Funso la ubongo la Behav. 2013; 9: 11.
4Kudalirika
Background
Orbitofrontal cortex (OFC) yakhala ikuwonetsedwa mosavomerezeka wazachipembedzo komanso zamankhwala osokoneza bongo. Komabe, palibe kafukufuku mpaka pano yemwe adasanthula makulidwe a OFC pazomwe zili ndi intaneti. Mu kafukufuku waposachedwa, tidafufuza kupezeka kwa kusiyana kwa cortical makulidwe a OFC mu achinyamata omwe ali ndi vuto la intaneti. Pamaziko amakono azolowera zaukadaulo, tinaneneratu za kutsika kwa OFC ya anthu omwe adayamba kugwiritsa ntchito intaneti.
Zotsatira
Ophatikizidwa anali achinyamata achimuna a 15 omwe adapezeka kuti ali ndi vuto la intaneti komanso 15 malembedwe oyenera amuna. Zithunzi zamagalamu zama ubongo zimapezeka pa 3T MRI ndipo kusiyana kwamagulu m'katikati mwa cortical kumawunikiridwa pogwiritsa ntchito FreeSurfer. Zotsatira zathu zidatsimikizira kuti achinyamata achimuna omwe ali ndi chizolowezi chogwiritsa ntchito intaneti adachepetsa kwambiri makulidwe amtundu woyenera pambuyo pake OFC (p<0.05).
Kutsiliza
Kupeza uku kumalimbikitsa malingaliro akuti kusintha kwa OFC mu achinyamata omwe ali ndi vuto la intaneti kumawonetseranso chidziwitso chazomwe zimayambitsa matenda osokoneza bongo ambiri.
Introduction
Kuledzera kwa pa intaneti kwadziwika kwambiri monga kusokonezeka kwa malingaliro. Ziwerengero zaposachedwa zakuchuluka kwake kwa anthu achichepere, kuphatikiza ndi umboni kuti kugwiritsa ntchito intaneti zovuta ndizovuta zina zomwe zingakhale ndi zotsatila zakugwira bwino ntchito komanso matenda amisala, zimathandizira kutsimikizika kwa matendawa [1]. Komabe, pakhala kusagwirizana kwakukulu pakukonzekera DSM-V za momwe angatanthauzire zatsopanozi, kapena maziko ake a psychopathology [2]. Poganizira izi, kuzindikiritsa kupezeka kwa zolemba zachilengedwe zilizonse zingathandize kupititsa patsogolo kuzindikira koyenera [3].
Maziko a neural a mankhwala osokoneza bongo amaphunziridwa kwambiri ndipo amakhazikitsidwa bwino poyerekeza ndi mitundu ina ya 'zosokoneza bongo' (mwachitsanzo, zosokoneza bongo). Pakadali pano, kafukufuku wambiri m'mabukuwa adapangitsa kuti gawo la orbitofrontal cortex (OFC) likhale losavuta [4-6]. Volkow ndiogwira nawo ntchito (2000, 2002) akuwonetsa kuti OFC ndi amodzi mwamalo omwe amachititsa chidwi kwambiri ndi mankhwala osokoneza bongo [4,7]. Posachedwa, ofufuza omwe ali mgulu lathu afotokoza zomwe zingachitike pakufufuza kwakanthawi kochepa koonetsa kuti zovuta zomwe zimapangidwa ku OFC zitha kudziwiratu komanso kuchititsa ngozi kuti ogwiritsa ntchito cannabis apambuyo pake [8]. Momwemonso, ngakhale maphunziro ochepa adachitidwa, kusintha komwe kudanenedwa ndikuwonetsa mu intaneti kwakhala kosasinthasintha posonyeza ntchito yasinthidwa ya OFC (makamaka mu hemisphere yoyenera) ndi kapangidwe kake [9-14].
