Faʻasalaga i luga ma lalo: O a latou matafaioi i le tulaga lamatia i vaisu i tagata (2013)

Marco Leyton^a,** ma Paul Vezina^b,*

Faamatalaga tusitala ► Faamatalaga o le Puletaofia ma Laisene ►

O le mausa i amioga e fai ma vaisu e fesoʻotaʻi ma le faʻalauteleina ma le faʻaitiitia i galuega masani. Ua lipotia uma ia talaaga i tagata e pei foi o meaola manu. Ae, o faiga e mafua ai nei aʻafiaga tetee ma le auala latou te fesoʻotai ai i le amio ma le faʻaalia o mea ua fai ma vaisu e tumau pea le manino. I le iloiloga o nei suʻesuʻega a le tagata, tatou te faʻamatalaina ni numera o mea e ono aʻafia ai pe o matauina le tele o le toto poʻo le hypo-function e faʻaalia ai se faʻataʻitaʻiga e faʻapipiʻiina ai le aʻafiaga o nei tali faʻafeagai e uiga i uiga o amioga faʻafeusuai. Ogatotonu i lenei faʻataʻitaʻiga o le matafaioi na faia e le auai faatasi ai ma le leai o faʻamatalaga o mea ua fai ma vaisu ma o latou gafatia e faʻatonutonu ai le tali atu i fualaau faasaina ma isi taui. O galuega tetele ma faʻamalosialuga tulaga faʻamalosia e faʻalauteleina i le auai o nei faʻaaliga ma faʻaititia i le latou toesea. O suiga i le va o nei setete e ono mafua ai le vavalalata o mea e fiafia i ai ao avea ma vaisu e atiae ma faasino i faiga talafeagai e taulai i togafitiga.

3.1. Aafiaga o faʻaaliga

I le aotelega o tagata faʻatau, o le faʻaalia i le faʻamalosia o fualaau faasaina e aofia ai le tele o tali o mea e fai, amio ma faʻaleiga faʻale-tino (Carter ma Tiffany, 1999; Childress et al., 1988; O'Brien et al., 1990). O nei tali o fualaau faasaina e ogatusa ma o latou gafatia e faʻaalia ai tulaga faʻamalosi e faʻaosofia ai fualaau faasaina (Stewart et al., 1984; Robinson ma Berridge, 2003)¹.

O faʻasalalauga e aofia ai le faʻaitiitia o le taulai atu ma le totoa i taui ma le faateleina o le tatau ona tulituliloa ma faʻalatalata atu ia i latou. Ole faiga faʻapitoa e fesoʻotaʻi ma gaoioiga i totonu o le striatum e le manaʻomia ona malamalama (Fischman, 1989; Tiffany, 1990; Tamai Mamoe ma al., 1991; Winkielman et al., 2005; Childress et al., 2008; Field et al., 2009; Perkins, 2009; Berridge, 2012; Waters et al., 2012); mafaufaʻatasi manaʻoga e mafai ona vavalalata vavalalata i gaioiga i fausaga faʻaoga (Goldstein et al., 2009; de Lange et al., 2011). E ui lava i lea, o le naunau e lipoti atu e le tagata lava ia o se sui e masani ona faʻaaogaina ma iloiloga o le siosiomaga e maua mai i faʻamatalaga faʻaonaponei faʻaonaponei e faʻamaonia ai le faʻaalia o fualaau faasaina, ma o latou manaʻoga o tuʻinanau manaʻoga, e masani ona tupu i minute ma itula aʻo leʻi amataina le faʻaaogaina o fualaau faʻasaina. (Epstein et al., 2009). I se tulaga talitutusa, i suʻesuʻega a suʻesuʻega suʻesuʻega, faʻataʻitaʻiga ma saili taui taui ua lipotia mai e faʻalautele pe a uma ona faʻaalia i faʻaaliga e fesootaʻi ma le amphetamine (Culbertson et al., 2010; Tolivar et al., 2010), cocaine (Childress et al., 1988, 1993), ava malosi (George et al., 2001; Bragulat et al., 2008), sikaleti (Droungas et al., 1995; Carter ma Tiffany, 2001; Wray et al., 2011), heroin (Fatseas et al., 2011; Zhao et al., 2012a), ma taui masani e pei o meaai (Jansen, 1998; Kelley ma Berridge, 2002; Mahler ma de Wit, 2010) ma feusuaiga (Conaglen ma Evans, 2006; Kim ma Zauberman, i le lomitusi).

O foliga vaaia e sili atu ona malosi pe a iloa e tagata o le a le pine ae maua se avanoa e faʻaaoga ai fualaau faasaina (Carter ma Tiffany, 2001; Dar et al., 2005; Juliano ma Brandon, 1998). O nei mea, o le mea moni, o masani masani ia e faʻaalia ai foliga i le natura masani. O se ata ofoofogia o lenei mea na tupu talu ai nei na lipotia mai i le au malaga. O le ulaula i soʻo se lua (3-5.5 h) poʻo vaʻa umi (8-13 h) na atiaʻe ai sikaleti agai i le pito o le malaga. O le taʻavale i le pito i lalo o le vaʻavave puupuu na malosi e pei o le taʻavale i le pito i tua o le vaʻa umi ma sili atu le maualuga nai lo i latou na vaʻaia i le vaitau puupuu i le umi o le vaalele (Dar et al., 2010).

