Neural Correlates of Reactivity Cac Reactivity Mwa Anthu omwe ali ndi popanda popanda chilakolako chogonana (2014)

Ndemanga: Kafukufuku wa Voon yemwe wakhala akuyembekezeredwa kwa nthawi yayitali, womwe wafotokozedwa mu chikalata cha ku UK cha " Porn on the Brain ," watuluka pomaliza. Monga momwe amayembekezera, ofufuza a ku Cambridge University adapeza kuti ogwiritsa ntchito zolaula mopitirira muyeso amachitapo kanthu pa zizindikiro za zolaula mofanana ndi momwe anthu omwe amamwa mankhwala osokoneza bongo amachitira ndi zizindikiro za mankhwala osokoneza bongo. Koma pali zina zambiri.

Anthu ogwiritsa ntchito zolaula mopitirira muyeso ankalakalaka zolaula (chilakolako chachikulu), koma analibe chilakolako chachikulu chogonana kuposa zowongolera. Kupeza kumeneku kukugwirizana bwino ndi njira yamakono yogwiritsira ntchito chizolowezi, ndipo kumatsutsa chiphunzitso chakuti "chilakolako chachikulu chogonana " ndicho chikuyambitsa kugwiritsa ntchito zolaula mopitirira muyeso. Anthu omwe amamwa mankhwala osokoneza bongo amaganiziridwa kuti amakakamizika kufunafuna mankhwala awo chifukwa akufuna - m'malo mosangalala nawo. Njira yosazolowereka iyi imadziwika kuti chilimbikitso cha chilimbikitso . Ichi ndi chizindikiro cha matenda osokoneza bongo.

Chinthu china chachikulu chomwe chinapezeka (chosanenedwa m'manyuzipepala) chinali chakuti anthu oposa 50% (azaka zapakati: 25) anali ndi vuto lopeza chilakolako chogonana ndi anthu enieni, koma anali ndi mwayi wopeza chilakolako chogonana ndi zolaula. Kuchokera mu kafukufukuyu:

Anthu omwe ali mu CSB adanena kuti chifukwa chogwiritsa ntchito kwambiri zinthu zolaula….. adakumana ndi kuchepa kwa chilakolako cha kugonana kapena ntchito yogonana makamaka muubwenzi wakuthupi ndi akazi (ngakhale kuti sizikugwirizana ndi zinthu zolaula) (N = 11 )…

Poyerekeza ndi odzipereka omwe ali ndi thanzi labwino, maphunziro a CSB anali ndi chilakolako chachikulu chogonana kapena akufuna kufotokozera momveka bwino ndipo anali ndi chidwi chochulukirapo pazinthu zolimbitsa thupi, motero kusonyeza kusiyana pakati pa kufuna ndi kukonda. Zolinga za CSB zinakhalanso ndi zovuta zambiri zokhudzana ndi kugonana komanso zovuta za erectile mu maubwenzi apamtima koma osati ndi zida zogonana zomwe zikuwonetsa kuti chikhumbo chokhudzana ndi chilakolako chogonana chinali chodziwikiratu pazinthu zodziwika bwino ndipo sizinakwaniritse chilakolako cha kugonana.

Amuna ambiri omwe ali ndi CSB anali ndi zaka 25, koma anthu 11 mwa anthu 19 omwe anali ndi vuto la kugonana anali ndi vuto la kugonana/kuchepa kwa chilakolako cha kugonana ndi anzawo, koma osati ndi zolaula. Kusafuna kugonana kwenikweni ndi anzawo enieni, koma kukhala ndi malo opezera mphoto ambiri owonera zolaula, kumatsutsa kwathunthu "chilakolako chachikulu chogonana" ngati chifukwa chogwiritsa ntchito zolaula mokakamiza. Kuphatikiza apo, anthu omwe anali ndi CSB "sanakonde" makanema ogonana pang'ono kuposa kungowalamulira. Mphepete ina m'bokosi la chitsanzo cha "chilakolako chachikulu chogonana" cha chizolowezi chogonana.

Izi zimathandizira nkhani zokhudzana ndi chizoloŵezi chokhala ndi zizoloŵezi zokhudzana ndi zowonongeka zomwe zili ndi mapepala apamwamba omwe amapereka mphotho ku zolaula.

Chachiwiri, izi zimasokoneza malingaliro akuti ogwiritsa ntchito zolaula amangokhala ndi chilakolako chogonana kuposa omwe sachita zolaula. Kodi tikudziwa bwanji?

  1. Amuna khumi ndi atatu mwa anyamata a 19 anali ndi vuto lokwanira kukwatulidwa ndi wokondedwa weniweni, koma osati zolaula zomwe amakonda.
  2. Amuna omwe ali ndi CSB sanakhale ndi chilakolako chachikulu chogonana.

Pomaliza, ofufuza adapeza kuti achinyamata omwe ali ndi vuto la kutopa kwambiri akakhala ndi zizindikiro zolaula. Kuchuluka kwa dopamine komanso kukhudzidwa kwakukulu kwa mphotho ndi zinthu zazikulu zomwe zimapangitsa achinyamata kukhala pachiwopsezo chachikulu cha chizolowezi chogonana.

Zotsatira za kafukufuku wa ku Cambridge , ndi kafukufuku wa ku Germany wa mwezi watha ( Brain Structure and Functional Connectivity Associated With Pornography Consumption: The Brain on Porn. 2014 ), zimapereka chithandizo champhamvu kwambiri pa malingaliro omwe aperekedwa pano pa YBOP kuyambira pomwe idakhazikitsidwa mu 2011.

Pomwe maphunziro a 2 apeza:

  • Zosintha zazikulu za 3 zokhudzana ndi zosokoneza zomwe zafotokozedwa m'makanema ndi zolemba za YBOP: kulimbikitsa, deensitizationndipo chinyengo,
  • Osangokhalira kukonda zithunzi za kugonana (zofunikira zolimbikitsa kwambiri).
  • Achinyamata owonetsa zolaula amawunikira kwambiri zomwe zimapangitsa kuti pakhale mphoto.
  • Mipamwamba kwambiri ya ED mu achinyamata, ogwiritsa ntchito zolaula.

Lofalitsidwa: July 11, 2014

Kudalirika

Ngakhale khalidwe lachiwerewere lachiwerewere (CSB) lalingaliridwa ngati "chizoloŵezi" chokhala ndi khalidwe labwino ndi maulendo omwe amapezeka kapena ophatikizana omwe amachititsa kuti zinthu zisawonongeke, zimadziwika bwino zokhudzana ndi zokhudzana ndi kugonana kwa anthu omwe alibe ndi CSB. Pano, kugwiritsidwa ntchito kwazinthu zosiyana zogonana kunayesedwa kwa anthu omwe alibe ndi CSB, poyang'ana pa zigawo za neural zomwe zakhala zikuyambirira pa kafukufuku wa mankhwala osokoneza bongo. Ophunzira a 19 CSB ndi odzipereka a 19 anayesedwa pogwiritsira ntchito MRI yogwira ntchito poyerekezera mavidiyo owonetsera zakugonana ndi mavidiyo osangalatsa. Zina zokhudzana ndi chilakolako cha kugonana ndi zokondweretsa zinapezeka.

Poyerekeza ndi odzipereka athanzi, anthu omwe ali ndi CSB anali ndi chilakolako chachikulu koma zotsatira zofanana ndi zomwe amakonda poyankha makanema owonetsa zachiwerewere. Kuwonetsedwa ku zizindikiro zogonana mu CSB poyerekeza ndi anthu omwe si a CSB kunalumikizidwa ndi kuyatsa kwa dorsal anterior cingulate, ventral striatum ndi amygdala. Kulumikizana kogwira ntchito kwa dorsal anterior cingulate-ventral striatum-amygdala network kunalumikizidwa ndi chilakolako chogonana (koma osakonda) kwambiri mu CSB poyerekeza ndi anthu omwe si a CSB . Kupatukana pakati pa chilakolako kapena kufuna ndi kukonda kumagwirizana ndi malingaliro a chilimbikitso chomwe chili pansi pa CSB monga momwe zilili ndi zizolowezi za mankhwala osokoneza bongo . Kusiyana kwa mitsempha pakukonza reactivity ya sex-cue kunazindikirika m'maphunziro a CSB m'madera omwe kale anali okhudzana ndi maphunziro a reactivity ya drug-cue. Kugwira ntchito kwakukulu kwa corticostriatal limbic circuitry mu CSB pambuyo powonetsedwa ku zizindikiro zogonana kumasonyeza njira za neural zomwe zili pansi pa CSB ndi zolinga zomwe zingatheke zamoyo kuti zilowererepo.

