Kutsogolo. Psychiatry, 13 Disembala 2017 | https://doi.org/10.3389/fpsyt.2017.00287
Yanbo Hu3, 
- 1Dipatimenti ya Psychology, Zhejiang Normal University, Jinhua, China
- 2Sukulu ya Psychology ndi Cognitive Science, East China Normal University, Shanghai, China
- 3Dipatimenti ya Psychology, London Metropolitan University, London, United Kingdom
- 4Sukulu ya Psychology, Southwest University, Chongqing, China
- 5Peking-Tsinghua Center for Life Science, Peking University, Beijing, China
- 6Department of Physics, Shanghai Key Laborator of Magnetic Resonance, East China Normal University, Shanghai, China
- 7Institute of Psychological and Brain Science, Zhejiang Normal University, Jinhua, China
Mavuto a masewera a pa intaneti (IGD), omwe amatanthauziridwa ngati kugwiritsa ntchito masewera a pa intaneti mosazindikira zotsatira zoyipa, akweza nkhawa za anthu ambiri. Kafukufukuyu akuwunikira njira zowonetsera zomwe zimayambitsa IGD poyerekeza njira zopangira zisankho pakati pa otenga mbali a 18 IGD ndi ma 21 ofanana olamulira athanzi (HCs). Zotsatira zamakhalidwe ndi fMRI zidalembedwa kuchokera pantchito yofulumira. Pa mulingo wakuchita, IGD idawonetsa kuchotsera kwakukulu k kuposa HC; ndi mgulu la IGD, nthawi yonse yochitira (kuchedwa - mwachangu) komanso mtengo wotsitsira k anali okhudzana kwambiri ndi kuuma kwa IGD. Pa mulingo wa neural, IGD idawonetsa kuchepa kwa ubongo mu dorsolateral prefrontal cortex ndi gretus yokhala kutsogolo kwapakati poyerekeza ndi HC pochita mayeso ochedwa posachedwa ndi omwe amapezeka posachedwa. Kutengedwera limodzi, zotsatira zake zikusonyeza kuti IGD adawonetsa zoperewera popanga zisankho ndikukonda kukhutira pomwepo. Makina oyambira amabwera chifukwa choperewera pakuwunika pakati pa mphotho yomwe yachedwa ndi kukhutitsidwa kwapompopompo, komanso kuthekera kwa kulepheretsa zolepheretsa, zomwe zimatha kuphatikizidwa ndi kusokonezeka kwa magwiridwe antchito. Izi zitha kukhala chifukwa chomwe IGD ikupitilira kusewera masewera apa intaneti ngakhale akukumana ndi zovuta zoyipa.
Introduction
Mavuto azosewerera pa intaneti (IGD) akweza kwambiri nkhawa za anthu. Amawonetsedwa ngati kugwiritsa ntchito masewera olimbitsa thupi mobwerezabwereza, zomwe zimabweretsa zotsatirapo zosiyanasiyana zovuta zokhudzana ndi moyo watsiku ndi tsiku komanso thanzi lam'mutu, monga kupweteketsa vuto, ubale wosagwirizana, ndikuchepetsa zomwe ophunzira amapeza (1, 2). Kafukufuku woyeserera ndi kafukufuku wazofunsa adawonetsa kuti anthu omwe ali ndi IGD amawonetsa kufanana kwakukulu ndi mitsempha yofanana ndi iwo omwe ali ndi mankhwala osokoneza bongo, kugwiritsa ntchito mankhwala osokoneza bongo, komanso vuto la kutchova njuga pazinthu zambiri, kuphatikizapo zokhudzana ndi malingaliro a psyorid.3-5). Komabe, poyerekeza ndi zovuta zokhudzana ndi zinthu komanso zosokoneza bongo (mwachitsanzo, vuto la uchidakwa), chinthu chofunikira kwambiri ku IGD sichinthu kapena mankhwala osokoneza bongo. Mu Meyi 2013, IGD yalembedwa m'Gawo "Zotsatira" za DSM-5 ngati mfundo yothandizira maphunziro ena (6-8).
Kupanga chisankho mozama kumatanthawuza mikhalidwe yomwe anthu amafunika kusankha pakati pazosankha ziwiri: mphotho yofulumira koma yaying'ono komanso yochedwa koma yayikulu (9). Kuchedwa kuchotsera ntchito (DDT) ndi njira yogwiritsidwa ntchito kwambiri pofufuza zisankho zopanga pakati komanso kuyeza zosankha zomwe zimakakamiza (10), koma osagwiritsidwa ntchito kwenikweni kuti apange chisankho ndi kulinganiza kwa IGD. Kuchedwa kukufupikitsidwa, anthu amakonda mphotho yayikulupo m'malo yaying'ono; koma pang'onopang'ono pakuchedwa, anthu adzakondwera ndi kulandira mphotho yaying'ono osati yayikulu. Anthu omwe amasintha zokonda zawo ngati mphotho zazifupi atachedwa kuonedwa kuti ndiwopanda chidwi kuposa anthu omwe amasintha zomwe amakonda pambuyo pakuchedwa11). Kafukufuku wogwiritsa ntchito DDT adawona kuti phindu lomwe limachedwa kumakhala limachepetsedwa kwambiri pazomwe zimagwiritsidwa ntchito pazomwe zimagwirizana ndi mowa (12), heroin (13), cocaine (14), methamphetamine (15), ndi otchova njuga (16) mukayerekezera ndi oyendetsa bwino (HCs). Kuphatikiza apo, pali umboni kuti anthu omwe ali ndi IGD ndiwokakamira kuposa ogwiritsa ntchito osangalatsa pa intaneti ndi HC (17-20). Zotsatira izi zimakweza mwayi kuti IGD, molingana ndi omwe amaletsa mankhwala osokoneza bongo ndi kutchova juga, akuwonetsa myopia yamtsogolo, mwachitsanzo, zokonda mphoto zazifupi (mwachitsanzo, masewera a pa intaneti) ndi umbuli wa kutayika kwakanthawi (mwachitsanzo, maubale) .
