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

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NDEMANGA: Mu kafukufukuyu, monga momwe zilili ndi ena, dzina lakuti "Compulsive Sexual Behaviors" (CSB) mwina limatanthauza kuti amunawo anali okonda zolaula. Ndikunena izi chifukwa anthu omwe anali mu CSB anali kugwiritsa ntchito zolaula pafupifupi maola 20 pa sabata. Anthu omwe anali mu CSB anali kugwiritsa ntchito zolaula pafupifupi mphindi 29 pa sabata. Chochititsa chidwi n'chakuti, anthu atatu mwa anthu 20 a CSB anali ndi "vuto la orgasmic-erection disorder," pomwe palibe amene anali mu CSB amene ananena kuti anali ndi mavuto okhudzana ndi kugonana.

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

Malinga ndi ofufuza, kusintha koyamba - kuwonjezeka kwa mphamvu ya amygdala - kungasonyeze kusintha kwabwino (kulumikizana kwakukulu ndi zizindikiro zomwe zinalibe mbali zomwe zimaneneratu zithunzi zolaula). Kusintha kwachiwiri - kuchepa kwa kulumikizana pakati pa ventral striatum ndi prefrontal cortex - kungakhale chizindikiro cha kulephera kulamulira zilakolako. Ofufuzawo anati, " [Kusinthaku] kukugwirizana ndi maphunziro ena ofufuza za ma neuron correlates a matenda osokoneza bongo ndi kulephera kwa mphamvu zowongolera zilakolako ." Zomwe zapezeka za kuyambitsa mphamvu ya amygdalar ku zizindikiro ( sensitization ) ndi kuchepa kwa kulumikizana pakati pa malo opatsa mphotho ndi prefrontal cortex ( hypofrontality ) ndi ziwiri mwa kusintha kwakukulu kwa ubongo komwe kumawoneka mu chizolowezi cha mankhwala osokoneza bongo.

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 , Kukonza , Kumva Chisoni , Zabwino , Mphotho , Chilakolako Chogonana

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

Mpaka pano, maphunziro awiri okha a functional magnetic resonance imaging (fMRI) ndi omwe afufuza za ma neural correlates a CSB ndipo apeza kuti ma activation akuwonjezeka mu amygdala ndi ventral striatum komanso kusintha kwa kulumikizana kwa mitsempha mwa anthu omwe ali ndi CSB panthawi yowonetsa zizindikiro zokhudzana (zogonana). 35 , 36 Mapangidwe awa akugwirizana ndi maphunziro ena omwe amafufuza ma neural correlates a matenda osokoneza bongo ndi kulephera kwa kulamulira kwa impulse. 37 , 38 Mwachitsanzo, zomwe zapezeka m'ma meta-analytical zawonetsa mgwirizano wofunikira pakati pa kuyambitsa kwa amygdala ndi mphamvu ya chilakolako. 37 Kafukufuku wina yemwe adagwiritsa ntchito kujambula kwa diffusion tensor adapeza kuti kuchuluka kwa umphumphu wa white matter microstructure m'malo a prefrontal mwa anthu omwe ali ndi CSB ndi mgwirizano woipa pakati pa CSB ndi kulumikizana kwa kapangidwe kake mu frontal lobe. 39

Kuwonjezera pa kufunika kwa njira zolimbitsa chilakolako cha chakudya, zovuta pakuletsa khalidwe losalamulirika ndizofunikira kwambiri pakukula ndi kusunga matenda ambiri amisala ndi machitidwe osagwira ntchito. 40 , 41 Mavuto awa okhudzana ndi kuletsa amatha kufotokoza kutayika kwa ulamuliro wa anthu omwe ali ndi CSB akakumana ndi zizindikiro zina. Ponena za ma neural correlates a khalidwe losalamulirika ndi malamulo ake, ventral striatum ndi ventromedial prefrontal cortex (vmPFC) zikuwoneka kuti ndi otsutsa ofunikira: ventral striatum imaganiziridwa kuti ndi yofunikira poyambitsa khalidwe losalamulirika, pomwe kuchepetsa kwake kumayendetsedwa ndi vmPFC kudzera mu kulumikizana kobwerezabwereza. 42 Mwachitsanzo, zotsatira zam'mbuyomu zagwirizanitsa kusokonezeka kwa ventral striatal ndi prefrontal connectivity ndi khalidwe losalamulirika komanso khalidwe losalamulirika. 42 , 43