Chiwerengerochi

Chidule: Voon V, Mole TB, Banca P, Porter L, Morris L, et al. (2014) Ma Neural Correlates a Sexual Cue Reactivity mwa Anthu Omwe Ali ndi ndi Opanda Ma Compulsive Sexual Behaviours. PLoS ONE 9(7): e102419. doi:10.1371/journal.pone.0102419

Mkonzi: Veronique Sgambato-Faure, INSERM/CNRS, France

Yalandiridwa: Marichi 6, 2014; Yavomerezedwa: Juni 19, 2014; Yofalitsidwa: Julayi 11, 2014

Copyright: © 2014 Voon et al. Iyi ndi nkhani yotseguka yogawidwa motsatira malamulo a Creative Commons Attribution License , yomwe imalola kugwiritsa ntchito, kufalitsa, ndi kubwerezanso mopanda malire mwanjira iliyonse, bola wolemba woyambirira ndi gwero lake atchulidwa.

Kupezeka kwa Deta: Olembawo akutsimikizira kuti deta yonse yomwe ili m'gulu la zomwe zapezeka ikupezeka mokwanira popanda choletsa. Deta yonse ili mkati mwa pepalalo.

Ndalama Zothandizira: Ndalama zoperekedwa ndi Wellcome Trust Intermediate Fellowship grant (093705/Z/10/Z). Dr. Potenza anathandizidwa pang'ono ndi ndalama zothandizidwa ndi P20 DA027844 ndi R01 DA018647 kuchokera ku National Institutes of Health; Connecticut State Department of Mental Health and Addiction Services; Connecticut Mental Health Center; ndi Center of Excellence in Gambling Research Award kuchokera ku National Center for Responsible Gaming. Othandizira ndalamawo sanatenge nawo gawo pakupanga kafukufuku, kusonkhanitsa deta ndi kusanthula, kusankha kufalitsa, kapena kukonzekera zolembazo.

Zokonda zopikisana: Olembawo anena kuti palibe zokonda zopikisana zomwe zilipo.

Introduction

Kuchita zogonana mopitirira muyeso kapena movutikira, komwe kumatchedwa khalidwe lokakamiza kugonana (CSB), vuto la hypersexuality kapena chizolowezi chogonana, ndi chinthu chofala kwambiri chomwe chingakhale ndi zotsatirapo zazikulu pa thanzi la maganizo ndi thupi [1] . Ngakhale kuti kuyerekezera kolondola sikudziwika chifukwa maphunziro ambiri akuluakulu okhudza matenda amisala sakuphatikizapo miyeso ya CSB, deta yomwe ilipo ikusonyeza kuti kuchuluka kwa CSB kungachokere pa 2 mpaka 4% mwa achinyamata ammudzi ndi aku koleji omwe ali ndi kuchuluka kofanana kwa odwala matenda amisala [2] - [4] , ngakhale kuti kuchuluka kwakukulu ndi kotsika kwanenedwa kutengera momwe CSB imafotokozedwera [5] . Chinthu chovuta kwambiri pakuzindikira kufalikira ndi zotsatira za CSB chimaphatikizapo kusowa kwa tanthauzo lovomerezeka la matendawa. Ngakhale kuti njira zochizira matenda a hypersexual zinaperekedwa pa DSM-5 [6] , vutoli silinaphatikizidwe mu DSM-5. Komabe, popeza CSB ikhoza kugwirizanitsidwa ndi kuvutika maganizo kwakukulu, manyazi komanso kusagwira ntchito bwino kwa maganizo, imafuna kufufuzidwa mwachindunji.

Kuganizira bwino za CSB kwakhala kukambidwa, ndipo zifukwa zomwe zaperekedwa zoganizira vutoli ngati vuto lolamulira maganizo kapena chizolowezi chosakhala cha mankhwala osokoneza bongo kapena "khalidwe" [7] . Kutengera ndi deta yomwe ilipo, kutchova juga kwa matenda (kapena vuto la kutchova juga) posachedwapa kwasinthidwa mu DSM-5 pamodzi ndi matenda ogwiritsa ntchito mankhwala osokoneza bongo ngati chizolowezi cha khalidwe [8] . Komabe, matenda ena (monga okhudzana ndi kugwiritsa ntchito intaneti mopitirira muyeso, kusewera masewera apakanema kapena kugonana) sanaphatikizidwe mu gawo lalikulu la DSM-5, chifukwa cha deta yochepa pazifukwa [9] . Chifukwa chake, kumvetsetsa bwino kwa CSB ndi momwe ingasonyezere kufanana kapena kusiyana kuchokera ku matenda ogwiritsa ntchito mankhwala osokoneza bongo kungathandize pakuyesetsa kugawa magulu ndikukula kwa njira zopewera komanso zochizira bwino. Popeza kufanana pakati pa kugwiritsa ntchito mankhwala osokoneza bongo, kutchova juga ndi matenda opatsirana pogonana (monga, kulephera kuwongolera machitidwe osangalatsa kapena opindulitsa), kufufuza zinthu zomwe zimakhudzana ndi zizolowezi (monga, kuyankha kwa cue) kumafuna kufufuza mwachindunji mu CSB.

Kubwerezabwereza kwa cue kumakhudzana kwambiri ndi zinthu zofunika kwambiri pa matenda okhudzana ndi kugwiritsa ntchito mankhwala osokoneza bongo. Mwachitsanzo, kuwonjezeka kwa kubwerezabwereza kwa cue kumagwirizanitsidwa ndi kubwerera m'mbuyo [10] , [11] . Kusanthula kwaposachedwa kwa kafukufuku wokhudza kubwerezabwereza kwa cue pazinthu zomwe zimagwiritsidwa ntchito molakwika kuphatikizapo mowa, nikotini ndi cocaine kunawonetsa kugwira ntchito kogwirizana ndi zizindikiro za mankhwala mu ventral striatum, dorsal anterior cingulate (dACC) ndi amygdala, ndi zochitika zolumikizana ndi chilakolako chodzidziwitsa chomwe chimayambitsa kubwerezabwereza mu dACC, pallidum ndi ventral striatum [11] . Komabe, momwe madera awa angasonyezere kusiyana kwa kubwerezabwereza kwa kubwerezabwereza kwa kugonana mwa anthu omwe ali ndi CSB komanso omwe alibe CSB sikunaphunziridwe.

Mitundu yosiyanasiyana yaperekedwa kuti ifotokoze makhalidwe osokoneza bongo, ndipo chitsanzo chimodzi chimanena kuti mu zizolowezi, "kufuna" kumasiyanitsidwa ndi "kukonda" munthu akayamba kuzoloŵa [12] . Komabe, momwe kukonda ndi kufuna kumagwirizanirana ndi reactivity ya kugonana ndi ma neural correlates ake mu CSB sizinafufuzidwe mwadongosolo, ndipo zomwe zapezeka kuchokera ku maphunziro otere zingapereke deta yothandizira kutsogolera gulu loyenera kwambiri la CSB ndikuzindikira zolinga za mitsempha kuti zipangidwe chithandizo.

Kafukufuku wambiri wayang'ana kale pa zizindikiro zogonana mwa odzipereka athanzi omwe amazindikira madera kuphatikizapo hypothalamus, thalamus, amygdala, anterior cingulate cortex, anterior insula, inferior frontal cortex, fusiform gyrus, precentral gyrus, parietal cortex ndi middle occipital cortex [13] - [19] . Madera awa amakhudzidwa ndi kudzuka kwa thupi ndi malingaliro, chidwi komanso makamaka chidwi cha visuospatial, komanso chilimbikitso. Pogwiritsa ntchito miyeso ya penile tumescence, striatum, anterior cingulate, insula, amygdala, occipital cortex, sensorimotor cortex ndi hypothalamus zawonetsedwa kuti zimagwira ntchito pakumanga kwa penile [15] , [20] . Kusiyana kokhudzana ndi amuna ndi akazi kwanenedwa ndi amuna omwe ali ndi amygdala ndi hypothalamic kwambiri pazilakolako zogonana poyerekeza ndi akazi, ndipo kusiyana kumeneku kungasonyeze momwe chilakolako chimakhalira [21] . Kusanthula kwa meta kunapeza netiweki yofanana ya ubongo ku zotsatira zachuma, zolaula komanso chakudya kuphatikiza ventromedial prefrontal cortex, ventral striatum, amygdala, anterior insula ndi mediodorsal thalamus [22] . Chakudya ndi mphotho zogonana zinkagwirizanitsidwa makamaka ndi zochita zakunja kwa thupi ndi mphotho zogonana makamaka ndi zochita za amygdala. Kafukufuku waposachedwapa wasonyezanso kuti kugwiritsa ntchito zinthu zowoneka bwino pa intaneti kwa amuna athanzi nthawi yayitali kumagwirizana ndi zochita za kumanzere kwa putaminal ndi ma voliyumu otsika kumanja kuti afotokoze zithunzi zogonana [23].

