Kusintha kwa Okhutira ndi Neural Kulumikizana M'maganizo Omwe Ali ndi Khalidwe Lochita Zachiwerewere (2016)

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MAFUNSO: Phunziroli, monganso ena, dzina loti "Zokakamiza Zokhudza Kugonana" (CSB) mwina limatanthauza kuti amunawa anali osokoneza bongo. Ndikunena izi chifukwa maphunziro a CSB amakhala pafupifupi maola 20 akugwiritsa ntchito zolaula sabata iliyonse. Kuwongolera kumakhala mphindi 29 pa sabata. Chosangalatsa ndichakuti, 3 ya maphunziro 20 a CSB adadwala "orgasmic-erection disorder," pomwe palibe m'modzi wowongolera omwe adanenapo zovuta zakugonana.

Zowunika Kwambiri: Zogwirizanitsa za neural zokhudzana ndi chilakolako chachisokonezo ndi kugwirizana kwa neural zinasinthidwa mu gulu la CSB.

Malinga ndi ofufuzawo, kusintha koyamba - kukulitsa kutsegulira kwa amygdala - kumatha kuwonetsa kukhazikitsidwa kosavuta ("kulumikizana" kwakukulu pamalingaliro omwe sanalowererepo akuneneratu za zolaula). Kusintha kwachiwiri -kuchepetsa kulumikizana pakati pa ventral striatum ndi preortal cortex - itha kukhala chodetsa cholephera kuthana ndi zikhumbo. Ofufuzawo anati, "[Kusintha] kumeneku kumagwirizana ndi kafukufuku wina wofufuzira za neural correlates za matenda osokoneza bongo ndi kuchepa kwachangu. ” Zotsatira zakuthandizira kwakukulu kwa amygdalar ku cues (kulimbikitsa) ndipo adachepetsa kugwirizanitsa pakati pa malo opatsa malipiro ndi prefrontal cortex (chinyengo) ndizo ziwiri zikuluzikulu za ubongo zimasinthidwa kuwonongeka kwa mankhwala.

Tim Klucken, PhDmakalata, Sina Wehrum-Osinsky, Dipl-Psych, J an Schweckendiek, PhD, Onno Kruse, MSc, Rudolf Stark, PhD

DOI: http://dx.doi.org/10.1016/j.jsxm.2016.01.013

Kudalirika

Introduction

Pakhala pali chidwi chowonjezereka kumvetsetsa bwino zokhudzana ndi kugonana kwachinyengo (CSB). Zimaganiziridwa kuti zowathandiza kukhala ndi chilakolako chokhutira zikhoza kukhala njira yofunikira kuti chitukuko ndi kusungidwa kwa CSB, koma palibe kuphunzira mpaka pano zomwe zafufuzira njirazi.

cholinga

Kufufuza kusiyana kwa magulu mu zochitika za neural zomwe zimagwirizana ndi vuto lachisokonezo ndi kugwirizana mu nkhani ndi CSB ndi gulu lolamulira bwino.

Njira

Magulu awiri (20 maphunziro ndi CSB ndi 20 maulamuliro) anadziwika ndi zovuta zowonongeka paradigm panthawi yogwiritsa ntchito maginito opanga masewero olimbitsa thupi, zomwe zowonongeka zowonongeka (CS +) zinaneneratu zochitika zogonana zowonongeka komanso chachiwiri (CS-) sichinatero.

Zotsatira Zazikulu

Mmene magazi amathandizira muyezo wa oxygen komanso kugwirizana kwa maganizo.

Results

Monga zotsatira zazikulu, tinapeza ntchito yowonjezera ya amygdala panthawi yachisokonezo cha CS + vs CS- ndipo inachepetsa kugwirizanitsa pakati pa ventral striatum ndi prefrontal cortex mu CSB vs gulu lolamulira.

Kutsiliza

Zotsatirazi zikuwonetsa kuti ma correlates a neural of conditioning and conditioning alliance amasintha kwa odwala omwe ali ndi CSB. Kuwonjezeka kwa amygdala kuyambitsidwa kungasonyeze njira zothandizira odwala omwe ali ndi CSB. Kuonjezera apo, zomwe adaziwona zinachepetsedwanso kuti zikhoza kutanthauzidwa kuti zikhale chizindikiro cha kupambana kwa malamulo okhudzidwa ndi maganizo olakwika mu gulu lino.

Mawu ofunika: Amygdala, Kukonzekera, Chisoni, zabwino, mphoto, Kugonana Kwachiwerewere

Introduction

Kupititsa patsogolo pa intaneti ndi maulendo opatsirana (mwachitsanzo, ndi mafoni a m'manja) wapereka njira zatsopano, zofulumira, komanso zosadziwika kuti zitha kuwona zolaula (SEM). Kuwonetsedwa kwa SEM kumaphatikizidwa ndi kudzipereka, kudziimira, khalidwe, ndi mayendedwe enieni.1, 2, 3, 4, 5, 6, 7 Kufufuza ku Britain ku 2013 kunasonyeza kuti pafupifupi 10% ya intaneti inali pa malo akuluakulu omwe anadutsa magalimoto kumalo onse ochezera.8 Funso lofufuza pa intaneti likufufuza kufufuza kwa zolaula pa intaneti zodziwika zinthu zinayi-ubale, kayendedwe ka maganizo, kachitidwe kachitidwe, ndi malingaliro.9 Ngakhale kuti ambiri mwa amuna ogwiritsa ntchito samakhala ndi vuto ndi SEM yawo, amuna ena amafotokoza khalidwe lawo ngati chizolowezi chogonana (CSB) chodziwika ndi kugwiritsira ntchito mopitirira muyeso, kutaya mphamvu, komanso kulephera kuchepetsa kapena kuletsa khalidwe lovuta, mavuto, azachuma, mwakuthupi, kapena okhumudwitsa payekha kapena ena. Ngakhale kuti amuna amenewa nthawi zambiri amadzifotokoza kuti ndi "kugonana kapena kugonana," pali zotsutsana zokhudzana ndi chikhalidwe ndi kulingalira kwa CSB. Ofufuza ena atanthauzira khalidwe ili ngati vuto lodziletsa,10 kusokonezeka kwa malamulo, kusokonezeka maganizo,11 matenda oledzera,12 pamene ena adapewa mabungwe a zamagulu pogwiritsa ntchito mawuwo matenda osokoneza bongo.13 Ofufuza ena adatsutsa kuti pakufunika kudziwika bwinobwino.14, 15 Choncho, kufufuza kwa sayansi yokhudzana ndi neurobiological kuyesa za neural correlates ya CSB ndizofunika kuti mudziwe zambiri za njira zoyendetsera.

