Front Psychiatry. 2018; 9: 77.
Idasindikizidwa pa intaneti 2018 Mar 27. do: 10.3389 / fpsyt.2018.00077
PMCID: PMC5881242
PMID: 29636704
Ji-Woo Seok1 ndi Jin-Hun Sohn2,*
Kudalirika
Maphunziro a Neuroimaging okhudzana ndi anthu omwe ali ndi vuto la masewera a pa intaneti (IGD) akhala akudziunjikira chifukwa cha nkhawa zomwe zikukula pokhudzana ndi zovuta zamaganizidwe ndi chikhalidwe cha anthu ogwira ntchito pa intaneti. Komabe, ndizochepa zomwe zimadziwika pazomwe zimayambira mu IGD, monga njira yolumikizira yogwirizana ndi kapangidwe kake. Cholinga cha phunziroli chinali kufufuzira kusintha kwa zinthu zaimvi (GM) kuchuluka ndi kulumikizana kwa magwiridwe antchito panthawi yopumula boma mwa anthu omwe ali ndi IGD ogwiritsa ntchito voxel-based morphometry ndi kusanthula kwapadera kwa boma. Omwe adaphatikizawo adaphatikizira anthu a 20 omwe ali ndi IGD ndi 20 m'badwo- komanso zowongolera zogonana. Zithunzi zopumulira za boma ndi zojambula zopangidwa zinapezedwa kwa onse omwe amagwiritsa ntchito makina a 3 T maginito a resonance. Tinayezanso kuuma kwa IGD komanso kusakhazikika pogwiritsa ntchito masikelo azamisala. Zotsatira zikuwonetsa kuti kuopsa kwa IGD kunalumikizidwa bwino ndi kuchuluka kwa GM mu caudate wamanzere (p <0.05, yokonzedwa poyerekeza kangapo), komanso yolumikizidwa molakwika ndi kulumikizana kwantchito pakati pa caudate wamanzere ndi girus wapakati wakumanja (p <0.05, yokonzedwa poyerekeza angapo). Kafukufukuyu akuwonetsa kuti IGD imalumikizidwa ndi kusintha kwa neuroanatomical pakatikati pakatikati koyenera ndi caudate wamanzere. Awa ndi madera ofunikira aubongo olandirira mphotho ndi njira zowongolera kuzindikira, ndipo zovuta zina mwazigawozi zanenedwa kuti ndizokonda zina, monga kugwiritsa ntchito mankhwala osokoneza bongo komanso kutchova njuga. Zomwe apezazi zikuwonetsa kuti kuchepa kwa kapangidwe kake ndi kuchepa kwa magwiridwe antchito mdziko la frontostriatal zitha kulumikizidwa ndi IGD ndikupereka chidziwitso chatsopano pazomwe zimayambira mu neural wa IGD.
Introduction
Masewera apa intaneti amakhala osangalatsa komanso amathandizira kupsinjika, kuwonjezera pazabwino zina zambiri. Zotsatira zake, kuchuluka kwa osewera pa intaneti kwachulukirachulukira padziko lonse lapansi. Masewera owonjezera pa intaneti amatha kuchepetsa zochitika zenizeni, zomwe zimabweretsa zotsatira zoyipa zamaganizidwe (1-3). Internet Gaming Disorder (IGD) imatanthauzidwa ngati kugwiritsidwa ntchito mokakamiza komanso kwanzeru kwa zida zomwe zikuthandizira kufikira intaneti ndipo zimakhala ndi zotsatirapo zoyipa. Gawo lachitatu la Diagnostic and Statistical Manual of Mental Disorder-5 (DSM-5) likuti IGD ndi chikhalidwe chomwe chimafunikira kafukufuku wambiri wazachipatala (4).
Posachedwa, maphunziro a neuroimaging pa IGD afufuza kusintha kosinthika ndi kachitidwe muubongo kuti azindikire mawonekedwe a neuronal okhudzana ndi kukula kwa IGD (5). Ntchito yogwiritsa ntchito maginito okhudzana ndi ntchito yogwiritsa ntchito maginito (fMRI) yawonetsa kusokonezeka kwa anthu omwe ali ndi IGD (2, 6, 7-11). Zotsatira za kafukufukuyu wa FMRI zikuwonetsa kuti mukamawonetsedwa pamasewera apakompyuta, masewera a pavidiyo, kapena masewera apamtaneti, anthu omwe ali ndi IGD, poyerekeza ndi kuwongolera wathanzi (HC), akuwonetsa kukhumba kowonjezereka kwamasewera komanso kusintha kwa ntchito zamaubongo m'magawo osiyanasiyana monga monga caudate nucleus, dorsolateral presetal area, nucleus accumbens, anterior cingulate cortex, and hippocampus (7-10).
Ngakhale maphunziro a fMRI omwe amagwira ntchito angazindikire kusokoneza komwe kumagwira ntchito mwa anthu omwe ali ndi IGD, kuwunika kwa mapumidwe olumikizana ndi maboma kungapereke tanthauzo losiyananso komanso lothekera (12). Kupuma-boma fMRI ndi njira yowunika kulumikizana ndi magwiridwe antchito pakati pamagawo panthawi yopanda ntchito. Kuunikira maukonde opumulira a boma la FMRI kumatha kupereka zambiri zokhudzana ndi zovuta zomwe zimagawidwa mu matenda a neuropsychiatric matenda (13, 14). Kafukufuku wopumula wa boma wa IGD wa IGD wachitika kuti adziwe mtundu wa neurobiological network womwe umadalitsika komanso momwe amagwirira ntchito mwanzeru pakalumikizidwe kantchito (15-18). Izi kafukufuku adanenanso zothandiza kulumikizana kapena gawo la homogeneity mkati mwa tempile gritus ndi cerebellum (15, 16, 18). Komanso, Hong et al. (17) anawona kuchepa magwiridwe olumikizana mu subcortical ubongo zigawo.
