J Reward Defic Syndr 1 (1): 46-64.
Kenneth Blum1-5,9, Benjamin Thompson6, Zsolt Demotrovics7, John Femino3,8, John Giordano9, Marlene Oscar-Berman10, Scott Teitelbaum1, David E. Smith3,11, A. Kennison Roy12, Gozde Agan3, James Fratantonio3, Rajendra D. Badgaiyan13 le Mark S. Khauta14,15
1Lefapha la Psychiki, Sekolo sa Bongaka le Setsi sa Bongaka sa McKnight, Univesithi ea Florida, Gainesville, FL, USA
2Lefapha la Tlhatlhobo ea Tlatsetso le Phekolo, Setsi sa Pholoso ea Malibu Beach, Malibu Beach, CA, USA
3Dominion Diagnostics, Inc., Kingstown Leboea, RI, USA
4IGENE, LLC., Austin, TX, USA
5RDSolutions, Del Mar, CA, USA
6Lenaneo la Behavioral Neuroscience, Boston University School of Medicine, le Boston VA Healthcare System, Boston, MA, USA
7Eötvös Loránd University, Setsi sa Psychology, Budapest, Hungary
8Setsi sa Pholoso ea Meadows Edge, North Kingstown, RI, USA
9Setsi sa Naha sa Bongaka ba Holistic, North Miami Beach, FL, USA
10Mekhatlo ea Psychiatry, Neurology, le Anatomy & Neurobiology, Boston University School of Medicine, le Boston VA Healthcare System, Boston, MA, USA
11Setsi sa Bophelo le Botsofali, Univesithi ea California e San Francisco, San Francisco, CA, USA
12Biobehaivereal Medical Corporation, Metairie, LA, USA
13Lefapha la Psychiatry, Univesithi ea Minnesota College of Medicine, Minneapolis, MN, USA
14Motsamaisi oa Tsamaiso, Tsamaiso ea Ts'ebeliso ea Lithethefatsi (DEA) Setheo sa thuto, Washington, DC, USA
15Mekhatlo ea Psychiatry & Behaevealal Science ho Keck, University of Southern California, Sekolo sa Bongaka, CA, USA
inahaneloang
Ho na le ba bang ba fanang ka maikutlo a hore bokhoba ba tahi le ts'ebeliso e mpe ea lithethefatsi ha se mafu ho hang ebile ha se litlamorao tsa bokuli ba kelello joalo ka ha bo tšehelitsoe haufinyane ke American Society of Addiction Medicine (ASAM). Ba bang ba ka pheha khang ea hore makhoba a ka tlohela ka bo bona le ho lekanyetsa ho noa ha bona le lithethefatsi. Ha ba itlhahisa lenaneong la kalafo kapa ba kena lenaneong la 12 Step & Fellowship, batho ba bangata ba lemalloang ba qetella ba tlohetse ho ithiba. Leha ho le joalo, ha tahi e laoloang e hloleha, ho ka ba le mekhoa e meng e atlehileng e lumellanang le lihlopha tse itseng tsa batho. Ka maikutlo ana a litsebi, re leka ho khetholla liphapang tsa motho ka boeena mabapi le ho hlaphoheloa, ka ho hlakisa metheo ea limolek'hule ea methapo ea mohato ka mong oa Lenaneo la Mehato e 12. Re hlahloba tšusumetso eo motheo oa limolek'hule oa methapo ea methapo ea mehato e 12 e ka bang le eona ho Reward Deficiency Syndrome (RDS) leha o lemaletse likotsi tsa liphatsa tsa lefutso. Patlo ena e se e phethetsoe karolo e 'ngoe ke Blum le ba bang ka 2013 Springer Neuroscience Brief. Morero oa maikutlo ana a litsebi ke ho hlakisa hakhutšoaane lihokelo tsa limolek'hule le liphatsa tsa lefutso, haholo ha li amana le karolo ea liphetoho tsa epigenetic tse ka etsahalang ho batho ba eang libokeng tsa AA khafetsa. E kopa potso ea hore na "manane a 12 a mananeo le botsoalle" a baka tšebetso ea methapo ea pelo mme a tsoela pele ho ata ha dopamine D2 receptor leha a nkile hypodopaminergic mofuta oa polymorphisms joalo ka DRD2 A1 allele. Lingaka tsa "maikutlo a tšoanang" tsa ASAM lia tseba hore bakuli ba kalafo ntle le "psycho-social-spiritual-trio", ba kanna ba se fumane melemo ea bohlokoa e fanoang ke ho amohela lithuto tsa mehato e 12. Na re betere ha re kopanya kalafo e thusang kalafo (MAT) e ratang ho kopanya dopamine agonist modalities (DAM) kamoo ho ka khonehang li-activator tsa histone-deacetylase le mehato e 12 e lateloang ke lenaneo le amohelang e 'ngoe kapa e' ngoe? Leha ho na le lipotso tse ngata tse sa arabeloang, bonyane re fihletse nako eo "mahlale a kopanang le ho hlaphoheloa", mme ka ho etsa joalo, a ka tsoelang pele ho lopolla thabo ho hlaphoheloeng.