Komabe, palibe kafukufuku amene wafufuza za kugwirizana kwa mitsempha ya njira zophunzirira chilakolako kapena kutayika kwa ulamuliro mwa anthu omwe ali ndi CSB poyerekeza ndi anthu omwe ali ndi thanzi labwino. Kutengera ndi mabuku omwe atchulidwa kale, cholinga choyamba cha phunziroli chinali kufufuza mayankho a hemodynamic a chilakolako cha chilakolako m'maphunzirowa poyerekeza ndi gulu lolamulira lofanana. Tinaganiza kuti kuwonjezeka kwa mphamvu mu amygdala ndi ventral striatum mwa anthu omwe ali ndi CSB poyerekeza ndi gulu lolamulira. Cholinga chachiwiri chinali kufufuza kusiyana kwa kulumikizana pakati pa magulu awiriwa. Kuzindikira gawo la mitsempha ya kusintha kwa chilakolako cha chilakolako ndi kulumikizana m'maphunzirowa sikungakhale ndi tanthauzo lokha pakumvetsetsa chitukuko ndi kusunga khalidweli komanso njira zochiritsira, zomwe nthawi zambiri zimayang'ana kwambiri kusintha kwa khalidwe kudzera muzokumana nazo zophunzirira zosinthidwa (monga, chithandizo cha khalidwe la chidziwitso). 44

Njira

ophunzira

Amuna makumi awiri omwe ali ndi CSB ndi olamulira 20 ofanana adasankhidwa mwa kudzitumiza okha pambuyo pa malonda ndi kutumiza kuchipatala chakunja kwa odwala kuti akalandire chithandizo chamaganizo ( Table 1 ). Ophunzira onse anali ndi masomphenya abwinobwino kapena okonzedwa kukhala abwinobwino ndipo adasaina chilolezo chodziwitsidwa. Kafukufukuyu adachitika motsatira Chikalata cha Helsinki. Ophunzira onse adachita nawo zokambirana zachipatala kuti adziwe matenda a Axis I ndi/kapena Axis II. Ophunzira omwe adalembedwa kuti ali ndi CSB adayenera kukwaniritsa zofunikira zonse za hypersexuality zomwe zidasinthidwa kuti zigwiritsidwe ntchito ndi CSB 13 :

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

Gome 1Miyeso ya Anthu ndi Zamaganizo a CSB ndi Magulu Olamulira *

Gulu la CSB

Gulu lolamulira

Statistics
Age 34.2 (8.6) 34.9 (9.7) m = 0.23, P = .825
BDI-II 12.3 (9.1) 7.8 (9.9) m = 1.52, P = .136
Nthawi yogwiritsira ntchito nthawi SEM, min / wk 1,187 (806) 29 (26) m = 5.53, P <.001

Chisokonezo Ndikusokonezeka
 Gawo la MD 4 1
 Matenda a MD omwe amapezeka 4
 Chikhalidwe cha anthu 1
 Matenda osintha 1
 Phobia wapadera 1 1
 Matenda osokoneza thupi 3
 Matenda a Somatoform 1

Matenda a Axis II
 Matenda a Narcissistic 1

Mankhwala opatsirana
 Amitriptyline 1

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

* Deta imaperekedwa ngati yapakati (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.

Mayeso onse adaperekedwa mwadongosolo losasinthika: CS yomweyi sinaperekedwe motsatizana kawiri. CS ziwirizi zidaperekedwa mofanana nthawi zambiri mu theka loyamba ndi lachiwiri la kugula. Mayeso awiri oyamba (kuyesa limodzi la CS+, kuyesa limodzi la CS−) sanaphatikizidwe mu kusanthula chifukwa kuphunzira sikunachitike, zomwe zidapangitsa kuti pakhale mayeso 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