Umboni wokwanira wochokera ku kafukufuku wamalingaliro a ubongo wapangidwe wavumbula kuti IGD ikhoza kulumikizidwa ndi kusintha kwamapangidwe mkati mwa ubongo (17, 19-22). Njira zogwiritsidwa ntchito kwambiri za morphometric pa kusanthula kwa ubongo ndizoyesa modutsa pang'onopang'ono (GM) monga voxel-based morphometry (VBM) komanso miyeso yolimba yozungulira ya cortical pogwiritsa ntchito FreeSurfer (23). Han et al. (19) ndi Weng et al. (21) adafufuza zopweteka muubongo wa achinyamata omwe ali ndi IGD pogwiritsa ntchito VBM ndipo akuti idachepetsa kuchuluka kwa GM mu orbitofrontal cortex, insula, gritus wa tempile, ndi occipital cortex. Kafukufuku wowunika makulidwe a cortical kuti awone kusintha kwa m'mitsempha ya anthu omwe ali ndi IGD awonetsa kuchepa kwa makulidwe a orortofrontal cortex, insula, parietal cortex, ndi postcentral gyrus (17, 22).
Posachedwa, kafukufuku wophatikizidwa komanso wogwira ntchito wa MRI adanenanso kuti pali kusiyana pakati pa kutsimikizika ndi kuchuluka kwa amygdala, komanso kulumikizana kwapakati pakati pa amygdala ndi dorsolateral prefrontal cortex (DLPFC) (13, 14). Zotsatira izi zikuwonetsa kuti kuchuluka kwa GM kosinthika ndikuwalumikizidwa kwina mu amygdala kungakhale kokhudzana ndi kusakhazikika ndikuyimira chiopsezo ku IGD (13, 14). Kafukufuku awiri waposachedwa adayesa kusiyana komwe kumagwirizana mu mawonekedwe aubongo onse ndi kulumikizana kwake. Choyamba, Jin et al. (24) adapeza kuti anthu omwe ali ndi IGD adatsitsa kwambiri kuchuluka kwa GM mu preortal cortex, kuphatikiza DLPFC, orbitofrontal cortex, anterior cingulate cortex, ndi malo owonjezera othandizira, ndikuchepetsa kulumikizana kwazomwe zikuchitika mu gawo loyambirira la striatal. Chachiwiri, Yuan et al. (25) idapezeka yachepa mphamvu ya striatum voliyumu ndi kupumula kwadongosolo kosiyanitsa magawo azolowera kutsogolo kwa mabwalo pakati pa anthu omwe ali ndi IGD ndi HC. Zotsatira izi zikuwonetsa kuti pagawo ladera, IGD imatha kugawana njira zofananira zamtunduwu ndi vuto la kugwiritsa ntchito zinthu (24, 25).
Pomaliza, zotsatira za kafukufuku wakale komanso malingaliro aposachedwa pogwiritsa ntchito njira za neuroimaging zikuwonetsa kuti IGD ndi yokhudzana ndi kusintha kwa ma neuroanatomical pama circostriatal circuits, ofanana ndi vuto la kugwiritsidwa ntchito kwa zinthu (7-11, 24-28). Komanso kufanana kwa psychopathological zviratidzo ndi ma neural process pakati pa IGD ndi vuto la kugwiritsidwa ntchito kwa zinthu zikusonyeza kuti pali njira inayake yomwe ingagwiritsidwire ntchito pangozi (9, 27, 28).
Mpaka pano, kafukufuku wochepa adachitika pazokhudza magwiridwe antchito ndi mapangidwe ku IGD pogwiritsa ntchito zomangamanga zophatikizidwa ndi kupumula kwa boma komwe ntchito ikuyendera (13, 14, 25, 29). Kuphatikiza apo, maphunziro awa a IGD sanachotse kutengera kwamakhalidwe (mwachitsanzo, maola ambiri a masewera) pa ubale pakati pa IGD ndi kusintha kwa ubongo ngakhale kuti kuchita mobwerezabwereza kumatha kusintha mawonekedwe a ubongo (30). Chifukwa chake, kulimbitsa kufotokozera kwa mawonekedwe a IGD kuphatikiza kusokonezeka kwa misala (monga, chizolowezi) ku ubongo wamaganizidwe, tinawongolera zotsatira za zochitika zamasewera pakusintha kwa mawonekedwe aubongo ndi kulumikizidwa ku IGD.
Mu phunziroli, tinayang'ana kusinthika kwapangidwe komanso kulumikizana kwazinthu mu ubongo wa anthu omwe ali ndi IGD, pogwiritsa ntchito kulingalira kwa 3 T kulingalira kwamaubongo a GM GM ndikuwunikira komwe boma lingagwiritse. Makamaka, tidafufuza ngati kuchuluka kwa GM kumasinthidwa kutsogolo kwa anthu omwe ali ndi IGD, komanso ngati kuchepa kwa voliyumu kumalumikizidwa ndi kulumikizidwa kwa magwiridwe antchito. Tidazindikiranso ngati zosinthazi zidawonetsedwa posankha masewera.
Zida ndi njira
Ophatikizira ndi Zipangizo Zoyeza
Amuna makumi awiri akumanja akumanja omwe ali ndi IGD (mibadwo: 20-26 zaka) adalembedwa kudzera kutsatsa pa bolodi zolengeza pa intaneti komanso pakati pa anthu omwe akupita kumalo opangira mankhwala osokoneza bongo pa intaneti, malo opezako zambiri pa intaneti, kapena pamisonkhano yamagulu ogwiritsira ntchito mankhwala osokoneza bongo. Onse omwe ali mgululi la IGD adafunsidwa ndi akatswiri awiri amisala yoyenerera, malinga ndi njira yofufuzira IGD yolongosoledwa mu Diagnostic and Statistical Manual of Mental Disorder-5 (31). Kugwiritsa ntchito njira zomwezi, zaka za 20- komanso kugonana-HC (zaka: 20-27 zaka) adalembedwanso. Palibe aliyense mwa ophunzira omwe anakwaniritsa zomwe zingachitike ndi matenda ena amisala kapena mitsempha yokhala ndi matenda amisempha, nkhawa, kukhumudwa, kutchova juga, kapena kudalira mankhwala osokoneza bongo. Palibe aliyense mwa omwe anachitapo kafukufuku wina yemwe anachitapo kale ndi juga kapena mankhwala osokoneza bongo.