Keywords
Mehato ea 12, Fitness, Bomoea, Dopamine agonistic modalities (DAM), Molimo, tlhahlobo ea liphatsa tsa lefutso, Neuroepigenetics, Moputso oa khaello ea Reward (RDS)
Selelekela
Likarolo tsa limolek'hule tsa The Twelve Step Program tse amoheloang ke lihlopha tsa ho ithusa tse kang Alcoholics Anonymous (AA) le Narcotic Anonymous (NA) ke tsona mohopolo oa setsebi sena. Morero ke ho tsebisa sechaba se lemaletseng hore ho latela mesebetsi e sa tsoa sibolloa ea "potry" ea boko, mekhoanyana e sebetsanang le lithuto tsa methati ea methapo ea 12 e kanna ea utloisisoa.
Rea tseba hore makhoba a lekholo a tahi a ntlafalitseng mehato ena mathoasong a lilemo tsa bo 1930 a entse joalo, ka matla, ntle le lisebelisoa tsa mahlale tseo re nang le tsona kajeno. Boko e ne e le sephiri sa 'nete, ho ne ho tsejoa hanyane haholo ka tšebetso ea eona haholo-holo karolo ea li-neurotransmitters le moputso oa potoloho. Ka ho fihla ha mahlale le meriana ea lekholo la bo21 la lilemo, haholo-holo mahlale a morao-rao, mahlale a qetella a fumane "The 12 Step Program and Fellowship". Liphiri tse hokahanyang tšebetso ea boko le moputso lia phutholloa.
Kutloisiso ea maqhubu a biuro ea neuro-molek'hule ea mehato ea The 12 le mosebetsi oa lihlopha tse fapaneng joalo ka Al-Anon e kanna ea ba mohato o mocha hape oa bohlokoa tseleng ea ho ba le ho lula o hloekile o hlaphohetsoe. Ho amohela melao-motheo ea neurobiology ea molek'hule ho ka qetella ho lebisitse ho bophelo bo botle ho hlaphoheloa.
Ho na le bopaki ba hore ka lenaneo la mehato e 12 le lipuisano tsa botsoalle lipakeng tsa Pre-Frontal Cortex-Cingulate (sebaka sa ho etsa liqeto) le Nucleus Accumbens (NAc) [sebaka sa boits'oaro ba takatso] se a ntlafatsoa. Liphuputso tse fetang tse mashome a mahlano tsa boithuto ba mahlale bo mabapi le mesolimbic li fane ka leseli la mekhoa ea methapo ea kutlo e amehang bokong ba lithethefatsi le takatso ea motho ea thabo. Ka bokhutšoanyane, sebaka sa boko moo motho a bang le maikutlo a boiketlo se bitsoa Mesolimbic System mme se bitsoa setsi sa meputso. Setsi sa moputso ke moo melaetsa ea lik'hemik'hale, ho kenyeletsoa dopamine (DA), serotonin, enkephalins, le γ-aminobutyric acid (GABA), li sebetsang 'moho ho fana ka tokollo ea letlooa la DA ho NAc. Hoa tsebahala hore liphatsa tsa lefutso li laola tšebetso ea pele, polokelo ea methapo, metabolism, sebopeho sa kamohelo ea mmele, le katabolism ea methapo ea kutlo. [1-3]. Ho fapana ha polymorphic liphatseng tsena tsa lefutso ho ka lebisa ho senyeheng ha liketsahalo tsa methapo ea kutlo tse bitsoang "Brain Reward Cascade" e tlisang tokollo ea DA [4] (Setšoantšo sa 1a & 1b, 2, 3). Ho felisoa ha Cascade ena ho tla lebisa ho tsitsinyehong le ho sebetsanang le lefu la homeostasis la DA. Dopamine e thehiloe e le molek'hule oa thabo le oa khatello ea maikutlo. Phokotso efe kapa efe mosebetsing oa DA e ka baka khaello ea moputso e lebisang boits'ebetsong ba ho batla lintho [5].
Kamora lilemo tsa 30,000, Homo sapiens e ntse e fetoha. Ka tlhaho re ikemiselitse ho noha, ho ja, ho ikatisa le ho lakatsa liphihlelo tse monate. Batho ba bile teng ka tšohanyetso; mehlala e 'maloa ea mekhoa ea morao-rao ke moriri o moputsoa o motšo, mahlo a buluu le mamello ea lactose. Phetoho ea ho ba agrarian ho tsoa ho tsoma le ho bokella mekhatlo ea batho, e lumelletsoeng liphetoho tse ncha tse ntle ka lebaka la tlhahiso e ntlafalitsoeng. Moloko oa motho le meloko ea kamoso e kanna ea ba mofuta oa genome e fetileng, ka lebaka la epigenetics. Bokhoni ba ho haha li-skyscrapers le litoropo li fana ka maikutlo a hore re fapane le mong ka rona oa hlooho ea khomo ea homo. Le ha boko ba chimp bo thehiloeng litekong tsa tlhahlobo ea kelello bo etsa le bana ba banyenyane, boholo ba boko ba motho bo eketsehile ka makhetlo a fetang limilione tse 4 ho kenyeletsa le likarolo tse potileng sistimi ea moputso [6].
Ho senyeha ha mekhoa e kenyellelitsoeng moputsong ho tsoa lits'ebetsong tsena tsa tlholeho ho lebisa mekhoeng e mengata e potlakileng, e qobelloang le e lemalloang e laoloang ke li-antecedents tsa liphatsa tsa lefutso. [7, 8]. Ho na le plethora ea liphatsa tsa lefutso maemong a mesolimbic mesebetsi. Li-polymorphisms tsa mefuta ena ke mefuta ea batho ba khetholloang, e tsejoang ka ho re batho ba ka ba le litakatso tse feteletseng mme e ba le boitšoaro bo bobe. Li kenyeletsa; serotonergic 2A receptor (5-HTT2a); transporter ea serotonergic (5HTTLPR); DA D2 receptor (DRD2); DA D4 receptor (DRD4); Robert transporter (DAT1); mofuta oa catechol-Omethyltransferase (COMT), le mofuta oa monoamine-oxidase (MOA) [9].