Tidawerengera kuti achinyamata omwe ali ndi vuto logwiritsa ntchito intaneti amawonetsa zonyansa za OFC, makamaka kudera lolondola. Mwachindunji, tinayendetsa kulinganiza-kuwongolera kwa makulidwe acortical mu achinyamata omwe alibe komanso osagwiritsa ntchito intaneti, makamaka kuyang'ana kwambiri masewera a pa intaneti, omwe ali m'gulu lazinthu zazikuluzikulu zavutoli [15].
Zida ndi njira
Ophunzira
Achinyamata khumi ndi atatu achimuna omwe ali ndi vuto la intaneti adasankhidwa ndikuwonetsa ku chipatala cha Seoul National University. Kufunsanaku kunachitika pakati pa february ndi June 2011. Inen kuti tipeze kutsimikizira kwa chizolowezi cha intaneti chomwe tidagwiritsa ntchito Young Internet Addiction Scale (YIAS) [16]. Kuphatikiza apo, onse omwe anali pamsonkhanowu adangokhala okhawo omwe akuwonetsa kuti ali ndi zofunikira pakuchita nawo zamasewera pa intaneti kuphatikiza: kulekerera, kusiya, kuchita chidwi ndi kusewera, mobwereza bwereza kuyesa kuchepetsa kapena kuyimitsa, kudodometsa malingaliro poyesa kuchepetsa, ndipo kunyalanyaza ubale kapena zochitika zofunika chifukwa cha izo [17,18].
Pofuna kupatula vuto lililonse pamaganizidwe a comorbid, tidagwiritsa ntchito Kiddie-schedule for Affective Dis shida ndi Schizophrenia-Present and Lifetime Version (K-SADS-PL) [19]. Achinyamata amoyo wathanzi adalembedwa kudzera m'masukulu am'deralo ndipo adayang'ana pogwiritsa ntchito zida zomwezo zomwe tafotokozazi. Njira zochotseredwa m'magulu onsewa zinali zovuta zilizonse zokhudzana ndi matenda amisala kuphatikizapo matenda osokoneza bongo, khunyu kapena matenda ena amitsempha, komanso mbiri yakale ya kuvulala kwambiri m'mutu. Kuchuluka kwa chizolowezi cha intaneti kwayerekezedwa kukhala kwokwera kwambiri kuposa amuna kuposa akazi [1]. Popeza abambo ndi omwe amaimiridwa kwambiri pamankhwala omwe ali ndi intaneti, komanso kupatsidwa nthawi ndi bajeti, tinaganiza zongoyang'ana achinyamata achinyamata. Kafukufukuyu adavomerezedwa ndi bungwe loyang'anira zochitika za anthu pa Seoul National University. Achinyamata onse ndi makolo awo anapatsa chilolezo cholembedwa asanaphunzire.
Kupeza deta
Zithunzi zonse za ubongo za T1 zolemera kwambiri za MR zidapezeka pa 3T Nokia scanner (Nokia Magnetom Trio Tim Syngo MR B17, Germany) yokhala ndi zotsatirazi: TR 1900 ms; TE 2.36 ms; nthawi yolowerera 700 ms; flip angle 9 °; kukula kwa voxel 1.0 mm3; magawo 224. Zomwe zimayendetsera mutu zimachepetsedwa ndikudzaza malo opanda kanthu kuzungulira mutu ndi chinkhupule chobera komanso kukonza nsagwada yakumunsi ndi tepi.
