Grey kusiyana kusiyana ndi anterior cingulate ndi orbitofrontal cortex achinyamata ndi Intaneti maseŵera matenda: Surface makale morphometry (2018)

J Behav Addict. 2018 Mar 13: 1-10. pitani: 10.1556 / 2006.7.2018.20.

Lee D^1,2, Park J³, Namkoong K^1,2, Kim IY³, Jung YC^1,2.

ZOKHUDZA

Mbiri ndi zolinga

Kupanga zisankho zosintha / mphotho kumayesedwa kuti kupangitse anthu omwe ali ndi vuto la masewera a pa intaneti (IGD) kuti asangalatse kwakanthawi kochepa, ngakhale atakhala ndi zotsatirapo zoipa. The anterior cingulate cortex (ACC) ndi orbitof mbeleal cortex (OFC) amasewera mbali zofunika kwambiri pakupanga chisankho. Kafukufukuyu adafufuza za kusiyana kwaimvi mu ACC ndi OFC ya achinyamata achinyamata omwe alibe IGD pogwiritsa ntchito morphometry (SBM).

Njira

Tidawerengera anyamata achikulire a 45 omwe ali ndi IGD ndi 35 yoyang'anira amuna. Tidachita chidwi ndi dera (chidwi) (ROI) - kusanthula kwa makulidwe acortical ndi voliyumu ya grey (GMV) mu ACC ndi OFC. Tinapanganso kusanthula kwamphamvu kwa ubongo wathunthu kuti ndikwaniritse kuwunika kwa ROI.

Results

Mitu ya IGD inali ndi cortices zopyapyala kumanja rostral ACC, ofufuza pambuyo pake a OFC, ndi orbitalis yamanzere kuposa zowongolera. Tidapezanso GMV yaying'ono mu caudal ACC yoyenera ndi masamba orbitalis amanzere mu maphunziro a IGD. Kapangidwe kakang'ono kamene kali ndi ofunika kwa ofunikira a OFC mu mitu ya IGD yolumikizidwa ndi kukhudzika kwakukulu kwazindikiritso. Kusanthula kwaubongo konse mu maphunziro a IGD kuwulula kachulukidwe kakang'ono kotetemera pamalo oyimitsa oyendetsa galimoto, kumanzere kwamaso, kutsogolo kwa parietal lobule, ndi posterior cingate cortex.

Mawuwo

Anthu omwe ali ndi IGD anali ndi kakhola kakang'ono kwambiri ndi GMV yaying'ono mu ACC ndi OFC, omwe ali malo ovuta kuwunikira phindu la mphotho, kukonza zolakwika, ndi kusintha mawonekedwe. Kuphatikiza apo, mmagawo okhudzana ndi ubongo wolumikizana ndi machitidwe, kuphatikiza madera am'maso, adakhalanso ndi cortices zoonda. Kusiyana kwa nkhani imvi kumatha kuthandiza IGD pathophysiology kudzera mu kusintha kosintha / malingaliro opereka mphotho ndi kuchepetsedwa kwa kayendedwe ka machitidwe.

MALANGIZO: Kusokonezeka kwa masewera pa intaneti; makulidwe a cortical; imvi nkhani; kupanga zisankho / kupereka mphotho; padziko ofotokoza morphometry

PMID: 29529887

DOI: 10.1556/2006.7.2018.20

Kuyambira Wamng'ono (1998b) idapereka lingaliro pafupifupi zaka makumi awiri zapitazo, malingaliro okhudzana ndi zochitika zokhudzana ndi intaneti adatulukira ngati nkhani yofunika kwambiri yokhudza thanzi la achinyamata (Kuss, Griffiths, Karila, & Billieux, 2014). Mwa zovuta izi zamakhalidwe, vuto la masewera a pa intaneti (IGD) lafufuzidwa kwambiri ngati nkhani yosangalatsa (Kuss, 2013). Kulimbikitsidwa kwamalipiro azolimbikitsa komanso kuchepa kwa chidwi cha kutayika kukuwonetsedwa mu milandu ya IGD (Dong, DeVito, Huang, & Du, 2012; Dong, Hu, & Lin, 2013). Zovuta pakuwunika zolakwika (Dong, Shen, Huang, & Du, 2013) ndi zovuta pakuwongolera zoyenera (Ko et al., 2014) adanenedwanso ku IGD. Zotsatira zake, kusiyana pakati pa kupititsa patsogolo kufunafuna mphotho ndi kuwongolera kakhalidwe ka IGD kumathandizira kupanga zisankho zolakwika / kupanga mphothoDong & Potenza, 2014). Mu IGD, kusankha kosintha / chiwopsezo, zomwe zimadziwika ndi kupanga chisankho pamikhalidwe yowopsa komanso kukonda mphotho yomweyo, zimagwirizana kwambiri ndi kusangalala kwakanthawi kochepa kuchokera pamasewera apa intaneti, ngakhale atakhala ndi zotsatirapo zoipa zazitali (Pawlikowski & Brand, 2011; Yao et al., 2015).

