerström a Nicotine Dependence (FTND) anali ngati chisonyezo cha kuopsa kwa kudalira kwa chikonga (Heatherton Et al. 1991). Palibe chochepera pa FTND chofunikira pa HSM. HSM idayenera kukhala yosuta usiku wonse, idadzaza mafunso m'mawa ndipo idasakazidwa masana (16-18 masaa). Kuziletsa kunatsimikiziridwa ndi muyeso wa mpweya wa carbon monoxide m'mawa, pogwiritsa ntchito micro + Smokerlyzer (Bedfont Science Scient, Ltd., Rochester, UK). HC sanasute, sanakhalepo ndi mbiri yovuta njuga ndipo sanachite nawo njuga zopitilira kawiri chaka chatha.

Gulu 1 

Makhalidwe a anthu otchova njuga, osuta kwambiri komanso owongolera athanzi

Njira zochotsera magulu onse anali: zaka zapakati pa 18 zaka; kuvuta kuwerenga Chi Dutch; kugwiritsa ntchito mankhwala a psychotropic; pang'onopang'ono matenda a schizophrenia kapena ma psychotic episode; kufufuza kwa mwezi wa 12 wa manic disorder, woyesedwa ndi magawo osiyanasiyana a Composite International Diagnostic Mafunso (CIDI; Heatherton Et al. 1991; World Health Organisation 1997); chithandizo chamakono cha matenda amisala ena kupatula omwe akuphunzira; machitidwe a thupi omwe amadziwika kuti amathandizira kuzindikira kapena magwiridwe antchito (monga ma sclerosis ambiri, matenda amitsempha); chithunzi chabwino cha mkodzo wa mowa, amphetamines, benzodiazepines, opioids kapena cocaine; kumwa kwa magawo ambiri a mowa wa 21 pa sabata. Magulu anali mosiyanasiyana pokhudzana ndi matenda amisala omwe amaphunzira. Mwachitsanzo, PRG ndi HC sanasute (kupatula PRG m'modzi yemwe amasuta ndudu zosakwana zisanu patsiku). Njira zina zowonjezera za HC ndi HSM, koma osati za PRG, zinali kupezeka kwa zovuta zamavuto (CIDI-gawo D), kupsinjika (CIDI-gawo E), kuvutika-kukakamiza kusokonezeka (CIDI-gawo K), kusokonezeka kwaposachedwa kwa nkhawa ( CIDI-gawo K) ndi chidwi-deficit / hyperacaction disorder (Conners ADHD Mavoti Apamwamba; Ma Conner & Mpheta 1999). PRG yokhala ndi mavuto a comorbid sanathere kunja, chifukwa kutchova njuga kumavuta kwambiri ndi zovuta izi. Kuopsa kwa zizindikiro za kukhumudwa kunayesedwa ndi Beck Depression Inventory (BDI-II; Beck Et al. 1996). Kugwiritsa ntchito moyenera vutoli kunayang'aniridwa ndi Dongosolo la Kuzindikira Matumba Kuzindikira Kuyeserera (Chitsamba Et al. 1998).

Kuphatikiza pa Cue Reacaction Task, ntchito yophunzitsanso yophunzitsanso, ntchito yokonzekera ndi choletsa ntchito zinagwiriridwa. Zotsatira kuchokera pantchito yophunzira yobwerera m'mbuyo ndi kulinganiza zakayikidwa kwina (de Ruiter Et al. 2009). Gulu loyang'anitsitsa zamaphunziro la Academic Medical Center lidavomereza kuti phunzirolo liphunzire ndipo chilolezo chodziwitsidwa chokha chidapezedwa. Ophunzira adabwezeredwa ndalama za € 50 zomwe adasamutsidwira ku akaunti yawo ya banki atatha kutenga nawo mbali.

FMRI paradigm: Ntchito ya Cue Reacaction

Chithunzi choyankha chosankha-kawiri chinagwiritsidwa ntchito (monga zitsanzo za zithunzi, onani Chith. 1). Zithunzi zimapangidwa mozama motere: Zithunzi zingapo zatsatanetsatane ndi zithunzi zatsatanetsatane zidasankhidwa pamachitidwe aliwonse (mwachitsanzo, anthu angapo otchova juga, osuta fodya kapena olankhula, motsutsana ndi zithunzi zatsatanetsatane za dzanja pamakina ogwiritsa, dzanja ndi ndudu, mgwirani ndi magazini). Chachiwiri, kuti chithunzi chikufanane ndikuwoneka bwino, zithunzi zonse zinajambulidwa munjira yofananira (mwachitsanzo, zithunzi zonse ndi anthu angapo adatengedwa ndi zinthu zingapo kumbuyo), amuna okha ndi omwe adayikidwa pazithunzi, ndipo chisamaliro chinatengedwa kuti chikufanane mawonekedwe azithunzi pakati pazithunzi zosiyanasiyana, pakuphatikiza zithunzi zokha zokhala ndi nkhope zakunja. Zithunzi makumi atatu za juga, zithunzi zokhudzana ndi kusuta kwa 30, zithunzi zosagwirizana ndi 30 ndi zithunzi zoyambira zotsika za 30 zidaperekedwa mwachisawawa, ndikuletsa kuti chiwonetsero cha gulu lomweli lamtunduwu sichinaperekedwe kopitilira katatu mzere. Zithunzi zoyambira zotsika kwambiri zokhala ndi mivi yolozera kumanzere kapena kumanja zinaperekedwa, ndipo kuyankha kumanzere kapena kumanja kunayenera kuperekedwa, kuti athe kufananitsa zojambula zovuta poyerekeza ndi mawonekedwe otsika otsika. Mu juga, zithunzi zokhudzana ndi kusuta komanso kusalowerera ndalamazi, ochita nawo mbali adayenera kukanikiza batani loyankha ndi chala chakumanzere chakumaso pomwe nkhope idakhalapo pachithunzichi ndipo adasindikiza batani loyankha ndi chala chakumanja chakumaso kwawo pomwe kulibe nkhope. Makumi asanu ndi anayi mwa zithunzi zonse m'gulu lililonse anali ndi nkhope. Chithunzi chilichonse chinaperekedwa kwa nthawi yayitali ya masekondi a 5, ndipo ophunzirawo adapemphedwa kuyankha mkati mwa nthawi imeneyi. Pakanapanda kuyankhidwa pambuyo pa masekondi a 5, ntchitoyi idachitika. Screen XXUMX-yachiwiri yopanda kanthu idawonetsedwa pakati pa chithunzi chilichonse. Palibe ndemanga yomwe idaperekedwa yankho lolondola kapena lolakwika. Gawo lofufuza linatenga mphindi za 2.5; iliyonse ya njuga, zithunzi zokhudzana ndi kusuta komanso kusalowerera zinawonetsedwa kamodzi. Omvera sanalimbikitsidwe kuyankha mwachangu momwe zingathere. Ntchitoyi idafotokozedwa ndikuchita kunja kwa scanner pogwiritsa ntchito zithunzi zina. Kukula kwa ntchitoyi kumatanthauza nthawi yomwe zithunzi zidzasunthidwa mgawo lililonse.