Ophunzira onse adapereka chidziwitso cholemba atalemba zambiri mwatsatanetsatane wa kuyesera. Bungwe la Chungnam National University Institutional Review Board linavomereza njira zoyeserera ndi kuvomereza (nambala yovomerezeka: P01-201602-11-002). Ophunzira onse adalandira chindapusa cha ndalama (madola a 50 US) chifukwa chotenga nawo mbali.
Ophunzira adamaliza kafukufuku wokhala ndi mafunso okhudzana ndi kuchuluka kwa anthu komanso masewera a pa intaneti m'miyezi yapitayi ya 12, monga "Chaka chatha, pafupifupi, masiku angati pa sabata mudachita masewera a pa intaneti?" Komanso "Chaka chatha. , pafupifupi, pafupifupi mphindi zingati patsiku zomwe wakhala mumasewera pa intaneti? ”Kuphatikiza apo, masikelo ofanana ndi Barratt Impulsiveness Scale-II [BIS (32)], Kuyesa Kudziwitsa Zizindikiro za Mowa33), ndi Beck Depression Inventory [BDI (34)] adagwiritsidwa ntchito kuyesa malingaliro aomwe ophunzira anali nawo.
Kuopsa kwa IGD kunayesedwa pogwiritsa ntchito mayeso osokoneza bongo a Achinyamata pa intaneti (IAT) (35). IAT ndi chida chodalirika komanso chovomerezeka chogawika matenda osokoneza bongo omwe ali pa intaneti (36). IAT imakhala ndi mafunso angapo a 20 omwe adapangidwa kuti ayese kugwiritsa ntchito intaneti mwachangu, zizindikiro zochotsa, kudalira zamaganizidwe, komanso mavuto okhudzana ndi moyo watsiku ndi tsiku. Mavoti adapangidwa kutengera mtundu wa 5-point, kuyambira 1 (konse) mpaka 5 (kwambiri). Ziwerengerozi zimachokera ku 20 mpaka 100, ndipo chiwerengero chonse cha 50 kapena chapamwamba chikuwonetsa zovuta kapena zina zokhudzana ndi intaneti chifukwa chogwiritsa ntchito intaneti mosalamulirika (http://netaddiction.com/internet-addiction-test/).
Kupeza Ma Deta
Makina a 3.0 T MRI scanner (Achieva Intera 3 T; Philips Healthcare, Best, Netherlands) adagwiritsidwa ntchito pazithunzi. Zithunzi zolemetsa za T1 zolemetsa zinapezeka pogwiritsa ntchito zigawo zotsatirazi: kubwereza nthawi = 280; nthawi ya echo = 14 ms; chingwe cholowa = 60 °; gawo lakuwona = 24 masentimita x 24 cm; matrix = 256 × 256; makulidwe oyenda = 4 mm. Panthawi yopumira-mawonekedwe a boma, zithunzi za 180 zidatengedwa ndi kuwombera kamodzi, echo-planar pulse sequence (nthawi yobwereza = 2,000 ms; echo nthawi = 28 ms; makulidwe amtundu = 4 mm, palibe malire; matrix = 64 × 64; shamba powonera = 24 cm x 24 cm; ndi flip angle = 80 °). Ophunzirawo adalangizidwa kuti akhale otseguka, kuti akhale maso, osaganizira kalikonse, osagona kapena kuwodzera pa nthawi yopuma. Atatha kujambula, onse omwe adatenga nawo mbali adafunsidwa ngati adakhala chete maso awo atatsekedwa panthawi yonse yosanthula. Zambiri kuchokera kwa ophunzira omwe anena zovuta pamavuto athunthu adachotsedwa ndipo sanagwiritse ntchito pakuwunikanso kwina.
Kusanthula kwa VBM
Kusanthula kwa moroxometry kochokera kwa Voxel kunachitika pogwiritsa ntchito pulogalamu ya SPM8 (http://www.fil.ion.ucl.ac.uk/spm) ndi bokosi lazida la VBM8 (http://dbm.neuro.uni-jena.de/vbm.html). Zithunzithunzi za MR zidakonzedwa pogwiritsa ntchito zilembo zamaukadaulo zosagwirizana ndi fayiloyo ya algorithm (diffeomorphic anatomical usajili kudzera mu njira ya exponentiated lie algebra, DARTEL) pofuna kupititsa patsogolo kufooka kwa chithunzi cha ubongo (37). Pang'onopang'ono, kusanthula kwa VBM kunali ndi magawo anayi otsatirawa: (1) zithunzi za MR zidagawika mu GM, nkhani yoyera (WM), ndi madzi a cerebrospinal; (2) makonda opangira ma GM adapangidwa kuchokera pazithunzi zophunzirira pogwiritsa ntchito njira ya DARTEL; (3) pambuyo pa kulumikizana kwaulere kwa ma tempuleti a GM DARTEL kupita ku mapu a minyewa ku Montreal Neurological Institute (MNI) danga, zithunzi zosagwirizana ndi GM zinayikidwa pa template ya DARTEL GM kenako ndikugwiritsidwa ntchito ngati njira yosinthira kuchuluka kwa kuchuluka kwa ma GM okwanira kusungidwa potsatira momwe masanjidwewo alili; (4) Zithunzi zosinthidwa za GM zidasinthidwa pogwiritsa ntchito 8-mm kwathunthu pakatikati kapamwamba ka Gaussian kernel pakuwunikira mawerengero.
Pambuyo pokonza, voliyumu ya GM idafanizidwa pakati pa anthu omwe ali ndi IGD ndi HC. Choyimira mtheradi cha 0.1 chinagwiritsidwa ntchito pakufufuza kwa GM kuti mupewe zotheka mozungulira malire pakati pa imvi ndi WM.
Kuwongolera zotsatira zakunja, zaka zamaphunziro, kufunsa, komanso kukhumudwa, izi zidawonjezeredwa ngati othandizira. Tidapangitsanso pakati pa kusanthula kwamagulu powonjezera maola ambiri amasewera monga covariate kuti tipeze zotsatira za IGD posankha kupatula zomwe mikhalidwe yathu ili ndi IGD.