Zaperekedwa kuti zomwe zathandiza kuti chilakolako chokhutiritsa chikhale chofunikira kwambiri kuti chitukuko ndikukonzekeretsa kuledzera komanso matenda ena opatsirana pogonana.16, 17 Mu zovuta zowonongeka za paradigms, kusakanikirana kosalekerera (CS +) kumaphatikizidwa ndi chiwonetsero chachisokonezo (UCS), pamene kachiwiri kafukufuku (CS-) akulosera kuti palibe UCS. Pambuyo pa mayesero angapo, CS + imayankha mayankho oyenerera (CRs) monga kuwonjezeka kwa mayendedwe a khungu (SCRs), kusinthidwa pazomwe amakonda, komanso kusintha machitidwe achisudzo.16, 18, 19 Ponena za neural correlates yokhudzana ndi chilakolako chokhutira, malowa amadziwika kuti ventral striatum, amygdala, orbitofrontal cortex (OFC), insula, kapangidwe kake (ACC), ndi occipital cortex.20, 21, 22, 23, 24 Choncho, ventral striatum imakhudzidwa ndi chilakolako chachisokonezo chifukwa cha ntchito yake yaikulu pakuyembekezerapo, kupindula mphoto, ndi kuphunzira.25, 26 Komabe, mosiyana ndi ventral striatum, udindo wa amygdala chifukwa cha chilakolako chokhutira ndi zovuta. Ngakhale kuti maphunziro ambiri a zinyama ndi aumunthu akhala akutsimikizira mobwerezabwereza amygdala ngati chigawo chapakati cha mantha,27 Kuphatikizidwa kwake mu chikhalidwe chachisokonezo chafufuzidwa kokha kawirikawiri. Posachedwapa, zinyama ndi maphunziro a anthu zasonyeza kuti amygdala ikuphatikizidwa pakukonza chisokonezo chokhutiritsa, kusokoneza maganizo, ndi kukonza za CSB pogwiritsa ntchito njira zosiyanasiyana.28, 29, 30, 31, 32, 33, 34, 35, 36 Mwachitsanzo, Gottfried et al29 adapeza kuwonjezeka kwa amygdala activation ku CS + vs CS- panthawi yachisangalalo chaumunthu pogwiritsa ntchito fungo labwino ngati UCS. Zochita mu OFC, insula, ACC, ndi occipital cortex nthawi zambiri zimamasuliridwa ngati njira zowunikira komanso / kapena zozama zoyeserera.16

Pakadali pano, maphunziro awiri okha a maginito opanga maginito (fMRI) omwe adafufuza ma neural correlates a CSB ndipo adapeza kuwonjezeka kwa ma amygdala ndi ventral striatum komanso kusintha kwa kulumikizana kwa neural m'mitu yomwe ili ndi CSB pakawonetsedwa zofananira (zogonana).35, 36 Izi zikugwirizana ndi kafukufuku wina wofufuza zamagulu amitsempha yamavuto omwe amayamba chifukwa cha zosokoneza bongo.37, 38 Mwachitsanzo, zofufuza za meta zawonetsa kulumikizana kwakukulu pakati pa kuyambitsa kwa amygdala ndi chidwi chakulakalaka.37 Phunziro lina lomwe linagwiritsa ntchito malingaliro owonetsera kufalikira kumapezeka mowonjezereka bwino wazitsulo zazitsulo zamakono m'madera omwe ali ndi CSB komanso kusagwirizana pakati pa CSB ndi kuyanjana kwazomwe zimagwirizanitsa.39

Kuwonjezera pa kufunika kwa njira zowonongeka, kukhumudwa mu chiletso cha khalidwe lopweteketsa ndilofunika kwambiri kuti chitukuko ndi kukonzanso matenda ambiri a maganizo ndi makhalidwe osayenera.40, 41 Mavuto awa ndi kulepheretsa angathe kufotokoza kuwonongeka kwa machitidwe ndi CSB pamene akukumana ndi zifukwa zofanana. Ponena za neural correlates ya chizoloŵezi chosayenerera ndi malamulo ake, ventral striatum ndi ventromedial prefrontal cortex (vmPFC) amawoneka kuti ndi ofunika kwambiri omwe amatsutsana nawo: ventral striatum imaganiza kuti ndi yoyenera poyambitsa khalidwe lopusitsa, pamene kugwedezeka kwake kumayendetsedwa ndi vmPFC kudzera mwachitsulo kugwirizana.42 Mwachitsanzo, zotsatira zammbuyo zakhala zikugwirizana ndi zovuta zogwirizana ndi khalidwe lachidziwitso komanso khalidwe lopanda chidwi.42, 43

Komabe, palibe phunziro mpaka pano lomwe lafufuzira njira zothandizira kuphunzira zoperewera kapena kutaya ulamuliro pazochitika ndi CSB poyerekeza ndi kulamulira bwino. Malingana ndi zolembedwa zomwe tazitchula kale, cholinga choyamba cha phunziroli chinali kufufuza njira zokhudzana ndi chikhalidwe chachisokonezo mu nkhaniyi poyerekeza ndi gulu lomwe likugwirizana. Tinagwiritsa ntchito njira yowonjezereka mu amygdala ndi ventral striatum mu maphunziro omwe ali ndi CSB poyerekeza ndi gulu lolamulira. Cholinga chachiwiri chinali kufufuza kusiyana pakati pa magulu awiriwa. Kuzindikiritsa chigawo cha neural cha kusintha kwa chilakolako chokhudzidwa ndi kugwirizana kwa nkhaniyi sikungangokhala ndi kumvetsetsa za chitukuko ndi kukonzanso kwa khalidweli komanso njira zothandizira, zomwe nthawi zambiri zimawongolera kusintha kwa makhalidwe kudzera m'masewero ophunzirira (mwachitsanzo, chikhalidwe chakumvetsetsa mankhwala).44