Olemba omwe adagwira ntchito ndi DDT adakhazikitsa ma neural correlates a zigawo zamaubongo popanga chisankho mwanjira zingapo kenako ndikufotokozera njira yowonera kawiri, yomwe imaganiza kuti panali magawo awiri osiyana omwe akuthandizira pazisankhozi (21, 22). Kachitidwe kamodzi (kotchedwa "β system") kanaphatikizanso zigawo za mesolimbic dopamine zowerengera komanso kulemera phindu lake (mwachitsanzo, nucleus accumbens ndi medial prefrontal cortex); dongosolo lina (lotchedwa "dongosolo") limaphatikizanso madera otsogola a m'makona otsogola komanso kuyeza mphotho yomwe idachedwa. Kafukufuku wamalingaliro amunthu adafufuzanso kutsegula kwa ubongo panthawi yotsitsa pochotsa machitidwe osokoneza bongo komanso kudalira mankhwala. Ochita juga pazakuwonetseratu amawonetsa zochitika zapamwamba mu ubongo wa dorsolateral prefrontal cortex (DLPFC) ndi amygdala posankha phindu lomwe linachedwa poyerekeza ndi HC (23). Oledzera akuti akuwonetsa zochulukitsa mu malo otsika kwambiri a gyrus (IFG), insula, ndi malo owonjezera othandizira magalimoto limodzi ndi kuchotsera pang'onopang'ono kwa mphotho zomwe zikuchedwa (24). Osuta adawonetseranso ubongo wogwira ntchito ku IFG, DLPFC, ndi chotsekera panthawi yopanga mphotho zazing'ono zomwe zimapezedwa zomwe zikachedwa (25). DLPFC yatsimikiziridwa kuti ikuchita nawo zoletsa zamakhalidwe, kukonza mphotho, ndi kupanga zisankho; IFG ndi yofunikanso kwambiri polepheretsa komanso popanga zisankho zowopsa; Kupatula apo, insulayi imathandizira pakuwongolera magalimoto ndi kuwongolera magalimoto (26-28). Makamaka, mawonekedwe osinthika ogwirizana mu lobe yapawiri yapambuyo yapezeka ku IGD (29).
Ngakhale Kafukufuku wam'mbuyomu adawululira zakupanga chisankho ku IGD, njira yomwe ili yopanda mphamvu yakuwongolera zomwe akuchitazi idadziwikabe. Kuti mupeze zomwe zimapangitsa anthu omwe ali ndi IGD kufunafuna zabwino zomwe amapeza nthawi yomweyo, osapindula ndi phindu lalitali, 21 HCs ndi 18 IGD adalembedwa kuti akachite DDT, yomwe inali ndi kusankha pakati pa mphotho zazifupi zomwe zimakhalapo komanso kuchedwa kulandira mphotho yayikulu.
Kafukufuku wathu wam'mbuyomu wapeza kuti omwe ali ndi IGD anali pachiwopsezo chodziika pachiwopsezo ndikuwonetsa kuyambitsa kwambiri ku IFG komanso gyri yayikulu yayikulu posankha zowopsa poyerekeza ndi HC (30). Kafukufuku yemwe adagwiritsa ntchito Go / No-Go paradigm yokhala ndi masewera osokoneza bongo adapeza kuti IGD idawonetsa kusokonezeka poyankha ndikuchepetsa zochitika zaubongo mu DLPFC yoyenera (31). Mwa anthu omwe ali ndi IGD, kuwonera makina okhudzana ndi masewera a pa intaneti amayambitsa kwambiri ubongo mu preortal cortex, parietal lobule, ndi striatum (19, 20, 32). Zotsatira izi zikuwonetsa kuti zigawo zamaubongo zomwe zimagwirizanitsidwa ndi kuwongolera kwazindikiritso, kulakalaka, kusankha zochita, ndikulipira zomwe zimapangitsa kuti zisachitike chifukwa chogwiritsa ntchito masewera a intaneti pafupipafupi ku IGD. Chifukwa chake, tidaganiza kuti gulu la IGD liwonetsetse momwe limakhalira mtsogolo (myopia mtsogolo) ndi ma activation a ubongo omwe akufanana ndi zomwe zapezeka mu zovuta zina. Potengera momwe timakhalira, timayembekezera kuwona kuchotsera kwamtsogolo kwa mphotho zomwe zikuchedwa mu IGD poyerekeza ndi HC komanso kusinthitsa kwakanthawi kwakubwezerera kwamalipiro ndi zovuta za IGD. Pa mulingo wa neural, timayembekezera kuti IGD iwonetse ma activation ochepa muubongo (monga, DLPFC, IFG), omwe akukhudzana ndi kuwunika kwa mphotho yomwe yachedwa, komanso kuyambitsa zopinga. Tinkayembekezeranso kuti kutsegula ubongo kungaphatikizidwe ndi machitidwe ochita mu gulu la IGD.