M'gulu lirilonse, kusanthula pang'ono kwakanachitika kuti kuwunika mgwirizano pakati pa kuchuluka kwa GM ndi kuuma kwa IGD (mwachitsanzo, kuchuluka kwa IAT) popewa kusiyanasiyana kosiyanasiyana (mwachitsanzo, zaka, zaka zamaphunziro, kusakhazikika, ndi kukhumudwa). Kuphatikiza apo, kuwunikanso kwina kosiyana kunachitika mwa kuwongolera zosintha zina ndi zina zowonjezera (mwachitsanzo, maola ambiri a masewera). Kukula kwa chiwerengero cha kusiyana kwamagulu kunakhazikitsidwa p <0.05, yokonzedwa poyerekeza angapo pogwiritsa ntchito njira yopezeka yabodza (FDR), pamgulu limodzi la> ma voxels 50.
Ntchito Yogwirizanitsa Ntchito
Kusanthula kogwira ntchito kunachitika pogwiritsa ntchito bokosi lothandizira la CONN v.15 [http://www.nitrc.org/projects/conn; yotchulidwa ku Whitfield-Gabrieli et al. (38)] kuzindikira malo opumulira aboma mu magawo osintha bongo. Zosintha za boma ndikupumula zimayamba kugwiritsa ntchito njira zowonjezera, kuphatikiza kusintha kwa kagawo, kusintha kayendedwe ka kukana kwa zinthu, kusintha kwa malo kumalo abwinobwino aubongo pogwiritsa ntchito chithunzi cha template, komanso kuwongolera ndi 8-mm isotropic Gaussian kernel. Asanayambe kusanthula kwam'mutu, njira zogwiritsira ntchito denoising zidachitika pa deta yomwe imagwiritsa ntchito BOLD (magazi-oxygen-modalira) chizindikiro chochokera ku masanjidwe a WM komanso kutsekeka kwa msana, komanso magawo omvekera osunthika kuchokera kumalo amakonzedweranso kwa kukonzekera kwa malo, monga othandizira alibe chidwi ndi mzere wamagulu osanja mawonekedwe. Kenako, fyuluta ya band-pass pakati pa 0.01 ndi 0.08 Hz idayikidwa munthawi yakutali kuti ichotse chizindikiro chadongosolo la pafupipafupi chokhudzana ndi zochitika zama cell.
Pambuyo pokwaniritsa njira ndi kupatsa denoising, kuwunika kogwirizira kogwira ntchito kunachitika ndikugwiritsa ntchito njira yokhazikitsidwa ndi mbewu posankha kaphokoso kazitsulo kamtundu wa caudate pazowunikira pa VBM, (−9 + 8 + 15) mu MNI space. Tidasankha gawo lamanzere la caudate ngati gawo lokhala ndi chidwi ndi kulumikizana kwina komwe kumathandizira chifukwa gawo lamanzere la caudate linalumikizidwa ndi kuopsa kwa IGD pakuwunika kwa VBM, komanso chifukwa kafukufuku wakale adawunikira kusintha kwazomwe zikuchitika mu gawo la caudate pakati pa anthu IGD (24, 25). Mgwirizano wolumikizana pakati pa ma voxel awa ambewu ndi ma voxels ena onse amawerengedwa kuti apange mapu olumikizana. Pa kusanthula kwachiwiri, ma coefficients osinthidwa adasinthidwa kuti azigawika z-magulu ogwiritsa ntchito Kusintha kwa Fisher. Zaka, zaka zamaphunziro, kusachedwa, ndi kukhumudwa zidawonjezeredwa ngati othandizira pakuwunika kwachiwiri. Poyerekeza gulu, magulu awiri t-Miyeso idachitidwa kuti tiyerekeze zMamapu osavomerezeka pakati pa anthu omwe ali ndi IGD ndi HC, omwe ali ndi kutalika kwa cholakwika p <0.001 ndi gawo lokhazikika la FDR-lokonzedwa p <0.05 pamlingo wamagulu. ANCOVA idachitidwanso ndikuwonjezera maora wamba amasewera ngati covariate kuti azindikire kusiyana pakati pamagulu kupatula zomwe zimakhudzana ndi IGD.
M'gulu lirilonse, kulumikizana pang'ono kumasiyanitsa kuopsa kwa IGD (mwachitsanzo, IAT) ndi pakati z-sukulu zingapo zaubongo zomwe zimawonetsera kuchepa kwa kulumikizika ndi mgwirizano wamanzere a caudate zidapangidwa kuti ayang'ane ubale womwe ulipo pakati pa IGD ndikusinthika kwa kulumikizana kwachidziwikire kupatula kusiyanasiyana kwapadera (monga, zaka, zaka zamaphunziro, kusakhazikika, ndi kukhumudwa). Kuphatikiza kwina kwakanthawi kumachitidwanso ndikuwonjezera maola angapo amasewera monga povariate ndi zosinthika zina.
Kusanthula kwa Correlation Pakati pa Maganizo a Bongo ndi Kugwirizana Kogwira
Kuti mufufuze mgwirizano womwe ulipo pakati pa kapangidwe kake ndi kagwiritsidwe kake kazigawo kumanzere ka caudate ka anthu omwe ali ndi IGD, kuwunika kosakanikirana kunachitika pambuyo podziwongolera kuwongolera ndi kukhumudwa.
Results
Zizindikiro za Ophunzira
Monga momwe tawonetsera mu Table Table1,1, anthu omwe ali ndi IGD ndi HC sanali osiyana kwambiri pazaka (t = 0.83, p > 0.05) ndi kutalika kwa maphunziro (t = 0.67, p > 0.05). Komabe, poyerekeza ndi HC, anthu omwe ali ndi IGD adakwera kwambiri pamiyeso yamasewera amasewera tsiku lililonse (t = 7.25, p <0.001) ndi masiku wamba amasewera pasabata (t = 7.42, p <0.001), ndipo ndinali ndi ziwonetsero zambiri za IAT (t = 11.37, p <0.001). Anthu omwe ali ndi IGD adakhumudwidwanso kwambiri (t = 4.88, p <0.001) komanso mopupuluma (t = 5.23, p <0.001) kuposa zowongolera. Zambiri zomwe zidagwiritsidwa ntchito pa intaneti zidalumikizidwa ndi kuchuluka kwa kukhumudwar = 0.71, p <0.001) ndi zambiri (...)r = 0.66, p <0.001).