O faʻamatalaga e fesoʻotai i vailaʻau e mafai foʻi ona faʻaalia ai aʻafiaga o amio. O nei mea e aofia ai mea e fiafia iai (Childs ma de Wit, 2009, i le lomitusi) ma faitioga faʻapitoa (Cox et al., 2006; Hogarth et al., 2008; Field et al., 2009; Little et al., 2012), faʻamalosia o aiaiga (Foltin ma Haney, 2000), faʻateleina le amataga o le faʻaaogaina o fualaau (Herman, 1974), faapea foi ma le faateleina o le sailia o fualaau faasaina (Panlilio et al., 2005; Hogarth et al., 2007) ma le pulea e le tagata o ia lava (Herman, 1974; Droungas et al., 1995; Mucha et al., 1998; Hogarth et al., 2010).

3.2. Aafiaga o fualaau faasaina

E pei ona talanoaina i luga, o le tele o meaola manu ua faailoa mai ai o le faifai pea o pulega o fualaau faasaina e mafai ona suia ai o latou aafiaga. I totonu o tagata, o suiga aupito sili ona lelei ua suia ua matauina i le mulimulitaia o fualaau faasaina, o le faapalepale tumau i aafiaga taua o mea e faaosofia ai (Brauer et al., 1996) ma i le atuatuvale o aafiaga o opiates ma benzodiazepines (Hug, 1972)². I le faʻatusatusaina, o le avanoa e ono tupu ai le fualaau oona i tagata ua sili atu ona finau. O le uluai faʻamaoniga na maua mai i faʻamatalaga na faia i Amerika ma Iapani ina ua mavae le Taua Lona Lua a le Lalolagi i le taimi o faʻasologa o le faʻaleagaina tele o fualaau amphetamine. O tala talu mai le taimi talu ai mai lenei vaitau ua faʻaalia ai o le faʻaalia o le faʻaalia i le maualuga o amphetamines (e masani lava 100 mg poʻo le sili atu) e mafai ona oʻo atu ai i faʻamaʻi o le mafaufau, e aofia ai le faʻailoga ma le faʻaʻoleʻole (Connell, 1958; Ellinwood, 1967; Griffith et al., 1972; Sato, 1992; Sato et al., 1992). O nei aʻafiaga e mafai ona toe faia i totonu o falesuesue (Angrist & Gershon, 1970; Bell, 1973). O le taimi o le a oʻo atu ai i le mea muamua o le mafaufau na maua e fesuisuiai i le va o tagata taʻitoʻatasi, o se aʻafiaga e ono aʻafia i le faʻasolosolo, taimi faʻaaogaina, le faʻaleagaina o isi mea, ma le i ai o uiga faʻamalosia muamua. O le mea e ofo ai, o vaitau o le faʻaaogaina o vailaau faʻasaina na mulimulitaia i nisi o tagata e ala i se gasegase tumau i le toe faʻafouina o faʻamaʻi o le mafaufau pe a uma ona toe faʻaalia i se vaega maualalo ifo o fualaau (Sato, 1992; Sato et al., 1992).

E ui lava e manaia, o lipoti o loʻo i luga e leʻi maua ai faʻamaoniga faʻapitoa e faʻaalia ai le faʻateleina o fualaau faʻasaina e mafai ona maua ai le tulaga faʻapitoa-e pei o meaola i totonu o tagata. O lenei faʻamatalaga ua lipotia mai talu ai nei. I totonu o le ono o suʻesuʻega suʻesuʻe e fitu o suʻesuʻega falesuesue lea na maua ai e le au auai le laʻititi o 20 mg (po) o d-amphetamine i taimi taitasi, o le iloa o le malosi o fualaau faasaina na matauina (Laulau 1). I suʻesuʻega aupito lata mai, o faʻamaoniga e mafai ona maua lenei aafiaga i lalo o le pulea o le siosiomaga. Mataupu na mauaina ni aumaga se lua o d-amphetamine i totonu o le potu lava e tasi na lipotia mai se tali taua i le lona lua, ao oi latou na mauaina le lona lua i totonu o se potu eseʻese eseese, na faʻaalia, pe afai ei ai, faʻamaoniga o le faapalepale (Childs ma de Wit, i le lomitusi).

  

Laulau 1

Faʻalavelave faʻalagolago i le faʻalavelaveina o le tali atu i le toe faia d-amphetamine i tagata soifua maloloina soifua.

E maitauina o taimi taimi mo le faʻalauteleina-ma le faapalepale-pei o mea faʻapitoa e eseese³. E ui lava o le faʻalauiloaina o se mea tumau umi,Robinson ma Becker, 1986; Boileau et al., 2006), o le faapalepale e sili atu ona le tumau (Vogel et al., 1948; Hug, 1972; Brauer et al., 1996). O le mea moni, o se faʻalavelave tele o vailaʻau faʻasaina ma le soifuaga faaletino e mafua mai i le mafai gafatia o fualaau o fualaau faʻataʻitaʻi e tatau ona maua i se taimi umi pe a maeʻa le faʻapalepale (Merrall et al., 2010).