Njira

ophunzira

Amuna makumi awiri omwe ali ndi CSB ndi 20 ofananira ndi omwe adatumizidwa adadzitumizira okha pambuyo pofalitsa ndi kuwatumiza kuchipatala chakunja kwa odwala kuti azitha kuzindikira zamankhwala (Gulu 1). Onse omwe atenga nawo mbali anali ndi masomphenya abwinobwino kapena okonzedwa mwanjira yachilendo ndipo adasaina chilolezo chodziwitsidwa. Kafukufukuyu adachitika malinga ndi Lamulo la Helsinki. Onse omwe atenga nawo mbali adafunsidwa kuti athe kupeza matenda a Axis I ndi / kapena Axis II. Ophunzira omwe amadziwika kuti ali ndi CSB amayenera kukwaniritsa zofunikira zonse zokhudzana ndi chiwerewere zosinthidwa ndi CSB13:

1. Kwa miyezi ingapo ya 6, malingaliro opatsirana achiwerewere ndi okhudzana ndi kugonana, akulimbikitsana, ndi khalidwe la chiwerewere ayenera kugwirizana ndi zosachepera zinayi zotsatirazi:

a. Nthawi yochulukirapo yowonongeka ndi kuganiza ndi kugonana ndi kukonzekera ndikuchita zogonana

b. Kubwereza mobwerezabwereza m'maganizo awa, kuganizira, ndi khalidwe poyankha chikhalidwe chachisoni

c. Kubwereza kugonana mobwerezabwereza, kuchenjeza, ndi khalidwe poyankha zochitika zokhudzana ndi kugonana

d. Kubwerezabwereza koma kusayesa kuthetsa kapena kuchepetsa kwambiri malingaliro ogonana, akudandaula, ndi khalidwe

e. Kubwereza kuchita chiwerewere mobwerezabwereza ndikunyalanyaza chiopsezo cha kuvulaza thupi ndi ena

2. Zovuta zapadera zomwe zimachititsa munthu kukhala ndi moyo, ntchito, kapena mbali zina zofunikira zomwe zimagwirizanitsidwa ndi kuchuluka kwa mphamvu za kugonana, zofuna, ndi khalidwe

3. Zogonana izi, zolimbikitsa, ndi khalidwe sizimangokhala ndi zotsatira za thupi zochokera ku zinthu zakuthambo, zochitika zachipatala, kapena zochitika zaumunthu

4. Zaka zosachepera zaka 18

Gulu 1Demographic and Psychometric Measurements for CSB and Control Groups*

Gulu la CSB

Gulu lolamulira

Statistics

Age34.2 (8.6)34.9 (9.7)m = 0.23, P = .825
BDI-II12.3 (9.1)7.8 (9.9)m = 1.52, P = .136
Nthawi yogwiritsira ntchito nthawi SEM, min / wk1,187 (806)29 (26)m = 5.53, P <.001

Chisokonezo Ndikusokonezeka

 Gawo la MD41
 Matenda a MD omwe amapezeka4
 Chikhalidwe cha anthu1
 Matenda osintha1
 Phobia wapadera11
 Matenda osokoneza thupi3
 Matenda a Somatoform1

Matenda a Axis II

 Matenda a Narcissistic1

Mankhwala opatsirana

 Amitriptyline1

BDI = Beck Depression Inventory II; CSB = chizolowezi chogonana; MD = kukhumudwa kwakukulu; SEM = zolaula.

*Deta zimaperekedwa ngati zowona (SD).

Ndondomeko yoyendetsa

Njira zowongolera zidachitika pochita fMRI (onani pansipa kuti mumve zambiri). Njira yosiyanitsira mitundu ndi mayeso a 42 adagwiritsidwa ntchito (21 pa CS). Mabwalo awiri achikuda (buluu limodzi, chikaso chimodzi) anali CS ndipo anali ofanana mofanana ndi CS + ndi CS- pamitu yonse. CS + idatsatiridwa ndi 1 ya zithunzi 21 zolaula (100% zolimbitsa). Zithunzi zonse zowonetsa maanja (nthawi zonse mwamuna m'modzi ndi mkazi m'modzi) akuwonetsa zolaula (mwachitsanzo, kugonana m'njira zosiyanasiyana) ndipo adawonetsedwa ndi utoto ndi mapikiselo a 800 × 600. Zoyeserera zija zidawonetsedwa pazenera kumapeto kwa sikani (visual field = 18 °) pogwiritsa ntchito pulojekiti ya LCD. Zithunzi zimawonedwa kudzera pagalasi lokhala pamutu wamutu. Kutalika kwa CS kunali masekondi 8. Zithunzi zolaula (UCS) zidawonekera nthawi yomweyo CS + (100% yolimbitsa) yamasekondi 2.5 ndikutsatira masekondi 12 mpaka 14.5.

Mayesero onse adaperekedwa mwadongosolo lopanda phindu: Zomwe CS sizinawonetsedwe kawiri kawiri. Zachiwiri CS zinaperekedwanso mofananamo nthawi yoyamba ndi yachiwiri ya kupeza. Mayesero awiri oyambirira (mayesero amodzi a CS +, a CS-trial) asanatengedwe chifukwa kusaphunzira sikunayambe kuchitika, kumayambitsa mayesero a 20 pa CS iliyonse.45

Zotsatira Zoganizira

Asanayesedwe ndipo atangotsata njira zowongolera, ophunzira adavotera valence, kudzutsa, komanso kukakamiza kugonana kwa CS +, CS-, ndi UCS pamiyeso ya 9-Likert komanso chiyembekezo chawo cha UCS pamiyeso ya 10-Likert. Kwa ziwerengero za CS, kusanthula kwa ziwerengero kunachitika pofufuza kusiyanasiyana (ANOVA) mu 2 (CS mtundu: CS + vs CS-) × 2 (nthawi: isanachitike vs itatha) × 2 (gulu: CSB vs gulu lolamulira) kamangidwe kotsatira ndi mayeso aposachedwa ku SPSS 22 (IBM Corporation, Armonk, NY, USA) pamlingo uliwonse. Mayeso oyenera a post hoc t adachitika kuti athe kuwunika zomwe zingachitike. Kwa zithunzi zolaula, zitsanzo ziwiri t -mayesero adachitidwa kuti athe kuyesa kusiyanasiyana kwamagulu.