Kujambula pazithunzi
Makulidwe a Cortical akuti akuti amagwiritsa ntchito FreeSurfer 5.1.0 (Massachusetts General Hospital, Boston, MA, US), zida zamapulogalamu zomwe zimapereka njira yodziyimira okha kuti afufuze ubongo morphometry. Mtsinje wozika pamwamba umaphatikizapo (i) makulidwe amtundu wa ubongo, (ii) kulanda chigaza, (iii) kugawa kwamutu ndi nkhani yoyera, (iv) kufotokozera za mawonekedwe oyera (mkati wamkati), ndi (v ) kufunafuna pial (kunja). Mtunda pakati pa malo ofanana pamalo awa awiri umaimilira makulidwe. Gawo lonse la nkhani iliyonse idayang'aniridwa ndikuwongoleredwa mwadongosolo zolakwika mosazindikira gulu lomwe ophunzira anali nalo. Tidagwiritsa ntchito zitsanzo zathu kuti tipeze chiwonetsero chazomwe tikutsatira ndipo zomwe aliyense atenga nawo mbali adasanjidwa ndi gawo lalikulu la theka-kukula kwa Gaussian kernel ya 10 mm kusanachitike kuwunikira.
Kusanthula deta
Kusanthula kwa dera-la-chidwi (ROI) -kwakudziwitsidwa komwe kunachitika poyerekeza makulidwe amtundu wa OFC opangidwa ndi FreeSurfer potengera nkhokwe ya Desikan-Killiany [20]. Mwatsatanetsatane, maulalo a Desikan-Killiany amatanthauzira magawo a OFC. Malire a rostral / caudal and medial / ofananira ndi izi mwa magawo awiriwa ndi mulingo wokhazikika wa gorus wotsatira wa orbital / gulus ya lateral ya orbital ndi midpoint ya olcusory sulcus / banki yotsatira ya oralital orbital sulcus (ndi / kapena zozungulira zozungulira zolimba) zotsogolera za OFC; ndi kukula kwa gial ya medial orbital / gulus ya gialus ya medial orbital (kapena gritus rectus) ndi cingate cortex / bank ofial frontal gritus wa medical OFC, [20]. Kusanthula kwa covariance (ANCOVA) pogwiritsa ntchito mitundu yofananira (GLM) kunachitidwa ndi SPSS 19.0 (SPSS Inc., Chicago, IL, USA), ndikuwunika kwakukulu kwa gulu (intaneti kukondera motsutsana ndi ulamuliro wathanzi) kunasinthidwa kuwongolera zaka , intelligence quotient (IQ), ndi volracranial vol (ICV). Zotsatira za kuwunikaku zidanenedwa ndi gawo lakufunika kwa p<0.05 (michira iwiri).
Results
Makhalidwe okhudzidwa
Magulu a achinyamata omwe amakhala ndi osagwiritsa ntchito intaneti popanda kugwiritsa ntchito intaneti mosiyana kwambiri (13.33 ± 2.84 pakulimbana kwa intaneti; 15.40 ± 1.24 yowongolera; p= 0.018). IQ inali yofanana pamagulu onsewa (103.80 ± 15.84 pazowonjezera pa intaneti; 109.06 ± 9.84 yowongolera; p= 0.283), ndipo kusiyana kwakukulu mu ICV kunapezeka (1434.42 ± 158.33 cm3 pa intaneti; 1577.21 ± 183.12 cm3 kuwongolera; p= 0.030). Chiwerengero cha YIAS chinali chachikulu kwambiri pagulu lazomwe zimagwiritsa ntchito intaneti (57.26 ± 16.11 pazomwe zimagwiritsa ntchito intaneti; 37.60 ± 9.72 yowongolera; p= 0.000).
ROI yochokera
Kuwunikaku kunawululira ma ROI anayi omwe ali ndi kusiyana kwakukulu mu makulidwe a cortical (p<0.05), omwe anali ofananira nawo OFC, isthmus of the cingate cortex, and par orbitalis in the hemisphere right and lateral occipital cortex in the hemisphere of left, all kusonyeza kortical thinning in achinyamata omwe ali ndi vuto lokonda kugwiritsa ntchito intaneti poyerekeza ndi kuwongolera athanzi (Table
1).