Gulu 1
Zowerengera ndi zamankhwala zamgulu la IGD ndi HC.
| Kusintha (kutanthauza ± SD) | IGD | HC | t |
|---|---|---|---|
| Zaka (zaka) | 21.70 ± 2.74 | 22.40 ± 2.62 | 0.83 |
| Maphunziro (zaka) | 14.55 ± 2.93 | 15.15 ± 2.72 | 0.67 |
| Avereji ya maola a masewera patsiku | 11.87 ± 5.33 | 1.90 ± 3.06 | 7.25 *** |
| Pakatikati masiku amasewera pa sabata | 6.75 ± 0.71 | 2.4 ± 2.52 | 7.42 *** |
| Chiwonetsero cha AUDIT | 4.73 ± 3.07 | 3.75 ± 2.59 | 1.09 |
| Gawo la BDI | 12.4 ± 7.36 | 3.3 ± 3.89 | 4.88 *** |
| BIS-II mphambu | 56.00 ± 5.34 | 47.50 ± 4.92 | 5.23 *** |
| Makala a IAT | 71.85 ± 12.82 | 29.80 ± 8.80 | 12.09 *** |
BDI, Beck Depression Scale; BIS, Barrett's Impulsiveness Scale-II; IGD, vuto la masewera a pa intaneti; IAT, kuyesa kwa intaneti; HC, owongolera athanzi.
*** p <0.001 poyerekeza magulu.
Kusanthula kwa VBM
Monga zikuwonetsedwa m'Gome Table22 ndi Chithunzi Figure1A, 1A, zotsatira za kusanthula kwa VBM zikuwonetsa kuti anthu omwe ali ndi IGD adachepetsa kuchuluka kwa GM mu bilteral middle frontal cortex [Brodmann area (BA) 10] (kumanja: t = 4.82, kumanzere: t = 4.30, p <0.05, FDR yakonzedwa) ndikuwonjezera kuchuluka kwa GM mu gawo lamanzere la caudate (t = 5.37, p <0.05, FDR yakonzedwa), poyerekeza ndi HC. Pambuyo pakuwongolera momwe masewera azosewerera azikhudzira, kuchuluka kwa GM koyambira pakati kumanja [kumanja: F(1, 38) = 5.58, p <0.05,
Gulu 2
Kusiyana kwa dera la imvi (GM) pakati pa gulu la IGD ndi HC kuwulula kulumikizana kwabwino ndi kuopsa kwa IGD.
| Dera la ubongo | MNI imagwirizanitsa | tMax | Kukula kwa masango (ma voxels) | ||
|---|---|---|---|---|---|
| x | y | z | |||
| IGD> HC | |||||
| L caudate | -8 | 14 | 10 | 5.37 | 234 |
| IGD <HC | |||||
| R / L MFG (BA 10) | 44 | 51 | 8 | 4.82 | 417 |
| -37 | 45 | 20 | 4.30 | 247 | |
| Kugwirizana pakati pa kachulukidwe ka GM ndi gawo la IAT | |||||
| L caudate | -9 | 8 | 15 | 4.91 | 75 |
BA, dera la Brodmann; L, kumanzere; MNI, Montreal Neurological Institute; MFG, gorus wapakatikati; R, pomwe; IGD, vuto la masewera a pa intaneti; IAT, kuyesa kwa intaneti; HC, owongolera athanzi.
MNI yolumikizira kuchuluka kwa ma t-scores akuwonetsedwa ku tsango lililonse.
Kufunika kwa zigawo za chiwongola dzanja, p <0.05, kuwongolera kwabodza kwakusokonekera.
Kusanthula kwa Voxel-based morphometry (VBM). (A) Nkhani zazimvi zimasiyana pakati pa gulu la IGD ndi HC (p <0.05, chiwongolero chabodza chakonzedwa) (MNI imagwirizanitsa: L caudate, -8, 14, 10; R MFG, 44, 51, 8; L MFG, -37, 45, 20). (B) Kuwunika kwa VBMp <0.01) (MNI imagwirizanitsa: L caudate, −9, 8, 15). Machaputala: HC, kuwongolera koyenera; IAT, kuyesa kugwiritsa ntchito intaneti; IGD, vuto la masewera a pa intaneti; L, Kumanzere; MFG, girus wakale wakutsogolo; R, chabwino; MNI, Montreal Neurological Institute.
Kwa gulu la IGD, kulumikizana kwabwino kwambiri kunapezeka pakati pa voliyumu ya GM mu dzanja lamanzere la caudate ndi kuuma kwa IGD (mwachitsanzo, kuchuluka kwa IAT) kupatula kusiyanasiyana kwapadera (kupatula pang'ono r = 0.58, p <0.01, FDR yakonzedwa) (Chithunzi (Figure1B), 1B), kupatula mphamvu za masewera a masewera ndi zinthu zina zakunja, malumikizidwe abwino awa adapezekanso pakati pa gawo lamanzere la caudate ndi zambiri za IAT (kulumikizana pang'ono r = 0.56, p <0.05). Malumikizidwe olakwika kwambiri adawonedwa pakati pa voliyumu yapakatikati ndi kukakamira monga momwe amayeza pogwiritsa ntchito Barrett's Impulsiveness Scale (kulumikizana pang'ono r = 0.39, p <0.05, FDR idakonzedwa) ndipo kulumikizaku sikunawonetsedwe pambuyo pakupatula zomwe zimachitika pamasewera (p > 0.05). Komabe, palibe dera laubongo lomwe limawonetsa kuyanjana kwakukulu ndi zambiri za BDI (p > 0.05, FDR yakonzedwa).