Kupenda kosankha meta kwawonetsa kuti ma orbitofrontal cortex (OFC) ndi zigawo za bongo za cortex cortex (ACC) ndizochita zokhudzana ndi zisankho zokhudzana ndi chiopsezo / mphotho (Krain, Wilson, Arbuckle, Castellanos, & Milham, 2006). Makamaka, OFC imaganiziridwa kuti ipereka mphotho pazosankha zamakhalidwe, kutengera zomwe zapezedwa kapena kuyembekezera zotsatira zake (Wallis, 2007). ACC ikufunsidwa kuti ikonzere zolakwitsa zolosera (kusiyana pakati pa mphotho yoloseredwa ndi zotsatira zenizeni) (Hayden, Heilbronner, Pearson, & Platt, 2011) ndikuchita mbali yayikulu pakuwunika zolakwika ndi kusintha maonekedwe (Amiez, Joseph, & Procyk, 2005). Anthu omwe ali ndi IGD anena kuti zasintha ntchito za ACC ndi OFC poyankha ntchito zingapo zamaganizowa, zomwe zingakhudze kuthekera kwawo pakupanga zisankho zogwirizana ndi mphotho / mphotho. Pakafukufuku wam'mbuyomu wogwiritsa ntchito ntchito yaessabilistic Guessing Task, anthu omwe ali ndi IGD adawonetsa kuwonjezereka mu OFC panthawi yamilandu ndikuchepetsa kuyambitsa ku ACC panthawi yamatayidwe (Dong, Huang, & Du, 2011). Anthu omwe ali ndi IGD adawonetsanso kusintha kosinthika mu ACC ndi OFC poyankha STroOP Task, kuwonetsa kuchepa mphamvu pakuwunika zolakwika ndikuwongolera kuzindikira kwamachitidwe awo (Dong, DeVito, Du, & Cui, 2012; Dong, Shen, et al., 2013). Zowonjezera, zomwe zapezazi ndizogwirizana ndi kusintha komwe kunanenedwa ku OFC ndi ACC yolumikizidwa ndi IGD (Lin, Dong, Wang, & Du, 2015; Yuan et al., 2011). Kafukufuku waposachedwa, wophatikiza mawonekedwe amtundu komanso wautali, adawonetsa kuti kuchepa kwa zinthu zakumaso kwa mzere ndi chisonyezo cha IGD (Zhou et al., 2017). Ubale pakati pa nkhani yosintha imvi mu ACC ndi kuwongolera kwazinthu zodziwoneka bwino imanenedwa ku IGD (Lee, Namkoong, Lee, & Jung, 2017; Wang et al., 2015). Popeza kutengera kwa kusintha kwa imvi pazinthu zofunikira za neural (Wokondedwa, Kötter, Breakspear, & Sporns, 2007), timaganizira zomwe zidasinthidwa ndimtundu wa OFC ndi ACC zimapangitsa kuti pakhale kuwopsa kwa zisankho / kupanga mphotho mu IGD.

Njira zingapo za neuroanatomical zimagwiritsidwa ntchito pofufuza zinthu za imvi, kuphatikiza kusanthula kwakumaso kwa morphometric (SBM), komwe kumapereka njira yothinira yoyezera mphamvu za maumboni a ubongo pogwiritsa ntchito mitundu ya geometric ya cortical surface (Fischl et al., 2004). Kuwunikira kwa SBM kumakhala ndi zabwino zambiri pakufufuza kwa cortical morphology: itha kugwiritsidwa ntchito kuyeza mawonekedwe a cortical folding (Fischl et al., 2007) ndi kuphimba minofu yaying'ono (Kim et al., 2005). Kuphatikiza apo, kusanthula kwa SBM kumapereka chidziwitso chokwanira pakukula kwa cortical, pomwe njira zofananira, monga voxel-based morphometry (VBM), ndizochepa pakuwunika mawonekedwe a cortical (Hutton, Draganski, Ashburner, & Weiskopf, 2009). Ngakhale maphunziro a VBM adapeza masinthidwe am'madera mwa IGG (GMV) mwa anthu omwe ali ndi IGD (Yao et al., 2017,, sipanakhale kusanthula kokwanira kwa SBM, kuphatikizapo kuwunika kwa makulidwe a cortical, a IGD. Kafukufuku wina wa SBM adapeza ocheperako wa OFC pa achinyamata omwe ali ndi IGD kuposa muzowongolera (Hong et al., 2013; Yuan et al., 2013). Komabe, kusanthula kwa SBM kwa akulu achinyamata omwe ali ndi IGD sikunachitike. Kuphatikiza apo, ngakhale achinyamata ndi achikulire omwe ali ndi IGD akuti ali ndi GMV yaying'ono ya ACC (Lee et al., 2017; Wang et al., 2015), sipanapezeke kafukufuku wazokulimba wa ACC. Chifukwa GMV ndi makulidwe acortical amapereka mitundu yosiyanasiyana yazidziwitso zokhudzana ndi vuto la neuropsychiatric (Lemaitre et al., 2012; Winkler et al., 2010), timalingalira kuti kuphatikiza kwa GMV ndi makulidwe acortion amatha kupereka chithunzi chathunthu cha nkhani ya imvi yosinthidwa ku IGD.