Kusanthula kwachiwiri
Kupereka mawonekedwe owonjezera pakupeza kwathu, kuwunikira kochokera muubongo kwathunthu pogwiritsa ntchito FreeSurfer's Qdec (mtundu wa 1.4) kunachitika mwa kuyenera pakati pa mutu wa GLM pamalo amtundu uliwonse kuti mufananitse makulidwe a cortical pakati pamagulu (osasankhidwa, p<0.001). Monga momwe chithunzi1, Kuchepetsa kwa makulidwe ofananira aCC kunayimbidwanso ndi kuwunikaku.
Kukambirana
Uku ndi kuphunzira koyamba kwa kulingalira kwa ubongo kwa makulidwe a cortical kwa achinyamata omwe ali ndi intaneti. Poyenderana ndi malingaliro athu, zotsatira zake zikuwonetsa kutsika kwa OFC m'gulu lowonjezera la intaneti poyerekeza ndi kuwongolera kwathanzi. Kupeza kumeneku kumagwirizana ndi zotsatira za maphunziro akale amakono aukonde wa intaneti [9-14], ndikuthandizira mtundu wamaganizidwe opezeka pamavuto osokoneza bongo, omwe amatsimikizira kutengapo gawo kwa OFC.
Kupeza kwaposachedwa pamsana pa intaneti kumachirikiza zotsatira za kafukufuku wakale pazolakwa zamankhwala, kuphatikiza zathu [8], omwe adati ufulu wa OFC umatenga gawo lofunikira kwambiri pakuwonekera kwachilengedwe pakuwonjezera mavuto. Zotsatira za phunziroli sizongogwirizana ndi zina zambiri zomwe zapezedwa m'mabuku zomwe zikupangitsa udindo wa OFC kuti ukhale wovuta [4-6], komanso ndi zomwe zikuwonetsa kuti gawo ili laubongo mu hemisphere yoyenera lingakhale lofunikira kwambiri [21].
Phunziroli, okhawo osati othandizira a OFC adawonetsedwa kuti ali osiyana kwambiri ndi achinyamata omwe ali ndi intaneti. Zotsatira zakupezazi sizodziwikiratu, koma pakhala pali maphunziro ochulukirapo ofotokoza ntchito zosiyanasiyana pakati pa ofiki ndi othandizira a OFC, makamaka pakupanga zisankho zokhudzana ndi mphotho [22]. Mwachitsanzo, medic OFC yapezeka kuti ikuchita kusankhidwa mwakusankha kophatikiza mphotho zokhazokha, pomwe ofufuza a OFC adakhudzidwa posankha zokhudzana ndi mphotho yomwe yachedwa kapena kupondereza mayankho omwe adalandilidwa kale [23,24]. Ndizofunikira kudziwa kuti parb orbitalis, yomwe imayandikana ndi laterC OF, iwonetsanso kuchepa kwakukulu kwa achinyamata ndi vuto la intaneti. Kupeza uku kumathandizira kuti kupendekera kwapakhosi kumakhala makamaka m'mbali ya OFC, popanda kapena kuphatikiza medial OFC. Ntchito inanso imayenera pa ntchito zotsatsa zamitundu ina.
NextC OFC yathandizidwanso pakuwongolera kosinthika kwazidziwitso komanso muzochitika zamakhalidwe azachipatala [25]. Pachifukwa ichi, a Chamberlain ndi anzawo (2008) adawonetsa kuti ofananira nawo a OFC akhoza kukhala apakati pa zitsanzo za neurobiological of obsessive-compive disorder (OCD) [26]. Zokonda zamakhalidwe nthawi zambiri zimawerengedwa kuti zimagawana zofanana ndi zovuta zina zodziwika kuphatikiza OCD [2], zomwe zimaphatikizapo zovuta zina popewa khalidwe linalake lomwe limabweretsa zotsatirapo zake zazikulu. Rotge ndi anzawo (2008, 2010), kutengera kutsimikiza kwawo meta [27,28], adafufuza ukulu wolozeka pakati pamapu pakati pa anatomical ndi magwiridwe antchito aubongo omwe adawonetsa kusintha kwakukulu kwa imvi ndi zochitika pakulimbikitsa zizindikiro, motsatana, mwa odwala OCD: olemba adapeza kuti gawo lokhathamiritsa la ubongo linali lotsatira la OFC. Posachedwa, Zhou ndi anzawo (2012) awonetsa kusokonezeka kwamaganizidwe komanso kulephera kuyankha koyipa mwa achikulire omwe ali ndi vuto la intaneti [29]. Zomwe zimapangitsa kuti makulidwe achulukidwe a cortical mu lateral OFC, pokhudzana ndi gawo lawo pakukonda kugwiritsa ntchito intaneti komanso zinthu zina zokhala ndi mawonekedwe ofanana a neurobeharanceal, ali ndi maphunziro amtsogolo.