Zida ndi njira
ophunzira
Kuyesera uku kumagwirizana ndi Code of Ethics of the World Medical Association (Declaration of Helsinki). Komiti Yofufuzira yaumunthu ya Zhejiang Normal University idavomereza izi. Ophunzira onse adasaina mafomu achidziwitso asanayesedwe. Ophunzira nawo anali ophunzira achimuna akumanja (18 IGD ndi 21 HC) adalembedwa kudzera mu malonda ku Shanghai, PR China. Amuna okha ndi omwe anaphatikizidwa chifukwa cha kuchuluka kwa IGD mwa amuna kuposa amayi. Panali njira zingapo zosiyanitsira anthu omwe atenga nawo mbali, kuphatikiza mbiri kapena kusokonekera kwa minyewa kapena matenda amisala monga zimayesedwa ndi MINI yapadziko lonse lapansi ya neuropsychiatric mayendedwe amomwemo, mbiri kapena matenda amisala aposachedwa (mwachitsanzo, kukhumudwa, schizophrenia), ndi mbiri ya kugwiritsa ntchito mankhwala osokoneza bongo (mwachitsanzo. , cocaine, mowa) kapena mtundu wina uliwonse wa zizolowezi zamakhalidwe malinga ndi kuyeserera koyenera ndi zida zodzilemba. Onse omwe sanatenge nawo sananenapo za mbiri ya zizolowezi zamakhalidwe, zosokoneza bongo, komanso mavuto amisala. Chofunikira, palibe amene ananena za kuvulala kwa ubongo, maopareshoni a muubongo, ndi mavuto aliwonse okhudzana ndi chidwi monga kusamalira chidwi cha kuchepa kwa chidwi. Kuphatikiza apo, onse omwe adatenga nawo gawo adauzidwa kuti asamamwe zakumwa zilizonse 3 h asanayesere kuyesa, kuphatikizapo khofi, ndudu, komanso mowa.
Kuzindikira kwa IGD kunatsimikiziridwa kutengera (1) mayeso osinthidwa achichepere apa pa Internet a Achinyamata (33), yomwe idagogomezera pa IGD (IAT, onani Zowonjezera), (2) kukula kwa zinthu zisanu ndi zinayi za IGD zozikidwa pa DSM-5 (34), ndi (3) njira ndi nthawi yamagetsi akusewera. Mafunso onse komanso njira zake zidamasuliridwa molondola ku Chitchaina kuti awone momwe ophunzira akutenga nawo mbali. Kuti tiwunikire mozama zamasewera ndi mawonekedwe a IGD, tidasinthira mawu onse azomwe tikuchita pa intaneti pazofunsidwa zoyambirira ndi zinthu zenizeni, monga kusewera masewera kapena masewera apa intaneti. Zowona za IAT yosinthidwa zidayesedwa, ndipo cholowa chodalirika cha Cronbach cha index yodalirika chinali 0.90 yovomerezeka. IAT yosinthidwa imakhala ndi zinthu za 20 zomwe zimakhudzana ndi masewera apakompyuta kuphatikizapo kudalira kwamaganizidwe, kugwiritsa ntchito mokakamiza, kusiya, mavuto okhudzana ndi sukulu kapena ntchito, kugona, banja, ndi kasamalidwe ka nthawi. Pa chilichonse, ophunzirawo adauzidwa kuti asankhe manambala kuchokera pamulingo wotsatirawa: 1 = "Sawirikawiri" kupita ku 5 = "Nthawi zonse," kapena "Sakulemba." Kulemba kwa IAT kosinthika kumachokera ku 20 mpaka 100, yomwe ikuyimira kuopsa kwa IGD. Zambiri pa 50 zimawonetsa zovuta pamakina kapena pafupipafupi pa intaneti, ndipo kuchuluka kwa 80 kumawonetsa mavuto akulu osokoneza bongo pa intaneti (35).
Makhalidwe aumagulu onsewa adawonetsedwa pa Mndandanda 1. IGD ndi HC sizinasiyane kwambiri pazaka komanso zaka zamaphunziro. Pakafukufukuyu, gulu la IGD lidapangidwa ndi anthu omwe (1) adalemba zoposa 50 pa IAT yosinthidwa, (2) adakwaniritsa zosachepera zisanu mwa zisanu ndi zinayi za DSM-5, (3) adakhala osachepera 2 h pamasewera apa intaneti pa tsiku pazaka 2 zapitazi, ndipo (4) adakhala nthawi yawo yambiri pa intaneti akusewera pa intaneti (> 80%). Komabe, gulu la HC silinakwaniritse zomwe tafotokozazi.
Gulu 1. Makhalidwe aumoyo wa otenga mbali pa HC ndi IGD.
Ntchito ndi Kachitidwe
Nthawi yonse ya ntchitoyi idatenga pafupifupi 15 mphindi kwa aliyense amene akutenga nawo mbali. Ophunzira adachita zoyeserera za 20 kuti adziwe bwino ntchitoyo asanamalize ntchito ya DDT mu scanner. Panthawi ya ntchitoyi, ophunzira ayenera kusankha pakati pa mphotho yomweyo ndi ndalama zochulukirapo ndi nthawi yomwe yachedwa (mwachitsanzo, tsopano 10 Yuan motsutsana ndi masiku XXUMX pambuyo pake 7 Yuan, $ 12 ndi yofanana ndi 1 Yuan). Ndalama zomwe zimasiyana kuyambira 6.6 mpaka 12, 15, 20, 30, ndi 40 Yuan, ndipo nthawi yochedwetsa ija inachokera ku 50 h mpaka 6, 1, 3, 7, ndi 30 masiku. Chifukwa chake, panali mayesero a 90 mu 36 block, ndipo ntchitoyi inali ndi midiyala ya 1 yonse. Mayesero mu phunziroli adawonetsedwa mwapadera mu E-prime (mtundu 2, Chida cha Mapulogalamu a Psychology, Chithunzi 1).