Cholinga cha phunziroli chinali kufananitsa ACC ndi OFC nkhani yaimvi mwa akulu ndi omwe alibe IGD. Kugwiritsa ntchito kusanthula kwa SBM, tidasanthula makulidwe amtundu wa GMV ndi cortical makulidwe amtundu wa intaneti. Tidawerengera kuti akulu achinyamata omwe ali ndi IGD atha kukhala ndi GMV yaying'ono ndi kortinelete yopyapyala mu ACC ndi OFC. Tikuyembekeza kuti kusintha kwa zinthu zongonena kumeneku kumayenderana ndi chizolowezi chofuna kupanga zisankho zakanthawi kochepa, monga zosangalatsa zamasewera, m'malo mwakuwunikira zoopsa zomwe zingachitike nthawi yayitali, monga zotsatira zoyipa zamaganizidwe. Poyesa malingaliro athu, tidayendetsa dera lokondweretsedwa (ROI) - lolunjika pa ACC ndi OFC, kuti tifufuze kukula kwa GMV ndi kukula kwa cortical mwa akulu akulu omwe ali ndi IGD. Tidagwiritsa ntchito kuwunikira komwe kumachitika posanthula ubale pakati pa zinthu zosintha imvi ndi zina zamatenda a IGD. Pa kusanthula kwachiwiri, tinayesa kusanthula kwamphamvu kwa ubongo wathunthu kuti tisanthule makulidwe a cortical kunja kwa ACC ndi OFC, monga njira yowunikira kusanthula kwa ROI.

Zida ndi njira

ophunzira

Ophunzira nawo pa kafukufukuyu adalembedwanso kudzera pa zotsatsa pa intaneti, ntchentche, komanso mawu pakamwa. Amuna okha ndi omwe adaphatikizidwa pakuphunziraku. Ophunzirawo adayesedwa chifukwa cha njira yawo yogwiritsira ntchito intaneti ndikuwunikira IGD pogwiritsa ntchito Mayeso Osekeredwa a Internet (IAT; Wamng'ono, 1998a). Ophunzira omwe adalemba ma 50 kapena pamwambapa pa IAT ndikuti ntchito zawo zazikuluzikulu pa intaneti ndikusewera masewera adawonetsedwa ngati ofuna kupezeka, omwe ali ndi IGD. Ofunsidwawo adayankhulana ndi ophunzitsidwa dokotala kuti awunikire zomwe zimapangitsa kuti akhale osokoneza bongo, kuphatikizapo kulekerera, kusiya, zotsatirapo zoyipa, komanso kugwiritsa ntchito kwambiri nthawi yayitali (Dulani, 2008). Mwakutero, maphunziro onse a 80 adatenga nawo gawo phunziroli; awa adaphatikiza amuna achikulire a 45 omwe ali ndi IGD ndi 35 zowongolera zamphongo zoyenera, onse anali amanzere akumanja ndi zaka zapakati pa 21 ndi 26 zaka (zikutanthauza: 23.6 ± 1.6).

Maphunziro onse adalandira kuyankhulana kwamankhwala kothandizidwa ndi zovuta za DSM-IV Axis I (Choyamba, Spitzer, & Williams, 1997) kuwunika kukhalapo kwa zovuta zazikulu zamaganizidwe amisala ndi mtundu wa Korea wa Wechsler Adult Intelligence Scale (Wechsler, 2014) kuyesa Intelligence Quotient (IQ). Poganizira kuti IGD nthawi zambiri imakhala ndi ma psychoroma ma psychor (6)Kim et al., 2016), tidachita Beck Depression Inventory (BDI; Beck, Steer, & Brown, 1996) pa kukhumudwa, Beck Anxcare Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) zokhala ndi nkhawa, komanso Wender Utah Rating Scale (WURS; Ward, 1993) kwa matenda aubongo a chidwi-deficit hyperactivity disorder (ADHD). Pomaliza, chifukwa IGD imagwirizana kwambiri ndi kusokonekera kwambiri (Choi et al., 2014), tidagwiritsa ntchito Barratt Impulsiveness Scale - mtundu 11 (BIS-11; Patton & Stanford, 1995) kuyesa kunyengerera. BIS-11 imakhala ndi ma subscales atatu: kutsimikizika kwachidziwitso, kuyendetsa galimoto, komanso kusakonzekera. Maphunziro onse anali opanda mankhwala pakukonzekera. Njira zochotsera maphunziro onse zinali zovuta zazikulu zamisala yachilendo kupatula IGD, nzeru yotsika yomwe imalepheretsa kumaliza maloto amomwe mungadzipangire nokha, zamitsempha, kapena zamankhwala, komanso kutsutsana pa MRI scan.

Kupeza deta ndi kukonza zithunzi

Zambiri za Brain MRI zidasonkhanitsidwa pogwiritsa ntchito sikani ya 3T Siemens Magnetom MRI yokhala ndi koyilo yamutu eyiti. Makina apamwamba a MRI adapezeka mu sagittal ndege pogwiritsa ntchito T1 yolemetsa yowonongeka ya 3D gradient echo sequence (echo time = 2.19 ms, time repetition = 1,780 ms, flip angle = 9 °, field of view = 256 mm, masanjidwewo = 256 × 256, transiceal kagawo makulidwe = 1 mm). Zambiri za MRI zidawunikidwa zowoneka kuti zapezeka. Masewera FreeSurfer 5.3.0 (http://surfer.nmr.mgh.harvard.edu/) adalemba ntchito SBM yowunika makulidwe a cortical ndi GMV. Mtsinje wochotsekerawo unaphatikizapo kutaya zinthu zopanda ubongo pogwiritsa ntchito njira yosakanizidwa (Ségonne et al., 2004), kukonza mwamphamvu kusafananaSled, Zijdenbos, & Evans, 1998), magawo azinthu zoyeraDale, Fischl, & Sereno, 1999), kusokonekera kwa malire a imvi ndi zodukizaSégonne, Pacheco, & Fischl, 2007), kuchuluka kwa madzi pamtunda komanso kusisitidwa (Fischl, Sereno, & Dale, 1999,, Kusintha kukhala danga lopendekera danga (Fischl, Sereno, Tootell, & Dale, 1999), komanso kudziwitsidwa kwina kwa chithokomiro cha anthuFischl et al., 2004). Makulidwe a cortical adatsimikizika poyesa mtunda pakati pa malire a imvi-yoyera (mkati wamkati) ndi mawonekedwe a pial (panja lakunja). Zomwe adasanjazo adazigwiritsa ntchito pogwiritsa ntchito 10-mm yodzaza ndi theka mulingo wina wa Gaussian.