Chithunzi 1 

Zitsanzo za kutchova njuga (kumanzere), zolimbikitsa zokhudzana ndi kusuta (pakati) komanso kusachita nawo mbali (kumanja)

Funsani mafunso

Kutchova juga kwa zinthu za 8, mafunso a 1-7 (MN Potenza & SS O'Malley, zomwe sizinalembedwe) ndi funso lazinthu 10 zosuta za mafunso, osiyanasiyana 1-7 (Tiffany & Drobes 1991), adaphatikizidwa kuti ayesere kuchuluka kwa kutchova njuga ndi chikhumbo cha chikonga, motsatana. Ophunzira adadzaza mafunso okakamiza kale komanso atangolowa fMRI.

Kuphunzira kupeza ndi kukonzanso

Zambiri zakufanizira zidapezeka pogwiritsa ntchito makina osakira a 3.0 Tesla Philips Intera wathunthu wokhala ndi fakitala ya SENSE RF (Quasar gradient system, Philips Medical Systems BV, Eindhoven, Netherlands) yomwe ili ku Academic Medical Center, Amsterdam. Pomwe omwe adagwira nawo ntchitoyi, T2 * - zojambula zazingwe zozungulira zamagetsi, zotengera magazi oxygenation-zomwe zimadalira (BOLD) zinapezeka (magawo a 35 axial, kukula kwa voxel 3 x 3 × 3 mm, interslice gap 0.3 mm, kukula kwa matrix 64 × 64 mm, bandwidth 90 kHz, TE 35 ms, kubwereza nthawi 2.28 masekondi), kuphimba ubongo wonse kupatula zigawo zotsika kwambiri za cerebellum. Sagittal T1-yolemetsa yoyeserera (kukula kwa voxel 1 × 1 × 1 mm, magawo a 170) idapangidwa kuti izitha kulembetsa nawo deta ya FMRI. Kusanthula koyeserera kunachitika pogwiritsa ntchito SPM2 (Statistical Parametric Mapping; Wellcome Department of Cognitive Neurology, London, UK). Zithunzizo zidasinthidwa, zidakonzedwanso ndikugawidwa ku voliyumu yoyamba. Chotsatira, mavoliyumu a T1-coregistr adasinthidwa kukhala mtundu wa SPM T1- template (pogwiritsa ntchito ma 12 mzere wolumikizana ndi gawo la ntchito zosagwirizana ndi mzere wa cosine), ndipo kuwongolera kwa malo kunachitidwa pogwiritsa ntchito 8 mm FWHM Gaussian kernel.

Kusanthula kusanthula

Kusiyana kwamagulu pazambiri za anthu komanso zamankhwala zidawunikidwa pogwiritsa ntchito kusanthula kosiyanasiyana kwa kusiyanasiyana (ANOVA) ndi Tukey's posachedwa mayesero. Kusiyana kwamagulu pamaphunziro kunayesedwa pogwiritsa ntchito mayeso a Pearson a chi-mraba. Ma ANOVA adagwiritsidwa ntchito pofufuza momwe magwiridwe antchito (amatanthauza nthawi yogwirira ntchito) ndi gulu ngati chinthu chapakati (PRG, HSM ndi HC), ndi gawo lolimbikitsa (kutchova juga motsutsana ndi ndale, zokhudzana ndi kusuta motsutsana ndi ndale, kapena zoyambira zotsika motsutsana ndi ndale) monga mkati-pamutu, pogwiritsa ntchito kusiyanasiyana kwamagulu. ANOVA idagwiritsidwa ntchito kusanthula kuchuluka kwa zolimbikitsa (kutanthauza kutchova juga, kutanthauza kusuta fodya), ndi nthawi (isanakwane komanso itatha ntchito) ngati chinthu cham'mutu. Kusanthula konse kunachitika mozungulira.

Kuchulukitsa kwa FTND ku gulu la HSM kunali kotsika (M = 4.0; SD = 1.5) poyerekeza ndi kuchuluka kwa FTND mwa omwe amasuta akuti mu maphunziro ena a fMRI cue reactivity (Franklin Et al. 2007, FTND = 4.8; McClernon Et al. 2007, FTND = 6.4; McClernon, Kozink & Rose 2008, FTND = 6.5), ndipo palibe chidziwitso chodalirika cha chikonga chomwe chinapezeka ku HSM, monga momwe amaphunzirira ena (Brody Et al. 2002). Chifukwa chake, kusanthula kowunikira kunachitika, kufanizira HSM ndi zambiri FTND zambiri (n = 10, FTND-high group M = 5.4, SD = 0.5) kupita ku HSM yokhala ndi ziwonetsero zotsika za FTND (n = 8, FTND-low-group: M = 2.9, SD = 1.0), kugawanika kwapakati kwapakati. Mgulu la PRG, palibe magawano omwe adapangidwa pakati pa PRG yayikulu, chifukwa zovuta zamavuto a njuga mu zitsanzo zathu, monga zimayesedwera ndi SOGS, zinali zofanana ndi zovuta zomwe zimanenedwedwa mu maphunziro ena mu ochita masewera olimbitsa thupi omwe amafunafuna chithandizo chamankhwala.

Zambiri za fMRI zidasanthulidwa potengera mtundu wazomwe zimagwiritsidwa ntchito, pogwiritsa ntchito ntchito za delta zopangidwa ndi ntchito yopanga hemodynamic kuyankha mayankho kumachitidwe amtundu uliwonse wolimbikitsa. Pakufanizira kulikonse kwa chidwi, zithunzi zosankha mutu umodzi zidalowetsedwa mu kusanja kwachiwiri (zotsatira zosasintha). Kuti mufufuze magawo osiyanasiyana osakanikirana pakati pamagulu, ANOVA inayendetsedwa ndipo zotsatira zake zimayenderana ndi zithunzi zosakanikirana mu PRG motsutsana ndi HC kapena HSM, komanso zithunzi zosemphana ndi kusuta zotsutsana ndi HSM (HSM gulu; FTND-high group; FTND-low group) motsutsana ndi PRG kapena HC. Zotsatira zazikulu ndi kuyanjana kwakanayesedwa ndi njira imodzi ANOVA yoyendetsedwa mu SPM2 ndipo amadziwika ndi choletsa kukula kwa magulu a 10 voxels ku P <0.05 yakonzedwa poyerekeza angapo malinga ndi njira Yolakwitsa Yabanja (Tiffany & Drobes 1991; Nichols & Hayasaka 2003). Kuchita zamagulu kumanenedwa ndi choletsa kukula kwa masentimita a 5 vo P <0.001, yophimbidwa ndi zotsatira zoyenerera.