Ma SCR adayesedwa pogwiritsa ntchito ma electrode a Ag-AgCl odzazidwa ndi isotonic (NaCl 0.05 mol/L) electrolyte medium omwe adayikidwa ku dzanja lamanzere losalamulirika. SCR idafotokozedwa ngati yankho limodzi la phasic pambuyo pa kuyambitsa kwa stimulus. Chifukwa chake, kusiyana kwakukulu pakati pa kucheperako ndi kupitirira apo mkati mwa masekondi 1 mpaka 4 pambuyo pa kuyamba kwa CS kudafotokozedwa ngati yankho loyamba la interval (FIR), kuti mkati mwa masekondi 4 mpaka 8 ngati yankho lachiwiri la interval (SIR), ndi kuti mkati mwa masekondi 9 mpaka 12 ngati yankho lachitatu la interval (TIR). Mayankho omwe ali mkati mwa mawindo owunikira adachotsedwa pogwiritsa ntchito Ledalab 3.4.4. 46 Mayankho awa ndi log (μS + 1) osinthidwa kukhala olondola chifukwa cha kuphwanya kugawa kwabwinobwino kwa deta. Anthu asanu (atatu omwe ali ndi CSB ndi zowongolera ziwiri) sanawonetse ma SCR aliwonse (palibe mayankho owonjezeka ku UCS) ndipo adachotsedwa mu kusanthula. Ma SCR apakati adawunikidwa ndi ANOVA mu kapangidwe ka 2 (mtundu wa CS: CS+ vs CS−) × 2 (gulu: CSB vs gulu lolamulira) kutsatiridwa ndi mayeso a post hoc 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.

Pa mlingo woyamba, kusiyana kotsatiraku kunasanthulidwa pa mutu uliwonse: CS+, CS−, UCS, ndi non-UCS (yomwe imafotokozedwa ngati nthawi yowonekera pambuyo pa CS− yofanana ndi nthawi yowonekera ya UCS pambuyo pa CS+ 47 , 48 , 49 ). Ntchito ya ndodo inasankhidwa pa regressor iliyonse. Regressor iliyonse inali yosiyana ndi zina, sinaphatikizepo kusiyana komwe kwagawidwa (cosine angle < 0.20), ndipo idalumikizidwa ndi ntchito ya hemodynamic response. Ma parameter asanu ndi limodzi a kusintha kwa thupi kolimba komwe kunapezedwa ndi njira yosinthira adayambitsidwa ngati ma covariate mu chitsanzo. Mndandanda wa nthawi wozikidwa pa voxel unasefedwa ndi fyuluta yodutsa kwambiri (nthawi yokhazikika = masekondi 128). Kusiyana kwa chidwi (CS+ vs CS−; CS− vs CS+; UCS vs non-UCS; non-UCS vs UCS) kunafotokozedwa pa mutu uliwonse padera.

Pa kusanthula kwa gawo lachiwiri, mayeso a t-chitsanzo chimodzi ndi ziwiri adachitika kuti afufuze zotsatira zazikulu za ntchito (CS+ vs CS−; UCS vs non-UCS) ndi kusiyana pakati pa magulu. Kukonza ziwerengero za kusanthula kwa dera la chidwi (ROI) kunachitika ndi malire a P = .05 (osakonzedwa), k = 5, ndi malire a kufunika ( P = .05; kukonzedwa chifukwa cha zolakwika za m'banja, k = 5), ndipo kusanthula kwa ubongo wonse kunachitika ndi malire pa P = .001 ndi k > 10 voxels. Kusanthula konse kunawerengedwa ndi SPM8.

Ngakhale kuti palibe kusiyana kwa magulu mu ziwerengero za UCS ndi ziwerengero za BDI komwe kunawonedwa, tinachita kafukufuku wina kuphatikizapo ziwerengero za UCS ndi ziwerengero za BDI monga covariates kuti tifotokoze zotsatira zomwe zingasokoneze zomwe UCS anakumana nazo komanso momwe zimakhalira. Zotsatira zake zinakhalabe zokhazikika (palibe kusiyana kwina kwa magulu; kusiyana kwa magulu komwe kunanenedwa kunakhalabe kwakukulu). Ma masks a anatomic a kusanthula kwa ROI kwa amygdala (2,370 mm 3 ), insula (10,908 mm 3 ), occipital cortex (39,366 mm 3 ), ndi OFC (10,773 mm 3 ) adatengedwa kuchokera ku Harvard-Oxford Cortical and Subcortical Structural Atlases ( http://fsl.fmrib.ox.ac.uk/fsl/fslwiki/Atlases ) (25% mwayi) woperekedwa ndi Harvard Center for Morphometric Analysis ndi ventral striatum mask (3,510 mm 3 ) kuchokera ku database ya Human Brain Project Repository kutengera database ya BrainMap. Buku la Harvard-Oxford ndi buku la Harvard-Oxford lomwe limafotokoza za anthu 37 athanzi omwe ali ndi zithunzi zolemera T1 (N = akazi 16). Chigoba cha vmPFC (11,124 mm 3 ) chinapangidwa ndi MARINA 50 ndipo chagwiritsidwa ntchito m'maphunziro ambiri am'mbuyomu. 51 , 52 , 53 , 54