3.3. Aafiaga o faʻamatalaga ma faʻaaliga + fualaau oona i mataupu eseese mataupu

I vaega o loʻo i lalo, matou te toe iloilo ai aʻafiaga o fualaau oona ma faʻatau atu fualaau faasaina. O nei aʻafiaga e suʻesuʻe eseese i mataupu soifua maloloina e aunoa ma le tagofia o mea ua fai ma vaisu, i mataupu e lamatia mo vaisu, ma i mataupu e faʻaaogaina ai vailaʻau. O le eseesega i le va o nei fuainumera e taua e pei o fualaau faasaina ma fualaau faasaina e faailoa mai ai aafiaga eseese i tagata eseese. Talu ai o aʻafiaga o faʻataʻitaʻiga ma faʻateleina fualaau faʻasaina e mafai ona faʻafesoʻotaʻi ma uiga patino o meaalofa a le tagata lava ia, e mafai ona latou tuʻuina atu malamalamaga i mea e faʻavaeina ai le atinaʻe ma le faʻaalia o uiga faaosofia na faʻaalia i le mauaina ma le faʻaaogaina e le tagata lava ia o fualaau faasaina. O le mea moni, e pei ona masani ai, naʻo nisi o tagata e faʻataʻitaʻi i fualaau faʻasaina e faʻalauteleina le faʻaogaina o le vailaau (Tsuang et al., 1998; Zinkernagel et al., 2001; Anthony, 2002; Agrawal et al., 2012; Kendler et al., 2012). O faʻamaoniga ua faʻamaonia e aʻafia ai le alualu i luma i le tagofia o mea ua fai ma vaisu e aofia ai uiga tauleleia (Ayduk et al., 2000; Conrod et al., 2000; Tarter et al., 2003), talafaasolopito anamua o olaga (Hyman et al., 2006; Enoch et al., 2010), faʻafouina suiga masani o aganuu-aganuu (Nutt, 2012), eseesega o tagata taitoatasi i vailaʻau faʻasaina faʻamalosi tino (Ferguson ma Tyndale, 2011), ma faʻaopopo mea faʻapitoa faʻamaoni ma le le mautonu. O se faʻaaliga o nei faʻamatalaga mo le suʻesuʻeina o mea ua fai ma vaisu ma mea e fai ma vaisu, o le manaʻoga e faailoa ma faʻamaonia aʻafiaga e ono tulai mai i totonu o se vaega o tagata taʻitoʻatasi (vaai foi Saunders ma Robinson, lenei lomiga).

4.1. Aafiaga o faʻaaliga

O le faʻasalaga e tauia taui faʻapitoa e faʻaauau ai ona faʻagaoioia le tulaga o tagata ola maloloina (Knutson ma Cooper, 2005). O lenei mea na suesueina i se auiliiliga aupito sili e faatatau i tau tupe. I nei suʻesuʻega, e tele ituaiga o fuamoa e maua mai. E aofia ai: (i) faʻamatalaga masani o mataupu ua uma ona iloa e fesoʻotai ma le auai poʻo le leai foi o taui, (ii) faʻamatalaga e le faʻaituau lea e aʻoaʻoina e mataupu i le taimi o le suʻesuʻega, (iii) faʻaaliga e taʻu mai ai o le taui o le a tuʻuina atu pe a maeʻa le faʻatali po o le maea ai o le faʻaalia o se tali a le tagata o lo o galue, ma (iv) le taui lava ia. O nei vala uma e mafai ona aʻafia ai le tele o le tali tele ma pe o matauina i totonu ole faletalimalo poʻo le taʻavale (O'Doherty et al., 2004; Knutson ma Cooper, 2005). O le taulaiga o le iloiloga o loʻo i ai i luga o le auala e aʻafia ai le eseesega o nei tali taʻitasi e eseesega a tagata taitoatasi ma vaega.

I le faaopoopo atu i le tau tupe, o lipoti soifua maloloina a tagata soifua ua lipotia mai e faʻaalia ai le tele o faʻasoasoaga pe a maeʻa ona faʻaalia i faʻamatalaga e fesoʻotaʻi ma meaʻai (Small & al., 2001; Beaver et al., 2006; Hommer et al., I le lomitusi; Demos et al., 2012; Tang et al., 2012), tafaoga (Hamann et al., 2004; Cloutier et al., 2008; Demos et al., 2012), ma le ava malosi (Seo et al., 2011)⁴. O loʻo i ai se faʻamaoniga e mafai ona tuʻuina atu nei faʻataʻitaʻiga o le toto o le cerebral flow (CBF) faʻatasi ma se faʻaopoopoga o le faʻamalologa a le DA (pusa 1). Mo se faʻataʻitaʻiga, o le faʻamavaega a le STAR i fua o le soifua maloloina e mafai ona faʻamaonia faʻatasi ai ma le faʻatupuina o le fuaina o fua ole fua (IMP)Schott et al., 2008). Ae o le mea e sili atu ona taua, o faʻamaoniga o le faʻamaoniaina o le faʻamavaega a le ATA ua matauina i tagata soifua soifua soifua maloloina e taaalo i taaloga vitioKoepp et al., 1998) ma mulimuli i le faʻaalia i faʻamatalaga muamua na tuʻufaʻatasia ma le tau tupe (Zald et al., 2004; Schott et al., 2008; Martin-Soelch et al., 2011; i, Hakyemez et al., 2008), meaai (Volkow et al., 2002; Small & al., 2003), ava malosi (Yoder et al., 2009) ma le amphetamine (Boileau et al., 2007).