Kuchita Makhalidwe a Khungu Kuyeza

SCRs zidasankhidwa pogwiritsa ntchito magetsi a Ag-AgCl odzaza ndi isotonic (NaCl 0.05 mol / L) electrolyte medium mediated pa osapambana dzanja lamanzere. SCR imatanthauzidwa ngati njira imodzi yokha yochitapo kanthu pambuyo pa kuyambitsa. Chifukwa chake, kusiyana kwakukulu pakati pazing'ono ndi zotsatirazi m'kati mwa 1 kwa 4 masekondi pambuyo pa CS isanayankhidwe ngati yankho loyambirira (FIR), kuti mkati mwa 4 mpaka 8 masekondi ngati yankho lachiwiri (SIR), ndilo mkati mwake 9 kwa masekondi a 12 ngati yankho lachitatu la nthawi (TIR). Mayankho a mawindo owonetsera adatengedwa pogwiritsa ntchito Ledalab 3.4.4.46 Mayankho awa ndi chipika (μS + 1) chosinthidwa kuti chikhale cholakwika pakuphwanya kufalikira kwachidziwitso. Maphunziro asanu (atatu omwe ali ndi CSB ndi maulamuliro awiri) sanawonetse ma SCR (palibe mayankho owonjezeka ku UCS) ndipo sanatulukidwe pakuwunika. Ma SCR amatanthauza kusanthula ndi ANOVA mu 2 (CS mtundu: CS + vs CS-) × 2 (gulu: CSB vs control group) kapangidwe kotsatiridwa ndi mayeso aposachedwa pogwiritsa ntchito SPSS 22.

Maginito a Maginito Opangidwira

Ntchito ya Hemodynamic

Zithunzi zogwira ntchito ndi anatomic zidapezeka ndi 1.5-Tesla thupi lonse tomograph (Nokia Symphony yokhala ndi gradient system; Siemens AG, Erlangen, Germany) yokhala ndi koyilo yamutu wamba. Kapangidwe kazithunzi kamakhala ndi zithunzi za sagittal za 160 T1 (magnetization yokonzekera kugula mwachangu; 1-mm kagawo kakulidwe; nthawi yobwereza = masekondi 1.9; echo time = 4.16 ms; gawo lowonera = 250 × 250 mm). Pazoyeserera, zithunzi 420 zidapezeka pogwiritsa ntchito T2 * -weighted gradient echo-planar imaging sequence ndi magawo 25 okuta ubongo wonse (kagawo makulidwe = 5 mm; gap = 1 mm; kutsika kagawo; nthawi yobwereza = masekondi 2.5; nthawi ya echo = 55 ms; pepala lozungulira = 90 °; gawo lowonera = 192 × 192 mm; kukula kwa matrix = 64 × 64). Mavoliyumu awiri oyamba adatayidwa chifukwa chosagwiritsa ntchito maginito. Zambiri zidasanthulidwa pogwiritsa ntchito Statistical Parametric Mapping (SPM8, Wellcome department of Cognitive Neurology, London, UK; 2008) yakhazikitsidwa ku MATLAB 7.5 (Mathworks Inc., Sherbourn, MA, USA). Zisanachitike kusanthula konse, deta idakonzedweratu, yomwe idaphatikizapo kukonza, kusasunthika (b-spline kutanthauzira), kukonza nthawi yaying'ono, kulembetsa nawo zodalirika pazithunzi za aliyense wa omwe akutenga nawo mbali, ndikuwongolera gawo laubongo wa Montreal Neurological Institute. Kuwongolera kwapakati kunayendetsedwa ndi fyuluta ya Gaussian yazithunzi zitatu yomwe ili ndi mulifupi wokwanira theka la 9 mm kuti ikwaniritse zowerengera.

Pachigawo choyamba, zosiyanazi zidasinthidwa pa mutu uliwonse: CS +, CS-, UCS, ndi osati UCS (yofotokozera ngati nthawi yowonekera pambuyo pa CS- mawonetsero ofanana ndi nthawi yowonetsa UCS pambuyo pa CS +47, 48, 49). Ntchito yamitengo idasankhidwa pa regressor iliyonse. Regressor iliyonse inali yodziyimira pawokha, sinaphatikizepo kusiyanasiyana (cosine angle <0.20), ndipo idakhudzidwa ndi ntchito yoyankha ya hemodynamic. Magawo asanu ndi limodzi amasinthidwe osinthika okhwima a thupi omwe amapezeka ndi njira yosinthira adayambitsidwa ngati ma covariates mchitsanzo. Nthawi yochokera pa voxel idasefedwa ndi fyuluta yodutsa (nthawi zonse = masekondi 128). Kusiyanitsa kwa chidwi (CS + vs CS-; CS- vs CS +; UCS vs non-UCS; non-UCS vs UCS) adatanthauziridwa pamutu uliwonse mosiyana.

Pofufuza kawiri-kawiri, mayesero amodzi ndi awiri adayesedwa kuti afufuze zotsatira za ntchito (CS + vs CS-; UCS vs osati UCS) ndi kusiyana pakati pa magulu. Kukonzekera kwa chiwerengero cha kulingalira kwa dera-of-interest (ROI) kunkachitidwa pang'onopang'ono P = .05 (osakonza), k = 5, ndi gawo lofunikira (P = .05; kukonzedweratu chifukwa chakulakwitsa kwakunyumba, k = 5), ndikuwunika kwaubongo wonse kunachitika ndi gawo loyandikira P = .001 ndi k> ma voxel 10. Kusanthula konse kunapangidwa ndi SPM8.

Ngakhale kuti panalibe kusiyana pakati pa gulu la UCS ndi ma BDI, tinapitiliza kufufuza kuphatikizapo UCS chiwerengero ndi maphunziro a BDI monga ma covariates kuti awononge zotsatira zowonongeka za zochitika za UCS ndi zovuta. Zotsatira zinakhalabe zokhazikika (palibe kusiyana kwa magulu; kusiyana kwa magulu kunasintha kwambiri). Masikiti a anatomic a ROI zofufuzira za amygdala (2,370 mm3), insula (10,908 mm3), occipital cortex (39,366 mm3), ndi OFC (10,773 mm3) anatengedwa kuchokera ku Harvard-Oxford Cortical ndi Subcortical Structural Atlases (http://fsl.fmrib.ox.ac.uk/fsl/fslwiki/Atlases) (25% mwayi) woperekedwa ndi Harvard Center ya Morphometric Analysis ndi ventral striatum mask (3,510 mm3) kuchokera ku database ya Human Brain Project Repository potengera nkhokwe ya BrainMap. Atlas ya Harvard-Oxford ndi ma atlas omwe angakhalepo potengera zithunzi zolemera za T1 zamaphunziro a 37 athanzi (N = 16 akazi). VmPFC mask (11,124 mm3) idapangidwa ndi MARINA50 ndipo wakhala akugwiritsidwa ntchito mu maphunziro ambiri apitalo.51, 52, 53, 54