Psychophysiologic Interaction Analysis

Kusanthula kwa Psychophysiologic interaction (PPI), 55 komwe kumafufuza kusintha kwa kulumikizana pakati pa dera la mbewu ndi madera ena a ubongo pogwiritsa ntchito ntchito yoyesera, yotchedwa psychological variable (CS+ vs CS−), idachitika. Madera a mbewu, ventral striatum ndi amygdala, adafotokozedwa kale m'mayeso awiri osiyana kutengera ma ROI omwe adagwiritsidwa ntchito (onani pamwambapa). Mu gawo loyamba, tidatulutsa eigenvariate yoyamba ya dera lililonse la mbewu monga momwe idakhazikitsidwira mu SPM8. Kenako, mawu olumikizirana adapangidwa pochulukitsa eigenvariate ndi psychological variable (CS+ vs CS−) ya munthu aliyense ndikuyigwirizanitsa ndi ntchito yoyankha ya haemodynamic. Kusanthula kwa gawo loyamba kunachitika pa munthu aliyense kuphatikiza mawu olumikizirana ngati regressor of interest (PPI regressor) ndi eigenvariate komanso task regressor ngati nuisance regressors. 55 Pa mlingo wachiwiri, tidasanthula kusiyana kwa magulu mu kulumikizana (PPI regressor) pakati pa gulu la CSB ndi gulu lolamulira pogwiritsa ntchito mayeso awiri a t-tests ndi vmPFC ngati ROI. Kusintha kwa ziwerengero kunali kofanana ndi kusanthula kwa fMRI komwe kunachitika kale.

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.

Onani Chithunzi Chachikulu | Tsitsani Slide ya PowerPoint

Mayankho a Makhalidwe a Khungu

ANOVA inawonetsa zotsatira zazikulu za mtundu wa CS mu FIR (F 1 ,33 = 4.58; P < .05) ndi TIR (F 1 ,33 = 9.70; P < .01) ndi chizolowezi mu SIR (F 1 ,33 = 3.47; P = .072) chowonetsa ma SCR owonjezeka ku CS+ ndi ku UCS, motsatana, poyerekeza ndi CS−. Palibe zotsatira zazikulu za gulu zomwe zidachitika mu FIR ( P = .610), SIR ( P = .698), kapena TIR ( P = .698). Kuphatikiza apo, palibe zotsatira za kuyanjana kwa mtundu wa CS × gulu zomwe zidapezeka mu FIR ( P = .271) ndi TIR ( P = .260) pambuyo pokonza kufananiza kosiyanasiyana (FIR, SIR, ndi TIR).

fMRI Analysis

Zotsatira Zazikulu za Ntchito (CS + vs CS-)

Pofufuza zotsatira zazikulu za conditioning (CS+ vs CS−), zotsatira za ubongo wonse zinawonetsa mayankho owonjezereka ku CS+ kumanzere (x/y/z = −30/−94/−21; maximum z [z max ] = 5.16; corrected P [ P corr ] <.001) ndi kumanja (x/y/z = 27/−88/−1; z max = 4.17; P corr <.001) occipital cortices. Kuphatikiza apo, kusanthula kwa ROI kunawonetsa kuwonjezeka kwa activation ku CS+ poyerekeza ndi CS− mu ventral striatum ndi occipital cortex ndi zomwe zikuchitika mu insula ndi OFC ( Table 2 ), zomwe zikusonyeza kuti mayankho a hemodynamic adakonzedwa bwino kwa onse omwe akutenga nawo mbali.