Kujambula kusanthula deta

Kusanthula kochokera ku ROI kunapangidwa kuti kuyerekeza kukula kwa GMV ndi makulidwe a cortical pakati pa anthu omwe ali ndi IGD ndikuwongolera. Ma ROI amatanthauziridwa pogwiritsa ntchito njira ya Desikan-Killiany cortical atlas (Desikan et al., 2006). Ma ROI anaphatikiza mbali zonse za ACC (caudal / rostral ACC) ndi OFC (ofananira / medial OFC, par orbitalis) (Chithunzi 1). Kuyesa kusiyana kwamagulu (anthu omwe ali ndi IGD vs. control) mu GMV ndi makulidwe a cortical, tanthauzo lama GMV, ndi makulidwe a cortical mkati mwa ROI iliyonse adachotsedwa pogwiritsa ntchito FreeSurfer. Pa ROI iliyonse, tinapanga kusanthula kwa covariance ndi SPSS 24.0 (SPSS Inc., Chicago, IL, USA) pamlingo wofunikira p = .05. Age, IQ, ndi voliyumu yopanda mphamvu (ICV) yamutu uliwonse idalowetsedwa ngati ma covariates pakuwunika kwa GMV. Zaka ndi IQ zidalowetsedwa ngati ma covariate pofufuza kukula kwa cortical, koma ICV sinaphatikizidwe ngati covariate, monga momwe kafukufuku wam'mbuyomu ananenanso kuti makulidwe a cortical samakhudzidwa ndi ICV (Buckner et al., 2004). Kuti tiwone maubwenzi amtundu waubongo, tidachita kuwunika kosinthira masinthidwe a imvi (GMV ndi makulidwe a cortical mu OFC ndi ACC) ndi sikelo yodzidziwitsa nokha (IAT ndi BIS).

Chithunzi 1. Magawo achidwi (ROI). ROI adafotokozedwa malinga ndi buku la Desikan-Killiany cortical atlas. Ma ROI a anterior cingrate cortex (ACC) anaphatikiza mbali zonse za caudal ACC (zobiriwira) ndi rostral ACC (lalanje). Ma ROI a orbitofrontal cortex (OFC) adaphatikiza mbali zonse za ofer of OFC (ofiira), a medial OFC (a buluu), ndi a orbitalis (achikasu)

Kuphatikiza kuwerengera kwa ROI, mawonekedwe owunikira aubongo onse opanga mawonekedwe a makulidwe a cortical adachitidwanso pogwiritsa ntchito mitundu ya mzere mu Fayilo ya FreeSurfer, Design, Chiyerekezo, gawo losiyanitsa pambuyo poyang'anira zaka ndi IQ pamutu uliwonse. Monga kafukufuku wofufuza waubongo wathunthu, kupendekera kwapang'onopang'ono kwa komwe kulibe vuto p <.005 idagwiritsidwa ntchito poyerekeza mwanzeru. Tidanenanso masango omwe ali ndi magawo angapo opitilira 200 kuti achepetse kuthekera kopanga zabwino zabodza (Fung et al., 2015; Wang et al., 2014).

Ethics

Kafukufukuyu adachitika motsogozedwa ndi malangizo ogwiritsira ntchito anthu omwe adakhazikitsidwa ndi Institutional Review Board ku Yonsei University. Institutional Review Board ya Yonsei University idavomereza phunziroli. Kutsatira kufotokozera kwathunthu kwa kuchuluka kwa phunziroli kwa onse omwe akutenga nawo gawo, chilolezo chodzilemba bwino chidapezeka.

Results

Chiwerengero cha anthu ndi zamankhwala

Omwe omwe ali nawo pamagulu owongolera ndi IGD adafananizidwa ndi msinkhu komanso IQ yodzaza kwathunthu (Gome 1). Omwe ali ndi IGD adakwera kwambiri poyesera kugwiritsa ntchito mankhwala osokoneza bongo pa intaneti (IA) komanso kusayerekezeka poyerekeza ndi maulamuliro (IAT: p <.001; BIS: p = .012). Kuphatikiza apo, mamembala a gulu la IGD adakwera kwambiri pamayeso a kukhumudwa, nkhawa, komanso zizindikiritso za ADHD zaubwana poyerekeza ndi kuwongolera athanzi (BDI: p = .001; BAI: p <.001; ZOCHITA: p <.001). Chiwerengero cha ICV sichinali chosiyana kwambiri pakati pazowongolera ndi maphunziro omwe ali ndi IGD (1,600.39 ± 149.09 cm³ wa gulu la IA; 1,624.02 ± 138.96 masentimita³ zowongolera; p = .467).

Gulu 1. Zowerengera za anthu ndi mitundu yamatendawo mwa otenga nawo mbali

Zindikirani. Makhalidwe amafotokozedwa ngati njira ± SD.

^aIntelligence Quotient (IQ) idayesedwa pogwiritsa ntchito Wechsler Adult Intelligence Scale.

^bWender Utah Rating Scale idachitidwa kuti iwone ngati ali ndi vuto la ana.