Chithunzi 1. Nthawi yodziyesa kamodzi pantchito yoletsa. Njira yachidule koma yaying'ono imakhazikitsidwa pa 10 Yuan; pazosachedwa koma zazikulu, ndalama zachuma kuyambira pa 12 mpaka 15, 20, 30, 40, ndi 50 Yuan, ndipo nthawi yachedwa ija kuyambira 6 h mpaka 1, 3, 7, 30, ndi 90. "Yuan" ndiye gawo lalikulu la ndalama ku China.
Onse omwe adalandira nawo adalipira 40 Yuan (≈ $ 6) kuti atengapo gawo komanso mphotho yowonjezera (kuyambira 12 mpaka 50 Yuan) zomwe zimatengera kusankha kwawo pantchito ya DDT. Kuti athandize ophunzira kuti ayankhe moyenera, adauzidwa kuti alandila ndalama zowonjezera molingana ndi zomwe achita pantchitoyo. Mwachitsanzo, ngati angasankhe ndalama zokhazikika pamlanduwo, ndiye kuti apeza 10 Yuan ndalama; akasankha njira yomwe yachedwa, amapeza ndalama zochuluka pambuyo pochedwa.
Zotsatira za Zomwe Zikuchitika
Kuchepetsa kuchotsera kukuyerekeza aliyense wogwiritsa ntchito njira yotsatira ya hyperbolic (36):
The V imayimira mtengo wogwirizana ndi mphotho yomwe yachedwa; A kuchuluka kwa mphotho yomwe yachedwa; D Kutalika kwake kuchedwa kuti paperekedwe; ndi k ndi parada yaulere yomwe ikuwonetsa phokoso la kuchotsera kuchotsera. Pamwambamwamba k mfundo zikuwonetsa kuchotsera mwachangu komanso kukhudzidwa kwambiri (37-39). Njira yofunika yoyerekezera k mtengo wake unali wongowerengera chidwi, zomwe zinali mfundo zomwe mphotho yokhazikika ndi mphotho yomwe idachedwa zinali zamtengo wapatali zofanana za munthu payekha. Zosagwirizana ndi zomwe zidawerengedwa zidawerengedwa kutalika kwakutali ndi ndalama zomwe zimayikidwa mu Eq. 1. Panali magawo awiri a kusanthula kwatsatanetsatane wa DDT. Mu gawo loyamba, pulogalamu yopanda malire yokhotakhota (Chiyambi 7.0) idagwiritsidwa ntchito pofuna kudziwa zabwino za aliyense ophunzira k. Gawo lachiwiri linali kuchita kuti chipika cha 10 chisinthe k mfundo. Kusintha kwa chipika kunali kofunikira pa izi chifukwa cha kugawa kwawo kosakhala kwachilendo (40, 41). Kuti muwone zochotsera zosiyanasiyana k wa IGD ndi HC, chitsanzo chodziyimira pawokha t kuyesedwa kunachitika.
Kupeza Zithunzi ndi Kukonzeratu
Zambiri za fMRI zidasonkhanitsidwa pogwiritsa ntchito sikelo ya 3T (Motorola Trio) yokhala ndi zigawo za gradient-echo EPI T2 zowongolera mozama pamagawo a 33 (magwiritsidwe otsatizana, makulidwe a 3-mm, nthawi yobwereza = 2,000 ms, echo time (TE) = 30 ms, flip angle 90 °, gawo lakuwona 220 × 220 mm2, matrix 64 × 64). Stimuli adawonetsedwa ndi Attivo dongosolo loyanjanitsa (Attivo Kampani)1 kudzera polojekiti yomwe ili pamutu. Zithunzi zojambula zomwe zidaphimba ubongo wonse zidasonkhanitsidwa pogwiritsa ntchito mawonekedwe a T1 olembetsedwa mbali zitatu zozungulira (magawo a 176, ngalande yolowera = 15 °, TE = 3.93 ms, kukula kwagawo = 1.0 mm, kudumpha = 0 mm, nthawi yolowera = 1100 ms, gawo lakuwona = 240 × 240 mm, ndi kutulutsa mkati mwa ndege = 256 × 256).
Kuwongolera kusanachitike kwa kulingalira kunachitika kudzera pa pulogalamu ya Statistical Parametric Mapping (SPM), SPM5.2 Zithunzizo zidasinthidwa, zidakonzedwanso, ndikugawidwa ku voliyumu yoyamba. Ma voliyumu a T1-omwe adalembetsedwa adasinthidwa kukhala template ya SPM T1 ndipo adasinthidwa moyera pogwiritsa ntchito 6-mm yodzaza ndi theka la mphamvu ya Gaussian kernel.
Kusanthula Kwam'magawo Koyamba
Pafupipafupi mzere wofananira (GLM) udayikidwa kuti udziwe chizindikiro cha kudalira kwa okosijeni wamagazi (BOLD) molingana ndi zinthu ziwiri: kusankha kwa mphotho yaying'ono posachedwa komanso kusankha kwa mphotho yayikulu. Mayeso olakwika sanachotseredwe. GLM idadziyimira pawokha kwa voxel iliyonse kuti adziwe ma voxel omwe adakhazikitsidwa kwambiri pamitundu yamitunduyi. Fayilo yodutsa yayikulu (nyengo yodula = 128 s) idayikidwa pofuna kukonza chiwonetsero cha phokoso mpaka kutulutsa phokoso lamagetsi.