Ho 1996, poleloana ea RDS e ne e reretsoe ho hlalosa boits'oaro bo amanang le mofuta o tloaelehileng oa liphatsa tsa lefutso o kenyang polymorphisms ea DRD2 [10, 11] e le selelekela se rerang sa boits'oaro bo sa susumetsang, bo qobelloang, le bo lematsang [[12-14] [15] [bona Lethathamo la 1].
Ho ba le liphatsa tsa lefutso tsa liphatsa tsa lefutso tseo, ka mohlala, li lebisang ho fokotseng ha serotonergic le / kapa dopaminergic receptor densities kapa sekhahla se eketsehang sa cataptism ea DA ea katoloso, ka lebaka la mofuta o moholo oa catabolic genotype ea mofuta oa COMT e ka be e fokolitse phumaneho ea DA. Lithethefatsi tsa tlhekefetso, li amahanngoa le ho lokolloa ha DA tsamaisong ea mesocorticolimbic kapa tseleng ea moputso oa kelello [15] [Setšoantšo sa 2]. Ntle le ts'ebetso e lekaneng ea DA motho a ka ikemisetsa ho bua ka ntho e 'ngoe le e' ngoe kapa boitšoaro bo tla etsa hore DA e lokolloe ho kenyeletsa joala, nicotine, psychostimulants, opiates, tsoekere, thobalano, papali ea chelete, esita le papali ea marang-rang e feteletseng. [16].
Dopaminergic system activation e etsa hore motho a ikutloe a khotsofetse ebile a le monyaka [17, 18] e anngoeng ke lintlha tsa epigenetic. Leha ho le joalo, ts'ebetso ea hypodopaminergic e ka sebetsa, ka lehlakoreng le leng, e ka baka ho ts'oara lithethefatsi le mekhoa e meng ea RDS eo ho bonahalang e feta [19-21]. Li-polymorphism tsa Gene li ka etsa hore hypodopaminergic e sebetse, ka mohlala, ea fokotsa khatello ea methapo ea DA, karabelo e phoso ho DA, kapa ea ntlafatsa katatism ea DA tseleng ea moputso [22]. Ho felisoa ha tšebeliso e mpe ea lithethefatsi ho ka boela ha tsitsipanya boemo ba hypodopaminergic bo khothalletsang boits'oaro ba ho batla lithethefatsi boitekong ba ho sebetsana le mmuso o hohelang. [23]].
Ts'ebeliso e ntle ea lintho tse nang le kelello e ka baka maikutlo a boiketlo, tlhekefetso e tšoarellang le e telele, ka bomalimabe, e lebisa ho "phahameng" e chefo mme e felle ka mamello, maloetse le pherekano. Kahoo, litakatso tse fetelletseng tse bakoang ke ho nka mofuta oa DRD2 A1 allelic genotype o bakang li-receptor tse tlase tsa DA li eketsoa ke boits'oaro bo latelang ba ho batla lithethefatsi. Ka lehlakoreng le leng, matšoenyeho a tloaelehileng a li-receptor tsa DA, ha a bake litakatso tsa boitšoaro. Morero oa ho thibela tšebeliso e mpe ea lithethefatsi kapa takatso e feteletseng ea tsoekere e ka etsoa ho batho ba nang le liphatsa tsa lefutso ka ho ata ha li-receptor tsa DA D2 [24]. In vitro, ts'usumetso e sa khaotseng ea sistimi ea receptor ea DA e nang le agonist ea D2 e tsebahalang ka litekanyetso tse tlase e baka phokotso e kholo ea li-receptor tsa D2 leha ho le joalo ka liphatsa tsa lefutso. [25]. Haholo-holo, ho mesolimbic system D2 receptor e ts'oarisang mekhoa e fosahetseng ea ho fana ka maikutlo ho susumetsa polelo ea mRNA mme e baka ho eketseha ha li-receptor tsa D2. Ho batho, ho ipapisitse le molek'hule ona oa tlhaho oa ho lokolloa ha DA ho ka sebelisoa ho hlahisa mRNA e tšoanang e tataisitsoeng ea D2 ho hatisa li-receptors tsa D2 e le hore li latele takatso ea tsona. Ebile, sena se ile sa sebetsa ha mokhoa oa phekolo ea liphatsa tsa lefutso; Tekanyetso e tataisoang ke DNA ea li-receptor tsa DRD2 e bakile phokotso e kholo litekanyetsong tsa tahi le tsa koae ho liphoofolo [26-29].
Motsoako o sebetsang oa RDS oa ho batla lithethefatsi le tšebeliso ea lithethefatsi ke hore ho sa tsotelehe mohloli oa teng, ho ba teng hoa boemo ba hypodopaminergic, ke sesosa sa mantlha sa boits'oaro ba lithethefatsi. Li-polymorphlies tsa lefutso tse khothalletsang ts'ebetso ea hypodopaminergic ke mokhoa o ka sehloohong oa ho sebelisa lithethefatsi hampe le ho oela hape [30]. Ts'ebeliso ea nako e telele ea mokhoa o sebelisang DA ka bonolo e ka ba kalafo e sebetsang le e bolokehileng bakeng sa boits'oaro ba RDS ho kenyelletsa; bothata ba tšebeliso ea lithethefatsi (SUD), tlhokomeliso ea khatello ea kelello (deficit hypicactivity disorder (ADHD)) le botenya.