Psychophysiologic Interaction Analysis

Kusanthula kwa Psychophysiologic (PPI),55 zomwe zimafufuza momwe kugwirizanirana pakati pa dera la mbeu ndi malo ena a ubongo ndi ntchito yoyesera, yotchedwa psychological variable (CS + vs CS-), inkachitidwa. Mbewu za m'madera, ventral striatum ndi amygdala, zinayikidwa muzitsulo ziwiri zosiyana pogwiritsa ntchito ROI (onani pamwambapa). Pachiyambi choyamba, ife tinatenga oigenvariate yoyamba kudera la mbeu iliyonse yomwe ikugwiritsidwa ntchito mu SPM8. Kenaka, mawu oyanjanirana adalengedwa powonjezereka eigenvariate ndi kusintha kwa maganizo (CS + vs CS-) pa phunziro lirilonse ndikulikonza ndi ntchito yowonongeka ya haemodynamic. Kufufuza kwapakati pazomwe kunkachitika pa phunziro lirilonse kuphatikizapo nthawi yogwirizana monga regressor chidwi (PPI regressor) ndi eigenvariate komanso ntchito yovuta monga zovuta zovuta.55 Pa mulingo wachiwiri, tidasanthula kusiyana kwamagulu polumikizira (PPI regressor) pakati pa gulu la CSB ndi gulu lolamulira pogwiritsa ntchito zitsanzo ziwiri t-mayeso ndi vmPFC ngati ROI. Zokonza zowerengera zinali zofanana ndi kuwunika koyambirira kwa fMRI.

Results

Zotsatira Zoganizira

ANOVA inasonyeza zotsatira zazikulu za CS mtundu wa valence (F1, 38 = 5.68; P <0.05), kudzutsa (F1, 38 = 7.56; P <.01), kukakamiza kugonana (F1, 38 = 18.24; P <.001), ndi kuwerengera kwa chiyembekezo cha UCS (F1, 38 = 116.94; P <.001). Kuphatikiza apo, mitundu yayikulu ya CS × yolumikizana ndi nthawi idapezeka ku valence (F1, 38 = 9.60; P <.01), kudzutsa (F1, 38 = 27.04; P <.001), kukakamiza kugonana (F1, 38 = 39.23; P <.001), ndi kuwerengera kwa chiyembekezo cha UCS (F1, 38 = 112.4; P <.001). Post hoc mayesero adatsimikizira kuti zinthu zikuyenda bwino (kusiyanitsa kwakukulu pakati pa CS + ndi CS-) m'magulu awiriwa, kuwonetsa kuti CS + idavoteledwa ngati yabwino kwambiri, yolimbikitsa, komanso yodzutsa chilakolako chogonana kuposa CS- pambuyo (P <.01 yofananitsa konse), koma osati gawo lopeza, likuwonetsa bwino m'magulu awiriwa (Chithunzi 1). Kuwonjezeranso kwina kunasonyeza kuti kusiyana kumeneku kunachokera pa kuwonjezeka kwa masewera a CS + ndi kuchepa kwa CS-scores nthawi.P <.05 pakuyerekeza konse). Palibe kusiyana kwamagulu komwe kunapezeka pokhudzana ndi valence (P = .92) ndi kudzuka (P = .32) kuwerengera kwa UCS (zolaula zogonana).

Chithunzi chazithunzi cha Chithunzi 1. Atsegula chithunzi chachikulu

Chithunzi 1

Mphamvu yayikulu yolimbikitsira (CS + vs CS-) pamavomerezo padera pamagulu awiriwo. Zolakwitsa mipiringidzo zikuyimira zolakwika zofananira. CS- = chilimbikitso chokhazikika -; CS + = chilimbikitso chokhazikika +; CSB = chizolowezi chogonana.

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Mayankho a Makhalidwe a Khungu

ANOVA inasonyeza zotsatira zazikulu za CS mu FIR (F1, 33 = 4.58; P <.05) ndi TIR (F1, 33 = 9.70; P <.01) ndimachitidwe mu SIR (F1, 33 = 3.47; P = .072) kusonyeza SCRs yowonjezera ku CS + ndi ku UCS, mofanana, poyerekeza ndi CS-. Palibe zotsatira za gulu zomwe zinachitika ku FIR (P = .610), SIR (P = .698), kapena TIR (P = .698). Kuphatikiza apo, palibe CS mtundu × wamagulu olumikizana omwe amapezeka mu FIR (P = .271) ndi TIR (P = .260) mutatha kukonza mafananidwe angapo (FIR, SIR, ndi TIR).

fMRI Analysis

Zotsatira Zazikulu za Ntchito (CS + vs CS-)

Pofufuza zomwe zimapangitsa kuti zinthu ziziyenda bwino (CS + vs CS-), zotsatira zaubongo wathunthu zikuwonetsa mayankho ku CS + kumanzere (x / y / z = -30 / -94 / -21; maximum z [zMax] = 5.16; kukonzedwa P [Pcorr] <.001) ndi kumanja (x / y / z = 27 / -88 / -1; zMax = 4.17; Pcorr <.001) ziphuphu za occipital. Kuphatikiza apo, kuwunika kwa ROI kunawonetsa kuyambitsa kwa CS + poyerekeza ndi CS- mu ventral striatum ndi occipital cortex ndi zochitika mu insula ndi OFC (Gulu 2), kuwonetsa kuti anthu onse omwe akukhala nawo akuyankhidwa bwino.

Gulu 2Kukhazikitsidwa Kwathunthu ndi Kafukufuku wa Ma Peak Voxels a Main Effect of Stimulus and Group Diffices for the CS + vs CS- (region-of-interest analysis)*

Kusanthula gulu

kapangidwe

mbali

k

x

y

z

Maximum z

Ayimitsidwa P mtengo

Chofunika kwambiri cha zolimbikitsaVentral striatumL19-15-1-22.80.045
Occipital kortexL241-24-88-84.28<.001
Occipital kortexR23024-88-54.00.002
OFCR491241-22.70.081
InsulaL134-3617173.05.073
CSB ndi gulu lolamuliraAmygdalaR3915-10-143.29.012
Muzilamulira vs CSB gulu††

CSB = chizolowezi chogonana; k = kukula kwa masango; L = gawo lakumanzere; OFC = orbitof mbeleal kotekisi; R = gawo lakumanja.