Gome 2 Kufotokozera ndi Ziwerengero za Ma Voxels Otchuka Kwambiri pa Zotsatira Zazikulu za Kulimbikitsa ndi Kusiyana kwa Magulu pa Kusiyana kwa CS+ vs CS- (kusanthula kwa chigawo cha chidwi) *

Kusanthula gulu

kapangidwe

mbali

k

x

y

z

Maximum z

Mtengo wa P wokonzedwa
Chofunika kwambiri cha zolimbikitsa Ventral striatum L 19 -15 -1 -2 2.80 .045
Occipital kortex L 241 -24 -88 -8 4.28 <.001
Occipital kortex R 230 24 -88 -5 4.00 .002
OFC R 49 12 41 -2 2.70 .081
Insula L 134 -36 17 17 3.05 .073
CSB ndi gulu lolamulira Amygdala R 39 15 -10 -14 3.29 .012
Muzilamulira vs CSB gulu††

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

* Malire anali P < .05 (yokonzedwa chifukwa cha cholakwika cha banja; kukonza pang'ono malinga ndi SPM8). Ma coordinates onse aperekedwa mu Montreal Neurological Institute.

† Palibe kuyambitsa kwakukulu.

Kusiyana kwa Gulu (CS + vs CS-)

Ponena za kusiyana kwa magulu, mayeso awiri a t-sample sasonyeza kusiyana kulikonse mu kusanthula kwa ubongo wonse koma adawonetsa mayankho owonjezereka a hemodynamic mu gulu la CSB poyerekeza ndi gulu lolamulira mu amygdala yolondola ( P corr = .012) ya CS+ vs CS− ( Table 2 ndi Chithunzi 2 A), pomwe gulu lolamulira silinawonetse kuyambitsidwa kwakukulu poyerekeza ndi gulu la CSB ( P corr > .05 pa kufananiza 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.

Onani Chithunzi Chachikulu | Tsitsani Slide ya PowerPoint

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

Kuwonjezera pa zotsatira za kulimbitsa chilakolako cha chakudya, tinagwiritsa ntchito PPI kuti tifufuze kulumikizana pakati pa ventral striatum, amygdala, ndi vmPFC. PPI imazindikira kapangidwe ka ubongo kogwirizana ndi ROI ya mbewu mwanjira yodalira ntchito. ventral striatum ndi amygdala zinagwiritsidwa ntchito ngati madera a mbewu chifukwa madera awa amagwirizanitsidwa ndi kulamulira malingaliro ndi kulamulira kusakhazikika. Zotsatira za ubongo wonse zinasonyeza kuchepa kwa mgwirizano pakati pa ventral striatum monga dera la mbewu ndi kumanzere kwa prefrontal (x/y/z = −24/47/28; z = 4.33; P uncorr < .0001; x/y/z = −12/32/−8; z = 4.13; P uncorr < .0001), kumanja kwa mbali, ndi kumanzere kwa mbali (x/y/z = 57/−28/40; z = 4.33; P uncorr < .0001; x/y/z = −12/32/−8; z = 4.18; P uncorr < .0001) ma cortices mu gulu la CSB vs control. Kusanthula kwa ROI kwa vmPFC kunawonetsa kuchepa kwa kulumikizana pakati pa ventral striatum ndi vmPFC m'maphunziro omwe ali ndi CSB poyerekeza ndi zowongolera (x/y/z = 15/41/−17; z = 3.62; P corr <.05; Gome 3 ndi Chithunzi 2 B). Palibe kusiyana kwa magulu mu amygdala-prefrontal coupling komwe kunapezeka.

Gome 3 Kukhazikika ndi Ziwerengero za Ma Voxels Ofunika Kwambiri pa Kuyanjana kwa Maganizo ndi Thupi (dera la mbewu: ventral striatum) ya Kusiyana kwa Magulu (kusanthula kwa dera la chidwi) *

Kusanthula gulu

Kugonana

mbali

k

x

y

z

Maximum z

Mtengo wa P wokonzedwa
CSB ndi gulu lolamulira††
Muzilamulira vs CSB gulu vmPFC R 137 15 41 -17 3.62 .029

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

* Malire anali P < .05 (yokonzedwa chifukwa cha cholakwika cha banja; kukonza pang'ono malinga ndi SPM8). Ma coordinates onse aperekedwa mu Montreal Neurological Institute.

† Palibe kuyambitsa kwakukulu.