Kusanthula Gulu Lachiwiri
Kusanthula kwachiwiri kunachitika pa gulu. Choyamba, tidazindikira kuti ndi ma voxels ati omwe amawonetsa zotsatira zazikulu zakuchedwa kuyesedwa motsutsana ndi mayeso apamtundu uliwonse (IGD, HC). Chachiwiri, tidayesa ma voxels omwe amasiyana kwambiri ndi siginito ya BOLD pakati pa IGD ndi HC [(IGDkuchedwa - IGDmwamsanga) - (HCkuchedwa - HCmwamsanga)]. Chachitatu, tidazindikira magulu amisili yofunika kwambiri pakhomo lopanda dongosolo p <0.05. Pomaliza, tinayesa masango awa kuti akonzekeretse masango a FWE p <0.05, ndipo kuyerekezera kwa AlphaSim kunawonetsa kuti masango okhala ndi ma voxels 102 ophatikizika amatha kukwaniritsa gawo labwino la FWE p <0.05. Kernel yosalala inali 6.0 mm, yomwe imagwiritsidwa ntchito poyerekeza mamapu abodza (phokoso) kudzera mu AlphaSim ndipo amayerekezeredwa kuchokera kumadera otsalira a mamapu osiyana omwe amagwiritsidwa ntchito pachitsanzo chimodzi t-ndipo.
Kusanthula kwa Zogwirizana
Kuwunikira kwa Correlation kudawerengedwa pakati pa zochitika zamaubongo ndi machitidwe ochitira poyesa malingaliro athu. Tinapitilizabe kafukufuku wa ROI ndi zigawo za mbewu mosiyana ndi mayeso ochedwa posachedwa ndi mayesero aposachedwa. Pa ROI iliyonse, mtengo woyimira beta umapezeka ndikutulutsira chizindikiro cha ma voxels onse mu ROI. Malumikizidwe pakati pa zovuta za IGD, chipika k mfundo, nthawi yochitira (RT), ndi mfundo za beta zidawerengedwa. RT imayimira kusiyana pakati poyankha pazosachedwa kusankha komanso kuyankha pazosankha zomwe zikuchedwa (kuchedwa - mwachangu).
Results
Kuchita Zochita
Zotsatira za chitsanzo chodziyimira pawokha t- Adatinso kuti k Mtengo wa IGD unali wapamwamba kuposa wa HC pamlingo wofunikira wakumbuyo (t = 2.01, p = 0.05, d = 0.53). Kutanthauza kuchotsera k mfundo ndi ma SDs omwe amagwirizana pa IGD ndi HC anali 0.19 ± 0.16 ndi 0.11 ± 0.14, motsatana (Chithunzi 2A), ndipo izi zikuwonetsa kuti IGD ichotsera mphotho zolimbikira kuposa HC (Chithunzi 2B). The R2 Mtengo wa ntchito yotsitsa (0.88 ya IGD ndi 0.71 ya HC) umawonetsa kusiyana komwe kudanenedwa ndi Eq. 1. RT (kuchedwa - posachedwa) ya IGD inali yayitali kuposa HC, koma sinafikire tanthauzo la mawerengero (HC: −86 ± 213 ms, IGD: −56 ± 194 ms, t (1, 37) = 1.43, p = 0.11). Kuphatikiza apo, zovuta za IGD zidakhudzana kwambiri ndi chipika k miyezo (r = 0.552, p = 0.027; Chithunzi 3A) ndi RT (r = 0.530, p = 0.035; Chithunzi 3B) pagulu la IGD. Koma kulumikizana pakati pa izi sikufikira gawo lalikulu mu gulu la HC.
Chithunzi 2. Kuchepetsa kuchotsera kwa kusiyana pakati pa masewerawa pa intaneti (IGD) ndi kuwongolera wathanzi (HC). (A) IGD inawonetsa kumtunda k mtengo kuposa HC. (B) Kuchedwa kuchotsera ntchito kwa HC ndi IGD. Zowonetsa zikutanthawuza mfundo zopanda chidwi pamalipiro azachuma ngati ntchito yanthawi yochedwa. R2 imayimira momwe kupindika kuli koyenera kuchokera ku zenizeni za data. Choyamba, kusiyanitsa pakati pa mfundo zamawu ndi tanthauzo kumatanthauza kuwerengera. M'mabwalo osakwanira, kuchuluka kwa mabwalo (TSS) kumaphatikizapo magawo awiri: kusiyanasiyana komwe kufotokozedwa ndikuwongolera komanso komwe sikufotokozedwa ndi regression [gawo latsalalo la mraba (RSS]]. Ndiye R2 = 1 - RSS / TSS.
Chithunzi 3. Kugwirizana pakati pa kutha kwa vuto la masewera a pa intaneti (IGD) ndi magwiridwe antchito. (A) Kugwirizana pakati pa kutha kwa IGD ndi chipika k. (B) Kugwirizana pakati pa kuuma kwa IGD ndi nthawi yothandizira (kuchedwa - mwachangu). (Scores zazikulu kuposa 3 SDs zimawonedwa ngati ogulitsa kunja ndipo sizimaphatikizidwanso pakuwunika kwina.)