Mu HC, palibe ubale wofunikira womwe umapezeka pakati pa mitundu iliyonse yamalingaliro (mwachitsanzo, IAT, BIS, ndi ma ScD BDI) ndi voliyumu ya GM m'dera lililonse laubongo (p > 0.05, FDR yakonzedwa).
Ntchito Yogwirizanitsa Ntchito
Mwa anthu omwe ali ndi IGD, caudate kumanzere inali yolumikizidwa ndimagawo osiyanasiyana aubongo, kuphatikiza thammus yachiwiriyo, putamen, posterior cingate cortex, precuneus, pallidum, accumbens, anterior cingate cortex, advanced occipital cortex, frontal cortex, front frontal cortex, frontal frontal kotekisi, ndi orbitof mbeleal kotekisi (kutalika, p <0.001, yosakonzedwa; pakhomo, p <0.05, FDR yakonzedwa). Pakati pa HC, gawo lamanzere la caudate limalumikizidwa ndi thalamus, putamen, posterior cingate cortex, pallidum, accumbens, anterior cingate cortex, orbitofrontal cortex, frontal cortex, chapakati chakumaso kotsogola, ndi ma medial frontal cortices (kutalika kwake, p <0.001, yosakonzedwa; pakhomo, p <0.05, FDR yakonzedwa).
Monga momwe tawonetsera mu Table Table33 ndi Chithunzi Figure2A, 2A, kulumikizidwa kwazowonjezera kwakuchitika pakati pa lamanzere a caudate ndi posterior cingulate gyrus (PCG) (BA 31) (t = 5.97, p <0.05, FDR yakonzedwa), gyrus wapakati wapakati (MFG) (BA 8) (t = 11.39, p <0.05, FDR yakonzedwa), ndikusiya precuneus (BA 31) (t = 5.48, p <0.05, FDR yakonzedwa) mkati mwa anthu omwe ali ndi IGD yokhudzana ndi zowongolera. Pambuyo pa kuwongolera zochitika zamasewera, kulumikizana uku kowonjezeka pakati pa maphunziro a IGD kudawonetsedwa kumanzere kwa caudate ndi mayiko awiri a PCG [F(1, 38) = 6.27, p <0.05,
Gulu 3
Kusiyana kwa magwiridwe antchito pakati pa gulu la IGD ndi HC kuwulula kulumikizana kwabwino ndi kuopsa kwa IGD.
| Mbewu ROI | Dera lolumikizidwa | MNI imagwirizanitsa | tMax | Kukula kwa masango (ma voxels) | ||
|---|---|---|---|---|---|---|
| x | y | z | ||||
| IGD> HC | ||||||
| L caudate | R / L PCG (BA 31) | 0 | -28 | 44 | 5.97 | 391 |
| R MFG (BA 8) | 35 | 12 | 40 | 11.39 | 506 | |
| L precuneus (BA 31) | -16 | -56 | 26 | 5.48 | 381 | |
| Kugwirizana pakati pa ntchito yolumikizidwa ndi gawo la IAT | ||||||
| L caudate | R MFG (BA 8) | 22 | 36 | 34 | 6.26 | 446 |
BA, dera la Brodmann; HC, zowongolera zathanzi; IGD, vuto la masewera a pa intaneti; L, kumanzere; MFG, gorus wapakatikati; MNI, Montreal Neurological Institute; PCG, posterior cingulate gyrus; R, pomwe; ROI, dera lokondweretsedwa.
Masango a Cluster FDR adakonzedwa, p <0.05, gawo loyambirira kutalika ndi p <0.001.
Ntchito yogwirizanitsa. (A) Kulumikizana kwakasiyana kwa ubongo pakati pa gulu la IGD ndi HC (p <0.05, FDR yakonzedwa) (MNI imagwirizanitsa: L caudate, -9, 8, 15; R / L PCG, 0, -28, 44; R MFG, 35, 12, 40; L precuneus, -16, -56, 26). (B) Kusanthula kwa ubale pakati pa zovuta za IGD ndi phindu lolumikizana (p <0.05, FDR yakonzedwa) (MNI imagwirizanitsa: L caudate, -9, 8, 15; R MFG, 22, 36, 34). Machaputala: HC, kuwongolera koyenera; IAT, kuyesa kugwiritsa ntchito intaneti; IGD, vuto la masewera a pa intaneti; L, Kumanzere; MFG, girus wakale wakutsogolo; PG, kutumiza gyrus; R, chabwino; FDR, kuchuluka kwopezeka zabodza; MNI, Montreal Neurological Institute; PCG, kumbuyo kwa cingate gyrus.
Pakati pa gulu la IGD, kuphatikiza kwabwino komwe kunapezedwa pakati pa zovuta za IGD (mwachitsanzo, zambiri za IAT) ndi cholumikizira chogwirizira cha mbali yakumanzere ya caudate ndi cholowera chakumaso chakumaso popanda kupatula zosinthika zina zowonjezera (kusakanikirana kwakanthawi r = 0.61, p <0.01, FDR yakonzedwa) (Chithunzi (Figure2B) .2B). Pambuyo pokana ntchito yamasewera, kuwongolera kwina kopindulitsa kunapezekanso pakati pa zovuta za IGD ndi kulumikizana kwadongosolo lamanzere am'mphepete mwa dzanja lamanzere pakati kutsogolo posiyanitsa zotsatira za masewerawa ndi zinthu zina zakunja (kuphatikizika kwina r = 0.63, p <0.01).
Palibe ubale wofunikira pakati pa mitundu ina yamalingaliro (mwachitsanzo, kuchuluka kwa BIS ndi BDI) ndi kulumikizidwa kwa nyumbayi ya caudate yamanzere ndi kumanzere kwakumaso kwapakati kwapakati komwe kudadziwika mu gulu la IGD (p > 0.05, FDR yakonzedwa). Pakati pa HC, panalibe kulumikizana kwakukulu pakati pazosintha zamaganizidwe (mwachitsanzo, IAT, BIS, ndi zambiri za BDI) ndi kulumikizana kwa gawo lamanzere la caudate ndi madera ena aubongo.