Maphunziro a neurophysiological okhudza CSB mwa anthu ambiri osati odzipereka athanzi ndi ochepa kwambiri. Kafukufuku wa MRI wokhudza kufalikira kwa magazi omwe amayang'ana pa gulu laling'ono la anthu omwe si a paraphilic CSB (N = 8) poyerekeza ndi odzipereka athanzi (N = 8) adawonetsa kufalikira kochepa m'madera apamwamba [24] . Anthuwa adasankhidwa kuchokera ku pulogalamu yothandizira odwala omwe ali ndi mbiri ya matenda oledzera mowa, 4 mwa 8 omwe ali ndi mbiri ya kugwiritsa ntchito mankhwala osokoneza bongo kapena kudalira mankhwala ena ndipo 1 mwa 8 omwe ali ndi mbiri ya matenda osokoneza bongo. Mu kafukufuku wokhudza anthu 52 a amuna ndi akazi a CSB omwe ali ndi mavuto olamulira kuonera zithunzi zogonana pa intaneti zomwe zatengedwa kuchokera ku malonda apaintaneti, kuwonetsedwa ndi zithunzi zogonana zosasunthika poyerekeza ndi zithunzi zosalowererapo kunalumikizidwa ndi kuchuluka kwa mayankho a P300, komwe kumakhudzidwa ndi kulamulira chidwi [25] . Popeza muyeso uwu umagwirizana ndi chilakolako chogonana cha dyadic koma osati njira zokakamiza kugonana, olembawo adapereka lingaliro la chilakolako chogonana chomwe chimayambitsa P300 m'malo mwa machitidwe okakamiza. Kugonana kwachiwerewere kwanenedwa pankhani ya matenda amitsempha ndi mankhwala ogwirizana nawo. Kugonana mopitirira muyeso, komwe kumachitika mwa 3-4% ya odwala matenda a Parkinson komanso okhudzana ndi mankhwala a dopaminergic [26] , [27] , kwaphunziridwanso pogwiritsa ntchito njira zojambulira. Lipotilo la mlandu pogwiritsa ntchito technetium-99 m-ethyl cysteinate dimer SPECT linawonetsa kuchuluka kwa magazi m'madera a mesial temporal mwa wodwala wa CSB [28] . Kafukufuku wamkulu wokhudza odwala matenda a Parkinson omwe ali ndi hypersexuality adawonetsa kuti MRI Blood Oxygen Level imagwira ntchito bwino kwambiri. Zochita zomwe zimadalira zizindikiro za kugonana zomwe zimagwirizana ndi chilakolako chogonana chowonjezeka [29] , zomwe olembawo adanenanso kuti zitha kuwonetsa malingaliro olimbikitsa kuledzera. Kafukufuku wozikidwa pa voxel-based-morphometry wa hypersexuality womwe umafotokozedwa kawirikawiri mu frontotemporal dementia, matenda omwe amakhudza ventromedial frontal ndi anterior temporal regions, adawonetsa kuchepa kwakukulu mu right ventral putamen ndi pallidum mogwirizana ndi zigoli zofunafuna mphotho [30] . Chodziwikiratu ndi chakuti, mu chitsanzo ichi, kugonana kwa anthu ambiri kunanenedwa kuti ndi 17%, ndipo makhalidwe ena ofuna mphoto kuphatikizapo kudya mopitirira muyeso mu 78%, komanso kumwa mowa kapena mankhwala osokoneza bongo mwa anthu 26% omwe ali mu kafukufukuyu. Mu kafukufukuyu, tikuyang'ana kwambiri anthu omwe ali ndi CSB.

Apa tinayesa momwe zinthu zimachitikira pogwiritsa ntchito zizindikiro zogonana poyerekeza zizindikiro za kanema ndi zinthu zosangalatsa zosagonana (monga makanema amasewera) ndipo tinayesa kuchuluka kwa chilakolako chogonana kapena kufuna ndi kukonda anthu omwe ali ndi CSB komanso omwe alibe. Tinaganiza kuti anthu omwe ali ndi CSB poyerekeza ndi omwe alibe angasonyeze chilakolako chachikulu (kufuna) koma osakonda (mofanana m'magulu) poyankha zizindikiro zogonana koma osati zinthu zosangalatsa zosagonana . Ngakhale madera osiyanasiyana akhudzidwa ndi zizindikiro zogonana mwa odzipereka athanzi, pamene tinkaphunzira odwala omwe ali ndi CSB, tinaganiza kuti padzakhala kuyambitsa kwakukulu kwa kugonana poyerekeza ndi zizindikiro zosangalatsa zosagonana m'madera omwe akukhudzidwa ndi maphunziro okhudza kusintha kwa mankhwala kuphatikizapo ventral striatum, dACC ndi amygdala. Tinaganizanso kuti kuyambitsa kumeneku kungagwirizane m'magulu koma mwamphamvu kwambiri mwa anthu omwe ali ndi CSB poyerekeza ndi omwe alibe, ndipo chilakolako chogonana (kufuna) chingagwirizane kwambiri ndi zochita mkati mwa madera awa mwa anthu omwe ali ndi CSB poyerekeza ndi omwe alibe. Popeza tawona kusintha kwachitukuko m'machitidwe olimbikitsa omwe amayambitsa machitidwe oopsa [31] , tinafufuzanso ubale ndi zaka.

Njira

Anthu omwe ali mu CSB adasankhidwa kudzera mu malonda opezeka pa intaneti komanso kuchokera kwa akatswiri odziwa za matenda. Odzipereka athanzi adasankhidwa kuchokera ku malonda opezeka m'madera aku East Anglia. Kwa gulu la CSB, kufufuza kunachitika pogwiritsa ntchito Internet Sex Screening Test (ISST) [32] ndi mafunso ambiri opangidwa ndi ofufuza okhudza tsatanetsatane kuphatikizapo zaka zomwe akuyamba, kuchuluka kwa nthawi, nthawi, kuyesera kuwongolera kugwiritsa ntchito, kudziletsa, njira zogwiritsira ntchito, chithandizo ndi zotsatirapo zoyipa. Anthu omwe ali mu CSB adafunsidwa pamasom'pamaso ndi dokotala wa matenda amisala kuti atsimikizire kuti adakwaniritsa zofunikira zodziwira matenda a CSB [6] , [33] , [34] (Table S1 mu File S1 ) yoyang'ana kwambiri kugwiritsa ntchito zinthu zolaula pa intaneti mokakamiza. Onse omwe adatenga nawo mbali adakwaniritsa zofunikira zodziwira matenda a Hypersexual Disorder [6] , [33] ndi zofunikira zodziwira chizolowezi chogonana [34] (Table S1 mu File S1 ).

Malinga ndi kapangidwe kake komanso mtundu wa zizindikirozo, anthu onse odzipereka a CSB ndi odzipereka athanzi anali amuna komanso akazi okhaokha. Amuna odzipereka athanzi anali ofanana ndi azaka (+/−5) ndi anthu odzipereka a CSB. Amuna ena 25 odzipereka athanzi omwe anali ndi zaka zofanana ndi amuna kapena akazi okhaokha adayesedwa makanema kunja kwa sikani kuti atsimikizire kuti mayankho aumwini ku mavidiyowo anali okwanira monga momwe mayankho aumwini amayesedwera. Zofunikira zochotsera zinaphatikizapo kukhala ndi zaka zosakwana 18, kukhala ndi mbiri ya matenda ogwiritsira ntchito mankhwala osokoneza bongo, kukhala wogwiritsa ntchito mankhwala osokoneza bongo nthawi zonse (kuphatikizapo chamba), komanso kukhala ndi matenda aakulu amisala, kuphatikizapo kuvutika maganizo kwakukulu komwe kulipo (Beck Depression Inventory >20) kapena matenda okakamiza, kapena mbiri ya matenda a bipolar kapena schizophrenia (Mini International Neuropsychiatric Inventory) [35] . Zizolowezi zina zokakamiza kapena zamakhalidwe zinalinso zosaloledwa . Anthuwo adawunikidwa ndi dokotala wamisala pankhani yogwiritsa ntchito masewera apaintaneti kapena malo ochezera, kutchova juga kapena kugula zinthu mokakamiza, vuto la kusagwira ntchito kwa ana kapena akuluakulu, komanso kuzindikira matenda odya kwambiri. Anthuwo adawunikidwanso kuti agwirizane ndi malo a MRI.

Ophunzira adamaliza UPPS-P Impulsive Behaviour Scale [36] kuti aone ngati munthu ali ndi vuto la kusakhazikika maganizo, Beck Depression Inventory [37] ndi State Trait Anxiety Inventory [38] kuti aone ngati munthu ali ndi vuto la kukhumudwa komanso nkhawa, motsatana, Obsessive-Compulsive Inventory-R kuti aone ngati munthu ali ndi vuto la kusakhazikika maganizo komanso Alcohol-Use Disorders Identification Test (AUDIT) [39] . Kugwiritsa ntchito intaneti nthawi zonse kunayesedwa pogwiritsa ntchito Young's Internet Addiction Test (YIAT) [40] ndi Compulsive Internet Use Scale (CIUS) [41] . National Adult Reading Test [42] idagwiritsidwa ntchito kuti ipeze index ya IQ. Mtundu wosinthidwa wa Arizona Sexual Experiences Scale (ASES) [43] unagwiritsidwa ntchito ndi mtundu umodzi wokhudzana ndi maubwenzi apamtima ndi mtundu wina wokhudzana ndi zinthu zogonana pa intaneti.