O le tele o le tali a le tali a le DA e mafai ona fesuisuiai ma le mautinoa o le a maua se taui. Mo se faʻataʻitaʻiga, i totonu o mea e le masani ai tagata, o le tele o faʻaopoopoga o taui na faʻailoaina mai i le faʻamaoniaina o le cell phone cell e faʻamaonia i lalo ole tulaga o le le mautonu (Fiorillo et al., 2003). O faʻamatalaga lata mai ua mafua ai le ono tulai mai o lenei aafiaga o le le mautonu i totonu o tagata: o maʻi o loʻo maua i le maʻi o Parkinson e maua ai le tele o le tali mai i le placebo, pe afai e logoina i latou o le avanoa e maua ai le L-DOPA o le 75% pe a faʻatusatusa i le 100% (Lidstone et al., 2010)⁵.

4.2. Aafiaga o faʻaaliga + faʻamaʻi

E pei ona vaaia i manu falesuesue, o loʻo i ai faʻamaoniga mo fegalegaleaiga faʻatasi i le va o fualaau faasaina ma faʻamatalaga faʻapitoa faʻataʻitaʻeli ma taʻiala taitasi i le tali i le isi. I tagata soifua maloloina lelei, o lenei mea ua sili ona matauina i ni suʻesuʻega se lua peitaʻi na faʻapupulaina le aafiaga dopaminergic o le methylphenidate e ala i le i ai o faʻafeiloaiga faʻaoga lelei (Volkow et al., 2002, 2004). I le suʻesuʻega muamua, na faia i le soifua maloloina lelei o meaai-faʻagata (16-20 h abstinent), o le tuufaatasiga o le maualalo o le methylphenidate (20 mg, po) ma meaʻai (visual, olfactory, taste) na faʻaalia ai le tele o faʻamalologa a le DA ma sili atu le talalaina e le tagata lava ia nai lo le na o ia (Volkow et al., 2002). Eseesega o tagata taʻitoʻatasi i le faʻamaoniaina faʻamaonia e faʻamaonia faʻatasi ma le fiaai ma le manaʻo mo meaai. I le suʻesuʻega lona lua, o le methylphenidate (20 mg, po) na faʻaaogaina ai le fuataga a le ATA pe a faʻatasi ma se galuega mathāmatika e mafai ai ona maua se taui tau tupe. O le tele o le tatalaina mai a le AT, o le sili atu o mataupu manaia na lipotia mai le galuega ia (Volkow et al., 2004).

O se suʻesuʻega lona tolu na tuʻuina atu muamua le faʻamaoniga manino o le faʻamautuina o fualaau faʻasaina e mafai ona taʻitaʻia ai le faʻaosofiaina o tagata i le DN (Mati. 1). O mataupu maloloina na maua ile tolu tootoo o d-amphetamine (0.3 mg / kg, po) i luga o isi faasologa o aso uma. A maeʻa le lua vaiaso, ona tuʻuina atu lea o le lona fa. O le tali a le AT i lenei faʻasaʻo lona fa e matua sili atu nai lo le mea na mafua mai i le fua muamua. O le lona lima o fualaau, na tuʻuina i le tausaga atoa mulimuli ane, na maua ai se faʻalavelave sili atu (Boileau et al., 2006). E le gata i lea, o fua uma o d-amphetamine sa faʻatautaia i le siosiomaga lava e tasi (o le PET), o loʻo tuʻuina mai ai taunuʻuga na maua i le faʻatusatusa ma le faʻaogaina patino o le siosiomaga. E ui o lenei suʻesuʻega e leʻi fuafuaina pe mafai ona faʻaalia le lagona o le ATA pe afai o le amphetamine sa faʻatonutonuina i se isi mea, e lua suʻesuʻega lata mai na faia i tagata e le faʻalagolago i fualaau faʻasaina o loʻo ogatasi ma le talosaga e mafai ona aʻafia ai le auai faatasi ma le leai o fualaau faasaina. le tele o tali faʻataʻitaʻiina a le DA. I le suʻesuʻega muamua, o le eseʻesega a tagata taitoatasi i le faʻateleina o le cocaine, o le faateleina o le extracellular DA na vaʻaia i talafaasolopito o le soifuaga o le faʻaaogaina o fualaau faasaina i luga o le auala: o le tele o fualaau oona ua faʻaaoga,Cox et al., 2009). I lenei suʻesuʻega, o tagata auai na saunia, faʻamalosi, ma pulea e le tagata lava ia fualaau faasaina ia latou masani masani. O lona uiga, na manino le auai mai ma fefaʻasoaaʻi faʻamatalaga o le koko. I le faʻatusatusa, i se isi suʻesuʻega lona lua e tutusa lava, o le soifua maloloina, e le faʻalagolago le faʻaaogaina o fualaau faʻasaina o loʻo faʻaaogaina se fua o le d-amphetamine. I lenei tulaga, o eseesega o tagata taitoatasi i le tatalaina mai o le AT, na matua le lelei le fesootaʻi ma le faaaogaina o fualaau faasaina:Casey et al., 2012). Talu ai ona o ia aafiaga ua lelei ona faamatalaina i suesuega na faia i totonu o fale suesue (Anagnostaras ma Robinson, 1996; Anagnostaras et al., 2002; Stewart ma Vezina, 1988, 1991; Vezina ma Leyton, 2009), o se faʻataʻitaʻiga faʻapitoa o faʻamatalaga o nei suʻesuʻega, o le tuʻufaʻatasia ma le leai o ni faʻamatalaga vavalalata ma fualaau faʻasaina e aofia ai faʻamatalaga e faʻafetaui ai le tali i le faʻamalosia o fualaau faasaina. O le mea lea, o le i ai o faʻataʻitaʻiga o faʻamanuiaga faʻapitoa e mafai ona faʻaalia ai le faʻaleleia o dopaminergic i le tali atu i se luitau faʻafomaʻi; o le leai o ia faʻaaliga e mafai ona taofia le faʻaalia o faʻamalosia atili tali a le ATA.