Ke Hobane'ng ha o Lokela ho Dopamine?
Dopamine, joalo ka ha ho boletsoe pejana, e amahantsoe le thabo ebile ke eona neurotransmitter ea mantlha e fetolang ts'ebetso ea ts'ebetso ea moputso oa boko, E 'nile ea bitsoa molek'hule ea anti-khatello le molek'hule ea thabo [5, 31-[34], e ithutile haholo. Ho utloisisa mokhoa oa ts'ebetso e susumetsoang le litlatsetso tse ntle ho hloka kutloisiso ea ho potoloha ha meputso [35].
Matlafatso ea ts'ebetso e hlalosoa ka ts'ebetso e le ketsahalo e tsejoang ho eketsa menyetla ea karabelo e latelang e amanang le marangrang a DA le lithethefatsi tsa tlhekefetso li nkuoa e le tse matlafatsang tse matla ho feta tsa tlatsetso ea tlhaho (joalo ka lijo le thobalano) [36-38]. Ho na le phapang ea bohlokoa lipakeng tsa meputso ea tlhaho le eo e seng ea tlhaho. Meputso ea tlhaho e kenyelletsa khotsofalo ea ho khanna hoa 'mele (joalo ka tlala le ho ikatisa le tlhonamo), le meputso eo e seng ea tlhaho ea ithutoa mme e kenyelletsa khotsofalo ea likoloi tse fumanoeng [39]. Ho khanna ho kenyelletsa ho kenyelletsa maikutlo a hedonic le monyaka o tsoang ho joala, lithethefatsi tse ling hape, ho tsoa papali ea chelete le mekhoa e meng e behang motho kotsing [2, 3, 36].
Litlamorao tse matlafatsang tsa lithethefatsi tsa tlhekefetso joalo ka koae, joala, nicotine, lijo le mmino li kenella ho NAc, sebaka se kahare sa "ventral striatum" Ho joalo, ho lumeloa hore sebopeho sena se tataisa boits'oaro bo susumetsoang, bo hlahisoang ke meputso ea tlhaho kapa bo susumetso. Mekhoa e metle ea matlafatso ke hore likarabo tsa makoloi li tla nyoloha ka bongata le matla ha li lateloa ke ketsahalo e nang le moputso. Maikutlo a rona ke hore mokhoa oa ts'ebetso bakeng sa litlamorao tse matla tseo lithethefatsi, 'mino, lijo, le thobalano li nang le tsona ho ts'usumetso ea motho li kanna tsa ba teng ka lebaka la ts'ebetso e tlase ea DA ho ventral striatum [40].
Tšusumetso ea motho bakeng sa litloaelo tse tharo tse hlokahalang tsa boitšoaro, tlala, lenyora le thobalano, kaofela e kanna ea e-ba le litloaelo tse tšoanang tsa tlhaho tsa molek'hule tseo haeba li ka senyeha, tse lebisang boitshwarong bo bobe. Re tšelisoa ke 'nete ea tšehetso ea mahlale eo tšebetso ea thobalano e joalo ka lithethefatsi, lijo le' mino e etsang hore boko bo tšehe moputso oa boko. Ho feta moo, liphatsa tsa lefutso tsa dopaminergic mohlomong le mefuta e meng e amanang le li-neurotransmitter tse amanang le tsona le li-polymorphism li ama sephetho sa boitšoaro ba hedonic le anhedonic. Ka lebaka leo re lebelletse hore lithuto tsa lefutso la tlhekefetso ea thobalano li tla fana ka bopaki bakeng sa likamano tsa polymorphic le sehlopha se ikhethileng sa mofuta oa thobalano se ipapisitse le liteko tse sebelisang lisebelisoa tsa bongaka. Re khothaletsa bo-rasaense ba thuto le ba bongaka hore ba qale lithuto tsa neonimaging tsa tlhaho tsa dopaminergic agonistic (joalo ka KB220Z ™) hore ba shebe li-polymorphlies tsa gene ka ho hlophisa le ho tloaetsa karabelo ea hyper-kapa hypo-thobalano. [41-43].
Liphuputso tse entsoeng ka lithethefatsi li bontšitse hore li-opioid tse fumanehang libakeng tsa moputso oa boko haholo ho Ventral Medial Striatum li holisa ho rateha ha meputso e monate. Ho fumanoe libaka tse chesang tsa Hedonic ka har'a li-accumbens le pallidum ho sebelisa 'mapa oa plume oa Fos. Li-hotspots tsena ke moo li-opioids li hlophiselitsoeng haholo ho phahamisa ho rata ha meputso ea lijo. Libaka tse chesang tsa Hedonic mehahong e fapaneng ea boko li ka sebelisana 'moho ka har'a potoloho e kholo ea tšebetso e li hokahanyang [44]. Ho rata moputso o fetelletseng oa moputso o itseng ho ka baka tšebeliso e mpe ea ts'ebeliso e mpe le mathata a kang RDS.
Ka kenyelletso ena e khuts'oane ho mesryro ea moputso oa mesolimbic e bonts'itsoeng [15] Setšoantšo sa 3 e fana ka moralo oa ho utloisisa karolo e ka bang teng ea neurogenetics le neurotransmission, e kenyeletsang DA le nts'etsopele ea kameho ea bophelo bo botle. Ka sena kelellong re ithutile molek'hule ea limolek'hule tse ka amang thuto ea bohato ea 12 e le mohlala oa ho hlaphoheloa likhatisong tsa pejana [45].