Zithunzi Zoganizira
Tidafanizira magulu awiriwa malinga ndi kusiyanasiyana kwa chizindikiro cha BOLD pakati pa chisankho chachedwa ndi zisankho zomwe zingachitike mwachangu. Kuyerekeza kwa gulu kunanenanso kuti IGD inawonetsa zosiyana zazing'onoting'ono za BOLD, pakati pa kuchedwa ndi kusankha posachedwa, chakumanzere kwa DLPFC ndi IFG yapakati kuposa HC (Chithunzi 4 ndi Table 2), zomwe zinali zogwirizana ndi malingaliro athu. Komabe, IGD sinawonetse zazikulu zazikulu ZOSAWA mu ubongo wonse poyerekeza ndi HC. Mu gulu lirilonse, IGD idawonetsa kuchititsa chidwi kwambiri mu girus ya anterior ndi ma activation a ubongo kumanzere kwa IFG ndi gial kutsogolo kwa zosankha zomwe zimachedwa kuposa kusankha posachedwa; HC idawonetsa kuyendetsa ubongo kwakukulu mu IFG yoyenera, gyrus wa orbital, ndi kutsogolo kwa kutsogolo kwa zosankha zomwe zimachedwa kuposa kusankha posachedwa (Chithunzi 5 ndi Table 3).
Chithunzi 4. Madera aubongo akuwonetsa kusiyana mu intaneti ya masewera osokoneza bongo (IGD) mukayerekezera ndi chiwongolero chathanzi (HC) [(IGDkuchedwa - IGDmwamsanga) - (HCkuchedwa - HCmwamsanga)]. (A) IGD iwonetsetsetsetsetsetsetsetso wamatsitsi mu kumanzere kwamkono koyambira kuposa HC. (B) IGD imawonetsa kuchepa kwa ubongo m'magawo awiri a IFG kuposa HC.
Gulu 2. Ma activation a ubongo amasintha pakati pa IGD ndi HC (kuchedwa - mwachangu).
Chithunzi 5. Ma activation a ubongo amasintha pakati pa zochitika zosiyanasiyana pa intaneti ya masewera (IGD) ndi kuwongolera wathanzi (HC) (kuchedwa - mwachangu). (A) IGD idawonetsa kutseguka kwaubongo mu ACC ndikuchepetsa kwa ubongo kumanzere otsika kutsogolo kwa gyrus (IFG) ndi medial frontal gyrus (kuchedwa> mwachangu). (B) HC idawonetsa kuyambitsa kwakubongo mu IFG yoyenera, orbital gyrus, ndi girus wapakatikati (kuchedwa> mwachangu).
Gulu 3. Ma activation a ubongo amasintha pakati pa zochitika zosiyanasiyana ku IGD ndi HC.
Zotsatira za
Malumikizidwe pakati pa zofunikira pa beta ndi momwe amagwirira ntchito adawunikiridwa mgulu lililonse. Maganizo aubongo mu DLPFC ndi IFG yapakati zonse zidali zogwirizana ndi chipika k mfundo m'magulu onsewa (onani zotsatira mu Chithunzi 6), ndi kuphatikiza pakati pa mtengo wa beta mu DLPFC ndi chipika k m'magulu awiriwa anali osiyana kwambiri ndi a Fisher Z mayeso (z = 2.44, p <0.05). Mu gulu la IGD, magwiridwe antchito aubongo mu IFG yapakati (kuchedwa - mwachangu) adalumikizidwa bwino ndi kuuma kwa IGD, koma sikunafike pamlingo waukulu (kumanzere kwa IFG: r = 0.478, p = 0.061; kumanja IFG: r = 0.480, p = 0.060; Chithunzi 7); Palibe kulumikizana kwakukulu komwe kunapezeka pakati pa kutsegula kwa ubongo ndi kuuma kwa IGD mu gulu la HC (p > 0.1). Kuphatikiza apo, kunalibe kulumikizana kwakukulu pakati pa magwiridwe antchito aubongo ndi RT mgulu lirilonse (p > 0.1).
Chithunzi 6. Malumikizidwe oyenera pakati pa ma activation a ubongo mu dorsolateral prefrontal cortex (DLPFC) ndi biliteal inferior frontal gyrus (IFG) ndi chipika k m'magulu onse awiri.
Chithunzi 7. Kuwongolera pakati pa kutha kwa vuto la masewera a pa intaneti (IGD) ndi kutsegula kwa ubongo muzochitika zapakati pa frontal gyrus (IFG). (A) Kusagwirizana pakati pachimodzimodzi kumanzere kwa IFG kutsegula (kuchedwa - mwachangu) ndi kuuma kwa IGD. (B) Kugwirizana pakati pachimake pa kutsegulira kwa IFG (kuchedwa - mwachangu) ndi kuuma kwa IGD. (Zambiri zomwe zimaposa ma 3 SDs zimawonedwa ngati ogulitsa kunja ndipo sizikuphatikizidwanso pakuwunika kwina.)
Kukambirana
Pogwirizana ndi malingaliro athu, IGD inawonetsa kuchotsera kwakukulu k ndi magwiridwe antchito aubongo ochepa kuposa HC. Zotsatira zomwe zanenedwazo zikuwonetsa kuti gulu la IGD linali lopanda chidwi komanso lingakhale ndi luso lopanga zisankho, zomwe zinali zogwirizana ndi maphunziro athu apitawa (42). Makamaka, tidapeza kuti DLPFC yakumanzere ndi IFG yapakati idalumikizidwa kwambiri poyeserera komwe IGD idasankha malipiro akuchedwa poyerekeza ndi HC, omwe angapereke maumboni kuti amvetsetse machitidwe omwe amayambira IGD.