Phunziro ili pano lili ndi malire ofunikira. Koposa zonse, magawidwe osiyana azaka zapakati pa maguluwa anali ochepetsa kwambiri phunziroli. Komabe, malipoti am'mbuyomu okhudza kubadwa kwabwino kwaubongo kwawonetsa kuti kukhuthala kwa cortical kumakwera pachaka pafupifupi 8-9 wazaka kenako kuchepa kwa cortical padziko lonse kumayamba pambuyo pake [30]. Zachidziwikire ndikuti onse omwe adatenga nawo gawo pochita kafukufuku anali opitilira zaka zino. Chifukwa chake, muubwana, achichepere amakonda kukhala ndiortort cortex; Kupeza kwathu kwa ufulu wakuonda wa OFC pagulu laling'ono lokonda kugwiritsa ntchito intaneti kotero kumapereka lingaliro loti kusiyana kwa mibadwo m'magulu sikunakhaleko komwe kukadawakhudza. Chachiwiri, sitinayeze kutalika kwa chizolowezi cha intaneti. Chachitatu, omwe amaphunzira nawo pagululi omwe anali osavuta pa intaneti anali ochita masewera olimbitsa thupi pa intaneti, chifukwa chake, zomwe zapezedwa pano zingakhudzenso ziwonetsero zina zazomwe zimapangitsa anthu kukhala osavuta kugwiritsa ntchito intaneti [15].
Mwachidule, zotsatira za kafukufuku wapano zikuwonetsa zoyambira zakukula kwa ufulu wa OFC mwa achinyamata omwe ali ndi vuto la intaneti. Zomwe zapezazi zikuwunikiranso pamalingaliro amtundu wa neurobiological wogwirizana pakati pazolimbana ndi intaneti komanso zovuta zina.
Zopereka za olemba
SBH idawunikira ndikusanthula ndikulemba zolembedwa zoyambirira. JWK, CDK, ndi SHY anali oyang'anira lingaliro lamalingaliro ndi kapangidwe. SBH, EJC, HHK, ndi YES anali ndi udindo wopeza deta yazachipatala ndi kuyerekezera. PK ndi SW anathandizira kulingalira kwa kusanthula kwa data. PK, SW, MY, ndi CP adathandizira nawo pamapepala omaliza. JWK, CDK, YANGA, CP, ndi SHY adathandizira kutanthauzira kwa data ndikupereka zofunikira zanzeru. Olemba onse adawunikiranso mozama zomwe zalembedwazo ndipo adatsimikizira mtundu womaliza woperekedwa kuti ufalitsidwe.
Zothokoza
Ntchitoyi idathandizidwa ndi Seoul National University Brain Fusion Program Research Fund. SBH idathandizidwa ndi thandizo la National Research Foundation of Korea (NRF) (Global Internship Program) lochirikizidwa ndi boma la Korea (MEST). MY idathandizidwa ndi thandizo loyanjana la NHMRC (#1021973). Othandizira ndalamawo analibe nawo gawo pantchito yophunzirira, kusonkhanitsa, kusanthula kapena kutanthauzira, kulemba zolemba pamanja, kapena kusankha kupereka pepalalo kuti lifalitsidwe.
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