*Chigawo chinali P <.05 (kukonzedwa molakwika m'mabanja; kukonza pang'ono kwakung'ono malinga ndi SPM8) Maofesi onse amaperekedwa ku Montreal Neurological Institute malo.

†Palibe zochitika zazikulu.

Kusiyana kwa Gulu (CS + vs CS-)

Ponena za kusiyana kwa magulu, mayesero awiri omwe sanagwiritse ntchito posonyeza kuti palibe kusiyana kwakukulu kwa ubongo koma adasonyeza kuwonjezeka kwa mayankho a gulu la CSB poyerekeza ndi gulu lolamulira mu amygdala (Pcorr = .012) kwa CS + vs CS- (Gulu 2 ndi chithunzi 2A), pamene gulu lolamulira silinasonyeze kuti likuwoneka bwino poyerekeza ndi gulu la CSB (Pcorr > .05 pakuyerekeza konse).

Chithunzi chazithunzi cha Chithunzi 2. Atsegula chithunzi chachikulu

Chithunzi 2

Gulu A liwonetsera machitidwe ochuluka omwe amachititsa kuti anthu azikhala ndi chilakolako chogonana poyerekeza ndi zovuta zotsutsana ndi CS + vs CS-. Zojambula za gulu la B zinachepetsa njira zogwirizanitsa mankhwala pakati pa ventral striatum ndi prefrontal cortex m'mitu yomwe ili ndi chizoloŵezi chogonana poyerekeza ndi zolamulira. Mtengo wazithunzi ukuwonetsera zamtengo wapatali pa kusiyana kwake.

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UCS vs osati UCS

Ponena za UCS vs osakhala UCS, kusiyana kwa magulu kunayesedwa pogwiritsa ntchito mayeso awiri. Palibe kusiyana komwe kunali pakati pa magulu chifukwa cha kusiyana kumeneku, kusonyeza kuti kusiyana kwa CRs sikudalira kusiyana kwa mayankho osavomerezeka.

Kulankhulana kwa Psychophysiologic

Kuphatikiza pa zotsatira zokhutiritsa, tidagwiritsa ntchito PPI kuti tiwone kulumikizana pakati pa ventral striatum, amygdala, ndi vmPFC. PPI imazindikira maubongo ophatikizidwa ndi mbewu ya ROI m'njira yodalira ntchito. Vralral striatum ndi amygdala zidagwiritsidwa ntchito ngati zigawo za mbewu chifukwa malowa amalumikizidwa ndikuwongolera kwamalingaliro ndikuwongolera kusakhudzidwa. Zotsatira zaubongo wathunthu zidawonetsa kuchepa kwa kulumikizana pakati pa ventral striatum ngati gawo la mbewu ndi kumanzere koyambirira (x / y / z = -24 / 47/28; z = 4.33; Puncorr Zamgululi x / y / z = -0001 / 12 / -32; z = 8; Puncorr <.0001), lateral right, and prefrontal (x / y / z = 57 / -28 / 40; z = 4.33; Puncorr Zamgululi x / y / z = -0001 / 12 / -32; z = 8; Puncorr <.0001) ma cortices mu CSB vs gulu lolamulira. Kusanthula kwa ROI kwa vmPFC kunawonetsa kuchepa kwamalumikizidwe pakati pa ventral striatum ndi vmPFC m'maphunziro omwe ali ndi CSB poyerekeza ndi zowongolera (x / y / z = 15/41 / -17; z = 3.62; Pcorr <.05; Gulu 3 ndi chithunzi 2B). Palibe kusiyana kwa magulu ku amygdala-prefrontal kuphatikiza anapezeka.

Gulu 3 Kukhazikika Kwapadziko Lonse ndi Kafukufuku wa Peak Voxels for Psychophysiologic Interaction (dera lachigawo: ventral striatum) la Gulu Losiyana (kusanthula kwachigawo)*

Kusanthula gulu

Kugonana

mbali

k

x

y

z

Maximum z

Ayimitsidwa P mtengo

CSB ndi gulu lolamulira††
Muzilamulira vs CSB guluvmPFCR1371541-173.62.029

CSB = chizolowezi chogonana; k = kukula kwa masango; R = gawo lakumanja; vmPFC = kotsekemera koyambirira kwamkati.

*Chigawo chinali P <.05 (kukonzedwa molakwika m'mabanja; kukonza pang'ono kwakung'ono malinga ndi SPM8) Maofesi onse amaperekedwa ku Montreal Neurological Institute malo.

†Palibe zochitika zazikulu.

Kukambirana

Zakale zam'mbuyomu zatsimikizira kuti chikhalidwe chachisokonezo ndicho njira yofunikira yopititsira patsogolo ndikukonzekera khalidwe lomwe likuyandikira ndi matenda okhudzana ndi matenda a maganizo.16 Choncho, cholinga cha phunziro lino ndi kufufuza za neural correlates zokhutiritsa zovuta mu nkhani ndi CSB poyerekeza ndi gulu lolamulira ndikuzindikira kusiyana komwe kumagwirizanitsa ndi ventral striatum ndi amygdala ndi vmPFC. Ponena za zotsatira zazikulu zokhudzana ndi chilakolako chachisokonezo, tinapeza ma SCR, kuchuluka kwa ziwerengero, komanso magazi okhudzana ndi mpweya wa oxygen, mayendedwe a ventral striatum, OFC, occipital cortex, ndi insula ku CS + vs CS-, zomwe zikusonyeza kuti zonsezi zimapindulitsa kwambiri .