Kulephera Kulipira Mphotho Yochedwetsa mu IGD
Poyerekeza ndi HC, IGD idawonetsa kuchepa kwa ubongo mu DLPFC kumanzere posankha zomwe zachedwa. Mogwirizana ndi izi, kafukufuku wa Hoffman et al. adapeza kuti anthu omwe amadalira methamphetamine adawonetsa kuyambitsa kochepa mu DLPFC kuposa HC posankha mochedwa (43). Malinga ndi makina awiri, dongosolo la δ, lomwe limaphatikizapo DLPFC, limagwiritsidwa ntchito polemetsa mphotho yomwe yachedwa (21, 22). Ofufuzawo apezanso kuti DLPFC imayankha makamaka kuchedwa kwa mphotho yomwe ikuchedwa, ndipo kuyambitsa ku DLPFC kumayenderana ndi kuwonjezeka kwa nthawi yochedwa (44). Makamaka, pali umboni kuti DLPFC ili ndi gawo lofunikira kwambiri pakukhazikitsa zomwe zikunenedweratu za mphotho zingapo mu mtengo wophatikizika (45).
Chifukwa chake, zochitika zochepa muubongo zomwe DLPFC imawona mu IGD zitha kuwonetsa kuti IGD inali ndi zoperewera pakuwunika kuchuluka ndi kuchedwa kwa mphotho. Sakanakhoza kuphatikiza chidziwitso chonse cha zomwe angasankhe, zomwe zingapangitse kuti asamaganize bwino, ngakhale akhale ndi nthawi yayitali yopangira chisankho. Kuphatikiza apo, kafukufuku wopumulitsa wapeza kuti anthu omwe ali ndi IGD amawonetsa mphamvu yolumikizana yolumikizana pakati pa DLPFC ndi caudate, ndikuwonetsa kusinthasintha kwa DLPFC pamalipiro (46), yomwe imawonedwanso m'magulu a anthu omwe amamwa mankhwala osokoneza bongo47). Kutanthauzira kwina pazotsatira ndikuti mwina pali gawo loyambirira la DLPFC kuti anthu asankhe mphotho yomwe ikuchedwa. Kutsegulira kumunsi kwa malo ochepera kumalumikizana ndi zisankho za mphotho yapafupi m'malo mochedwa. Chifukwa IGD imakhala ndi ma activation ochepa a DLPFC, amafika pang'ono pochedwa kuposa HC.
Kuphatikiza apo, RT idalumikizidwa bwino ndi kuuma kwa IGD, kuwonetsa kuti zovuta zomwe IGD ili, nthawi yayitali yomwe amafunika kupanga zisankho. Zotsatira zophatikizika zidathandizira kufotokozera kuti IGD idawonetsa kuwunika kolakwika kwa zinthu zomwe zachedwa pang'ono. Pomaliza, tinazindikira kuti IGD mosaganizira zopindulitsa kwakanthawi, zomwe zitha kuphatikizidwa ndi kusawerengera bwino kwa mphotho.
Kuletsa Kuletsa Zoletsa mu Kusankha-Kupanga mu IGD
Kupatula gawo lodziwika pakukonzanso mphoto, DLPFC, monga dera loyitanitsa kwambiri, lili ndi udindo woyang'anira monga kupewa zoletsa komanso kusankha zochita zingapo (48, 49). Makamaka, kafukufuku watsimikizira kuti zochitikazo mu DLPFC ziziwoneka bwino ngati anthu azichita kudziletsa (50). Kuphatikiza apo, kuchepa kwa ubongo wa IFG kumawonekeranso ku IGD panthawi yopanga zoletsa pakafukufuku waposachedwa. Zadziwika kuti IFG imakhudzidwa ndikuwongolera kwazindikiritso komanso kulepheretsa zinthu (51, 52). Kuphatikiza apo, IFG ili ndi udindo wodziletsa komanso choletsa kuyankha patsogolo pokonzekera kukhutira posachedwa komanso kufunafuna zokhalitsa (53-55). Kwambiri, IFG yadziwika kuti ndi yofunika kwambiri pakukhazikitsa ubale wosinthika pakati pazotsatira ndi zochita zopindulitsa (56). Mwambiri, DLPFC ndi IFG zimagwira ntchito zofunikira pakudziletsa komanso kudziletsa. Phunziroli, chizindikiro cha BOLD chotsika mu IFG ndi DLPFC chitha kuwonetsa kuti kusokonezeka kwa IGD kuwongolera machitidwe awo ndikuzilepheretsa zomwe akuchita.
Zochita zosintha muubongo mu DLPFC ndi IFG zidafotokozedwapo kafukufuku wakale, zomwe zimavumbula kuchepa kwapang'onopang'ono kwa zolepheretsa poyankha mphotho zapafupi mu IGD. Ntchito yotsitsa ya probabilistic yazindikira kuti IGD idawonetsa kukwiya kwakukulu ndikuchepetsa chizindikiro cha BOLD mu IFG kuposa onse omwe ali ndi HC komanso ochita masewera osangalatsa (18, 57). Pakusankha zowopsa, IGD idawonetsa kusintha kwa DLPFC yapakati posankha zowopsa (58). Komanso, tidapezanso kuti maopareshoni a mu DLPFC ndi IFG yapakati adalumikizidwa bwino ndi chipika k Makhalidwe, ndikuwonetsa kuti IGD yokhala ndi ntchito yambiri ku DLPFC ndi IFG idachita zambiri. Ngakhale adayesedwa kuti ayeserera kupititsa patsogolo ntchito, a IGD sangathe kudziwongolera okha kuti asankhe mphotho yomwe ikuchedwa posankha.