Kusanthula kwa Correlation Pakati pa Maganizo a Bongo ndi Kugwirizana Kogwira
Panalibe kulumikizana kwakukulu pakati pa voliyumu ya GM ndi kulumikizana kwazogwira ntchito mkati mwa caudate nucleus (r = 0.08, p > 0.05).
Kukambirana
Kafukufukuyu adafufuza maubwino azigawo komanso magwiridwe antchito a IGD pophatikiza ma MRI komanso kupuma kwa boma fMRI. Kugwirizana ndi maphunziro am'mbuyomu pa comorbid psychopathology yogwiritsa ntchito kwambiri intaneti (39, 40), tidawona kuti anthu omwe ali ndi IGD anali ndi nkhawa zambiri komanso samatopa. Zotsatira za neuroimaging zikuwonetsa kuti kuchuluka kwa IAT kumalumikizidwa bwino ndi kuchuluka kwa GM mu dzanja lamanzere la caudate ndi kufunika kolumikizana pakati pa gawo lamanzere la caudate ndi kolowera pakati pakati. Chosangalatsa ndichakuti, kuchepa kwa GM mu gawo lamanzere la caudate ndi kulumikizidwa kosasinthika kwa boma pakati pa pakati pa caudate nucleus ndi bokosi lamkati lamkati kutsogolo adawonetsedwa atatha kuwongolera za momwe masewera azitha pakati pa anthu omwe ali ndi IGD. Komabe, sitinawone kulumikizana pakati pa kusintha kwazomwe zikuchitika komanso zothandiza. Zomwe apezazi zikuwonetsa kuti nambala yakumanzere ya caudate ndi gawo lofunikira mu pathogenesis yamakhalidwe ochita masewera apamwamba pa intaneti.
Tinapeza zosintha mwazigawo zamanzere za caudate za anthu omwe ali ndi IGD zowongolera, ndipo voliyumu ya GM kumanzere a caudate kogwirizana inali yolimba ndi IGD zovuta. Zotsatira izi ndizogwirizana ndi kafukufuku wakale wamankhwala osokoneza bongo, kuphatikiza maphunziro pazakumwa za mankhwala osokoneza bongo (41, 42), mankhwala osokoneza bongo (43), ndi IGD (25, 44). Phata la caudate ndi gawo lofunikira la striatum ndipo limatenga gawo lofunikira kwambiri pakuphunzira bwino pamalipiro. Kuphatikiza apo, gawo la caudate limalumikizidwa kwambiri ndi chisangalalo ndi chidwi, komanso pakupanga ndi kukonza machitidwe owonetsa (45-47). Kafukufuku angapo adanenanso kuti IGD imalumikizidwa ndi zonyansa mu striatum, makamaka ma caudate nucleus. Mwachitsanzo, Kim et al. (3) ndi Hou et al. (48) adanenanso kuchepetsa kuchepa kwa dopamine D2 receptor ndi dopamine transporter mu caudate pakati pa anthu omwe ali ndi IGD, zomwe zikusonyeza kuti IGD imagwirizanitsidwa ndi kuchepa kwa zochitika za dopaminergic mumayendedwe amalipiro aubongo, ofanana ndi zovuta zina zowonjezera. Kuphatikiza apo, kafukufuku waposachedwa wa fMRI gulu lathu pogwiritsa ntchito chisankho chawonetsa kuti kuyambitsa kwapamwamba kumanzere komwe kumalumikizidwa ndikusankha njira zowopsa, zomwe zimapereka chidziwitso chambiri pakugwira nawo gawo lamanzere la caudate mu ntchito za neural zolosera za mphotho ndi kuyembekezera (11). Pamodzi, zopezazi, zikuwonetsa kuti kuchepa kwa GM mu kachulukidwe ka caudate kumatha kukulitsa chidwi cha chiyembekezo cha mphotho kwa anthu omwe ali ndi IGD; gawo lamanzere la caudate motero limatha kukhala gawo la zoyeserera zogwirizana ndi IGD.
Kuti tifufuze ubale wamkati mwazosinthika ndi ma kagwiritsidwe kantchito, tidayesa njira yolumikizira yolumikizira mbewu. Kuwunikira komwe kumagwira ntchito ndi mbewu yomwe ili kumanzere kolumikizana kwa caudate kunawulula kuti mbali yoyang'ana kutsogolo ya cortex (mwachitsanzo, DLPFC) idalumikizidwa bwino ndi kuopsa kwa IGD, kuwonetsa kuti anthu omwe anali ndi chidwi kwambiri ndi masewera a pa intaneti anali ndi kulumikizana mwamphamvu pakati pa gawo lamanzere la caudate. ndi DLPFC yoyenera. Malo omwe akuwonetsedwa muzotsatira za VBM sanagwirizane ndendende ndi malo omwe akuwonetsedwa mu zotsatirapo za rs-fMRI. Dera lomwe likuwonetsedwa mu VBM ndi zotsatira za rs-fMRI zinali BA 10 ndi 8, motsatana, ndipo malo odutsa sawonerapo. Komabe, onse m'derali akuphatikizidwa ku DLPFC. DLPFC-striatal dera ndi gawo lofunikira kwambiri mu gawo la mphoto ya dopamine ndipo imalimbikitsidwa kwambiri pantchito zazikulu monga kukonzekera, kupanga bungwe, kukhazikika, ndi chidwi (49). Kuwonongeka kwa netiweki kungasinthe kukhathamira kwa kusokoneza bongo mwa kuchepetsa mwayi wowongolera kusakanikirana ndi kusankha kwa chizindikiritso komanso chizolowezi cholimbikitsa (49). Mabwalo aberrant frontostriatal adawululidwa kale mwa anthu omwe ali ndi IGD. Kafukufuku wokhudzana ndi kupumula kwa magwiridwe antchito akuwonetsa kuti achinyamata omwe ali ndi vuto losokoneza bongo la intaneti ali ndi zosinthika m'mabwalo awo amtsogolo omwe amakhudza, kusuntha, komanso kuwongolera kuzindikira (50). Potsatira zotsatira zathu, Kafukufuku wina adawonetsa kuti kulumikizana kwazomwe zikuyenda bwino kumalumikizana kwambiri ndi kutha