Maikutlo: Hoo e ka bang ntho e 'ngoe le e' ngoe ka bokhoba ba tahi e entsoe ka mokhoa o sa hlakaheng.
Adv Psychosom Med. 2011; 30: 22-60. Epub 2011 Apr 19.
Gardner EL.
mohloli o moholo
Karolo ea Neuropsychopharmacology, Lenaneo la Lipatlisiso la Intramural, Setsi sa Naha sa Tlhekefetso ea Lithethefatsi, Litheo tsa Naha tsa Bophelo, Baltimore, MD 21224, USA. [imeile e sirelelitsoe]
inahaneloang
Lithethefatsi tse lemalloang li tšoana ka hore ka boithatelo li laoloa ke liphoofolo tsa laboratori (hangata ka cheseho), le hore li matlafatsa tšebetso ea potoloho ea moputso ea boko (e hlahisang 'phahameng' e sebelisoang ke mosebelisi oa lithethefatsi). Potoloho ea moputso oa mantlha e na le potoloho ea 'in-series' e hokahanyang sebaka sa ventral tegmental, nucleus accumbens le ventral pallidum ka mothapo o moholo oa forebrain.
Le ha qalong ho ne ho lumeloa hore e kentse ntlha e hlakileng ea molumo oa hedonic, lipotoloho tsena joale ho lumeloa hore li sebetsa ka mokhoa o rarahaneng ho feta, hape li beha tlhokomelo, tebello ea moputso, ho se tiisoe tebello ea moputso le tšusumetso ea tšusumetso. 'Hedonic dysregulation' ka har'a lipotoloho tsena e ka lebisa ho lemaleng.
Karolo ea bobeli ea "dopaminergic" potolohong ena ea moputso ke karolo ea bohlokoahali e lemalloang ke lithethefatsi. Lithethefatsi tsohle tse lemalloang li tšoana hantle hore li ntlafatsa (ka kotloloho kapa ka ho sa tobang kapa le ka transsynaptically) dopaminergic moputso synaptic function in the nucleus accumbens. Boitlhopho ba taolo ea lithethefatsi bo laoloa ke li-nucleus accumbens dopamine level, mme e etsoa ho boloka nucleus accumbens dopamine kahare ho sebaka se itseng se phahameng (ho boloka boemo ba hedonic bo batlang).
Bakeng sa lihlopha tse ling tsa lithethefatsi tse lemalloang (mohlala, li-opiate), mamello ho litlamorao e ba teng ka ts'ebeliso e sa foleng. Postuse dysphoria e ntan'o tla ho busa moputso oa potoloho ea hedonic, 'me ba lemaletseng lithethefatsi ha ba sa sebelisa lithethefatsi ho phahama, empa ba mpa ba khutlela setloaeling (' otloloha '). Lijana tsa boko tse sebetsanang le litlamorao tse khahlisang tsa lithethefatsi tse lemalloang ke anatomically, neurophysiologically le neurochemically li fapane le tse amanang le ts'epahalo ea 'mele, le ho ba kenang takatso le ho khutla hape.
Ho na le phapang ea bohlokoa ea liphatsa tsa lefutso ea ho ba kotsing ea ho lemalla lithethefatsi, empa maemo a tikoloho a joalo ka khatello ea maikutlo le ho hloloa ke sechaba a boetse a fetola mekhoa ea ho putsa bokong ka tsela e fanang ka ts'oaetso ea bokhoba ba tahi. Ka bokhutšoanyane, mofuta oa etiology oa 'bio-psycho-social' o tšoere hantle haholo bakeng sa tahi.
Ho lemalla ho bonahala ho lumellana le boemo ba ho se sebetse ba hypodopaminergic maemong a kelello a kelello. Lithuto tse nang le phetoho e matla ho batho li eketsa kholo ea tumello ena. Bopaki bo totobetseng bo boetse bo hlahisa mekhoa ea serotonergic, opioid, endocannabinoid, GABAergic le glutamatergic.
Ka bomalimabe, bokhoba ba lithethefatsi bo tsoela pele ho tloha tšebelisong ea boithabiso e tlang ka linako tse ling ho isa ho ts'usumetso e tloahang ho tšebeliso e tloahelehileng. Sena se tsamaisana le ho hola ho tloha mokhoeng o khannoang ke moputso ho ea ho boitsoaro bo khannoang ke lithethefatsi.
Kholiseho ena ea boits'oaro e lumellana le ho hola ka neuroanatomical ho tloha ho "ventral striatal" (nucleus accumbens) ho laola dorsal striatal taolong ea boitšoaro bo batlang lithethefatsi.
Likarolo tse tharo tsa khale tsa ho lakatsa le ho oela hape ke (a) ho pepesetsoa lithethefatsi tse lemalloang, (b) khatello ea maikutlo, le (c) ho pepeseha boits'oaro ba tikoloho (batho, libaka, lintho) tse neng li amana le boits'ebetso ba lithethefatsi pele. Ho khutla hape ho bakoang ke lithethefatsi ho kenyelletsa li-bokong tsa nucleus le dopamine ea neurotransmitter.
Ho boela o sithabetsoa ke khatello ea maikutlo ho kenyelletsa (a) khubu ea mokokotlo oa amygdala, mokokotlo oa bethe ea stria terminalis, le neurotransmitter corticotrophin-releasing factor, le (b) lateral tegmental noradrenergic nuclei ea boko stem le neurotransmitter norepinephrine.
Ho khutla ha Cue-triggered ho kenyelletsa mokokotlo oa basolateral oa amygdala, hippocampus le glotamate ea neurotransmitter. Tsebo ea neuroanatomy, neurophysiology, neurochemistry le neuropharmacology ea ts'ebetso ea lithethefatsi tse kenang bokong hajoale e ntse e hlahisa maano a fapaneng a kalafo ea pharmacotherapeutic ea ts'ebeliso ea lithethefatsi tsa joala, eo tse ling tsa tsona li hlahang li tšepisa.
Tokelo ea Copyright © 2011 S. Karger AG, Basel.
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