  

Mati. 1

Amphetamine-induced DA faʻalauteleina i tagata. O tamaʻitaʻi soifua maloloina e maua ni atumaga se lima d-amphetamine (0.3 mg / kg, po) aʻo tuʻuina i totonu se scanner PET. O uluai tolu inumaga sa faia i aso uma lona lua. O le fua lona fa na tuʻuina atu i le mulimuli i ...

4.3. Eseesega vavalalata tausaga: faʻafitauli mo le atinaʻe

O se tusi ua faʻaaogaina o loʻo taulaʻi atu i le eseesega o le tali atu i fua faʻatatau o tauleleʻa i tupulaga talavou (13-15 tausaga o le matua) e fesoʻotaʻi ma talavou matutua (vave 20s). Mo se faʻataʻitaʻiga, ua lipotia mai le tauleʻaleʻa e faʻaalia le sili atu o le faʻamalosiaga nai lo tagata matutua pe a tuʻuina atu i ai se mea e faʻamalosi ai e iloa ai le avanoa e tali atu ai mo tupe (Geier et al., 2010) ma i le tali i le mauaina o le taui (Ernst et al., 2005; Galvan et al., 2006). E le gata i lea, i totonu o le au matutua, o le tele o le tali atu i nei ala, o le maualuga o latou lagona e sailia ai togi o le tagata ma le fiafia e lipoti mai e le tagata lava ia (Bjork et al., 2008a)⁶. O nei tali o tausaga e faʻatulagaina e faʻatautaia ai feeseeseaiga i le atinaʻeina o faʻataʻitaʻituina ma faʻaaogaina taui taui (Spear, 2011; Ernst ma Fudge, 2009; Somerville et al., 2010). O le mea moni, o loʻo i ai le faʻamaoniga e faapea o nei aʻafiaga tetele o loʻo i ai le faʻamuamua. Mo se faʻataʻitaʻiga, i totonu o le soifua maloloina o tamaiti aʻoga (n = 58), o le telē tele o le tali i tali o meaʻai, o le sili atu o le mamafa o mataupu na mauaina i le mulimulitaʻi i le ono masina mulimuli ane; o le telē le tali atu i feusuaiga, o le sili atu lea o le tele o feusuaʻiga (Demos et al., 2012).

5.1. Aafiaga o faʻaaliga

O se tala laʻititi e faamatalaina ai tali i taui ma taui taui i mataupu e lamatia ai le faʻaaogaina o vailaʻau (vaai Laulau 2 ma Ma3) .3). Mo se faʻataʻitaʻiga, pe a faʻatusatusa atu i le faʻaitiitia o le lamatiaga o le faʻalavelave, o le tele o tali taʻitasi ua maitauina i mataupu e aʻafia ai aiga mo le ava i le taimi o le faatinoina o le galuega a le Iowa Gambling Task (Acheson et al., 2009) ma mulimuli i le faʻaalia o le inu ava (Kareken et al., 2004; Oberlin et al., 2012). I le faʻatusatusaina, i suʻesuʻega e le masani ai poʻo isi faʻamatalaga tau tupe faʻaituau e tuʻuina atu, o tagata e maualuga le lamatia o loʻo faʻaalia ni tali laiti atu nai lo pulega faʻalesoifua maloloina (Andrews et al., 2011; Schneider et al., 2012; Yau et al., 2012).

  

Laulau 2

GMRI FAʻAMATALAGA faʻaauau gaioioiga o loʻo matauina i tagata soifua i le auai ma le leai o ni faʻamatalaga faʻapitoa. O mataupu o tagata taʻitasi e iai ni faʻafitauli i, poʻo faʻatasi ai ma faʻafitauli o mea ua fai ma vaisu.

  

Laulau 3

PET [¹¹C] raclopride tali tuusaʻo na matauina i tagata soifua i le auai ma le leai o taui faʻaalia. O mataupu o tagata taʻitasi e iai ni faʻafitauli i, poʻo faʻatasi ai ma faʻafitauli o mea ua fai ma vaisu.