ROI yochokera

Kafukufuku wa ROI wofufuza za makulidwe a cortical adapeza kuti maphunziro omwe ali ndi IGD anali ndi kakhola kakang'ono kwambiri mu rostral ACC, kumanzere kwamanja kwa OFC, ndi orbitalis ya kumanzere kuposa kotekisi yoongolera (rostral ACC: p = .011; ofananira OFC: p = .021; zigawo orbitalis: p = .003; Gome 2). Zotsatira izi zidakhalabe zofunikira pambuyo poti ziphatikizidwe ndi ma comorbid (BDI, BAI, ndi WURS) monga covariates (rostral ACC: p = .008; ofananira OFC: p = .044; zigawo orbitalis: p = .014). Kusanthula kochokera ku ROI kwa GMV kunawonetsa kuti maphunziro omwe ali ndi IGD anali ndi GMV yaying'ono mu ACC yolondola caudal ndi parb orbitalis yakumanzere, poyerekeza ndi zowongolera (caudal ACC: p = .042; zigawo orbitalis: p = .021). Zotsatira izi zidakhalabe zofunikira mu caudal ACC (p = .013) pambuyo pakuphatikizira zovuta (BDI, BAI, ndi WURS) ngati ma covariates koma osati mu pars orbitalis (p = .098). Zokhudzana ndi zowongolera, maphunziro omwe ali ndi IGD analibe GMV yayikulu kapena kotetemera wochuluka mu ROI.

Gulu 2. Chigawo chofanizira poyerekeza ndi makulidwe a cortical ndi imvi nkhani pakati pa anyamata achichepere omwe ali ndi vuto la masewera a pa intaneti (IGD) ndi zowongolera (Gulu la IGD

Zindikirani. Makhalidwe amafotokozedwa ngati njira ± SD.

M'maphunziro a IGD, kakhothi kakang'ono kwambiri komwe kumakhala koyambirira kwa OFC kamakhudzana kwambiri ndi zowonekera kwambiri, pambuyo poti zochitika za comorbid (BDI, BAI, ndi WURS) zimaphatikizidwa ngati covariates (r = −.333, p = .038; Chithunzi 2). Sitinapeze kuwerengera kwapakati pakusintha kwa imvi nkhani, makamaka GMV yaying'ono ndi kakhonde kakang'ono kwambiri, ndi kuchuluka kwa IAT.

Chithunzi 2. Kusanthula kwa ubale wamakhalidwe aubongo. Kuwongolera kwakanthawi pakati pamakulidwe a cortical mkati mwa oralofortal cortex (OFC) komanso chidziwitso chodziwikiratu cha Barratt Impulsiveness Scale (BIS) pambuyo poyendetsa ma covariates (m'badwo, IQ, BDI, BAI, ndi WURS). Kuti muwone ngati kuphatikizika, mitundu inasinthidwa pamakina ogwiritsa ntchito mayendedwe ena. Ziwembu za Scatter zidapangidwa pogwiritsa ntchito zotsalira zosasinthika. The cortical makulidwe ofananira nawo ofanira aCC amathandizana kwambiri ndi kusokonezeka kwa kuzindikira mu mitu ya IGD (r = −.333, p = .038)

Kusanthula kwamphamvu kwaubongo

Kafukufuku wopanga ubongo wathunthu wamatenda amtundu wa cortical adawonetsa kuti maphunziro omwe ali ndi IGD anali ndi kakhola kotetemera pamalo oyenerera oyimitsa galimoto (SMA; nsonga ya Talairach: X = 7, Y = 21, Z = 53; Chithunzi 3A). Kuphatikiza apo, anthu omwe ali ndi IGD anali ndi kakhola kakang'ono kwambiri kumunda wamaso wamtsogolo (FEF; nsonga ya Talairach: X = -10, Y = 17, Z = 45; Chithunzi 3B), lamanzere posterior cingulate cortex (PCC; nsonga Talairach yang'anira: X = -9, Y = -30, Z = 40; Chithunzi 3B), ndi lamanzere apamwamba parietal lobule (SPL; peak Talairach organiser: X = -15, Y = -62, Z = 61; Chithunzi 3C) kuposa zowongolera. Mamembala a gulu la IGD analibe madera ena aliwonse aubongo omwe ali ndi kotakata kotakata poyerekeza ndi zowongolera.

Chithunzi 3. Kusanthula kwamphamvu kwaubongo kwazonse. Zowerengera za p <.005 (yopanda tanthauzo) idagwiritsidwa ntchito poyerekeza mwanzeru. Poyerekeza ndi zowongolera, maphunziro omwe ali ndi IGD anali ndi kotetemera wocheperako mu (A) malo owonjezera oyendetsa magalimoto (SMA; pachimake pa Talairach: X = 7, Y = 21, Z = 53; kuchuluka kwake: 271), (B) kumaso kwamaso kumaso (FEF; chigwirizano cha Talairach: X = -10, Y = 17, Z = 45; kuchuluka kwa mawonekedwe: 224) ndi kumanzere kwakumbuyo kwa cingate cortex (PCC; nsonga ya Talairach ikugwirizana: X = -9, Y = -30, Z = 40; kuchuluka kwake: 215), ndipo (C) adasiya parietal lobule (SPL; pachimake MNI ikugwirizana: X = -15, Y = -62, Z = 61; kuchuluka kwa mawonekedwe: 216)