Alcoholics Anonymous / Motho ea sa tsejoeng ka narcotic
Alcoholics Anonymous (AA) e thehiloe ka 1935 ke Bill Wilson le Dr. Bob Smith (Bill W. & Dr. Bob) e Akron Ohio ke mokhatlo oa machabeng oa ho thusana. Morero oa mantlha o boletsoeng oa AA ke ho khothaletsa makhoba a tahi "ho lula ba hlaphohetsoe kelellong le ho thusa makhoba a mang a tahi ho fihlela ho hlaphoheloa". Wilson le Smith ka thuso ea litho tse ling tsa pele ba ile ba theha lenaneo la AA la Leshome le Metso e 'Meli la kholo ea semoea le boits'oaro. Ka 1946, Litloaelo tse Leshome le Metso e ile tsa hlahisoa ho thusa AA ho matlafatsa le ho hola. Meetlo e khothaletsa hore lihlopheng tsa litaba tsa sechaba le litho li lule li sa tsejoe, ho kenyeletsoa bohle ba lakatsang ho khaotsa ho noa le ho thusa ba bang ba tahi ka boithatelo. Meetlo e boetse e khothaletsa hore litho tsa AA, tse emelang mokhatlo oa botsoalle li qhele ka thoko lithuto, ho nka karolo litabeng tsa sechaba le ho laola maemo a phahameng. Likamano tse latelang tse kang Narcotics Anonymous li amohetse le ho fetola Mehato e Leshome le Metso e 'Meli le Litloaelo tse Leshome le Metso e' Meli molemong oa tsona oa mantlha [47].
Leha, AA ka kakaretso e qoba ho tšohla mofuta oa bongaka oa botahoa ba tahi A e nkuoa e le motsoako le tumello ea lefu la khale la bokhoba ba tahi [48]. American Psychiatric Association e khothalelitse lenaneo la AA kapa lisebelisoa tse tšoanang tsa sechaba, ka kopanelo le kalafo e tšoarellang bakeng sa joala bo sa foleng bo sa arabeleng kalafo e khuts'oane. Lintlha tsa AA li re 64% ba tlohetse AA selemong sa bona sa pele [49, 50].
Botho ba AA ho tloha ka 1935 bo hasane "ho pholletsa le litso tse fapaneng tse tšoereng litumelo le litekanyetso tse fapaneng", ho kenyeletsoa le libaka tsa lipolotiki tse hananang le motsamao oa metso. AA e tseka litho tse fetang limilione tse 2. Ha ho ntse ho na le phapang lipakeng tsa lenaneo la mehato e 12 le setsoalle sa AA / NA ka bobeli li ka bapala karolo ea bohlokoa ho foleng ka katleho. Sehloohong sena re fapanyelitse mantsoe "setsoalle" le "lenaneo" hobane ho na le ba lumelang hore a tšoana ka kutloisiso ea 'nete. Lebitso la AA le nkiloe bukeng ea eona ea pele, eo ka mokhoa o sa reroang e bitsoang "Buka e Kholo," eo qalong e neng e bitsoa "Alcoholics Anonymous: Pale ea kamoo banna ba fetang lekholo ba hlaphohetsoeng Bokhobeng ba Tahi". Le ha ho kanna ha ba le pheko ea 'nete ea ethanol ka lebaka la liphatsa tsa motho tsa lefutso, batho ba kanna ba se ke ba timetsoa. Ha joale re tseba bohlokoa ba tšusumetso ea tikoloho liphatseng tsa lefutso tsa rona tsa polymorphic haholoholo ba amehang ho potoloha ha moputso oa boko. Hape rea tseba hore batho ba bangata ba kanna ba amohela mananeo a mehato e 12 empa leha ho se na kulo ea boloi re ntse re atamela "ho qhotsa lehe le lemalloang"? [51, 52].
Epigenetics ea ho lemalla
Kutloisiso e bonolo ea pejana ea liphatsa tsa lefutso le tikoloho e ne e re P = G + E moo P = mofuta ofe kapa ofe oa phenotype; G = Genes le E = likarolo tsa tikoloho ke motheo oa ho utloisisa hore na hobaneng re sa timeloe ka lebaka la liphatsa tsa lefutso tsa DNA. Le ha ho lumeloa hore liphatsa tsa rona tsa lefutso li kenya letsoho phapang e ka bang 50-70% ea phapang ho RDS tikoloho e bonahala e bapala karolo ea bohlokoa ho latela polelo ea liphatsa tsa lefutso mme ka tsela eo boitšoaro bo joalo "bo tloaelehileng" kapa bo sa tloaelehang ". Ka lipatlisiso tse pharaletseng lilemong tse leshome tse fetileng re se re qala ho utloisisa tšusumetso ea tikoloho ho genome ea rona [53].