Makhalidwe a anthu omwe ali ndi vutoli afotokozedwa mu Table S1 mu File S1 . Anthu omwe ali ndi CSB anali ndi zigoli zambiri za kuvutika maganizo ndi nkhawa (Table S2 mu File S1 ) koma palibe matenda omwe alipo panopa okhudza kuvutika maganizo kwakukulu. Awiri mwa anthu 19 omwe ali ndi CSB anali kumwa mankhwala oletsa kuvutika maganizo kapena anali ndi vuto la nkhawa lomwe limabwera chifukwa cha matenda enaake komanso mantha okhudza anthu (N = 2) kapena mantha okhudza anthu (N = 1) kapena mbiri ya ADHD ali mwana (N = 1). Munthu m'modzi wa CSB ndi munthu m'modzi wathanzi ankagwiritsa ntchito chamba nthawi ndi nthawi.

Chiwerengero chovomerezedwa cholembedwa chinaperekedwa, ndipo phunzirolo linavomerezedwa ndi Komiti ya University of Cambridge Research Ethics. Ophunzira adalipidwa chifukwa chotenga mbali.

Ziwerengero za makhalidwe

Makhalidwe ndi ziwerengero zofunsidwa zinkafaniziridwa pogwiritsa ntchito mayeso odziimira okha kapena mayeso a Chi-square. Kufufuza kwa Multivariate kunagwiritsidwa ntchito pazithunzithunzi za ASES. Zowonongeka za kugonana kapena zofuna zokhudzana ndi kugonana, ANOVA zinagwiritsidwa ntchito kufanizitsa kufotokozera momveka bwino ndi zosiyana ndi gulu (CSB, osati CSB) monga chiwerengero pakati pa maphunziro, mtundu wa kanema (zofotokozera kapena zowonongeka), ndi chidziwitso chogonjera (chilakolako kapena kukonda) monga momwe mungayankhire.

Neuroimaging

Mu ntchito yojambula zithunzi, anthuwa anaonera makanema owonetsedwa mosiyana ndi momwe zinthu zilili zisanu: kugonana koonekeratu, kugonana kosayenera, zosangalatsa zosakhala zachiwerewere, ndalama ndi zosalowerera ndale. Makanemawa anawonetsedwa kwa masekondi 9, kenako funso ngati kanemayo anali m'nyumba kapena panja. Anthuwa anayankha pogwiritsa ntchito kiyi ya mabatani awiri ndi manambala awo achiwiri ndi achitatu a dzanja lawo lamanja kuti atsimikizire kuti akumvetsera. Funsoli linachitika panthawi yoyeserera pakati pa ma millisecond 2000 mpaka 4000. Makanema owonetsa bwino adawonetsa kugonana kogwirizana pakati pa mwamuna ndi mkazi komwe kudapezeka kuchokera kumavidiyo omwe adatsitsidwa pa intaneti ndi zilolezo zomwe adapeza ngati pakufunika kutero. Zitsanzo za makanema owonetsa zolaula zinali mkazi wovala akuvina mokakamiza kapena chithunzi cha mkazi akupukuta ntchafu yake. Makanema osangalatsa osagonana adawonetsa makanema amasewera ofanana ndi zithunzi zodzutsa chidwi kuchokera ku International Affective Picture System monga skiing, sky-dumping, rock-mounting, kapena njinga yamoto. Makanema andalama adawonetsa zithunzi za ndalama kapena ndalama zamapepala zikulipidwa, kugwa kapena kufalikira. Makanema osalowerera ndale adawonetsa zithunzi za malo okongola. Matendawa adachitika mwachisawawa ndipo mayeso asanu ndi atatu pa vuto lililonse adawonetsedwa kuti awonetse makanema okwana 40. Makanema asanu osiyanasiyana pa vuto lililonse adawonetsedwa kuti awonetse makanema okwana 25 osiyanasiyana.

Mu ntchito yowunikira makanema kunja kwa scanner, anthu omwe adawonera makanema omwewo ndipo adamaliza muyeso wopitilira wa chilakolako chogonana ndi kukonda. Anthu omwe adafunsidwa adafunsidwa mafunso otsatirawa pa masilaidi awiri osiyana: 'Kodi izi zidakulitsa bwanji chilakolako chanu chogonana?' ndi 'Kodi mudakonda kanemayu bwanji?' ndipo adawonetsa yankho pogwiritsa ntchito mbewa pamzere wozikidwa pa 'Zochepa Kwambiri' mpaka 'Zochuluka Kwambiri'. Amuna ena 25 odzipereka athanzi adayesedwa pa ntchito yowunikira makanema. Anthu omwe adafunsidwa adafunsidwa ngati adawonerapo makanemawo kale asanayambe kafukufukuyu. Ntchito zonse zidalembedwa pogwiritsa ntchito pulogalamu ya E-Prime 2.0.

Kupeza data ndi kukonza

Magawo opezera kafukufuku wa fMRI afotokozedwa mu File S1 . Makanema a masekondi 9 ndi nthawi zoyeserera pakati pa mayeso zinayesedwa ngati ntchito za bokosi-galimoto zomwe zimagwirizanitsidwa ndi ntchito zoyankhira hemodynamic. Kusanthula kunachitika pogwiritsa ntchito njira yodziwikiratu. Mikhalidwe ya kanemayo inayerekezeredwa pogwiritsa ntchito ANOVA ndi gulu (CSB, non-CSB) ngati chinthu pakati pa anthu ndi mkhalidwe (mtundu wa kanema) ngati chinthu chamkati mwa anthu. Zotsatira zazikulu za gulu pamikhalidwe yonse zinayerekezeredwa koyamba. Zotsatira za mkhalidwe zinayerekezeredwa payekhapayekha mosiyana ndi mikhalidwe yowonekera, yolaula komanso yandalama ndi mkhalidwe wosangalatsa. Makanema osangalatsa amasewera adagwiritsidwa ntchito ngati chowongolera mikhalidwe yowonekera komanso yolaula chifukwa onsewa anali okhudzana ndi kusuntha anthu m'mavidiyo. Zochita zomwe zili pamwamba pa cholakwika cha banja lonse (FWE) chokonzedwa P<0.05 zidawonedwa ngati zofunika kwambiri poyerekeza zotsatira zazikulu. Gulu ndi gulu (monga CSB (yowonekera - yosangalatsa) - Kuyanjana kwa anthu odzipereka (yowonekera - yosangalatsa)) komwe kumayang'ana kwambiri madera ofunikira kwambiri kunachitika ngati kusiyana kwa mkhalidwe (monga yowonekera - yosangalatsa) kunazindikira madera ofunika kwambiri pamlingo wa FWE P <0.05 wa ubongo wonse. Ziwerengero za zaka ndi kuvutika maganizo zinagwiritsidwa ntchito ngati zinthu zomwe zimagwirizana ndi zomwe zikuchitika. Zinthu zomwe zimaphatikizapo miyeso ya chilakolako chogonana ndi mayankho okonda ku mavidiyo, zigoli pa Young Internet Addiction Test, ndi masiku omwe sanachitepo kanthu zinaphatikizidwa m'mamodeli ngati zinthu zomwe zimagwirizana ndi zomwe zikuchitika. Zinthu zomwe zimagwirizana ndi zaka zinafufuzidwanso, kuwongolera kuvutika maganizo ndi chilakolako chogwirizana ndi zomwe zikuchitika, m'magulu onse ndikugwiritsa ntchito masking yowonekera.

Ma ventral striatum, amygdala ndi dorsal cingulate anali madera oganiziridwa kuti ndi ofunika. Pa madera atatuwa omwe ali ndi malingaliro amphamvu a priori , tinaphatikiza ma ROI pogwiritsa ntchito small-volume-correction (SVC) ndi Family-Wise-Error correction pa p<0.05 yomwe imaonedwa kuti ndi yofunika kwambiri. Popeza kuti zomwe zapezeka zimagwirizanitsa ma ratings a chilakolako ndi dorsal anterior cingulate activation, kusanthula kwa psychophysiological interaction kunachitika ndi dorsal cingulate ngati gawo la mbewu (coordinates xyz = 0 8 38 mm, radius = 10 mm) mavidiyo osiyanitsa owonetsa - osangalatsa. Popeza kuti kukhudzidwa kwa mesolimbic ndi mesocortical circuitry kungatheke, ntchito mu substantia nigra inayesedwanso pamlingo wofufuza. Venral striatal anatomical region of interest (ROI), yomwe idagwiritsidwa ntchito kale m'maphunziro ena [44] , idajambulidwa ndi manja mu MRIcro potsatira tanthauzo la ventral striatum ndi Martinez et al. [45] . Ma ROI a cingulate ndi amygdala adapezeka kuchokera ku ma tempuleti a aal mu WFUPickAtlas SPM Toolbox [46] . Ma tempuleti awiri osiyana a substantia nigra ROI adagwiritsidwa ntchito kuphatikiza tempuleti ya WFUPickAtlas ndi ROI yokokedwa ndi manja mu MRIcro pogwiritsa ntchito njira zotumizira maginito kuchokera kwa odzipereka 17 athanzi. Deta yonse yojambula zithunzi idakonzedwa kale ndikusanthulidwa pogwiritsa ntchito SPM 8 (Wellcome Trust Centre for NeuroImageing, London, UK).