Kukambirana

Malingaliro am'mbuyomu adanena kuti kusinthasintha kwa chilakolako ndi njira yofunika kwambiri yopangira ndi kusunga khalidwe loyandikira komanso matenda okhudzana ndi matenda amisala. 16 Chifukwa chake, cholinga cha phunziroli chinali kufufuza ma neural correlates a kusinthasintha kwa chilakolako m'maphunziro omwe ali ndi CSB poyerekeza ndi gulu lolamulira ndikupeza kusiyana komwe kungachitike pakulumikizana kwa ventral striatum ndi amygdala ndi vmPFC. Ponena za zotsatira zazikulu za kusinthasintha kwa chilakolako, tapeza ma SCR ochulukirapo, mavoti odziyimira pawokha, ndi mayankho odalira mpweya m'magazi mu ventral striatum, OFC, occipital cortex, ndi insula ku CS+ vs CS−, zomwe zikusonyeza kuti kusinthasintha kwa chilakolako kumapambana m'maphunziro onse.

Ponena za kusiyana kwa magulu, anthu omwe ali ndi CSB adawonetsa mayankho owonjezereka a hemodynamic a CS+ vs CS− mu amygdala poyerekeza ndi olamulira. Kupeza kumeneku kukugwirizana ndi kusanthula kwaposachedwa komwe kwawonetsa kuti kuyambitsa kwa amygdala nthawi zambiri kumawonjezeka mwa odwala omwe ali ndi vuto la chizolowezi choledzera poyerekeza ndi olamulira 37 komanso matenda ena amisala, omwe akukambidwa pankhani ya CSB. Chodabwitsa n'chakuti, kusanthula kwa meta kunaperekanso umboni wakuti amygdala ingakhale ndi gawo lofunika kwambiri pakulakalaka odwala. 37 Kuphatikiza apo, amygdala imapanga chizindikiro chofunikira chokhazikika cha chizindikiro chophunzirira. 16 Chifukwa chake, kuwonjezeka kwa amygdala reactivity komwe kwawonedwa kungatanthauzidwe ngati chogwirizana ndi njira yopezera yothandiza, yomwe imapangitsa kuti zinthu zomwe zinali kale zopanda ndale zikhale zizindikiro zomveka (CS+) kuti zipangitse mosavuta machitidwe a anthu omwe ali ndi CSB. Mogwirizana ndi lingaliro ili, kuwonjezeka kwa amygdala reactivity kwanenedwa kuti ndi chinthu chosungira matenda ambiri amisala okhudzana ndi mankhwala osokoneza bongo komanso osakhudzana ndi mankhwala osokoneza bongo. 56 Chifukwa chake, munthu angaganize kuti kuwonjezeka kwa amygdala activation panthawi yolimbitsa thupi kungakhale kofunikira pakukula ndi kusamalira CSB.

Komanso, zotsatira zomwe zilipo pano zimalola malingaliro okhudza ntchito zosiyanasiyana za amygdala mu mantha ndi mu chilakolako chofuna kudya. Tikuganiza kuti ntchito yosiyana ya amygdala mu mantha ndi chilakolako chofuna kudya ikhoza kukhala chifukwa cha kutenga nawo mbali mu ma CR osiyanasiyana. Mwachitsanzo, kuchuluka kwa startle amplitude ndi imodzi mwa ma CR ovomerezeka kwambiri panthawi ya mantha ndipo imayendetsedwa makamaka ndi amygdala. Chifukwa chake, kuyambitsa kwa amygdala ndikupeza kwamphamvu panthawi ya mantha ndipo zilonda za amygdala zimapangitsa kuti kusokonezeka kwa startle amplitude mu mantha kukhale koipa. 57 Mosiyana ndi zimenezi, startle amplitude imachepa panthawi ya chilakolako chofuna kudya, ndipo milingo ina yoyankhira monga mayankho a m'mimba (omwe sakhudzidwa kwambiri ndi amygdala) akuwoneka kuti ndi zizindikiro zoyenera kwambiri pa kugonana. 58 Kuphatikiza apo, ma nuclei osiyanasiyana a amygdala mwina amakhudzidwa kwambiri ndi mantha ndi chilakolako chofuna kudya ndipo motero amatha kugwiritsa ntchito njira zosiyanasiyana zochepetsera chilakolako chofuna kudya ndi mantha. 16