Zithunzi zamtundu wa juga kapena zokhudzana ndi kusuta zosemphana ndi zithunzi zosaloledwa zimasankhidwa chifukwa cha mgwirizanowu womwe timagulitsana, chifukwa kusiyanaku ndikofunikira kwambiri pakukhudzanso kwa cue-reacaction: kubwerezanso ku malingaliro osemphana ndi malingaliro osagwirizana ndi vuto. Kufanizira kwa zithunzi zofananira ndi zomwe zili pachiyambipo zingaphatikizepo njira zosawoneka bwino (monga zophatikizira, kusuntha zinthu) zomwe zimayikidwa poyang'ana zovuta zovuta zowoneka poyerekeza ndi chidwi chosavuta (mivi woloza kumanzere kapena kumanja) . Kulumikizana pakati pazithunzi zokhudzana ndi chizolowezi ndi mafayilo osavomerezeka sikungakhale kwachilendo kwenikweni, chifukwa mawonekedwe owonetsera amatha kugwirizananso ndi zotsatira za cue. Komabe, mwa anthu osokoneza bongo, ndikofunikira kudziwa kuti kutanthauzira kooneka koyambira nkofanana kwa onse omwe ali osokoneza bongo komanso osagwirizana ndi ena. Pakufufuza kwina kuchokera ku gulu lathu, zidapezeka kuti anthu omwe ali ndi vuto laukazitape amakhala ndi kuthekera kwakukulu muubongo pazithunzi zosaloledwa poyerekeza ndi zoyambira (Zijlstra Et al. 2009). Chifukwa chake, tikufotokozeranso momwe zingakhalire zosiyanabe ndi zotsutsana, kuwonetsa kuti zithunzi zosaloŵerera m'ndale zimatulutsa magulu ofanana.

Kuphatikiza apo, chidwi chomwe chimapangitsa dzanja lamanzere pamachitidwe azinthu zamaubongo zinafufuzidwa ndikuwunikira onse ndikuchita nawo popanda kumanzere. Zochita zomwe zidapezedwa kuchokera kumanzere ochita kumanzere zinali zofanana kwambiri ndi zomwe zidapezedwa kuphatikiza onse omwe akumanzere ndi kumanzere. Chifukwa chake, mu gawo la Zotsatira, timangopereka zomwe zimatengera chitsanzo chonse.

Kusanthula kwakanthawi kunachitidwa kwa PRG ndi HSM mosiyana, kuti afufuze ngati kutseguka kwa ubongo poyankha zomwe zimayambitsa kukhudzana ndi kusuta (kutchova njuga ndi kusuta,) molimbana ndi zithunzi zosaloŵedwa m'ndale zomwe zimalumikizidwa ndi kudzinena nokha pambuyo powajambula. Kusanthula kwa kusanthula kunapangidwanso kuti afufuze ngati ma co-morbid ADHD [ma Scers Adult ADHD Rating Scales (CAARS)] ndi zododometsa (zambiri za BDI-II) zogwirizana ndi kutseguka kwa ubongo komwe kulumikizana ndi cue-reacaction (zithunzi zokhudzana ndi zosemphana ndi zithunzi) . Chifukwa PRG idakwera kwambiri pa CAARS, komanso yayikulu kwambiri pa BDI-II kuposa magulu ena awiri (onani Gulu 1,, kusanthula uku kunachitika mosiyana ndi gulu lirilonse. Ma PRG anayi anali ndi matenda osokoneza bongo a co-morbid (nkhawa ndi / kapena kukhumudwa). Chifukwa chake, kulumikizana kwamagulu kuphatikiza PRG kudasinthidwa onse ndi omwe sanatenge nawo mgwirizano.

ZINTHU

Zotsatira zaumoyo wazamankhwala

Gulu 1 Chidule cha kuchuluka kwa anthu komanso magulu azachipatala m'magulu atatuwo. PRG inali ndi pafupifupi pafupifupi $ 60 000 m'mangongole okhudzana ndi njuga. Miyezo ya mpweya wa mpweya wopumira inali yapamwamba kwambiri ku HSM, poyerekeza ndi PRG ndi HC. PRG idapeza zambiri ku CAARS ndi BDI-II kuposa onse HSM ndi HC.

Zotsatira za chidziwitso cha ntchito ndikufunitsitsa

Nthawi zamachitidwe azithunzi zamtundu wa juga (M: 1143 ms, SD: 340) zinali zazitali kuposa nthawi zoyankha pazithunzi zosalowerera ndale (M: 1006 ms, SD: 311), F(1,49) = 50.1, P <0.0001; amatanthauza nthawi yomwe anthu amayamba kusuta pazithunzi zosuta (M: 929 ms, SD: 235) zinali zazifupi kuposa nthawi zovuta kuchitapo kanthu pazomwe sizinachitike (F(1,49) = 12.9, P <0.0001; ndikutanthauza nthawi zoyankhira pamunsi wotsika (M: 717 ms, SD: 169) zinali zazifupi kuposa zoyambitsa ndale, F(1,49) = 80.3, P <0.0001, koma palibe mtundu wolimbikitsira wamagulu womwe udalipo (gulu lonse mwa kusiyanasiyana kolimbikitsa F makhalidwe <1, NS). Zowona zinali zazikulu; Kutanthauza kuti zolakwika zingapo zomwe zidafotokozedwa munthawi zonse zinali 1.2, ndipo palibe kusiyana pakulakwitsa pakati pamagulu kapena zikhalidwe zomwe zidapezeka (F <1, NS). ANOVA idawonetsa kuti kulakalaka kusuta fodya usanayese kunali kwakukulu mu HSM poyerekeza ndi HC, F(1,34) = 87.4, P <0.0001, ndikuyerekeza ndi PRG F(1,34) = 57.8, P <0.0001. Kulakalaka sikunasiyane pakati pa gulu la FTND-lalitali ndi gulu la FTND-low, F(1,17) <1, NS. Palibe kusiyana pakati pa kusuta fodya isanakwane komanso itatha ntchito yolembanso ntchito pagulu lonse la HSM F(1,17) = 1.42, P = 0.25, kapena mgulu lalitali la FTND motsutsana ndi gulu lotsika la FTND, F(1,16) = .29, P = 0.60 analipo. Kulakalaka kutchova juga kunali kokulirapo mu PRG poyerekeza ndi HSM ndi HC, F(2,51) = 6.92, P <0.002, komanso chizolowezi chowonjezeka cholakalaka kutchova juga pambuyo poti ntchito yolembanso ntchito iwonedwe mu PRG, F(1,16) = 3.18, P = 0.09, pang'ono pang'ono2 = 0.17 (yatanthauzidwa ngati kukula kwakukulu, Stevens 1996).