Kukambirana

Kugwiritsa ntchito kusanthula kwa SBM, tinayerekezera nkhani ya ACC ndi OFC mwa akulu akulu ndi IGD ndi yoyang'anira yolondola. Zotsatira zathu zikugwirizana ndi malingaliro oti achinyamata achinyamata omwe ali ndi IGD ali ndi cortices ocheperako komanso ma GMV ang'onoang'ono mu ACC ndi OFC kuposa zowongolera. Tidachita kusanthula kochokera ku ROI ndipo tidapeza kuti anthu omwe ali ndi IGD ali ndi kotakata kotakata mu rostral ACC, lateral OFC, ndikumanzere kwa orbitalis kuposa zowongolera. Kafukufuku wam'mbuyomu wanena za kanyumba kakang'ono kwambiri mu ofooka wa OFC ndi orbitalis ya achinyamata omwe ali ndi IGD (Hong et al., 2013; Yuan et al., 2013). Kafukufukuyu adangoyang'ana pa achikulire achinyamata ndipo adapeza zotsatira zofananira ndi makulidwe a cortical ku OFC ndi rostral ACC. M'maphunziro omwe ali ndi IGD, kakhazikitsidwe kakang'ono kwambiri koteroko ka cortex kogwirizana ndi kukhudzika kwakukulu, kuwonetsa chizolowezi chopanga zosankha motengera kukhutitsidwa kwakanthawi kochepa. Kuphatikiza apo, tidapeza kuti maphunziro omwe ali ndi IGD anali ndi GMV yaying'ono mu caudal ACC yoyambira ndi masamba orbitalis wa kumanzere. Kupeza kumeneku kumagwirizana ndi maphunziro apitawa a VBM, omwe adanena kuti maphunziro omwe ali ndi IGD ali ndi ma GMV ang'onoang'ono mu ACC ndi OFC (Yuan et al., 2011; Zhou et al., 2011). Monga m'maphunziro am'mbuyomu (Hutton et al., 2009; Tomoda, Polcari, Anderson, & Teicher, 2012), zotsatira zathu za GMV ndi makulidwe acorto adagwirizana, koma tidapezanso kusiyana. Zomwe tapezazi zikuonetsa kuti makulidwe a cortical samagwirizana kwathunthu ndi GMV, kuwonetsa kuti GMV ndi makulidwe a cortical ayenera kulingaliridwa palimodzi kuti chithunzi cholondola cha kusintha kwa imvi.

Kupeza kofunikira pa kafukufukuyu ndikuti achinyamata omwe ali ndi IGD ali ndi kusintha kwa imvi mu ACC; mwachindunji, anthu awa ali ndi mwayi wakonda kwambiri rostral ACC cortex, komanso GMV yaying'ono mu caudal ACC yoyenera, poyerekeza ndi zowongolera. Gawo la rostral la ACC limakhudzidwa mu mayankho okhudzana ndi zolakwika, kuphatikiza othandizira, ndipo gawo lonyansa la ACC limalumikizidwa ndikuwona kusamvana kuti kubwezeretse chiwongolero chazidziwitso (Van Veen & Carter, 2002). Chifukwa kudera kwamakondo kumayenderana ndi chikhalidwe (Bledsoe, Semrud-Clikeman, & Pliszka, 2013; Ducharme et al., 2012), rostral ACC cortex yocheperako ku IGD ikhoza kuthandizira kulephera kuyankha zotsatira zoyipa za masewera olimbitsa thupi pogwiritsa ntchito zolakwika zolakwika. Komanso GMV yaying'ono ya caudal ACC mumasewera ochezera pa intaneti ingathandizire kuti kutayika kwa kuwongolera kuzindikirika pamasewera opitilira muyeso. Kuphatikiza apo, zomwe tapeza posiyanitsa za imvi kumbali yakumanja ya ACC ndizogwirizana ndi umboni wapitawu kuti kuwunika ndi kuwongolera mayendedwe okhudzana ndi njira yotsimikizika kumayendedwe akumanja (Stuss, 2011).

Apa, tidapeza kuti amuna achikulire achichepere omwe ali ndi IGD anali ndi kakhola kakang'ono kumbuyo kwapakhosi koyambirira kwa OFC poyerekeza ndi zowongolera. Pazonse, OFC imathandizira kuwunika momwe mphotho zimaperekera zosankha zosiyanasiyana; makamaka, mbali yoyambirira ya OFC yakhala ikuwunikira njira zoletsa zomwe zimachepetsa zisankho zomwe zidalandilidwa kale (Elliott & Deakin, 2005; Elliott, Dolan, & Frith, 2000) ndikulimbikitsa kusankhidwa kwa ndalama zomwe zachedwa kubwezeredwa pamalipiro apano (McClure, Laibson, Loewenstein, & Cohen, 2004). Komanso, posachedwa, udindo wa ofunzira woyenera wa OFC adakonzedwa kuti aphatikize kusakanikirana kwa zidziwitso zotsogola ndi chidziwitso chaposachedwa kuti apange ziwonetsero zofunikira pazosankha (Nogueira et al., 2017). Zambiri, izi zikuwonetsa kuti ofunika pambuyo pake a OFC amawongolera kupanga zisankho pogwiritsa ntchito chidziwitso chamkati ndi chakunja m'njira yosinthika komanso yosinthira. Zilonda zakutsogolo kwa OFC zimapangitsa chisankho kupanga zokhudzana ndi mphotho yomwe yachedwa, zomwe zimabweretsa zisankho zazakanthawi kakanthawiMar, Walker, Theobald, Mphungu, & Robbins, 2011). Apa, makulidwe amakulidwe a ofunsa ofunikira wa OFC m'magawo a IGD amaphatikizidwa kwambiri ndi kuzindikira kwachidziwikire, komwe kumatanthauzidwa kuti "kupanga zisankho mwachangu" (Stanford et al., 2009). Posachedwa, kusokonekera kwazidziwitso kunali kogwirizana kwambiri ndi kuphunzira kochokera pamfundo ndi kupanga zisankho (Cáceres & San Martín, 2017). Chifukwa chake, potengera zomwe tapezazi ndi zomwe zilipo, tikuganiza kuti kakhazikitsidwe kakang'ono kwambiri ka OFC cortex kumalepheretsa anthu omwe ali ndi IGD kuphatikiza bwino zidziwitso kuti athe kuyerekeza phindu, potero, zomwe zimapangitsa kuti azisangalala posakhalitsa komanso kuti asankhe zochita mwachangu .