Ponena za kusiyana kwa magulu, maphunziro a CSB anasonyeza kuwonjezereka kwa mayankho a CS + vs CS- mu amygdala poyerekeza ndi machitidwe. Zomwe akupezazi zikugwirizana ndi kafukufuku wam'mbuyo watsopano umene wasonyeza kuti amygdala ntchito yowonjezera imakhala ikuwonjezeka kwa odwala omwe ali ndi vuto lakumwa poyerekeza ndi kulamulira37 ndi matenda ena a maganizo, omwe akukambidwa mu nkhani ya CSB. Chochititsa chidwi, kufotokozera meta kunaperekanso umboni wakuti amygdala angakhale ndi gawo lalikulu lokhumba odwala.37 Kuonjezera apo, amygdala ndi chizindikiro chofunika kwambiri chothandizira kuunika kwaphunziro.16 Choncho, kuwona kuti kuwonjezeka kwa amygdala reactivity kungatanthauzidwe kuti ndi mgwirizano wa njira yowunikira, yomwe imapangitsa kuti poyamba asamalowerere m'ndandanda (CS +) kuti ayambe kukwiyitsa makhalidwe omwe ali ndi CSB. Malinga ndi lingaliro limeneli, kuwonjezeka kwa amygdala reactivity kunanenedwa kukhala chinthu chochidalira mu matenda ambiri okhudza mankhwala osokoneza bongo ndi osagwirizana ndi mankhwala.56 Choncho, wina angaganize kuti kuwonjezeka kwa amygdala kuchitapo kanthu panthawi yachisokonezo kungakhale kofunikira pa chitukuko ndi kusamalira CSB.

Komanso, zotsatira zamakono zimalola zoganiza za ntchito zosiyanasiyana za amygdala mu mantha ndi chikhalidwe chachisokonezo. Timaganiza kuti ntchito yosiyana ya amygdala mu mantha ndi chikhalidwe chokhutira zikhoza kukhala chifukwa cha kukhudzidwa kwake ku CRs zosiyana. Mwachitsanzo, kuwonjezeka kwa msangwiro wamakono ndi imodzi mwa CRs nthawi yambiri poopa mantha ndipo imayimira pakati pa amygdala. Choncho, kuyambitsa amygdala ndiko kupeza kwakukulu pa nthawi ya mantha ndi amygdala zilonda zomwe zimapangitsa kuti ziwonongeke za chikhalidwe choyambira chimakhala ndi mantha.57 Mosiyana ndi zimenezi, startle amplitudes yacheperapo panthawi yachisokonezo, ndipo mayankho ena monga chiwerewere (omwe sagwirizane ndi amygdala) amawoneka kuti ndi oyenera kwambiri pa chiwerewere.58 Kuwonjezera pamenepo, amygdala nthano zosiyanasiyana zimakhala ndi mantha komanso zokhudzana ndi chilakolako chachisokonezo ndipo potero zimatha kugwira ntchito zosiyanasiyana kuti zisawonongeke ndi mantha.16

Komanso, tapeza kuchepa kwa mgwirizano pakati pa ventral striatum ndi vmPFC mu maphunziro omwe ali ndi CSB poyerekeza ndi gulu lolamulira. Kuphatikizana kosagwirizana pakati pa ventral striatum ndi madera oyandikana nawo adanenedwa pambali ya kukhumudwa kwa mankhwala, matenda osokoneza bongo, ndi kulamulira kutengeka kwa thupi ndipo zakhala zikuwonetsedwa mukutchova njuga.43, 59, 60, 61 Kafukufuku wambiri wanena kuti njira zopangidwira zogwiritsira ntchito zingakhale zofanana za kuwonongeka kwa kulepheretsa ndi kuyendetsa galimoto.41, 43 Choncho, kuchepetsedwa kwa mgwirizano kungasonyeze njira zowonongeka zopanda mphamvu, zomwe zikugwirizana bwino ndi zotsatira zapitazo zomwe zikuwonetseratu kugwirizana kwa odwala omwe ali ndi vuto loletsa kuletsa.62

Tinawona kusiyana kwakukulu pakati pa CS + ndi CS- mwaziwerengero zenizeni komanso mu SCRs m'magulu awiriwa, zomwe zikusonyeza kuti zinthu zikuyendera bwino, koma palibe kusiyana pakati pa magulu awiriwa. Izi zikugwirizana ndi maphunziro ena omwe amavomereza kuti ali ovomerezeka monga chiwerengero chodalirika cha zotsatira zowonongeka (mwachitsanzo, kusiyana kwakukulu pakati pa CS + ndi CS-), koma osati kuti azindikire kusiyana kwa magulu mu chikhalidwe. Mwachitsanzo, palibe kusiyana kwa gulu komwe kunapezeka mndandanda wa malemba ndi SCRs panthawi yovuta22, 23, 24 kapena zotsutsa48, 53, 54, 63, 64, 65 Kuwongolera pakati pa magulu osiyanasiyana, pamene kusiyana kwa magulu kunkawoneka mu machitidwe ena monga kuwonongeka kapena mayankho okhudzana ndi mlingo wa oxygen.22, 23, 24, 63 Zowoneka kuti, kuchuluka kwa chiwerengero sikumangokhala chizindikiro chokwanira cha kusiyana kwa magulu komanso kumawoneka kuti sichikukhudzidwa ndi njira zambiri zoyesera, monga kutayika kapena kutseka.66, 67 Tinawona zotsatira zofananazo mu SCRs, ndi kusiyana kwakukulu pakati pa CS + ndi CS- koma palibe zokhudzana ndi gulu. Zotsatirazi zikuthandizira lingaliro lakuti ziwerengero zovomerezeka ndi SCR zingakhale ngati zizindikiro zosamalitsa zowonongeka, pamene ziyeso zina zimawoneka bwinoko pakuwonetsera kusiyana kwake. Kufotokozera kumodzi kungakhale kuti mawerengedwe ndi ma SCR amalandira amygdala-odziimira okha (mwachitsanzo, cortical kapena ACC) malo am'maganizo kusiyana ndi machitidwe oyanjanitsa monga machitidwe a zisokonezo, omwe amadziwika kwambiri ndi mayankho a amygdala.68 Mwachitsanzo, tawonetsedwa kuti SCRs yokhazikika, koma osati mayendedwe oyambira, amawoneka kwa odwala omwe ali ndi zilonda za amygdala.69 Kafukufuku wamtsogolo ayenera kufufuza njira zomwe zingayambitse kusokoneza kayendedwe kabwino ka zowonongeka mwatsatanetsatane ndipo ziyenera kuphatikizapo kukula kwake kwayang'anani ngati chiyeso chofunikira poyesa kusiyana kwa gulu.