Results

makhalidwe

Amuna khumi ndi asanu ndi anayi ogonana amuna kapena akazi okhaokha omwe ali ndi CSB (zaka 25.61 (SD 4.77)) ndi amuna 19 ogwirizana ndi amuna kapena akazi okhaokha (zaka 23.17 (SD 5.38) odzipereka athanzi opanda CSB adaphunziridwa (Table S2 mu Fayilo S1 ). Amuna ena 25 odzipereka athanzi ofanana ndi amuna kapena akazi okhaokha omwe ali ndi zaka zofanana adavotera makanemawo. Anthu omwe adaphunzira za CSB adanena kuti chifukwa chogwiritsa ntchito kwambiri zinthu zolaula, adataya ntchito chifukwa chogwiritsa ntchito kuntchito (N = 2), adawononga maubwenzi apamtima kapena adakhudza kwambiri zochita zina za anthu (N = 16), adachepetsa chilakolako cha kugonana kapena ntchito yogonana makamaka muubwenzi wakuthupi ndi akazi (ngakhale kuti sanali pachibwenzi ndi zinthu zolaula) ( N = 11 ), adagwiritsa ntchito ma escorts mopitirira muyeso (N = 3), adakumana ndi malingaliro ofuna kudzipha (N = 2) ndikugwiritsa ntchito ndalama zambiri (N = 3; kuyambira £7000 mpaka £15000). Anthu khumi anali ndi kapena anali mu upangiri pa machitidwe awo. Anthu onse omwe adafunsidwa adanenanso kuti adagwiritsa ntchito njira zodziseweretsa maliseche komanso kuonera zinthu zolaula pa intaneti. Anthu omwe adafunsidwa adanenanso kuti adagwiritsa ntchito mautumiki operekeza (N = 4) ndi kugonana pa intaneti (N = 5). Pa mtundu wosinthidwa wa Arizona Sexual Experiences Scale [43] , anthu omwe adafunsidwa ndi CSB poyerekeza ndi odzipereka athanzi anali ndi vuto lalikulu ndi chilakolako chogonana ndipo adakumana ndi mavuto ambiri okhudzana ndi kugonana muubwenzi wapamtima koma osati pazinthu zolaula ( Table S3 mu File S1 ).

Poyerekeza ndi odzipereka athanzi, anthu a CSB anayamba kuona zinthu zolaula pa intaneti ali aang'ono (HV: 17.15 (SD 4.74); CSB: 13.89 (SD 2.22) m'zaka) poyerekeza ndi zaka zomwe anayamba kugwiritsa ntchito intaneti (HV: 12.94 (SD 2.65); CSB: 12.00 (SD 2.45) m'zaka) (kuyanjana kwa gulu ndi gulu: F(1,36) = 4.13, p = 0.048). Anthu a CSB anali ndi intaneti yambiri poyerekeza ndi odzipereka athanzi (Table S3 mu File S1 ). Chofunika kwambiri, anthu omwe ali ndi CSB adanena kuti akugwiritsa ntchito intaneti poonera zinthu zolaula pa intaneti kwa 25.49% ya ntchito zonse pa intaneti (kwa zaka pafupifupi 8.72 (SD 3.56) poyerekeza ndi 4.49% mwa odzipereka athanzi (t = 5.311, p <0.0001) (CSB vs. HV: kugwiritsa ntchito zinthu zolaula: 13.21 (SD 9.85) vs. 1.75 (SD 3.36) maola pa sabata; kugwiritsa ntchito intaneti konse: 37.03 (SD 17.65) vs. 26.10 (18.40) maola pa sabata).

Cue reactivity

Mavoti okhudzika a chikhumbo ndi kukonda makanema adasiyanitsidwa pomwe panali kulumikizana kwa gulu ndi mtundu wa kanema (F(1,30) = 4.794, p = 0.037): mavoti okhudzika a makanema olankhulidwa anali akulu mu CSB poyerekeza ndi odzipereka athanzi (F = 5.088, p = 0.032) koma osati ku zizindikiro zogonana (F = 0.448, p = 0.509), pomwe mavoti okhudzika ndi zizindikiro zogonana anali akulu mu CSB poyerekeza ndi odzipereka athanzi (F = 4.351, p = 0.047) koma osati ku zizindikiro zolankhulidwa (F = 3.332, p = 0.079). Chilakolako ndi kukonda zigoli ku zizindikiro zomveka bwino zinali zogwirizana kwambiri (HV: R2 = 0.696, p<0.0001; CSB: R2 = 0.363, p = 0.017) ngakhale kuti kusinthasintha kwa mzere sikunali kosiyana kwambiri pakati pa magulu (F = 2.513, p = 0.121). Panalibenso kusiyana pakati pa zigoli za makanema pa chilakolako ndi kukonda pa vuto lililonse pakati pa odzipereka athanzi omwe adaskenidwa ndi odzipereka ena 25 athanzi omwe akusonyeza kuti zigoli za mavidiyowo zinali zoyimira (p>0.05). Anthu onse omwe adaphunzira adanena kuti sanawonepo mavidiyowo kale asanayambe kafukufukuyu.

Kujambula kuganizira

Palibe kusiyana kwa mphamvu ya ubongo pakati pa magulu awiri komwe kunapulumuka kukonzedwa kwa ubongo wonse. Kusiyana kwa makanema osangalatsa pakati pa magulu osiyanasiyana kunawonetsa kuyambika kwa ventral striatum, dACC ndi amygdala pamlingo wa FWE p <0.05 wokonzedwa ndi ubongo wonse ( Chithunzi 1 , Matebulo S4 ndi S5 mu Fayilo S1 ). Kusiyanaku kunawonetsanso kuyambika kwa hypothalamus ndi substantia nigra (FWE p <0.05 yokonzedwa ndi ubongo wonse), madera omwe amakhudzidwa ndi chilakolako chogonana komanso ntchito ya dopaminergic, motsatana [13] , [22] . Kusiyana kwa ntchito yosangalatsa - yosangalatsa komanso yosangalatsa yomwe imawonedwa m'madera a occipito-temporal, parietal ndi inferior frontal cortices ndi right caudate (FWE p <0.05 yokonzedwa ndi ubongo wonse) (Table S4 mu Fayilo S1 ). Komabe, kusiyana kwa erotic - yosangalatsa sikunazindikire madera omwe amaganiziridwa kuti ndi a priori . Mofananamo, kusiyana kosangalatsa kwa ndalama kunapeza ma cortices a parietal ndi inferior frontal (FWE p <0.05 yokonzedwa ndi ubongo wonse) koma osati madera omwe adaganiziridwa kuti ndi a priori.

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Chithunzi 1. Chikhalidwe chikusiyana.

Ubongo wamagalasi ndi zithunzi zam'mbali zimawonetsa zovuta m'magulu azosiyanazi: zomveka - zosangalatsa (kumanzere, mzere wapamwamba), zolaula - zosangalatsa (pakati, pakati) ndi ndalama - zosangalatsa (kumanja, mzere wapansi). Zithunzizo zikuwonetsedwa muubongo wathunthu wa FWE-P <0.05. Mawonekedwe a axial (kumanja kumanja) akuwonetsa kusiyanasiyana kwamagulu amakanema owonetsa - osangalatsa omwe amayang'ana kwambiri substantia nigra. Chithunzicho chikuwonetsedwa ndi chigawo cha substantia nigra chosangalatsa chomwe chimakutidwa ndi maginito osunthira.

onetsani: 10.1371 / journal.pone.0102419.g001

Kenako tinayang'ana kusiyana pakati pa magulu mu kusiyana kowonekera bwino - kosangalatsa komwe kunawonetsa zotsatira zazikulu m'magulu m'madera omwe tinkaganiza. Anthu a CSB adawonetsa ntchito yayikulu mu striatum yakumanja (peak voxel xyz mu mm = 18 2 −2, Z = 3.47, FWE p = 0.032), dACC (0 8 38, Z = 3.88, FWE p = 0.020) ndi amygdala yakumanja (32 −8 −12, Z = 3.38, FWE p = 0.018) ( Chithunzi 2 ). Popeza tinapatsidwa gawo la dopaminergic circuitry mu reactivity ya cue, tinafufuzanso ntchito mu substantia nigra. Anthu a CSB anali ndi ntchito yayikulu mu substantia nigra yakumanja (10 −18 −10, Z = 3.01, FWE p = 0.045) mu kusiyana kowonekera bwino - kosangalatsa. Kusanthula pang'ono kupatula anthu awiri omwe anali kumwa mankhwala oletsa kupsinjika maganizo sikunasinthe zomwe zapezeka.