5.2. Aafiaga o faʻaaliga + faʻamaʻi

E i ai le faʻamaoniga o aʻafiaga o fualaau faasaina ma fualaau faasaina e mafai ona fegalegaleai i mataupu e lamatia mo vaisu. I totonu o tagata e le o faalagolago i le inu sikaleti sikaleti, mo se faʻataʻitaʻiga, o le inu ava malosi na maua ai le tele o tali i tali sikaleti (Tupu et al., 2010). I le isi itu, o loʻo i ai le faʻamaoniga e mafai e faʻataʻitaʻiga ona faʻaleleia aafiaga o fualaau. I mataupu na maualuga le lamatiaga mo vaisu, na faateleina le tali a le DA e uiga i mataupu maualalo laʻititi pe a faʻaaogaina le vailaau i masani masani (Setiawan et al., 2010) ae na faʻaitiitia pe a faʻaaogaina le fualaau faʻasaina i le leai o fualaau faʻatau fualaau (Casey et al., 2012). O le tali faanatinati na atagia mai ai se uiga masani faaleaiga ma se aafiaga o le faaaogaina o fualaau faasaina: o le sili atu i le talafaasolopito o le soifuaga o fualaau faasaina, o le laitiiti o le tali a le AT (Casey et al., 2012). O aʻafiaga o uiga faʻa-aiga ma taimi ua tuanai o fualaau faasaina na tutoatasi. Na faaalia lenei mea i ni auala se lua. Muamua, sa aofia ai se vaega e aofia ai le faʻamalosia o fualaau faʻasaina e faʻaaoga ai mataupu e fetaui ma le faʻaaogaina o vailaʻau i mataupu e sili ona lamatia ae leai se talafaasolopito o aiga o faʻaaogaina fualaau oona. O mataupu ogaoga ma se talafaasolopito o aiga o le faʻaaogaina o vailaau oona na faʻaalia ai le tuʻufaʻatasia o le DC nai lo le faʻaogaina o nei fualaau faʻatau fualaau faʻamalosi e faʻaaoga ai le kulupu poʻo le faʻamalosia o mataupu tau fualaau faasaina. Lona lua, e aofia ai le faʻaaogaina o fualaau faasaina o se vailaau e faʻafefeteina ai i le fuainumera o fuainumera faamaumauina e leʻi faʻaitiitia ai le saofaga o talafaasolopito o aiga. O lona uiga, o le aiga ma le faaaogaina o fualaau faasaina na maua ai le aafiaga tutusa ae na avea o ni tagata e tutoatasi.

6.1. Aafiaga o faʻaaliga

E lua ni suʻesuʻega faʻataʻitaʻiga na faʻataunuʻuina e le tagata lava ia e faʻamalosia ai le faʻaaogaina o le striatum e ala i le faʻaaogaina o fualaau faʻatau fua i vailaau mataupu mo suʻesuʻega mo le faʻaaogaina o vailaʻau.s (Chase et al., 2011; Tang et al., 2012). TO tali tali mai e mausali (Schacht et al., 2011) ma maualuga, pe a faʻatusatusa i tagata e le o ni mea faʻatauvalea. Mo se faʻataʻitaʻiga, pe a faʻatusatusa atu i tagata faʻasalalau fefaasoaaʻi masani, ua lipotia mai i latou e inu le inu e faʻaalia le sili atu o le ava malosi e faʻaaogaina ai le malosi (Vollstädt-Klein et al., 2010; Ihssen et al., 2011): o le tele atu o tali, o le sili atu foi lea o le faʻailoaina atu o mea faʻapitoa (Vollstädt-Klein et al., 2011) ma o le sili atu foi ona ogaoga o uiga leaga o le inu ava malosi (Vollstädt-Klein et al., 2010). I se tulaga talitutusa, i se suʻesuʻega tele o 326 tagata inu ava malosi, o le sili atu o le ava malosi na mafua ai le faʻamalosia o le malosi, o le tele atu lea o le malosi o le faʻaaogaina o le ava (Claus et al., 2011)⁷.

O loʻo i ai faʻamaoniga e mafai ona tuʻuina atu faʻamalosiaga tetele i luga nei i le faateleina o le faʻamalologa a le ATA. Suiga i le PET o faʻamaufaʻailogaina o faʻamaumauga a le PET ua faʻatautaia pe a maeʻa ona faʻaalia i faʻaaliga e fesootaʻi ma le koko (Volkow et al., 2006; Wong et al., 2006; Fotros et al., 2012) ma heroin (Zijlstra et al., 2008). O le sili atu i le faʻamaoniaina faʻamaumauga a le AT, o le sili atu lea o le naunau (Volkow et al., 2006; Wong et al., 2006; Zijlstra et al., 2008; Fotros et al., 2012).

E pei ona vaaia i isi fuainumera, o loʻo i ai foi faʻamaoniga ia i latou e faʻaaogaina mea e faʻaaogaina ai vailaʻau e faʻalavelaveina ai le faʻamalosiina o le tino nai lo le faʻaopoopoga pe a le oi ai faʻamatalaga o mea ua fai ma vaisu. Pe a faʻatusatusa i le pulea o mataupu, o faʻalavelave faʻafuaseʻi e tutupu i le tali atu i ata o mea taumafa i mea inu malolosi (Ihssen et al., 2011) ma le le masani ai poʻo se isi itu tau tupe e le faʻaituau i totonu o tagata ulaula (Peters et al., 2011) ma faʻamamafa ai le ava malosi (Wrase et al., 2007; Beck et al., 2009; ff Bjork et al., 2008b).

6.2. Aafiaga o faʻaaliga + faʻamaʻi

I totonu o mataupu e faʻaaogaina ai vailaau faʻaaogaina, faʻaalia ai le faʻamalosia o tali a le DC, ua lipotia mai o le a faʻaitiitia pe a faʻatusatusa i latou na matauina i pulega maloloina (Volkow et al., 1997, 2007; Martinez et al., 2005, 2007, 2011, 2012; Wang et al., 2012; Thompson et al., I le lomitusi; ff Urban et al., 2012; Vaʻai Laulau 2 ma Ma3) .3). O nei faʻaititia e ono ono faʻaleagaina ai le ata o le falemaʻi. O le faʻaititia o le tali a le AT, o le sili atu foi lea o le faʻamalosia o le faʻamalosia o fualaau faʻasaina o loʻo matauina i ni vasega eseese lea na maua ai le fualaau faasaina ma ona faʻamatalaga faʻapitoa (Martinez et al., 2007) ma le sili atu ona leaga le taunuʻuga o le falemaʻi i le tulitataoina (Martinez et al., 2011; Wang et al., 2012).