Kupeza kwina kofunikira ndikuti maphunziro omwe ali ndi IGD adawonetsa GMV yaying'ono ndi kakhola kakang'ono kwambiri mu orbitalis yamanzere poyerekeza ndi zowongolera. The or orthitalis ili pa gawo lakunja la girus yotsika, ndipo girus yotsika kwambiri imakonda kuphatikizana ndi lateral OFC (Zald et al., 2012). Komanso, masamba a orbitalis, limodzi ndi zigawo zina za orbitofrontal, adalumikizidwa ndikupanga zidziwitso zokhudzana ndi mphotho ndi kupanga zisankho (Dixon & Christoff, 2014). Makamaka, mbali yakumanzere ya orbitalis yasonyezedwa kuti imalumikizana kwambiri ndi gritus yapakati yapakati ndipo imakhudzidwa ndikuwabweza kukumbukira mwaulemu (Badre, Poldrack, Paré-Blagoev, Insler, & Wagner, 2005). Popeza kusintha kwakasinthidwe kumaphatikizaponso kuyang'anira kwamachitidwe amakumbukidwe (Poldrack & Packard, 2003), kusintha kwa imvi mkati mwa orbitalis wamanzere kungapangitse kuti kukhale kovuta kutsogoza khalidwe kutengera chidziwitso cham'mbuyo (Badre & Wagner, 2007). Chifukwa chake, poganizira zolembedwazo, zomwe tapezazi zikuwonetsa kuti GMV yaying'ono komanso yopyapyala kotengera mu orbitalis yakumanzere ya maphunziro a IGD zitha kuthandiza pa kugwiritsa ntchito intaneti kosalamulirika mwa kuwongolera kuthekera kwawo kusintha machitidwe awo potengera chidziwitso cham'mbuyo.

Pakufufuza kwanzeru kwa ubongo wathunthu, tidapeza kuti maphunziro omwe ali ndi IGD anali ndi kakhalidwe kakang'ono kwambiri mu SMA yoyenera, FEF ya kumanzere, SPL yamanzere, ndi PCC kumanzere poyerekeza ndi zowongolera. SMA lamanja limagwira ntchito yolumikizira kuzindikira ndi chikhalidwe (Nachev, Kennard, & Husain, 2008) ndipo ndi gawo lofunikira poyankha zoletsa (Picton et al., 2007). Zochita muubwino mu PCC zimasinthidwa ndi kusintha kwachilengedwe kwina, ndipo kusinthaku kungaphatikizidwe ndi kusintha kosintha kwa chizindikiritso (Pearson, Heilbronner, Barack, Hayden, & Platt, 2011). FEF ndi SPL ndi gawo lofunikira kwambiri laubongo lomwe limayang'aniridwa pakumvera kwapang'onopang'ono (Corbetta & Shulman, 2002). Kugwirizana koyenera kwa zigawo zamtsogolo ndi za parietali kumafunikira kuti ndikofunikira pakukonzekera kuchitapo kanthu (Andersen & Cui, 2009). Ngakhale madera a FEF kapena SPL sanali ma ROI mu phunziroli, tikupereka lingaliro loti kakhonde kakang'ono kotetezeka m'malo awa a ubongo, makamaka m'malo oyang'ana kutsogolo, amasewera mbali zofunikira pakuchepetsa kuyang'anira kwa anthu omwe ali ndi IGD. Kuwongolera kwa chikhalidwe kumeneku kumatha kusintha magwiridwe azisankho / kupereka mphotho, zomwe zimapangitsa kuvuta kupondereza zokhumba komanso kufunafuna kukhutitsidwa kwakanthawi.