fMRI cue kukonzanso

Zotsatira zazikulu (zithunzi motsutsana)

Zotsatira zazikulu pakuwona zithunzi zosalowererapo poyerekeza ndi zithunzi zoyambira zotsika zinaonedwa m'magulu onse atatu makamaka mumtsinje wowonera (occipital lobe: pakati, wotsika komanso wolankhula), komanso m'malo ogwirizana ndi mphotho / chilimbikitso, komanso chidwi ndi kuwongolera; medial temporche lobe kuphatikiza amygdala, mayiko apakati dorsolateral prefrontal cortex (DLPFC), komanso patterior thalamus yamayiko awiri Chith. 2, gulu lamanzere. Pazithunzi zanjala zotsutsana ndi zithunzi zoyambira ndi zithunzi zoyambira kusuta, zigawo zofananira zidadziwika. Kuphatikiza apo, tidapeza kutsegulira kwapakati pa ventrolateral prefrontal cortex (VLPFC) ya juga ndi zithunzi zokhudzana ndi kusuta motsutsana ndi zithunzi zoyambira, komanso dorsomedial prefrontal cortex activation for grafex zithunzi ndi zithunzi zamasewera (Chith. 2, pakati ndi kumanja mapanelo, motero).

Chithunzi 2 

Maonekedwe a magulu onse pazithunzi zosalowererapo poyerekeza ndi zithunzi za mzere wotsika (pamwamba kumanzere), zithunzi zanjuga motsutsana ndi zithunzi za mzere wotsika (gulu lapakati pakati), zithunzi zosuta motsutsana ndi zithunzi za mzere wotsika (pamwamba kumanja), ...

Kuchita zamagulu

Zithunzi zosalowererapo poyerekeza ndi zithunzi zoyambira zotsika, palibe zotsatira zoyipa zamagulu zomwe zinaonedwa. Mwa zithunzi zamtundu wa juga zosemphana ndi zithunzi zosalowerera ndale, tidapeza kutsegulira kwakukulu kumanzere a occipital cortex, parahippocampal gyrus, amygdala kumanja ndi DLPFC yakumanja kwa PRG yokhudzana ndi HC. Woyenderana ndi HSM, PRG adawonetsa zapamwamba zazipinda ziwiri zam'magulu awiri, malo awiri apamtundu wa girus, mayiko amygdala, DLPFC ndikusiya kutsegulira kwa VLPFC poyang'ana kutchova juga ndi zithunzi zosagwirizana (Gulu 2 ndi Chith. 3). Kusiyana kwamagulu komweko kunawonedwa pomwe PRG yokhala ndi co-morbid psychopathology idasiyidwa, ngakhale kusiyana mu DLPFC activation ku PRG kuyerekeza ndi HC, ndi kusiyana pakachitidwe mu amygdala wamanzere ndikusiya DLPFC mu PRG poyerekeza ndi HSM idasiya kukhala yofunikira.

Gulu 2 

Ntchito ya Cue Reacaction: Ntchito zopangidwa ndi BOLD pazotsatira zazikulu (zithunzi zosagwirizana / kutchova njuga / zithunzi zokhudzana ndi kusuta motsutsana ndi zithunzi zapansi pamunsi); zochitika pagulu (zithunzi zamtundu wa juga motsutsana ndi zithunzi zosalowerera ndale, ndi zithunzi zokhudzana ndi kusuta motsutsana ndi zithunzi zosalowerera); ...
Chithunzi 3 

Kuchita zamagulu: Madera omwe adawunikidwa kuti ayambitse kuthana ndi mavuto otchova njuga (PRG) motsutsana ndi zitsanzo zoyeserera zamaulamuliro athanzi (HC) ndi omwe amasuta fodya (HSM) pazoyang'anira −9, 0, −18. Kutulutsidwa kwa PRG ndi zovuta za Co-morbid psychiatric ...

Palibe gulu lalikulu chifukwa cha machitidwe omwe adawonedwa pojambula zithunzi mu HSM poyerekeza ndi PRG kapena HC. Kuyambitsa kwakukulu kunalipo mu ventromedial prefrontal cortex (VMPFC) mozungulira, mu rostral ACC mayiko awiri komanso kumanzere kwa VLPFC m'gulu la FTND-mkulu poyerekeza ndi HC komanso gulu lalitali la FTND-low. Zotsatira zofananazi zinaonedwa poyerekeza gulu la FTND-mkulu ndi PRG (onani Gulu 3 ndi Chith. 4). Kuphatikiza apo, pagulu lalitali la FTND, kuthandizira kumanzere kwamanzere, kumanzere kumanzere ndi kumanzere kwakanthawi komanso kwamphamvu kwambiri kunali kwakukulu kuposa gulu la FTND-low. Palibe gulu lalikulu pazogwirizana zomwe zidawonedwa mu gulu la FTND-low poyerekeza ndi HC kapena PRG.

Gulu 3 

Ntchito ya re-reacction: ZOPHUNZITSA za BOLD zokhudzana ndi zochitika zamagulu: zithunzi zokhudzana ndi kusuta motsutsana ndi zithunzi zosalowerera ndale.
Chithunzi 4 

Kuyanjana kwamagulu: Malo omwe akuwonetsedwa kuti ayambitse ntchito yayikulu mu Fagerström Mayeso a Nicotine Dependence (FTND) - gulu latsutsana ndi gulu lomwe lakhazikitsidwa la FTND-otsika gulu, otchova njuga (PRG) ndi maulamuliro athanzi (HC) pazogwirizanitsa 3, −51, ...

Zogwirizana pakati pa BOLD activation, zokhumba zogonjera, BDI-II ndi CAARS

Kupenda kosindikiza kunawonetsa kuyanjana pakati pakulakalaka kutchova juga pambuyo pa kujambulidwa mu PRG ndi kutsegulitsidwa kwa BOLD mu VLPFC, adasiya kulowera kumanzere ndi kumanzere kwa mutu wowonera pamene akuwona zithunzi za njuga motsutsana ndi zithunzi zosaloŵerera m'nkhondo (onani Gulu 2). Chiyanjano chabwino pakati pa kulakalaka chikonga pambuyo pakuwunika mu HSM ndi BOLD activation ku VLPFC ndikusiya dera la amygdala panthawi yowonera zithunzi zokhudzana ndi kusuta motsutsana ndi zithunzi zosalowererapo zinalipo (Gulu 4).