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Chithunzi 2. Zolondola ndi zochititsa chidwi.

Malingaliro amtunduwu amayimira kulumikizana kwamitundu-yamakanema ndimaphunziro okakamiza pakugonana (CSB)> odzipereka athanzi (HV) kusiyanitsa zolaula> zosangalatsa zosangalatsa. Zithunzizo zikuwonetsedwa ngati zigawo zosangalatsa pa P <0.005. Kufufuza kwa nthawiyo kumayimira% kusintha kwa ma vidiyo owonekera (pamwamba) ndi makanema osangalatsa (pansi) okhala ndi CSB omvera odzipereka ofiira komanso athanzi lakuda. Zolakwitsa mipiringidzo zikuyimira SEM.

onetsani: 10.1371 / journal.pone.0102419.g002

Kuti tiwone ubale womwe ulipo pakati pa mayankho a mitsempha ku zizindikiro ndi ziwerengero za chilakolako ndi kukonda, tinachita kafukufuku wa covariate wokhudza mayankho a ubongo ku zizindikiro zodziwika bwino. M'magulu onse awiri, ziwerengero za chilakolako chogonana chaumwini zinali zogwirizana bwino ndi ntchito ya dACC (−4 18 32, Z = 3.51, p = 0.038), popanda kusiyana pakati pa magulu ( Chithunzi 3 ). Panalibe mgwirizano wa mitsempha ndi kukonda kwaumwini.

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Chithunzi 3. Chilakolako cha kugonana.

A. Zokhumba zakukonda ndi kukonda zambiri pamitundu yamavidiyo m'maphunziro omwe ali ndi zizolowezi zakugonana (CSB) komanso otenga nawo mbali wathanzi (HV). Panali kulumikizana kwakukulu kwamagulu-ndi-makanema-ndi-kukhumba / kukonda. Zolakwitsa mipiringidzo zikuyimira SEM. * p <0.05. B. Desire covariate ya makanema omasulira mu maphunziro onse a CSB ndi HV omwe ali ndi chithunzi chofananira cha regression chazomwe zimapangidwira (PE) ndikukhumba zambiri. C. Kusanthula kwa psychophysiological yolumikizana ndi chikhumbo covariate chosiyanitsa-chosangalatsa mosiyana ndi mbewu yakuthengo. Zithunzi zojambulidwa ndi ma graph zikuwonetsa mitu ya CSB yokhala ndi chigoba cha HV chokha komanso kusanthula kofananira kwa ventral striatum ndi amygdala parameter kuyerekezera ndikukhumba zambiri. Zithunzizo zikuwonetsedwa ngati zigawo zosangalatsa pa P <0.005.

onetsani: 10.1371 / journal.pone.0102419.g003

Pa mlingo wofufuza, ntchito ya mitsempha inafufuzidwa ngati ntchito ya msinkhu. Zaka pa anthu onse sizinagwirizane bwino ndi ntchito mu striatum yakumanja (kumanja: 8 20 −8, Z = 3.13, FWE p = 0.022) ndi dACC (2 20 40, Z = 3.88, FWE p = 0.045). Ntchito yayikulu ngati ntchito ya msinkhu inawonedwa mu gulu la CSB poyerekeza ndi odzipereka athanzi mu striatum ya m'mimba ya m'mimba (kumanja: 4 18 −2, Z = 3.31, FWE p = 0.013; kumanzere -8 −18 −2, Z = 3.01, FWE p = 0.034) ( Chithunzi 4 ).

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Chithunzi 4. Zaka.

Kuwonetseraku kumawonetsa zaka zomwe zimapangidwa ndi makanema omveka bwino m'mitu yomwe ili ndi Zovuta Zogonana (CSB) yokhala ndi chigoba chodzipereka chodzipereka (HV). Chithunzicho chikuwonetsa kusanthula kofananira kwa kuyerekezera kwamkati mwa striatal parameter kulinganiza (PE) ndi zaka m'zaka. Chithunzicho chikuwonetsedwa ngati dera lokondweretsedwa ndi P <0.005.

onetsani: 10.1371 / journal.pone.0102419.g004

Popeza pali mgwirizano pakati pa ziwerengero za zochita za dACC zokhudzana ndi chilakolako chogonana, kusanthula kwa kuyanjana kwa maganizo pogwiritsa ntchito dACC ngati mbewu kunachitika poyerekeza zizindikiro zosangalatsa. M'magulu onse awiri, panali kulumikizana kwabwino kwa dACC ndi striatum yakumanja (8 20 −4, Z = 3.14, FWE p = 0.029) ndi amygdala yakumanja (12 0 −18, Z = 3.38, FWE p = 0.009). Panalibe kusiyana pakati pa magulu pakulumikizana kwa ntchito. Pamene zigoli za chilakolako cha munthu payekha zinayesedwa ngati covariate, panali mgwirizano wabwino pakati pa zigoli za chilakolako ndi kulumikizana kwakukulu kwa ntchito mu maphunziro a CSB pakati pa dACC ndi right ventral striatum (12 2 −2, Z = 3.51, FWE p = 0.041) ndi amygdala yakumanja (30 −2 −12, Z = 3.15, FWE p = 0.048) ( Chithunzi 3 ) ndipo, pamlingo wofufuza, left substantia nigra (−14 −20 −8, Z = 3.10, FWE p = 0.048) poyerekeza ndi odzipereka athanzi. Panalibe zotsatira zazikulu zokhudzana ndi miyeso yokonda.

Kukambirana

Mu kafukufukuyu wokhudza zizindikiro zogonana, zolaula komanso zosakhudzana ndi kugonana, anthu omwe ali ndi CSB ndi omwe alibe anasonyeza kufanana ndi kusiyana pankhani ya momwe mitsempha imayankhira komanso ubale pakati pa mayankho okhudzana ndi momwe munthu amayankhira komanso momwe ubongo umayankhira. Chilakolako chogonana kapena kufuna zizindikiro zogonana mwachindunji kunalumikizidwa ndi netiweki yogwira ntchito ya dACC-ventral striatal-amygdala yomwe imawonekera m'magulu onse awiri ndipo imayendetsedwa kwambiri komanso yolumikizidwa ndi chilakolako chogonana m'gulu la CSB. Chilakolako chogonana kapena njira zodzifunira zomwe munthu amafunikira zinkaoneka kuti sizikugwirizana ndi kukonda, mogwirizana ndi malingaliro olimbikitsa a chizolowezi [12] momwe muli chilakolako chowonjezeka koma chosakonda mphotho zazikulu. Tinawonanso gawo la zaka momwe unyamata, makamaka m'gulu la CSB, unkagwirizanitsidwa ndi zochita zambiri mu ventral striatum.

Poyerekeza ndi odzipereka athanzi, anthu a CSB anali ndi chilakolako chachikulu chogonana kapena kufuna zizindikiro zoonekeratu ndipo anali ndi zigoli zambiri zokonda zizindikiro zogonana, motero kusonyeza kusiyana pakati pa kufuna ndi kukonda. Anthu a C SB analinso ndi zovuta zambiri zokhudzana ndi chilakolako chogonana komanso zovuta zogonana muubwenzi wapamtima koma osati ndi zinthu zogonana zomwe zikusonyeza kuti zigoli zowonjezera chilakolako zinali zenizeni ku zizindikiro zoonekeratu osati chilakolako chogonana chowonjezeka . Mu anthu a CSB poyerekeza ndi odzipereka athanzi, zigoli zambiri zogonana ndi zizindikiro zoonekeratu zinali zogwirizana ndi ntchito yayikulu ya dACC komanso kulumikizana bwino pakati pa dACC, ventral striatum ndi amgydala (monga tafotokozera pansipa), zomwe zikusonyeza kuti pali gulu lomwe likukhudzidwa ndi kukonza chilakolako chokhudzana ndi zizindikiro zogonana. Kafukufuku wakale wa kukakamiza kugonana kokhudzana ndi dopamine agonists mu matenda a Parkinson, omwe angaphatikizepo machitidwe monga kugwiritsa ntchito mokakamiza zinthu zogonana, adawonetsa zochita zazikulu za mitsempha ku zizindikiro zogonana zomwe zimagwirizana ndi chilakolako chogonana chowonjezeka [29] . Zomwe tapeza zokhudzana ndi CSB mwa anthu onse zimagwirizananso ndi malingaliro olimbikitsa chilimbikitso omwe akugogomezera kulakalaka kapena chilimbikitso chogwiritsa ntchito mankhwala osokoneza bongo kapena chikhumbo chogonana, koma osati 'kukonda' kapena kamvekedwe ka hedonic [12].

Kafukufuku wokhudzana ndi kugwiritsa ntchito mankhwala osokoneza bongo komanso chilakolako cha nikotini, cocaine ndi mowa zimakhudza maukonde kuphatikizapo ventral striatum, dACC ndi amygdala [13] . Mu kafukufuku wapano, madera awa adayambitsidwa panthawi yowonera zinthu zolaula m'magulu omwe ali ndi CSB komanso omwe alibe. Kuwona momwe maderawa amagwirira ntchito mwamphamvu mu CSB poyerekeza ndi omwe ali ndi thanzi labwino ndi ofanana ndi zomwe zapezeka pazifukwa zomwe anthu amamwa mankhwala osokoneza bongo, zomwe zikusonyeza kufanana kwa mitsempha pazovuta zonse.