Habohlokoa, bopaki bo bontša hore mekhoa ea epigenetic e kentse letsoho bokhobeng ba lithethefatsi. Ho sa tsoa ithutoa li-enzyme tse amehang phetisong ea chromatin. Simon- O'Brien et al. [54] e fumane hore histone deacetylase (HDAC) inhibitors (HDACi) e bile le litlamorao tsa bohlokoa ho etseng phepelo le ethanol hape. Ka ho khetheha, ba fumane hore tšebeliso e feteletseng ea joala ea litoeba tse itšetlehileng (empa eseng tse sa tšepahaleng) ho paradigm ea ts'ebetso ea ts'ebetso ea boitšoaro e fokotsehile haholo ke Sodium Butyrate (NaB) le MS-275. NaB e fokotse ho nwa ho feteletseng mme e thibele ho ata ha ethanol phakeng ea nakoana ea 20% ethanol paradigm mme e thibetse ka botlalo keketseho ea ts'ebeliso ea ethanol e hlahisoang ke tlholeho ea joala. Liphetho tsena li bonts'a tšusumetso ea NaB ea ho oela hape.
Ntle le moo, Febo et al. [55] fumana hore ho pepeseha ka matla k'hok'heine ho hlahisitse ts'ebetso e atileng ea BOLD ho pelehi le bo-mosesane, leha ho le joalo, ho pepeseha ho sa feleng ha ho joalo. Tšabo e nang le histone deacetylase inhibitor NaB e khutlisitse lipontšo tsa BOLD phatleng kamora ho pepesetsoa koae khafetsa. Libaka tsa ts'ebetso li kenyellelitsoe hippocampus / amygdala, likarolo tse fapaneng tsa "cortex" ea limbic le sensory le ts'ebetso e boletsoeng ho anthior thalamus. Liphumano tsena li fana ka maikutlo a hore modumo oa HDACi kamora ho pepesetsoa khafetsa, o kenyelletsa "corticolimbic circry" e laolang maikutlo, ho susumetsa le mohopolo.
Kaha ho tsejoa hantle hore mohopolo oa boiphihlelo ba lithethefatsi ke senotlolo sa bohlokoa sa ho khutlisetsoa ha ts'ebeliso ea lithethefatsi le litlamorao tse mpe le tsona ke mekhoa ea ho thibela ho khutlisoa. Mabapi le sena Sen [56], e tlalehile hore taolo e tlase ea liphatsa tsa lefutso ka lebaka la liphetoho ho epigenetics e lebisa ho bofokoli ba kutloisiso bo ka bang le karolo ts'ebetsong ea ho lemalla. Sehlopha sa Kenny [57] fana ka maikutlo a hore ho na le bopaki ba hore methapo ea DNA e bapala karolo ea mantlha lits'ebetsong tsena, mohlomong ka ho susumetsa ka kotloloho polelo ea liphatsa tsa lefutso tse amehang ho kopaneng ea synaptic.
Ho thehiloe hantle hore tlhekefetso ea li-opiate, e kenyelletsa adapta ea "synaptic" libakeng tse ngata tsa boko ho kenyeletsoa sebaka sa "ventral tegmental" (VTA). Litloaelo tsena li ka tlatsa ts'ebetso le ts'ehetso ea ts'ebeliso ea opioid le ho lemalla batho le mefuta ea liphoofolo. Wang et al. [58], e bontšitse hore liphatsa tse ling tsa lefutso tse amehang tšebetsong ea glutaminergic li fetoloa ke morphine. Ka mekhoa ea epigenetic morphine e fetola protheine e amehang ho bongata ba postsynaptic bo bitsoang "protein 95" (PSD-95). Protheine ena e amehile haholo ho butsoeng ha synaptic ea glutamatergic le polasetiki methapong e bohareng.
Bo-rasaense lefatšeng ka bophara baa lumela hore ho pepesoa ha ethanol e matla le e sa foleng ho ka kenyelletsa ho nchafatsoa ha chromatin ka lebaka la liphetoho tse kopaneng tsa histone le methapo ea methapo ea methapo ea methapo ea methapo e amanang le karolo ea boko ea Amygdala. [59]. Tabeng ena, Pandey et al. [60] e senotse karolo e nooang bakeng sa ho nchafatsoa ke amygdaloidal chromatin nakong ea ts'ebetso ea bokhoba ba joala. Ba boetse ba fana ka maikutlo a hore li-inhibitors tsa HDAC e kanna ea ba bakuli ba ka fanang ka kalafo ho phekola matšoao a tlisoang ke joala.