Gulu 4 

Ntchito ya Cue Reactivity: malumikizano pakati pa kuchititsa kwa BOLD ndi omwe akuti anangolakalaka atakhala okonda kutchova njuga komanso ovuta kwambiri

Palibe kuyanjana kwakukulu pakati pa BDI-II kapena kuchuluka kwa CAARS komanso kusintha kwa magazi m'magazi posachedwa pakuwona njuga kapena zithunzi zokhudzana ndi kusuta motsutsana ndi zithunzi zosalowererapo zinalipo ku PRG, HSM kapena HC.

KUKANGANANI

Uwu ndi kafukufuku woyamba wofufuzira za cue kuchitanso kutchova njuga pakufunafuna chithandizo cha PRG poyerekeza ndi HSM ndi HC, pogwiritsa ntchito chithunzi cha FMRI chokhudzana ndi chochitika. PRG idawonetsa kutseguka kwa ubongo kwakukulu poyerekeza ndi HC ndi HSM poyang'ana zithunzi za juga (poyerekeza ndi zithunzi zosaganizira) m'malo aubongo okhudzana ndi zochitika zowonera ndi kukumbukira (bilateral occipital cortex, parahippocampal gyrus), komanso kutengeka ndi chidwi (amygdala dera, VLPFC). Makamaka, kukonzanso kwa malo opanga mawonedwe azinthu zokhudzana ndi kusintha kwa kusintha kwa dopaminergic mu ma neural system ophatikizidwa ndi kudalira kwa zinthu: (1) malingaliro / othandizira komanso kukumbukira / kuphunzira gawo, kuphatikiza orbitofadalal, subcallosal cortex, amygdala ndi hippocampus; ndi (2) dera lotsogolera / lolamulira, kuphatikiza kutsogolo ndi ACC (Wolemba & Rosen 1999; Goldstein & Volkow 2002; Kalivas & Volkow 2005). Kuyambitsa kokwanira mu PG mu malo opangira mauthenga awa akhoza kukhala okhudzana ndi malo apamwamba akutchova njuga, kudzera mu njira zosungiramo ma dopamine kuchokera ku maukosi a ma nucleus, gawo la gawo la gawo ndi gawo la nthambi. Magawo ofanana ndi ubongo adapezeka kuti adapangidwa mu maphunziro a fMRI cue reacaction a osuta komanso anthu omwe amadalira mowa (George Et al. 2001; chifukwa Et al. 2002; Myrick Et al. 2004). Kuseweretsa kopitilira muyeso kwa dera la amygdala ndi parahippocampal gypus kumawonetsa kuti zithunzi zamtundu wa juga zinayambitsa kutengeka kwamaganizidwe / kukhudzika ndi zochitika zokhudzana ndi kukumbukira kwambiri mu PRG kuposa HSM ndi HC. Gypus ya parahippocampal imaphatikizidwa pokonza zovuta zowoneka bwino, imalandira zofunikira kuchokera ku maukosi a nitus ndi amygdala, ndipo ndi njira yothandizana nayo ku hippocampus. Kafukufuku wamatsenga omwe amakumana ndi vuto la kutchova juga, kudalira mowa komanso kudalira kwa chikonga adanenanso za kutseguka kwa ubongo mu parahippocampal gyrus (Crockford Et al. 2005; Smolka Et al. 2006; Park Et al. 2007). Kafukufukuyu ndiye woyamba kuwonetsa kutengapo gawo kwa dera la amygdala mu kafukufuku wama cue-reacaction ku PRG, ndikuwona kuti kutseguka m'malo aubongo monga insular cortex ndi caudate nucleus kumalumikizidwa ndi chilako chofuna kubera. Zotsatira izi zikuwonetsa kukhudzidwa kosalekeza kwa kutchova juga kwa odwala omwe ali munthawi yamankhwala othandizira mavuto a juga.

Onse a PRG anali kuthandizidwa ndi PG pomwe adatenga nawo gawo phunzirolo, ndipo adanena kuchuluka kwakutali kwa zovuta za juga zaka 13 (deta yomwe sinasonyezedwe). Maphunziro awiri a fMRI cue reactivity mu PG omwe alipo mu mabuku (Potenza Et al. 2003; Crockford Et al. 2005) ikuyang'ana pa PRG yomwe idalemba anthu, ndipo sinalembepo amygdala, insort cortex kapena caudate nucleus activation. Zotsatira za phunziroli zikuwonetsa kuti kuyambiranso zochitika za PRGs zofunafuna chithandizo zitha kukhala zokhudzana kwambiri ndi kubwezeretsanso kwa ubongo mokhudzana ndi zochitika zamagetsi ndi zolimbikitsa kuposa kuyambiranso mu ma PRG omwe siopanda chithandizo.

Kusiyana kwa njira zopangira ubongo kwa omwe amasuta zithunzi pakati pa omwe amasuta FTND-HC kapena PRG anali opezeka kwambiri mu VLPFC, VMPFC ndi rostral ACC, ndikufanana ndi maphunziro am'mbuyomu a fMRI cue reactivity in fodya (osuta fodya)David Et al. 2005; Lee Et al. 2005; McClernon Et al. 2005, 2008). Kuperewera kwa vuto la cue-reactivity mu gulu la FTND-low HSM poyerekeza ndi PRG kapena gulu la HC mwina likugwirizana ndi kutsika kwa chikumbumtima chodalira gulu langali. Adanenedwa kuti FTND zambiri zikugwirizana molondola ndi kubwerekanso kwa ubongo m'chigawo ndi fodya wosuta (Smolka Et al. 2006; McClernon Et al. 2008). Chifukwa chake, mmaphunziro amtsogolo, kusankha kwa anthu omwe amasuta kwambiri, omwe ali ndi chiwerengero chochepa pa FTND kapena kudziwika kwa DSM-IV ND kungakhale koyenera.