Ae ui i lea, i suesuega uma o loʻo taua i luga, o le faʻamaumauga a le NA na fuaina i le leai o fualaau faasaina. O lenei mea e mafai ai, e tusa lava pe iʻu i le taimi ua leva ona fai ma vaisu, o le faaitiitiga o tali a le MA na atagia, a itiiti mai i se vaega, pe o le le maua o fualaau faasaina e talafeagai ma mafai ai ona faaalia le faaleleia o le dopaminergic poo le i ai o fualaau faasaina e le totogia lenei tali (Vezina ma Leyton, 2009). Ua naʻo le tasi le suʻesuʻega ua matou iloa na faʻataʻitaʻiina ai lenei manatu. I lenei suʻesuʻega, na faʻaaogaina ai le amphetamine i le cocaine i taimi o suʻega ma pe leai ni faʻamatalaga o fualaau oona (vitio o tagata e faʻatusaina fualaau faʻatau fua). Pe a faʻatusatusa i le faʻatinoga o le suʻega na faia e aunoa ma ni fualaau faasaina, o le iai o faʻamatalaga o fualaau faasaina na faʻaitiitia ai le tali a le AT (Volkow et al., 2008), o se faʻafeagai e faʻafeagai ma le itu i mea na valoia e tusitala. Ae o lenei faʻamatalaga e faaopoopo atu i le faʻamaoniga e mafai e faʻamatalaga tau le siosiomaga ona faʻafesuiaʻia aafiaga o vailaau faʻasaina o se faʻafitauli o fualaau faasaina. E le gata i lea, e pei ona matauina e le au tusitala, talu ai e leʻi moni le faʻamaonia o fualaau faasaina, o le a ono iai se faʻamatalaga taufaʻailoga faʻamaonia e fesoʻotai ma le faʻaitiitia o le faʻamaumauga a le DA (Schultz et al., 1997; Yoder et al., 2009). O lenei faʻamatalaga, e ui i lea, e tumau pea le faʻamalamalamaina seia oʻo ina lipotia le tele o suʻesuʻega e suʻeina ai le talosaga. O isi mea e mafai ona taʻitaʻia ai le faʻaitiitia o le faʻamaʻiina o le faʻamaʻiina o fualaau faʻasaina i fuainumera e faalagolago i le vailaʻau e aʻafia ai le aʻafiaga o le tele o fualaau faʻasaina (Little et al., 2003, 2009) ma uiga muamua o le tulaga lamatia (Casey et al., 2012). E mafai foi ona talafeagai mea e gata mai ai. E pei ona taua i Narendran ma Martinez (2008), o le faʻaitiitia o le dopaminergic tali atu e mafai ona atagia ai le faʻaititia i totonu o le D2 poʻo le D3 DA le aʻafiaga o le receptor, faʻaititia i le fua faatatau o le D3 i le D2 DA receptors, poʻo le faʻaopoopoga i le faasologa o vaevaega TA. Muamua taumafaiga e faʻatalanoa nisi o nei mea, e ui i lea, ia fautua atu o le faʻamalosia o mea tau vailaau faʻasaina, faʻataʻitaʻiina i lalo o tulaga tutusa e pei ona i ai i luga o suʻesuʻega o loʻo i luga, e maualalo ifo nai lo tulaga maualuga o le taotoga o le DA (Martinez et al., 2009) ma sili atu nai lo le maualalo ifo ole laʻasese o le D3 DA i le D3 DA receptor o loʻo maua ai le tamaoaiga o le mafaufau e pei ole midbrain ma globus pallidus (Boileau et al., 2012).

O lenei iloiloga na mafai ona maua e ala i fesoasoani a le Canadian Institute of Health Research (MOP-36429 ma MOP-64426, ML) ma National Institutes of Health (DA09397, PV). Matou te faapaiaina lenei iloiloga ia Ann Kelley. O lona malosi malosi, o lona fiafia i le olaga, ma le malamalama loloto ma le naunau mo lana galuega na avea ai o ia ma se faataitaiga mo i tatou uma.

¹O aʻafiaga e fesoʻotaʻi ma opiates ma le ethanol e maua ai se faʻalavelave faʻalavelave o fualaau faʻasaina ma faʻaaogaina fualaau faʻasaina (Wikler, 1973; Eikelboom ma Stewart, 1982; Stewart et al., 1984; O'Brien et al., 1998; Stewart, 2004). Mo talatalanoaga pe faʻapefea ona mafai e faʻafitauli o tupe paʻu ona faʻaopoopoina tulaga faʻamalosia ma le faʻaogaina o faʻamatalaga manaʻoga, vaʻai Toates (1986), Hutcheson et al. (2001), ma Berridge (2012). O se matafaioi mo vaega o le dysphoric i le tausiga o le faaosofiaina o le faaaogaina ua faapea foi ona fuafuaina i se tulaga tetee tetee vaaiga i le faaaogaina o fualaau faasaina (Koob ma Le Moal, 1997). O nei tulaga e masani ona matauina i se taimi vave pe a maeʻa ma faʻaauau pea ona aʻafia i fualaau faʻasaina, ae o la latou faʻasolosolo mulimuli ane i luga o faʻamaumauga ua tuʻuina atu e fesoasoani i le toe faʻafoʻi (Siegel, 1979).