Habohlokoa, li-microRNA ke li-molecule tsa RNA tse sa ngolang likhoutu tse laolang ho fokotsa kapa ho eketsa sebopeho sa polypeptide joalo ka tšebetso ea polelo ea mRNA. Ba etsa mosebetsi ona ka ho kopanya marang-rang ka tatellano e tlatselletsang ho 3'-UTR ea li-mRNA tse shebiloeng. Ho tloha ha ho sibolloa la pele la miR, lin-4 ho Caenorhabditis Elegans, li-miR tse makholo li fumanoe ho tsoa ho batho ka livaerase, tse faneng ka lesela le pharalletseng la taolo ea liphatsa tsa lefutso kamora ho ngoloa. Sisteme ea methapo ea motho ke mohloli o ruileng oa polelo ea miR, e nang le mefuta e fapaneng ea mesebetsi ea miR lits'ebetsong tsa mantlha tsa methapo ea kutlo ho kenyelletsa nts'etsopele ea neuronal, polasetiki, metabolism, le apoptosis le bokhoba. [61]. Hoa tsebahala hore ka mohlala, polelo ea mofuta oa NMDA receptor 2B (NR2B) e nyolleloa kamora ho phekoloa le ho emisoa ka nako e telele. Keketseho ena e fana ka liphetoho lipakeng tsa boitšoaro [62]. Litlalehong tse ling tsa histonetrylferans (HMTs) Qiang et al. [62] e fumane taolo e tlase ea maemo maemong a lefats'e ka bophara le chromatin ea lehae ea mofuta oa NR2B e latelang kalafo ea CIE. Ntle le moo, ho ile ha fumaneha hape hore ho chromatin ea mofuta oa morekisi oa mofuta oa NR2B, ho fokotseha ha G9a, Suv39 h1 le HDAC1-3 ke tsona tse ikarabellang bakeng sa liphetoho tse fetotsoeng tsa H3K9 tse bakiloeng ke CIE. Liphetoho ho H3K9 li bontša keketseho ea methylation le ethanol e matla le phokotso e latelang ea methylation nakong ea ho khaotsa le keketseho ea histone acetylation. Habohlokoa, ona ke mohlala o mong oa liphetoho tse fetotsoeng H3K9 ho chromatin ea lehae ea mofuta oa NR2B underlie alcohol-induction neuroadaptation. Ho feta moo, Taqi et al. [63] e senoletse hore kamora ho joala ka hara lithane tsa kamora lefu ho na le methylation ho lino tse tahang ha e bapisoa le taolo. Leha ho le joalo, methylation e fumanoe ho allele e se nang kotsi ea prodynorphine-gene (PDYN). Kahoo, joala ka kotloloho e ka ama polelo ea gene ka ho fetola ts'ebetso ea mongolo oa PDYN le ho ba tsietsing ha batho ba nang le C, bao eseng ba kotsi ho holisa ts'ebeliso ea lino tse tahang.
Ho bile le liphuputso tse ngata tsa liphoofolo tse bonts'a hore ho tsuba koae ea "cannabis" ho ka baka phetoho ea limolek'hule tsa methapo tsamaisong ea moputso e lebisang ho mathata a boitšoaro a nako e telele. Ho ea pele, hona joale ho netefalitsoe ke mosebetsi oa morao-rao oa Szutorisz et al. [64]. Ba fumane hore ho pepesetsoa ha motsoali karolong e ka sehloohong ea "cannabis" (e seng e ts'oanang le cannabis e holileng) Δ (9) -tetrahydrocannabinol (THC), ho lebisa ho ts'ebetsong ha heroin e batlang boits'oaro mme e fetotse striatal synaptic plasticity melokong e latelang. Phatlalatso ea Germline THC e fumanoe e fokotsa mRNA, ka phokotso e tšoanang ea li-receptor tsa NMDA tse bonoang ka har'a dorsal striatum ea bana ba baholo. Liphetho tsena li fana ka maikutlo a hore ho pepesetsoa ha THC ho ama litšobotsi tsa limolek'hule mme ho ka ama phenotype ea bana, ho lebisang kotsing e kholo ea mathata a mafu a kelello molokong o latelang ka litlamorao tsa neurogenetic.
Matla a likarolo tsa tikoloho ho sengolo sa mRNA ke sebaka sa bohlokoa sa ho etsa lipatlisiso. Ka ho khetheha, li-MicroRNA (miRNAs) ke mofuta oa RNA e se nang protheine e nang le protheine e le 'ngoe, hangata ka 20-25 nt ka bolelele. Ha ho na pelaelo hore li-miRNA li bapala karolo ea bohlokoa lits'ebetsong tse ngata tsa likokoana-hloko, ho kenyelletsa ntlafatso, ho ata ha lisele, phapang, le apoptosis. Xu et al. [65] e fumane hore boemo ba polelo ea miR-212 bo lula bo phahama nakong ea tsamaiso ea koae. Ka tsela e tšoanang Bahi & Dreyer [66] e bonts'itse hore striatal miR124a le signature ea BDNF li na le likarolo tsa bohlokoa tšebelisong ea joala le moputso oa boemo ba ethanol. Zhang et al. [67] e tlalehiloe ka karolo ea bohlokoa ea miR-190 taolong ea ts'ebetso ea morphine ka tšusumetso ea eona ho polelo ea OPRM1.
Molaetsa o isitsoeng hae ke hore ho fetoha hoa liphatsa tsa lefutso ho ka eketsa kotsi ea boits'oaro bo lemalloang ho motho ka mong le ho pepesehela litlamorao ho litlamorao tsa lithethefatsi ho li-circuro tse kopaneng tsa boko. Ho batho ba kotsing ea ho fetoha liphatsa tsa lefutso, li-neuroadaptation tsena li etsa phetoho ho, le ho boloka, ke naha e lemaletseng. Ho feta moo, liphetoho tsena li etsahala seleng ea sele, ea limolek'hule kapa ea epigenetic 'me li amana le polasetiki ea synaptic le polelo e fetotsoeng ea mofuta oa gene. Litlamorao tsena ho polelo ea liphatsa tsa lefutso li ka hlaha ka mabaka a susumetsang phetolelo (epigenetics) le phetisetso (li-non-coding microRNAs) tsa DNA kapa esita le RNA ka boeona [68-70].
Na ho na le Liphello tsa Epigenetic ho Mananeo a Mehato e 12 le Kopano?
Le ha ho kanna ha ba thata ho paka ka lebaka la hore "ho sa tsejoe" ho thibela tlhahlobo ea nako ea nnete, ho na le lintlha tse ngata tsa tlatsetso ena ea bohlokoa ts'ebetsong ea ho hlaphoheloa e fanang ka maikutlo a hore epigenetics e kanna ea ba le tšusumetso e matla ho neurobiological ho potoloho ea moputso. Bukeng ea "Molecular Neurobiology of Recovery: 12 Steps Programs and Fellowship" Blum et al. [46] ka nepo rarolla bothata bona.