Kuphatikiza pazomwe tapeza pakuchita bwino kwa ubongo ku VMPFC ndi osuta a rostral ACC omwe amasuta fTND-yayikulu poyerekeza ndi magulu ena, tinaona kuti kusuta kwa fodya mu HSM kunakhudzana bwino ndi zochitika m'malo aubongo zokhudzana ndi kutengeka mtima ndi mphotho / kukonzekera (amygdala ndi VLPFC), madera omwe kale anali ndi chidwi chofuna kusuta (David Et al. 2005; McClernon Et al. 2008).

sitingathe

Ngakhale tidawona kuwonjezereka kwa ubongo poyankha zithunzi zamtundu wa PRG komanso kusuta kwa fodya yemwe ali mgulu la FTND-HSM lalitali, kuwonera zithunzizi kunangotipatsa chidwi chofuna kudziwonetsa pa PRG, pomwe mu HSM sizinachitike ndi kubwereranso kwachidziwikire. Ntchito yolakalaka kusuta idalipo. Zosintha pakufuna kungachitike ntchitoyo isanachitike komanso itatha itatha chifukwa cha kuchuluka kwa nthawiyo: pepala ndi cholembera chofunafuna zidadzazidwa atasiya kujambula, pomwe zotsatira za ntchito pakulakalaka zitha. Kafukufuku wamtsogolo, njira zolakalaka za pakompyuta zomwe zimayendetsedwa mu sikani, pakati kapena atangomaliza kumene ntchitoyo, ndichabwino.

Atalembetsa gulu la HSM, zinaonekeratu kuti zambiri FTND zambiri zimasiyana mgululi. Chifukwa chake, posachedwa kuyerekezera kunapangidwa pakati pamagulu awiri a HSM: gulu la FTND-lalitali ndi gulu la FTND-low. Kupeza kwakosiyana m'magulu a FTND-high ndi FTND-otsika kumatanthawuza kuti ndikofunikira kuphatikiza kuchuluka kwa kudalira kwa chikonga m'maphunziro a cue reaciture mwa osuta, kuphatikiza posankha omwe amasuta potengera kuchuluka kwa ndudu zomwe amasuta. Makulidwe am'magulu a FTND anali ochepa (n = 10 ndi n = 8, motsatana), ndipo zotsatira zake pamagululi ziyenera kutanthauziridwa mosamala. Kafukufuku wamagulu akuluakulu a omwe amasuta omwe ali mu FTND zambiri ayenera kuchitidwa kuti azithandizanso zomwe zapezedwa.

Kutsiliza

Kafukufukuyu akuwonetsa kuti kuwona zithunzi zamtundu wa juga (mosiyana ndi zithunzi zosaloŵererapo) kumayenderana ndi kuchititsa ubongo kwakukulu pakuwongolera, kusunthira chidwi ndi kusamalira makutu poyang'anira PRG yofunafuna chithandizo, poyerekeza ndi HC ndi HSM, ndikuti kutsegulira kumeneku ndi zogwirizana ndi zolimbikitsa kutchova juga. Zotsatira izi zimagwirizana ndi zomwe zimawonedwa mwa anthu omwe amadalira mankhwala.George Et al. 2001; Myrick Et al. 2004; Franklin Et al. 2007). Mu kafukufuku wapano, tawonanso kuwonjezereka kwa ubongo ku kusuta kwa anthu omwe ali ndi FTND zambiri zomwe zikuwonetsa kudalira kwenikweni kwa chikonga poyerekeza ndi HC, koma sitinapeze kusiyana pakati pa anthu omwe ali ndi FTND chithunzi chosonyeza kudalira kochepa kwa chikonga. Kulimbikitsa kwambiri kusuta mu HSM kumalumikizidwa ndi zochitika zowonjezeka mu mphoto ndi malo okhudzana ndi ubongo. Kafukufuku wamtsogolo akuyenera kudziwa ngati zotsatira za nthawi yayitali za kutchova juga pa ubongo ku PRG mu chithandizo cha mankhwala zikukhudzana ndi kubwereranso ku njuga.

Kuvomereza

Kufufuza kumeneku kunaperekedwa ndi ndalama kuchokera ku Netherlands Organisation for Health Research and Development (#31000056) ya Netherlands Organisation for Science Science (NWO) kupita ku AG, DV, JO ndi WB, komanso mwa New Investigator thandizo (AG, Veni chilolezo) kuchokera ku Dutch Science Science Organisation (NWO ZonMw, #91676084, 2007-10). Kutsegula mitengo kudalipiridwa ndi Amsterdam Brain Imaging Platform. AG, MR, DV, JO ndi WB sanena kusamvana pa zokonda. Tithokoza a Jellinek Amsterdam chifukwa chothandizidwa pantchito yotenga njuga.

Zolemba Zolemba

AG, MR, ndi DV amatenga udindo pakukhulupirika pamasamba komanso kulondola kwa kusanthula kwa deta. Olemba onse akhala ndi mwayi wodziwa zonse zomwe zidawerengeredwa. AG, MR, JO, WB, ndi DV anali ndi udindo pa lingaliro la kaphunziridwe ndi kapangidwe kake. MR anali ndi udindo wofufuza zinthu. MR, AG, ndi DV anali ndi udindo wofufuza zowerengera ndi kutanthauzira kwa chidziwitso. AG adalemba zolemba pamanja. MR, JO, WB ndi DV adasinthiratu zolemba pamanja kuti zikhale zanzeru. Olemba onse adawunikiranso mozama zomwe zalembedweratu ndipo adavomereza zomaliza kuti zitha kufalitsidwa. Zoyambirira za kafukufukuyu zidaperekedwa pa Msonkhano wa Anthu Akuchita Bwino June 15-19, 2008, Melbourne, Australia.