Kuphatikiza apo, kulumikizana kwabwino kunapezeka pakati pa kuuma kwa IGD ndi chipika k Makhalidwe, kuwonetsa anthu omwe ali ndi IGD omwe adawonetsa kwambiri zizindikiro za IGD nawonso anali okakamizidwa. Kuphatikizika kwina pakati pa kuuma kwa IGD ndi kutsegulika kwa ubongo mu IFG yocheperako kungawonetse kuti momwe zovuta za IGD zilili, ndizowonjezera zomwe zimafunikira kuti azisankha kusankha mochedwa. Zowonjezera, owongolera oyang'anira ndi mayendedwe apadera apezeka ku IGD (42), zomwe zikufanana ndi zomwe tapeza. Poganizira zonse, zotsatira zake zidafotokozera kuti IGD iwonetse kuthekera kosakwanira pakuwunika mphotho ndi zoletsa zomwe sizingagwirizane, zomwe zingakhale zokhudzana ndi kusagwira ntchito koyambitsa chisanachitike. Zotsatira izi zikugwirizana ndi kusanthula kwa meta kusanthula kwa maphunziro a fMRI, ndikuwonetsa kuti kutsegula kusanachitike kuyenera kumapangitsa gawo lofunikira la IGD59).
sitingathe
Panali malire angapo omwe ayenera kudziwika. Choyamba, ndi amuna okha omwe adalemba nawo kafukufukuyu, chifukwa chake maphunziro owonjezera ayenera kuwunikira kwa otenga nawo mbali achikazi. Chachiwiri, kuti muchepetse zovuta za ntchitoyo ndikulola ophunzira kuti aziganizira kwambiri popanga zisankho, sitinasankhe momwe zosankhazi zikuyendera komanso zomwe zikuchedwa, zomwe mwina zingafanane ndi zotsatirazi.
Kutsiliza
Mwachidule, kafukufukuyu adati IGD adawonetsa kuchotsera mwachangu komanso kusintha zochitika muubongo mu DLPFC ndi IFG. Makinawo akhoza kugonja mu kuwonongeka kwawo pakuwunika kuchepa kwa mphotho ndi kulepheretsa luso loleza popanga zisankho, zomwe zimalumikizidwa ndi kusagwira bwino ntchito. Ichi chitha kukhala chifukwa chomwe amakonda kukhutira pompopompo ndi mphotho zazikulu zomwe zikuchedwa. Kwambiri, zomwe tapeza pakufufuzaku zimatithandizanso kudziwa chifukwa chomwe IGD imapitiliza kusewera masewera a pa intaneti ngakhale atakumana ndi zovuta zoyipa zomwe zimachitika chifukwa chotenga mbali kwambiri pamasewera pa intaneti.
Chikhalidwe
Kuyesaku kukugwirizana ndi The Code of Ethics of the World Medical Association (Declaration of Helsinki). Komiti Yofufuzira yaumunthu ya Zhejiang Normal University idavomereza izi. Maphunziro onse adasaina mafomu okuvomerezeratu musanayese.
Zopereka za Wolemba
YW idathandizira kuyesa mapulogalamu, kusonkhanitsa deta ndi kusanthula deta ndikulemba kusanja koyambirira kolemba pamanja. GD adapanga kafukufukuyu. YH ndi GD adasintha ndikusintha zolemba pamanja. JX, HZ, XL, ndi XD adathandizira kuyesa mapulogalamu, komanso kusonkhanitsa deta. Olemba onse adathandizira ndipo avomereza zolemba zomaliza.
Kutsutsana kwa Chidwi
Olembawo akunena kuti kufufuza kunkachitika popanda mgwirizano uliwonse wa zamalonda kapena zachuma zomwe zingatengedwe kuti zingatheke kukangana.
Kuvomereza
Kufufuzaku kunathandizidwa ndi National Science Foundation of China (31371023).
ndalama
Othandizira ndalamawo analibe nawo gawo pakuphunzira, kusonkhanitsa deta ndi kusanthula, kusankha kufalitsa, kapena kukonza zolembedwazo.
Zowonjezera Zowonjezera
Zowonjezera Zowonjezera pa nkhaniyi zitha kupezeka pa intaneti pa http://www.frontiersin.org/article/10.3389/fpsyt.2017.00287/full#supplementary-material.
Mawu a M'munsi
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Mawu osakira: Kusokonezeka kwa masewera pa intaneti, kupanga chisankho, kuchedwetsa ntchito yochepetsa, dorsolateral pre mbeleal cortex, gorus lowal frontal
Citation: Wang Y, Hu Y, Xu J, Zhou H, Lin X, Du X ndi Dong G (2017) Ntchito Zoyipa Zoyambira Poyamba Zimalumikizidwa ndi Kukhudzika Kwa Anthu Omwe Akusokoneza Masewera paintaneti Pakachitika Kuchepetsa kwa Ntchito. Kutsogolo. Psychiatry 8: 287. onetsani: 10.3389 / fpsyt.2017.00287
Zalandiridwa: 14 August 2017; Zavomerezedwa: 01 December 2017;
Wolemba: 13 December 2017
Lolembedwa ndi:
Jintao Zhang, Beijing Normal University, China
Kuwunikira by:
Gilly Koritzky, Argosy University, United States
Bernardo Barahona-Correa, Nova Medical School - Faculdade de Ciências Médicas, Portugal
Copyright: © 2017 Wang, Hu, Xu, Zhou, Lin, Du ndi Dong. Ichi ndi nkhani yotseguka yotsegulidwa molingana ndi Malamulo a Creative Commons Licribution (CC BY). Kugwiritsiridwa ntchito, kufalitsa kapena kubereka m'mabwalo ena amavomerezedwa, kupatula ngati wolemba oyambirira kapena wothandizira chilolezo amavomerezedwa ndi kuti buku loyambirira m'magazini ino likutchulidwa, malinga ndi chizolowezi chophunzitsidwa. Palibe ntchito, kufalitsa kapena kubalana kumaloledwa zomwe sizikugwirizana ndi mawu awa.
* Makalata: Guangheng Dong, [imelo ndiotetezedwa]
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