Mu kafukufuku waposachedwa poyankha zizindikiro zogonana, chilakolako chogonana chinali chogwirizana ndi ntchito yayikulu ya dACC, ndipo ntchito yayikulu ya netiweki yogwira ntchito ya dACC-ventral striatal-amygdala inali yokhudzana ndi chikhumbo chowonjezeka kwambiri mwa anthu omwe ali ndi CSB kuposa anthu omwe ali ndi thanzi labwino. Anthu omwe ali ndi CSB adawonetsanso ntchito yayikulu ya substantia nigra poyerekeza ndi odzipereka athanzi, motero mwina amagwirizanitsa zomwe zapezeka ndi ntchito ya dopaminergic. Mwa anthu ndi anyani omwe si anthu, dACC ndi cholinga chofunikira cha ma dopaminergic projections kuchokera ku substantia nigra ndi ventral tegmental area [47] , kutsatira zizindikiro zolakwika za salience ndi kulosera. dACC imatumiza ma anatomical projections ku ventral ndi dorsomedial striatum, zomwe zimakhudzidwa ndi kuyimira kwa zizindikiro zamtengo wapatali ndi mphotho komanso chilimbikitso ndipo ili ndi kulumikizana kofanana ndi lateral basal nucleus ya amygdala motero imalandira chidziwitso pazochitika zodziwika bwino [48] , [49] . Derali lilinso ndi maulumikizidwe angapo ndi madera a cortical kuphatikiza premotor, primary motor ndi fronto-parietal cortices ndipo lili bwino kuti likhudze kusankha zochita. DACC imagwira ntchito pokonza ululu, zoyambitsa zoipa komanso kuwongolera kuzindikira [48] , ndipo kafukufuku waposachedwa akuwonetsa udindo wa DACC pakuwonetsa zolakwika zolosera komanso kuyembekezera mphotho [50] , [51] , makamaka kutsogolera kuphunzira za mphotho ndi zochita [52] , [53] . Zomwe tapeza zokhudzana ndi kulumikizana zimagwirizana ndi gawo la netiweki yolumikizana pa DACC pakupanga mphotho zogonana komanso mu reactivity yokhudzana ndi kugonana komanso ubale wake ndi chilakolako ngati chizindikiro cholimbikitsa.

Zomwe tapeza zikusonyeza kuti zochita za dACC zikuwonetsa ntchito ya chilakolako chogonana, chomwe chingafanane ndi kafukufuku wa P300 mwa anthu a CSB okhudzana ndi chilakolako [25] . Tikuwonetsa kusiyana pakati pa gulu la CSB ndi odzipereka athanzi pomwe kafukufuku wakaleyu analibe gulu lowongolera. Kuyerekeza kwa kafukufukuyu waposachedwa ndi zofalitsa zakale mu CSB zomwe zikuyang'ana pa MRI yofalikira ndi P300 n'kovuta chifukwa cha kusiyana kwa njira. Kafukufuku wa P300, kuthekera kokhudzana ndi zochitika komwe kumagwiritsidwa ntchito pophunzira tsankho la chidwi pamavuto ogwiritsa ntchito mankhwala osokoneza bongo, akuwonetsa miyeso yokwera pankhani yogwiritsa ntchito nikotini [54] , mowa [55] , ndi ma opiates [56] , ndi miyeso yomwe nthawi zambiri imagwirizana ndi zizindikiro zakulakalaka. P300 imaphunziridwanso nthawi zambiri m'mavuto ogwiritsa ntchito mankhwala osokoneza bongo pogwiritsa ntchito ntchito zachilendo momwe zolinga zochepa zothekera nthawi zambiri zimasakanizidwa ndi zinthu zomwe sizili zolinga zazikulu. Kusanthula kwa meta kunawonetsa kuti anthu omwe ali ndi vuto la kugwiritsa ntchito mankhwala osokoneza bongo ndi achibale awo omwe sanakhudzidwe adatsika P300 amplitude poyerekeza ndi odzipereka athanzi [57] . Zomwe zapezekazi zikusonyeza kuti mavuto okhudzana ndi kugwiritsa ntchito mankhwala osokoneza bongo amatha kudziwika ndi kusagawa bwino zinthu zomwe zimafunika kuti munthu azitha kuyang'ana kwambiri zinthu zomwe zimamukhudza (zosakhudzana ndi mankhwala osokoneza bongo) komanso kukonda kwambiri zinthu zomwe zimamukhudza. Kuchepa kwa P300 amplitude kungakhalenso chizindikiro cha matenda a endophenotypic. Kafukufuku wa zochitika zokhudzana ndi zochitika zomwe zimayang'ana kwambiri kufunika kwa cocaine ndi heroin cues akuwonetsanso zolakwika m'magawo omaliza a ERP (>300 milliseconds; late positive potential, LPP) m'madera akutsogolo, zomwe zingasonyezenso chilakolako ndi kugawa chidwi [58] - [60] . LPP imakhulupirira kuti ikuwonetsa kugwidwa koyambirira kwa chidwi (400 mpaka 1000 msec) komanso pambuyo pake kupitilira kwa zinthu zomwe zimamulimbikitsa. Anthu omwe ali ndi vuto la kugwiritsa ntchito cocaine anali atakweza miyezo yoyambirira ya LPP poyerekeza ndi odzipereka athanzi omwe akusonyeza kuti ndi gawo lothandizira kuti munthu azitha kuyang'ana kwambiri chidwi komanso mayankho ochepetsedwa kuzinthu zosangalatsa zamaganizo. Komabe, miyezo yomaliza ya LPP sinali yosiyana kwambiri ndi yomwe ili mwa odzipereka athanzi [61] . Zomwe zimayambitsa kuthekera kwa P300 kokhudzana ndi zochitika zokhudzana ndi zolinga zimakhulupirira kuti ndi parietal cortex ndi cingulate [62] . Chifukwa chake, zochita zonse za dACC mu kafukufuku wa CSB wapano ndi zochita za P300 zomwe zanenedwa mu kafukufuku wakale wa CSB zitha kuwonetsa njira zofanana zogwirira chidwi. Mofananamo, maphunziro onsewa akuwonetsa mgwirizano pakati pa miyeso iyi ndi chilakolako chowonjezeka. Apa tikuwonetsa kuti zochita za dACC zimagwirizana ndi chilakolako, chomwe chingawonetse chizindikiro cha chilakolako, koma sichikugwirizana ndi kukonda chitsanzo cha chilimbikitso cha zizolowezi.

Zomwe zapezeka pano zikusonyeza kuti achinyamata ali ndi mphamvu zokhudzana ndi ukalamba pakugwiritsa ntchito zizindikiro zogonana. Kukula kwa zinthu zoyera za fronto-cortical zomwe zimakhudzana ndi ulamuliro wa akuluakulu kumapitirira muunyamata mpaka pakati pa zaka za m'ma 20 [63] . Kuwonjezeka kwa chiopsezo mwa achinyamata kungasonyeze kukula koyambirira kwa chilimbikitso cha limbic ndi circuitry ya mphotho poyerekeza ndi kuchedwa kwa chitukuko cha machitidwe owongolera oyang'anira kutsogolo omwe amakhudzidwa ndi kuwunika kapena kuletsa machitidwe [31] , [64] , [65] . Mwachitsanzo, achinyamata awonetsa zochita zazikulu za ventral striatal poyerekeza ndi zochita za prefrontal cortical panthawi yokonza mphotho poyerekeza ndi akuluakulu [65] . Apa tikuwona kuti m'maphunziro osiyanasiyana, unyamata umagwirizanitsidwa ndi zochita zazikulu za ventral striatal ku zizindikiro zogonana. Zotsatirazi mu zochita za ventral striatal zikuwoneka zolimba kwambiri m'maphunziro a CSB, zomwe zikusonyeza kuti ukalamba ukhoza kukhala ndi gawo lowongolera mayankho ku zizindikiro zogonana nthawi zonse komanso makamaka mu CSB.