Zothandizira

  1. Beck AT, Steer RA, Mpira R, Ranieri WF. Kuyerekeza kwa Beck Depression Inventories-IA ndi -II mu Psychiatric Outpatients. J Pers Yesani. 1996; 67: 588-597. [Adasankhidwa]
  2. Breiter HC, Rosen BR. Yogwira ntchito yamagalasi oyang'ana m'maganizo muubwino wamaubwino wamaubongo mwa munthu. Ann NY Acad Sci. 1999; 877: 523-547. [Adasankhidwa]
  3. Brody AL, Mandelkern MA, London ED, Childress AR, Lee GS, Bota RG, Ho ML, Saxena S, Baxter LR, Jr, Madsen D, Jarvik ME. Ubongo umasintha mukulakalaka ndudu. Psychi Psychiatry. 2002; 59: 1162-1172. [Adasankhidwa]
  4. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. Mafunso a AUDIT omwera mowa (AUDIT-C): kuyesa mwachidule kwa vutoli. Ntchito Yogwira Ntchito Yogwira Ntchito Yabwino Kwambiri (ACQUIP). Kuyeserera kwa Mafuta Ogwiritsira Ntchito Mowa. Arch Intern Med. 1998; 158: 1789-1795. [Adasankhidwa]
  5. Conners CK, Sparrow MA. Conners Adult ADHD Rating Scales (CAARS) New York: Njira Zosiyanasiyana; 1999.
  6. Cooney NL, Litt MD, Morse PA, Bauer LO, Gaupp L. Mowa utayambiranso mowa, kusinthanso mtima mosaganizira, ndikuyambiranso ntchito kwa anthu omwe akhala akuledzera. J Abnorm Psychol. 1997; 106: 243-250. [Adasankhidwa]
  7. Crockford DN, Goodyear B, Edward J, Quickfall J, el-Guebaly N. Cue-adalimbikitsa ubongo mu ochita masewera andewu. Psychology ya Biol. 2005; 58: 787-795. [Adasankhidwa]
  8. David SP, Munafo MR, Johansen-Berg H, Smith SM, Rogers RD, Matthews PM, Walton RT. Ventral striatum / nucleus inagwiritsidwa ntchito poyesa kusuta fodya kwa anthu osuta ndi osasuta: maphunziro opanga maginito opanga masomphenya. Biol Psychiatry. 2005; 58: 488-494. [Adasankhidwa]
  9. de Ruiter MB, Veltman DJ, Goudriaan AE, Oosterlaan J, Sjoerds Z, van den Brink W. Kulimbikitsana kulimbikitsana ndi mphamvu zowonongeka kuti apereke mphoto ndi chilango kwa anthu otchova njuga ndi osuta fodya. Neuropsychopharmacology. 2009; 34: 1027-1038. [Adasankhidwa]
  10. Chifukwa cha DL, Huettel SA, Hall WG, DC Rubin. Kugwira ntchito m'masolimbic ndi visuospatial neural circuits zopangidwa ndi kusuta fodya: umboni wochokera ku maginito opangidwa ndi maginito. Am J Psychiatry. 2002; 159: 954-960. [Adasankhidwa]
  11. Franklin TR, Wang Z, Wang J, Sciortino N, Harper D, Li Y, Ehrman R, Kampman K, O'Brien CP, Detre JA, Childress AR. Kugwiritsa ntchito mankhwala osokoneza bongo kusuta fodya popanda kujambula kwa chikonga: kuyesera fMRI kuphunzira. Neuropsychopharmacology. 2007; 32: 2301-2309. [Adasankhidwa]
  12. George MS, Anton RF, Bloomer C, Teneback C, Drobes DJ, Lorberbaum JP, Nahas Z, Vincent DJ. Kukhazikitsidwa kwa preortalal cortex ndi anterior thalamus mu zakumwa zochotsekeratu pakukhudzana ndi mawonekedwe a mowa. Psychi Psychiatry. 2001; 58: 345-352. [Adasankhidwa]
  13. Goldstein RZ, Volkow ND. Kugwiritsa ntchito mankhwala osokoneza bongo komanso maziko ake a neurobiological: umboni wa neuroimaging wokhudzana ndi khola lam'maso. Ndine J Psychiatry. 2002; 159: 1642-1652. [Nkhani yaulere ya PMC] [Adasankhidwa]
  14. Goudriaan AE, Oosterlaan J, de Beurs E, van Den Brink W. Njuga yachiwerewere: kuwunikira kwathunthu zomwe zapezeka pakupezeka kwa biobeharanceal. Neurosci Biobehav Rev. 2004; 28: 123-141. [Adasankhidwa]
  15. Heatherton TF, Kozlowski LT, Frecker RC, Fagerstrom KO. Kuyesedwa kwa Fagerstrom kwa Nikotine Kudziyimira: kukonzanso kwa Fagerstrom Tolerance Mafunso. Br J Addict. 1991; 86: 1119-1127. [Adasankhidwa]
  16. Hodgins DC, el Guebaly N. Kubwereza komanso chiyembekezo chazomwe zachitika posonyeza kuti anzeruwo ayambiranso kutchova njuga. J Funsani Clin Psychol. 2004; 72: 72-80. [Adasankhidwa]
  17. Kalivas PW, Volkow ND. Chikhalidwe chachisokonezo cha chizoloŵezi: chizoloŵezi cha zolimbikitsa ndi zosankha. Am J Psychiatry. 2005; 162: 1403-1413. [Adasankhidwa]
  18. Ma CD a Kilts, Gross RE, Ely TD, Drexler KP. Zosakanikirana zam'maso za cue-zomwe zimapangitsa kuti azimayi omwe amadalira mankhwala a cocaine atenge. Ndine J Psychiatry. 2004; 161: 233-241. [Adasankhidwa]
  19. CD Kilts, Schweitzer JB, Quinn CK, RE Yonse, Faber TL, Muhammad F, Ely TD, Hoffman JM, Drexler KP. Zochitika za Neural zokhudzana ndi chilakolako cha mankhwala osokoneza bongo mu cocaine. Arch Gen Psychiatry. 2001; 58: 334-341. [Adasankhidwa]
  20. Kosten TR, Scanley, Tucker KA, Oliveto A, Prince C, Sinha R, Potenza MN, Skudlarski P, Wexler BE. Zochitika za ubongo zomwe zimapangitsa kuti munthu azichita zinthuzo zimasintha ndi kubwereranso ndi odwala a cocaine. Neuropsychopharmacology. 2006; 31: 644-650. [Adasankhidwa]
  21. Ledgerwood DM, Petry NM. Kodi tikudziwa chiani pa kubwereranso mu njuga zamatenda? Clin Psychol Rev. 2006; 26: 216-228. [Adasankhidwa]
  22. Lee JH, Lim Y, Wiederhold BK, Graham SJ. Kufufuza kwa magnetic resonance imaging (FMRI) ya chilakolako chofuna kusuta fodya m'madera onse. Appl Psychophysiol Biofeedback. 2005; 30: 195-204. [Adasankhidwa]
  23. Lesieur H, Blume SB. The South Oaks Gging Screen (SOGS): chida chatsopano chodziwitsira anthu otchova njuga. Ndine J Psychiatry. 1987; 144: 1184-1188. [Adasankhidwa]