²O le faʻapalepale faʻamaloilo e faatatau i le faʻaitiitia o le malosi o fualaau faasaina poʻo le aoga (e pei o le maualuga o le fualaau) faʻatasi ai ma le faʻaalia soo. I se isi itu, o le faʻalauiloaina, faʻapipiiina foi o le toe faʻafesoʻotaʻi, e faasino i le faateleina o le malosi o fualaau faasaina poʻo le malosi (o nisi taimi e faʻasinoina o se tali taua i se faʻasolosolo le aoga). O nei faaupuga e lua o loʻo faʻamatalaina ai manatu mamafa; i latou ma latou lava latou te le o faʻamatalaina le masini.

³E ui lava i taimi eseese mo le faʻapalepale ma le faʻalauiloaina, e mafai ona faʻaogaina faaletino ona o nei faʻatulagaga taitasi e mafai ona tutupu i le taimi e tasi, i totonu o faiga eseese, e pei o, mo se faʻataʻitaʻiga, i latou e faatonutonuina le siʻosiʻomaga faʻatasi ai ma na faʻasalalauga faʻaosofia faaosofiaga.

⁴O faʻamalosiaga faʻafuaseʻi e mafai foi ona tupu pe a maeʻa tupe (Kühn et al., 2011). I lenei suʻesuʻega, o e sa auai e 154 14-tausaga le matua tagata taaalo vitio. Taʻalo masani (> 9 h / vaiaso) faʻaalia se lapoʻa striatal tali atu i tupe leiloa e pei ona fuaina i le faʻatinoina maneta resonance imaging (fMRI) faʻatusatusa i laʻititi masani taʻalo. O le maitau, faʻaosofia faʻailoaina o leiloa e sili malamalama mo taʻaloga. Faʻatasi ai ma tagata tomai faapitoa taʻaloga, sili atu striatal faʻatoagaina mai faʻapea foi ona valoia vave gaioiga, o se aʻafiaga ono atagia ai se faʻalauteleina le agavaʻa o faʻaaliga e faʻaaogaina auala auala (Wan et al., 2011).

⁵O nei tuutuuga o le tuʻuina atu o le faʻamaonia o le faʻataʻitaʻiga, o se vaega autu o le vavalalata. E le gata i lea, i togi, o le tau le maua o le faʻatagaina e mafai ona faʻaleleia ai se gaioiga faʻaosofia (Robinson ma Berridge, 2012) ma taʻitaʻia ai le faʻaalia o amioga i se luitau amphetamine (Singer et al., 2012).

⁶E i ai foi tulaga pe a maitauina tali maualalo ifo i lalo, e ui o le taunuuga na lipotia mai i le taimi nei e faigata ma o le a tumau pea le le mautonu o itu taua. Mo se faʻataʻitaʻiga, ua maitauina i lalo o tali a le autalavou ma tagata matutua le iloiloina o se mea ao le i mafai ona tali atu i ai (Geier et al., 2010). E faʻapea foi, aʻo talavou e sili atu tali latou te tali atu nai lo tagata matutua i taui (Ernst et al., 2005; Galvan et al., 2006), o le tupe maua i le tele o tali i le va o le tele ma le itiiti o taui ($ 5 i le 20 cents) ua lipotia mai ua itiiti ifo (Bjork et al., 2004). O se tasi o faʻamatalaga, o talavou e faʻaalia tali sili atu i taui ma tauleleʻa faʻasalalauga, ae o tali laiti i nisi faʻamatalaga le mautonu e manaʻomia ai nisi faʻamatalaga auiliili.

⁷O se suʻesuʻega talu ai nei o loʻo faʻataʻitaʻiina ai pe faʻafefea ona faʻaopoopo ma faʻaitiitia i totonu o galuega faʻavae e mafai ona fesuisuiaʻi ma amioga faʻatau fualaau ma mea ua fai ma vaisu. O se tagata maʻi gasegase na maua ni sauniga o le faʻavaveina o le magnetal (TMS) o le tua o le cingulate tua. O gaioiga faʻaitulagi ma le faʻatuatuaina e le tagata lava ia na fuaina i le taimi lava e tasi. E pei ona faʻamoemoeina, o le inu malosi o le 'ava malosi na fesoʻotaʻi ma le faʻatupulaia o le gaioiga i le tumutumu. O le mea e ofo ai, o le TMS na faʻaitiitia uma le manava ma le faʻaaogaina o le nucleus accumbens, o aʻafiaga na tausia mo le tolu masina (De Ridder et al., 2011).

⁸O faʻasologa o le 'ai ole Binge e faʻasoa faʻatasi ai mea masani masani ma faʻafitauli o mea e faʻaaogaina ai vailaʻau ma mea faʻaletonu e faʻaletonu. O le sailia o le Dysregulated, o le faʻaosofia o le manava, ma le tele o isi mea ua fai ma vaisu, e masani ona faʻaumatia. O le tele foi o mea taua ua fuafuaina e avea ma ituaiga o vaisu amioga, e ui lava o lenei manatu e sili atu ona feteenai. Mo se talanoaga o nei mataupu, vaai Ziauddeen et al. (2012).

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