kwambiri kwa chizolowezi cha intaneti (51). Komabe, mosiyana ndi zomwe zapezekazi, maphunziro ena ogwiritsira ntchito kulumikizana awonetsa kuti anthu omwe ali ndi IGD achepetsa kulumikizana kwazomwe zikuchitika mu gawo la frontostriatal (24, 25). Ndemanga zaposachedwa pazomwe zapezedwa mu IGD zawonetsanso zotsatira zosagwirizana pakati pa kafukufukuyu ndikuwonetsa kuti ubongo womwe wasinthidwa suli wangwiro ndipo uyenera kufufuzidwanso.28). Kusiyana pakati pazomwe apezazi kungakhale chifukwa cha kuchuluka kwa anthu kapena zinthu zina monga kugonana, zaka, kudwala, kapena mawonekedwe ofuna chithandizo. Kafukufuku wambiri a neuroimaging adawonetsanso kuti ma caudate nucleus ndi DLPFC amatenga nawo mbali pamasewera amasewera (52-54). Kafukufukuyu akuwonetsa kuti striatum yakumanzere ndi pulasitiki ya DLPFC ndizokhudzana ndi kuchuluka kwa kusewera masewera / maphunziro pazinthu zomwe sizinawonetsetse. Mu phunziroli, kuzindikira kuti kusintha m'magawo awa ndikogwirizana kwambiri ndi mawonekedwe a IGD kuphatikiza mawonekedwe osokoneza bongo kapena ogwirizana kwambiri ndi zochitika zamasewera, tinayang'ananso ndikatha kuwongolera momwe ntchitoyo imayambira (mwachitsanzo, maola ambiri a masewera). Zotsatira za kusanthula kwinaku zikuwonetsa bwino kusiyana pakati pa maguluwa. Chifukwa chake, zosinthika m'malo awa zitha kukhala zokhudzana ndi mawonekedwe a IGD m'malo machitidwe a masewera. Kutengedwa palimodzi, mosasamala kanthu za kulephera kotere, zomwe zapezedwa mpaka pano zikuwonetsa kuti kusokonezeka kwa gawo lakutsogolo panthawi yopuma komanso ubale wake ndi zovuta za IGD zitha kuphatikizidwa ndi zosankha zoyenera, monga kufuna kugwiritsa ntchito intaneti ngakhale mutakhala ndi zotsatirapo zoyipa.
Zowerengeka zingapo za phunziroli ziyenera kudziwika. Choyamba, chifukwa cha gawo la kafukufukuyu, ubale wake ndi zotsatira zake sizikudziwika. Kafukufuku wamtsogolo akuyenera kuzindikira zotsatira zazitali za IGD. Chachiwiri, timangokhala ndi zaka za 20-27 zazimuna zomwe tikufuna kuphunzira, ndipo tiyenera kusamala popanga zotsatira za kafukufuku wathu kwa anthu wamba, komanso poganizira kukula kwa zitsanzo. Chachitatu, kafukufuku wamtsogolo angaganize za kuyezetsa nthawi kuyambira pakudziwitsa IGD kuti afotokoze kusinthasintha kulikonse kofunikira pakugwira ntchito kwa neural. Pomaliza, pali kusamvana pakati pa zomwe tapeza ndikuwonetsa kuwonjezeka ndikuchepetsa kulumikizidwa kwa ntchito mu gawo la frontostriatal. Chifukwa chake, zotsatira zake ziyenera kutanthauziridwa mosamalitsa komanso maphunziro owonjezereka pansi pamikhalidwe imodzimodziyo (mwachitsanzo, zikhalidwe za anthu kapena omwe ali ndi omwe atenga nawo mbali) amafunika kuti afotokozere zotsutsana (24, 25, 28).
Pomaliza, kafukufukuyu akuwunikira kusintha kwa mapangidwe aukaliti komanso kusokonekera kwa maukadaulo a kutsogolo kwa anthu omwe ali ndi IGD. Chofunika kwambiri, mitundu yonse yosinthika idalumikizidwa ndi kuuma kwa IGD. Zotsatira zathu zikusonyeza kuti nanusite ya caudate yamanzere imathandizira kwambiri pathogeneis wa IGD ndikuti IGD ndi kugwiritsa ntchito mankhwala osokoneza bongo amagawana magawo ofanana.
Chikhalidwe
Ophunzira onse adapereka chidziwitso cholemba atalemba zambiri mwatsatanetsatane wa kuyesera. Chungnam National University Institutional Review Board (IRB) idavomereza njira zoyeserera ndi zovomerezeka (nambala yovomerezeka: P01-201602-11-002). Ophunzira onse adalandira chindapusa cha ndalama (madola a 50 US) chifukwa chotenga nawo mbali.
Zopereka za Wolemba
JWS inathandizira kuti pakhale kuzindikira komanso kuyesera, kapena kupeza deta, kapena kusanthula ndi kumasulira kwa deta, ndipo JHS anathandizira kwambiri kutanthauzira kwa data ndikusanja nkhaniyo kapena kusinthanso mozama kuti ikhale ndi chidziwitso chofunikira.
Kutsutsana kwa Chidwi
Olembawo akunena kuti kufufuza kunkachitika popanda mgwirizano uliwonse wa zamalonda kapena zachuma zomwe zingatengedwe kuti zingatheke kukangana.
Mawu a M'munsi
Ngongole. Kufufuzaku kunathandizidwa ndi Basic Science Research Program kudzera National Research Foundation of Korea (NRF) yothandizidwa ndi Ministry of Education (NRF-2015R1D1A1A01059095).
achidule
BIS, Barratt Impulsiveness Scale-II; BDI, Beck Depression Inventory; DLPFC, dorsolateral prefrontal cortex; FDR, kuchuluka kopezeka mwabodza; fMRI, maginidwe othandizira olimbitsa thupi; GM, imvi; IAT, kuyesa kwa intaneti; IGD, vuto la masewera a pa intaneti; VBM, voxel-based morphometry; MNI, Montreal Neurological Institute; WM, nkhani yoyera.
Zothandizira
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