  24. McBride D, Barrett SP, Kelly JT, Aw A, Dagher A. Zotsatira za kuyembekezera ndi kudziletsa pazithunzithunzi zokhudzana ndi kusuta fodya mu osuta ndudu: kufufuza kwa fMRI. Neuropsychopharmacology. 2006; 31: 2728-2738. [Adasankhidwa]
  25. McClernon FJ, Hiott FB, Huettel SA, Rose JE. Kusintha chifukwa cha kudziletsa kumasewera okhudzana ndi kudzikonda kumagwirizanitsa ndi mayankho a FMRI omwe amakumanapo ndi zochitika ku fodya. Neuropsychopharmacology. 2005; 30: 1940-1947. [Nkhani yaulere ya PMC] [Adasankhidwa]
  26. McClernon FJ, Hutchison KE, Rose JE, Kozink RV. Polymorphism ya DRD4 VNTR imalumikizidwa ndi mayankho osakhalitsa a fMRI-BOLD pazosuta fodya. Psychopharmacol (Berl) 2007; 194: 433-441. [Adasankhidwa]
  27. McClernon FJ, Kozink RV, Rose JE. Kusiyanitsa kwa wina ndi mnzake kumadalira ku chikonga, zizindikiro zowonongeka, ndi kugonana zimatanthawuza kuyankha kwa fMRI-BOLD nthawi yayitali kuti asuta fodya. Neuropsychopharmacology. 2008; 33: 2148-2157. [Adasankhidwa]
  28. Marissen MA, Franken IH, Madzi AJ, Blanken P, van den Brink W, Hendriks VM. Kukonda chidwi kuneneratu kuti heroin ayambiranso kutsatira chithandizo. Kuledzera. 2006; 101: 1306-1312. [Adasankhidwa]
  29. Mudo G, Belluardo N, Fuxe K. Nicotinic receptor agonists ngati mankhwala a neuroprotective / neurotrophic. Kupita patsogolo kwamankhwala opanga ma cell. J Neural Transm. 2007; 114: 135-147. [Adasankhidwa]
  30. Myrick H, Anton RF, Li X, Henderson S, Drobes D, Voronin K, George MS. Kusiyanasiyana kwa ubongo muzoledzera ndi omwa mowa mwauchidakwa cues: ubale ndi chilakolako. Neuropsychopharmacology. 2004; 29: 393-402. [Adasankhidwa]
  31. Nichols T, Hayasaka S. Kuwongolera zolakwika za banja mzere muzochitika zatsopano: kuwunika kofanizira. Njira Zopangira Med Res. 2003; 12: 419-446. [Adasankhidwa]
  32. Park MS, Sohn JH, Suk JA, Kim SH, Sohn S, Sparacio R. Brain magawo a chilakolako cha zakumwa za mowa pazochitika ndi zakumwa zoledzeretsa. Mowa Woledzera. 2007; 42: 417-422. [Adasankhidwa]
  33. Petry NM. Kodi kuchuluka kwa zizoloŵezi zoledzera kuyenera kuwonjezeka kuphatikizapo kutchova njuga? Chizoloŵezi. 2006; 101 (Suppl 1): 152-160. [Adasankhidwa]
  34. Petry NM, Kiluk BD. Maganizo ofuna kudzipha komanso kuyesa kudzipha pakufunafuna njuga. J Nerv Ment Dis. 2002; 190: 462-469. [Nkhani yaulere ya PMC] [Adasankhidwa]
  35. Potenza MN. Kodi mavuto ozunguza bongo ayenera kukhala osagwirizana ndi mankhwala? Chizoloŵezi. 2006; 101 (Suppl 1): 142-151. [Adasankhidwa]
  36. Potenza MN, Fiellin DA, Heninger GR, Rounsaville BJ, Mazure CM. Kutchova njuga: chizolowezi chomangokhala ndi thanzi komanso zotsatira zoyipa za chisamaliro. J Gen Intern Med. 2002; 17: 721-732. [Nkhani yaulere ya PMC] [Adasankhidwa]
  37. Potenza MN, Steinberg MA, Skudlarski P, Fulbright RK, Lacadie CM, Wilber MK, Rounsaville BJ, Gore JC, Wexler BE. Kutchova juga kumathandizira kutchova njuga: kuphunzira maginidwe opatsa chidwi a maginito. Psychi Psychiatry. 2003; 60: 828-836. [Adasankhidwa]
  38. Reuter J, Raedler T, Rose M, Dzanja I, Glascher J, Buchel C. Njira zachiwerewere zachikhalidwe zimalumikizidwa ndi kutseguka kwa dongosolo la mphoto ya mesolimbic. Nat Neurosci. 2005; 8: 147-148. [Adasankhidwa]
  39. Robins L, Cottler L, Bucholz K, Compton W. Diagnostic Mafunso Ndondomeko ya DSM-IV (Dis-IV-Revision 11 Sep 1998) St. Louis, MO: Washington University, School of Medicine, department of Psychiatry; 1998.
  40. Smolka MN, Buhler M, Klein S, Zimmermann U, Mann K, Heinz A, Braus DF. Kudalirika kwa chikodzo chodalira kumatengera zochita za ubongo mu zigawo zomwe zimakonzedwa ndikuwonetsa ma mota. Psychopharmacol (Berl) 2006; 184: 577-588. [Adasankhidwa]
  41. Stevens J. Adagwiritsa Ntchito Ziwerengero Zosiyanasiyana za Sayansi ya Zachikhalidwe. 3rd. Mahwah, NJ: Lawrence Erlbaum; 1996.
  42. Sullivan EV. Makina ophatikizika a pontocerebellar ndi cerebellothalamocortical system: malingaliro pazopereka zawo pakuzindikira komanso kuyendetsa galimoto mu uchidakwa wa nonamnesic. Mowa Clin Exp Res. 2003; 27: 1409-1419. [Adasankhidwa]
  43. Tapert SF, Brown GG, Baratta MV, Brown SA. FMRI BOLD yankho lakumwa mowa mwauchidakwa kwa atsikana omwe ali ndi mowa mwauchidakwa. Chizolowezi Behav. 2004; 29: 33-50. [Adasankhidwa]
  44. Tiffany ST, Drobes DJ. Kukula ndi kutsimikizika koyambirira kwafunso pazofunsira kusuta. Br J Addict. 1991; 86: 1467-1476. [Adasankhidwa]
  45. Welte JW, Barnes G, Wieczorek W, Tidwell MC, Parker J. Mowa ndi njuga zamaphunziro pakati pa akulu akulu aku US: kuchuluka, mawonekedwe a demographic ndi comorbidity. J Maphunziro Mowa. 2001; 62: 706-712. [Adasankhidwa]
  46. World Health Organisation. Mafunso Ofunsidwa Kwina Padziko Lonse Lapansi — Version 2.L. Geneva: World Health Organisation; 1997.
  47. Zijlstra F, Veltman DJ, Booij J, van den Brink W, Franken IH. Magulu a Neurobiological a cue-elicited hamu ndi anhedonia mwa amuna omwe amadalira opioid posachedwa. Kudwala Mowa. 2009; 99: 183-192. [Adasankhidwa]