Phunziroli lili ndi malire omwe akuyenera kuwaganizira. Choyamba, kupezeka kwa kakhonde kakang'ono kwambiri mu ACC ndi OFC poyerekeza ndi ROI sikunatsimikizidwe pakuwunikira kwaubongo wonse. Timalingalira kuti kusinthaku kudachitika makamaka chifukwa cha kusiyana kwa njira. Mwachitsanzo, kusanthula kochokera ku ROI kunachitika powerengera momwe makulidwe am'kati mwa malo opangidwira pamanja ndipo kusiyana kwamagulu kunasanthulidwa ndi kuwunika kwotsatira kwa mawerengero; Mosiyana ndi izi, kuwunika kwa ubongo wonse kunagwiritsa ntchito mtundu wa mzere kuyerekeza kusiyana kwa magulu anzeru ndi magulu amtundu wolondola. Chifukwa njira za ROI zochokera mu ROI komanso ubongo wonse zimapereka zidziwitso zosiyanasiyana, njira ziwirizi zikufotokozedwa kuti ndizothandiza (Giuliani, Calhoun, Pearlson, Francis, & Buchanan, 2005). Zomwe tapeza pano zingafotokozeredwe ndi kafukufuku wowonjezerapo kuti muchepetse zolakwika pakuwunika kwa ROI komanso ubongo wathunthu, makamaka zolakwitsa zochokera muzoyendetsa masanjidwe a spatial. Chachiwiri, ngakhale kuti kafukufukuyu adafotokozera ma ROI poganiza kuti kusintha kosintha mu OFC ndi ACC komwe kumapangitsa kuti pakhale chisankho / malingaliro opanga mphotho ku IGD, panalibe muyeso wolunjika wa kupangira chisankho mwa mayeso a neuropsychological. Chifukwa chake, kulingalira mosamalitsa kuyenera kuchitika polumikiza zomwe tapeza poganiza ndi zovuta zomwe zingachitike / kupanga mphotho mu IGD. Chachitatu, ngakhale kuti kuwunika kwa IGD phunziroli kunapangidwa pogwiritsa ntchito kuyesa kwa IAT ndi zamankhwala, njira zowunikira za DSM-5 za IGD sizinagwiritsidwe ntchito. Njira zowunikira za DSM-5 IGD zimagwiritsidwa ntchito kwambiri, popeza DSM-5 idazindikira IGD ngati imodzi mwazofunikira zomwe zimafunikira kuphunzira kwambiri (Petry & O'Brien, 2013). Kuti mupeze maumboni odalirika a IGD, ndikofunikira kugwiritsa ntchito chida chodalirika chofufuzira. Chifukwa chake, maphunziro amtsogolo a IGD ayeneranso kugwiritsa ntchito njira zowunikira za DSM-5. Chachinayi, ngakhale tidangochita maphunziro awa ku IGD omwe adalemba kuti kusewera pa intaneti ndi njira yawo yoyamba yogwiritsira ntchito intaneti, maphunziro ambiri adachitanso zochitika zina pa intaneti, kuphatikiza ochezera a pa Intaneti. Chifukwa chake, kapangidwe kakapangidwe ka kafukufuku wopangidwa mtsogolo komanso kogwirira ntchito komwe kamayesa zochitika za neural poyenderana ndi zomwe zimachitika mu masewerawa zimathandizira zomwe tapeza. Lachisanu, tidagwiritsa ntchito kapangidwe kake kagawo lino. Kafukufuku wamtsogolo omwe adagwiritsa ntchito mapangidwe a kuphunzira kwakanthawi kuti athe kuyeza kusintha kwa makulidwe a cortical paubwana ndi ukalamba ukadasanthula ngati pali ubale wapakati pazomwe timaganizira komanso kusewera kwambiri pa intaneti. Chachisanu ndi chimodzi, zitsanzo zathu pa phunziroli zinali zochepa komanso zimangophunzitsidwa ndi amuna. Kusiyana kwa jenda kumanenedwa pokhudzana ndi mawonekedwe azachipatala a IGD (Ko, Yen, Chen, Chen, & Yen, 2005). Maphunziro akulu omwe akuphatikiza amuna ndi akazi ndi ofunika kuti timvetsetse IGD.

Kutsiliza

Tidasanthula a SBM achichepere amuna achikulire omwe ali ndi IGD kuti afufuze zosintha za imvi mu ACC ndi OFC, zomwe zinali zokhudzana ndi chiopsezo / kupanga zisankho. Kuyerekeza kochokera ku ROI ndi zowongolera kunawonetsa kuti maphunziro a IGD anali ndi kakhola kotetemera kumanja rostral ACC, ofunika pambuyo pake wa OFC, ndi masamba orbitalis wamanzere, ndi GMV yaying'ono mu caudal ACC ndi parbitalis yamanzere. Cortex yopyapyala yoyambirira yapambuyo lamanja la OFC yolumikizidwa ndi kukhudzika kwapamwamba m'maphunziro a IGD, ndikupereka chidziwitso pakupanga chisankho potengera kukhutira kwakanthawi mu IGD. Kusanthula kwaubongo konse kwa maphunziro a IGD adapeza kuti anali ndi kakhola kakang'ono kwambiri pamagawo olumikizana ndi ubongo, kuphatikiza madera a frontoparietal. Zotsatira zathu zikuwonetsa kuti kusintha kwa imvi kungaperekenso chidziwitso cha IGD pathophysiology, powonetsa kusintha kosankha / mphoto yopanga zisankho komanso kuchepa kwa kayendedwe ka machitidwe.

Zopereka za olemba

DL ndi Y-CJ anaganiza ndikupanga phunzirolo. DL adalemba omwe adatenga nawo gawo ndikulemba zolemba pamanja. JP adasanthula ndikuwamasulira. IYK ndi KN adawunikiranso mozama pamanja pamanja komanso zanzeru. Olemba onse anali ndi mwayi wodziwa zambiri mu phunziroli ndipo amatenga nawo mwayi pakukhudzika kwa chidziwitso ndi kulondola kwa kusanthula kwa deta. Olemba onse anaunikanso mozama komanso kuvomereza kuti buku lomasulira lomalizirali lifalitsidwe. IYK ndi Y-CJ adathandizidwanso chimodzimodzi pa kafukufukuyu ngati olemba ogwirizana.

Kusamvana kwa chidwi

Olembawo amanena kuti palibe kutsutsana kwa chidwi.

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