Mogwirizana ndi mabuku okhudza ntchito ya ubongo mwa odzipereka athanzi kumadera okhudzidwa ndi chilakolako chogonana, tikuwonetsa netiweki yofanana kuphatikiza ma cortices a occipito-temporal ndi parietal, insula, cingulate ndi orbitofrontal ndi inferior frontal cortices, pre-central gyrus, caudate, ventral striatum, pallidum, amygdala, substantia nigra ndi hypothalamus [13] - [19] . Kugwiritsa ntchito nthawi yayitali zinthu zodziwika bwino pa intaneti mwa amuna athanzi kwawonetsedwa kuti kukugwirizana ndi ntchito ya putaminal yakumanzere kufupi ndi zithunzi zowoneka bwino zomwe zikusonyeza kuti zitha kukhala ndi gawo la desensitization [23] . Mosiyana ndi zimenezi, kafukufukuyu akuyang'ana kwambiri gulu la matenda omwe ali ndi CSB lomwe limadziwika ndi vuto lolamulira kugwiritsa ntchito komwe kumayenderana ndi zotsatira zoyipa. Kuphatikiza apo, kafukufukuyu akugwiritsa ntchito makanema poyerekeza ndi zithunzi zowoneka bwino. Mwa odzipereka athanzi, kuwonera zithunzi zowoneka bwino poyerekeza ndi makanema kumakhala ndi njira yochepa yogwirira ntchito kuphatikiza hippocampus, amygdala ndi posterior temporal ndi parietal cortices [20] zomwe zikusonyeza kusiyana komwe kungachitike pakati pa zithunzi zowoneka bwino ndi makanema ataliatali omwe agwiritsidwa ntchito mu kafukufukuyu . Kuphatikiza apo, matenda osokoneza bongo monga matenda ogwiritsira ntchito cocaine awonetsedwanso kuti akugwirizana ndi kukondera kwambiri kwa chidwi pomwe ogwiritsa ntchito cocaine osangalatsa sanawonetsedwe kuti ali ndi kukondera kwakukulu kwa chidwi [66] zomwe zikusonyeza kusiyana komwe kungachitike pakati pa ogwiritsa ntchito zosangalatsa ndi omwe amadalira . Motero, kusiyana pakati pa maphunziro kungawonetse kusiyana kwa anthu kapena ntchito . Kafukufuku wathu akuwonetsa kuti mayankho a ubongo kuzinthu zodziwika bwino pa intaneti akhoza kusiyana pakati pa anthu omwe ali ndi CSB poyerekeza ndi anthu athanzi omwe angakhale ogwiritsa ntchito kwambiri zinthu zodziwika bwino pa intaneti koma osataya ulamuliro kapena kuyanjana ndi zotsatirapo zoyipa.

Kafukufuku wapano ali ndi zoletsa zambiri. Choyamba, kafukufukuyu anali wokhudza amuna okhaokha, ndipo maphunziro amtsogolo ayenera kufufuza anthu osiyanasiyana okhudzana ndi kugonana komanso akazi, makamaka popeza atsikana omwe ali ndi nkhawa za thanzi la maganizo akhoza kuwonetsa kuchuluka kwa CSB [67] . Chachiwiri, ngakhale kuti maphunziro a CSB mu kafukufukuyu adakwaniritsa zofunikira zodziwira matenda ndipo adawonetsa kuwonongeka kwa magwiridwe antchito okhudzana ndi kugonana pogwiritsa ntchito masikelo angapo ovomerezeka, pakadali pano palibe njira zodziwira matenda a CSB ndipo motero izi zikuyimira malire omvetsetsa zomwe zapezeka ndikuziyika m'mabuku akuluakulu. Chachitatu , poganizira momwe kafukufukuyu alili, malingaliro okhudza chifukwa chake sangapangidwe. Maphunziro amtsogolo ayenera kuwona momwe kuyambika kwa mitsempha ku zizindikiro zogonana kungasonyezere zoopsa zomwe zikuwonetsa kufooka kwakukulu kapena ngati kuwonetsedwa mobwerezabwereza, mwina chifukwa cha unyamata komanso kuwonetsedwa kwambiri kuzinthu zogonana, kungayambitse machitidwe a mitsempha omwe awonedwa mu CSB. Maphunziro ena a chikhalidwe choyembekezeredwa kapena omwe amayang'ana kwambiri achibale omwe sanakhudzidwe ndi izi akuyenera. Zaka zochepa mu kafukufukuyu zithanso kuchepetsa zomwe zingachitike. Chachinayi, kafukufuku wathu adayang'ana kwambiri kugwiritsa ntchito zinthu zapaintaneti mokakamiza ndi maliseche okhudzana ndi kugonana komanso kugwiritsa ntchito pafupipafupi cybersex kapena kugwiritsa ntchito mautumiki operekeza. Popeza anthuwa adatengedwa kuchokera ku malonda apaintaneti komanso malo ochiritsira, kaya akuyimira anthu onse m'malo ochiritsira sikumveka bwino. Kafukufuku wa anthu 207 omwe akufuna chithandizo cha CSB omwe adagwiritsidwa ntchito mu DSM-5 field trial poyesa matenda a hypersexual disorder adawonetsanso machitidwe omwe amapezeka kwambiri monga kugwiritsa ntchito zolaula (81.1%), kuseweretsa maliseche (78.3%), kugonana pa intaneti (18.1%) ndi kugonana ndi akuluakulu ovomerezeka (44.9%) [33] akusonyeza kufanana pakati pa anthu athu ndi anthu omwe adanenedwawa. Komabe, maphunziro omwe amayang'ana pa anthu omwe akufuna chithandizo angasonyeze kuopsa kwa zizindikiro. Tinagwiritsa ntchito kusanthula dera lomwe tikufuna chidwi m'malo mogwiritsa ntchito njira yonse ya ubongo. Chifukwa chake, chitsanzo chaching'ono komanso kusowa kwa njira yonse yokonzedwa ndi ubongo ndi malire. Komabe, poganizira malingaliro athu amphamvu a priori kutengera deta yopezeka kuchokera ku maphunziro a cue reactivity, tinamva kuti kusanthula dera lomwe tikufuna chidwi cholakwika cha banja chokonzedwa poyerekeza zingapo, njira yomwe imagwiritsidwa ntchito kwambiri pamaphunziro ojambula zithunzi [68] , inali njira yoyenera.

Zomwe zapezeka panopa komanso zomwe zilipo zikusonyeza kuti pali netiweki yofanana ya reactivity-cue-cue ndi reactivity-cue-cue m'magulu omwe ali ndi CSB ndi chizolowezi cha mankhwala osokoneza bongo, motsatana. Zomwe zapezekazi zikusonyeza kusakanikirana kwa ma netiweki omwe amayambitsa matenda a kumwa mankhwala osokoneza bongo ndi mphotho zachilengedwe. Ngakhale kuti kafukufukuyu angasonyeze kusakanikirana kwa matenda ogwiritsira ntchito mankhwala osokoneza bongo, maphunziro ena azachipatala amafunika kuti adziwe ngati CSB iyenera kugawidwa ngati matenda oletsa kukhudzidwa ndi kukhudzidwa, mkati mwa obsessive-compulsive spectrum kapena ngati chizolowezi cha khalidwe. Maphunziro akuluakulu a matenda ambiri omwe ali ndi zotsatira za nthawi yayitali amafunika kuti aone kuchuluka kwa CSB ndi zotsatira zake za nthawi yayitali. Maphunziro a epidemiological pa ubale pakati pa CSB ndi matenda a impulsivity, compulsivity ndi chizolowezi amafunika. Mofananamo, kufananiza kwakukulu pa mbiri ya neurocognitive ndi neurophysiological pa matenda osiyanasiyana kungakhale kothandiza kumvetsetsa bwino physiology ndi neural networks zomwe zimayambitsa matendawa. Tikugogomezeranso kuti zomwe zapezekazi ndizofunikira makamaka ku gulu laling'ono la anthu omwe amakumana ndi mavuto ndi kugwiritsa ntchito zinthu zolaula pa intaneti mokakamiza ndipo mwina saganizira za anthu ambiri omwe amagwiritsa ntchito zinthuzi m'njira zosavulaza. Zomwe zapezekazi zikusonyeza kuti ukalamba umakhudza kwambiri mphamvu ya limbic reactivity ku mphotho zogonana, makamaka m'gulu la CSB. Popeza kuchuluka kwa kugwiritsa ntchito intaneti kwawonjezeka posachedwapa, kuphatikizapo pakati pa achinyamata, komanso mwayi wopeza zinthu zolaula pa intaneti, maphunziro amtsogolo omwe akuyang'ana pa kuzindikira zinthu zomwe zingawopseze anthu (makamaka achinyamata) omwe ali pachiwopsezo chotenga CSB akuyenera.

Kuthandiza Information

Lembani S1.

Kusamalitsa mfundo.

onetsani: 10.1371 / journal.pone.0102419.s001

(DOCX)

Kuvomereza

Tikufuna kuthokoza onse omwe adagwira nawo phunziro ndi ogwira ntchito ku Wolfson Brain Imaging Center. Dr. Voon ndi mnzake wapamtima wa Wellcome Trust. Channel 4 inathandizidwa pakuthandizira ndi kuitanitsa poyika malonda okhudza intaneti pa phunzirolo.

Zopereka za Wolemba

Zimalengedwa ndipo zinapanga zoyesayesa: VV. Anayesa zochitika: VV TBM PB LP SM TRL JK MI. Analongosola deta: VV TBM PB LP LM SM TRL JK NAH MNP MI. Papepalali: VV TBM PB LP LM SM TRL JK NAH MNP MI.

Zothandizira

Zothandizira

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