Komanso, tapeza kuchepa kwa mgwirizano pakati pa ventral striatum ndi vmPFC mwa anthu omwe ali ndi CSB poyerekeza ndi gulu lolamulira. Kusintha kwa mgwirizano pakati pa ventral striatum ndi madera a prefrontal kwanenedwa pankhani ya kuchepa kwa malingaliro, matenda osokoneza bongo, ndi kuwongolera kutengeka ndipo kwawonedwa mu kutchova juga kwa matenda. 43 , 59 , 60 , 61 Kafukufuku angapo wasonyeza kuti njira zolumikizirana zosagwira ntchito zitha kukhala chifukwa cha kulephera kwa kuletsa ndi kuwongolera kayendedwe ka thupi. 41 , 43 Chifukwa chake, kuchepa kwa kulumikizana kungawonetse njira zowongolera zosagwira ntchito, zomwe zikugwirizana bwino ndi zotsatira zam'mbuyomu zomwe zikuwonetsa kulumikizana kosinthika mwa odwala omwe ali ndi zovuta pakuletsa. 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

Zoletsa zina ziyenera kuganiziridwa. Sitinapeze kusiyana pakati pa magulu awiriwa. Kufotokozera kwina kwa izi kungakhale kuti zotsatira za denga zikanatha kuletsa kusiyana kwa magulu. Kafukufuku angapo adanenanso kuti zizindikiro zogonana zimatha kuyambitsa kufalikira kwa dopaminergic kuposa zolimbikitsa zina zabwino. 1 , 58 , 70 Komanso, ziyenera kudziwika kuti vmPFC si dera lodziwika bwino ndipo lingakhale ndi magawo osiyanasiyana omwe amagwira ntchito zosiyanasiyana zamaganizo. Mwachitsanzo, gulu loyambitsa vmPFC m'maphunziro ena lili kumbali komanso patsogolo pa zotsatira zathu. 43 Chifukwa chake, zomwe zapezeka pano zitha kuwonetsa njira zingapo chifukwa vmPFC imagwira ntchito zosiyanasiyana monga kusamala kapena kukonza mphotho.

Kutsiliza ndi Zotsatira

Kawirikawiri, kuchuluka kwa ntchito ya amygdala komwe kwawonedwa komanso kuchepa kwa mgwirizano wa ventral striatal-PFC kumalola malingaliro okhudza chifukwa chake ndi chithandizo cha CSB. Anthu omwe ali ndi CSB amawoneka kuti amakonda kukhazikitsa mgwirizano pakati pa zizindikiro zosalowererapo ndi zinthu zokhudzana ndi chilengedwe zokhudzana ndi kugonana. Chifukwa chake, anthuwa amatha kukumana ndi zizindikiro zomwe zimayambitsa khalidwe loyandikira. Kaya izi zikutsogolera ku CSB kapena ndi zotsatira za CSB ziyenera kuyankhidwa ndi kafukufuku wamtsogolo. Kuphatikiza apo, njira zowongolera zolakwika, zomwe zimawonekera mu kuchepa kwa mgwirizano wa ventral striatal-prefrontal, zitha kuthandizira kwambiri kusunga khalidwe lovuta. Ponena za zotsatira zachipatala, tapeza kusiyana kwakukulu mu njira zophunzirira ndi kuchepa kwa kulumikizana pakati pa ventral striatum ndi vmPFC. Njira zophunzirira zolimbitsa thupi pamodzi ndi malamulo osagwira ntchito amalingaliro zitha kulepheretsa chithandizo chopambana. Mogwirizana ndi lingaliro ili, zomwe zapezeka posachedwapa zanena kuti kusintha kwa mgwirizano wa ventral striatal-PFC kungawonjezere kwambiri mwayi wobwereranso. 71 Izi zitha kusonyeza kuti chithandizo chomwe chimayang'ana kwambiri malamulo amalingaliro chingakhalenso chothandiza pa CSB. Umboni wothandizira lingaliro ili wasonyeza kuti chithandizo cha machitidwe ozindikira, chomwe chimachokera ku njira izi zophunzirira ndi malamulo amalingaliro, ndi chithandizo chothandiza pa matenda ambiri. [72] Zomwe zapezekazi zimathandiza kumvetsetsa bwino njira zoyambira za CSB ndipo zikusonyeza zotsatira zomwe zingachitike pa chithandizo chake.

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

  • (a)

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

  • (a)

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.
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Kusamvana kwa Zosangalatsa: Olembawo sananene kuti palibe kusamvana kwa zokonda.

Ndalama: Kafukufukuyu adathandizidwa ndi German Research Foundation (STA 475/11-1)