Kuphatikiza apo, zingakhale zosangalatsa kuyerekeza ndi neural correlates ya maphunziro ndi CSB ndi gulu lolamulira lomwe likuwonetsetsa kutentha kwa SEM koma palibe khalidwe lopanda ntchito. Njirayi ingakuthandizeni kumvetsetsa bwino zotsatira za kuwonjezeka kwa SEM momwe mukugwiritsira ntchito njira zamakono za SEM.

sitingathe

Zina zoperewera zimayenera kuganiziridwa. Sitinapeze kusiyana kwa ventral striatum pakati pa magulu awiriwa. Kufotokozera kokha kwa izi kungakhale kuti zotsatira za padothi zikanalepheretsa kusiyana kwa gulu. Kafukufuku wambiri wanena kuti kugonana kungayambitse kupititsa patsogolo kwa dopaminergic kuposa zowonjezera zokondweretsa.1, 58, 70 Komanso, ziyenera kudziwika kuti vmPFC si dera lofotokozedwa bwino ndipo ikhoza kukhala ndi magawo osagwirizana omwe amagwira ntchito zosiyanasiyana. Mwachitsanzo, gulu la vmPFC lothandizira pa maphunziro ena ndilolumikiza kwambiri komanso lachilendo ku zotsatira zathu.43 Choncho, kupeza komweku kungathe kusonyeza njira zingapo chifukwa vmPFC ikugwira ntchito zosiyanasiyana monga kusamala kapena kupindula.

Kutsiliza ndi Zotsatira

Mwachidziwitso, ntchitoyi inachulukitsa ntchito ya amygdala ndipo kugwirizanitsa kwapakati pa PFC kumaphatikizapo mfundo zokhudzana ndi chikhalidwe cha Etiology ndi chithandizo cha CSB. Anthu omwe ali ndi CSB amawoneka kuti amatha kukhala ndi mayanjano pakati pa machitidwe osalowerera ndale komanso zolimbikitsa zachilengedwe. Choncho, nkhanizi zikhoza kukumana ndi zomwe zimayambitsa khalidwe loyandikira. Kaya izi zikutsogolera CSB kapena zotsatira za CSB ziyenera kuyankhidwa ndi kufufuza kobwerako. Kuonjezera apo, njira zolepheretsa malamulo, zomwe zimasonyezedwa ndi kugwirizanitsa kwazomwe zikuchitika, zimathandizira kukonzanso khalidwe lovuta. Ponena za zovuta zachipatala, tapeza kusiyana kwakukulu mu njira zophunzirira ndi kuchepetsa kugwirizana pakati pa ventral striatum ndi vmPFC. Kuwongolera njira zophunzirira zokhutiritsa kuphatikiza ndi malamulo osokoneza maganizo omwe angapangitse kuti asamapangidwe bwino. Malinga ndi lingaliro limeneli, zotsatira zaposachedwapa zakhala zikusonyeza kuti kusintha komwe kuli kusintha kwa PFC kungachititse kuti anthu ayambe kubwerera m'mbuyo.71 Izi zitha kuwonetsa kuti chithandizo chomwe chimayang'ana kwambiri pamalamulo amomwemo chitha kukhala chothandiza kwa CSB. Umboni wotsimikizira izi wawonetsa kuti chithandizo chazidziwitso, chomwe chimakhazikitsidwa ndi njira zophunzirira izi, ndi njira yothandiza pamavuto ambiri.72 Zotsatirazi zikuthandizira kumvetsetsa bwino njira zowonongeka za CSB ndikuwonetseratu zotsatira zothandizira.

Ndondomeko yolemba

Category 1

  • (a)

Mimba ndi Kulengedwa

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Rudolf Stark
  • (b)

Kupeza kwa Deta

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek
  • (c)

Kufufuza ndi Kutanthauzira kwa Data

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Onno Kruse; Rudolf Stark

Category 2

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Kusindikiza Chigamulo

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Onno Kruse; Rudolf Stark
  • (b)

Kuwukonzanso Iwo kwa Zapangidwe Zamaganizo

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Onno Kruse; Rudolf Stark

Category 3

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Kuvomerezedwa Kwachidule kwa Nkhani Yomalizidwa

  • Tim Klucken; Sina Wehrum-Osinsky; Jan Schweckendiek; Onno Kruse; Rudolf Stark

Zothandizira

Zothandizira

  1. Georgiadis, JR, Kringelbach, ML Kusintha kwa kugonana kwaumunthu: Umboni woganizira ubongo wogwirizanitsa kugonana ndi zosangalatsa zina. Prog Neurobiol. 2012;98:49-81.
  2. Karama, S., Lecours, AR, Leroux, J. et al, Makhalidwe opanga ubongo pakati pa amuna ndi akazi poona mafilimu owonetseratu zolaula. Hum Brain Mapp. 2002;16:1-13.
  3. Kagerer, S., Klucken, T., Wehrum, S. et al, Neural ikuyambitsa kukakamiza kugonana kwa amuna kapena akazi okhaokha komanso amuna kapena akazi okhaokha. J Kugonana Med. 2011;8:3132-3143.
  4. Kagerer, S., Wehrum, S., Klucken, T. et al, Kugonana kumakopa: kufufuzira kusiyana komwe kumagwirizana ndi zofuna za kugonana. PLoS One. 2014;9:e107795.
  5. Kühn, S., Gallinat, J. Kusanthula meta kambiri pazomwe zimapangitsa amuna kuti azigonana. J Kugonana Med. 2011;8:2269-2275.
  6. Wehrum, S., Klucken, T., Kagerer, S. et al, Kugonana pakati pa amuna ndi akazi komanso kusiyana pakati pa kugonana kwachithunzithunzi chogonana. J Kugonana Med. 2013;10:1328-1342.
  7. Wehrum-Osinsky, S., Klucken, T., Kagerer, S. et al, Pachilendo chachiwiri: kukhazikika kwa maonekedwe a mitsempha kumayang'ana zolaula. J Kugonana Med. 2014;11:2720-2737.
  8. Buchuk, D. UK online nan nan: kuwunika pa intaneti pazakuonera zolaula ku Britain. ; 2013 (Ipezeka pa:)
    http://blog.similarweb.com/uk-online-porn-ban-web-traffic-analysis-of-britains-porn-affair/

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Kulimbana: Olembawo amafotokoza kuti palibe zosokoneza.

Ngongole: Phunziroli linalandizidwa ndi German Research Foundation (STA 475 / 11-1)