Joalokaha re bontšitse, sehlopha se ntseng se hola sa bopaki se ts'ehetsa tseko ea hore AA le mananeo a mehato e 12 a sebetsa ho ba bangata empa eseng ho bohle. Taba e 'ngoe e khahlisang ke hore ba eang libokeng khafetsa ho bonahala ba ikamahanya le maemo hore ba fole ka "psyche e ncha". Sephetho sena se ka fetohelang bophelong bo bocha le bo ntlafetseng ba ho hlaphoheloa kelellong le kapa nako e hloekileng le kamohelo ea ba bang ntle le kahlolo. Re lumela hore ka botsoalle ho tlameha ho ba le litlamorao tse matla tsa epigenetic. "Lerato" la motho e mong mohlomong le ka ho khetha ka mokhoa o khethollang khemikhale e kopanyang ea oxytocin e ka baka "phetoho ea synaptic" e lebisang boemong bo itseng ba thabo e ncha e fumanoeng. Ntle le moo, Michael Meaney le bo-mphato ba Univesithi ea McGill, ba bonts'itse hore litlamorao tsa boits'oaro ba bo-mme li rarollotsoe ho isa tekanyong e itseng, ka epigenetics. Haholo-holo bo-'mè ba likhoto ba bonts'ang boits'oaro bo phahameng ba ho hlokomela, ho nyeka le ho hlopha malinyane a bona, ho baka bana ba sa tšoenyeheng haholo mme ba hlahise lihormone tse tlase tsa khatello ea maikutlo ho feta bana ba holisoang ke bo-mme ba sa tsotelleng. Lebaka la mantlha la sena le kenyelletsa mekhahlelo e fapaneng ea methylation e hokahaneng le receptor ea glucocorticoid ho hippocampus. Ho se tsotelle hakaalo ho bakile methylation e ngata le ho fokotsa linomoro tsa li-receptor. Sena se fella ka tlhahiso e ntlafalitsoeng ea cortisol, e nang le khatello ea maikutlo e matlafatsang [71].
Leha ho le joalo, re tlameha ho botsa lipotso tse latelang tse se nang likarabo:
1. Na ho na le liphetoho tsa boko le li-brainoplastic tse lulang li tšoarella ho liboka tse tloaelehileng?
2. Na ho na le tokollo e khethiloeng ea DA / oxytocin nakong ea ho ba teng ha AA?
3. Na ho na le keketseho ea li-receptors tsa DRD2 esita le ho makoloi a DRD2 A1 (30-40% e fokotse li-receptor tsa D2) ha batho bana ba ea libokeng tsa AA khafetsa;
4. Na re ka laola maemo a khatello ea ho khutlisetsa lithethefatsi ka mekhoa e akaretsang joalo ka: KB220Z.to ea fokotseha methylation ho glucocorticord receptor. [KB220Z ke mochine o etsang hore boko bo sebetse hantle esita le phomolong, hyperbaric oxygenation, yoga, ho thuisa, ja, ho ikoetlisa, kalafo ea 'mino, kalafo ea molumo, kalafo ea moqomo, phekolo ea maikutlo a ho hlaphoheloa kelellong, boits'oaro bo botle ba kelello bo teng har'a mekhoa e meng e tsebahalang];
5. Ka ho ba teng libokeng tsa AA na kannete re ka eketsa li-receptors tsa D2?
Ho eketseha ha li-receptor tsa D2 ke mohlala o mong oa ho hohela khatello ea methapo ea kutlo, ho fokotsa litakatso, ntlafatso ea liqeto, ho matlafatsa kamano, ho fokotsa tloaelo ea boitšireletso (ho bua leshano le kapa ho thetsa). E ka boela ea laola pele ho cortices-cingate ho thibela ho khutlela morao, ho eketsa ho tsepamisa mohopolo, ho eketsa ho itšepa le ho itšepa, ho fokotsa botlokotsebe, ho fokotsa thobalano e sa sireletsehang, ho matlafatsa moputso oa kelello e tšoeu / pherekano ea taba, 'me qetellong e hutse bomoea le ho tsosetsoa bocha. [45, 52].
Joale na ho etsa kelello ho kenyelletsa lenaneo la mehato e 12 le ts'ebelisano 'moho le kalafo ea thuso ea bongaka (MAT)?
Hape re lokela ho botsa potso ea bohlokoa-Haeba lithethefatsi tsa hajoale tsa FDA li amohela ho thibela ts'ebetso ea DA; Hobaneng re ka batla ho thibela DA nakong e telele, haholo ha re ntse re batla thuso ka methati e 12? Karabo ea khokahano ena ke hore bonyane re amohele mohopolo oa hore ho thibela DA ha se mokhoa o motle ka ho fetesisa, ho fihlela re fumana mofuta o nepahetseng oa MAT ka thabo e ntlafalitsoeng le khahlano le khatello ea maikutlo ho thusa ba hlaphoheloang. Morero o mong e ne e tla ba ho fokotsa "bokhabane ba makhakhapha a masoeu" ho lekhoba le hlaphoheloang.
Habohlokoa le ho feta, hona joale ho na le motheo oa limolek'hule bakeng sa hypothesis ea heke haholo bakeng sa nikotini [72]. Kamehla ho ne ho nahanoa hore bacha ba sebelisa lithethefatsi tsa tlhekefetso ka methati le hore lithethefatsi tse ling tse kang matekoane le nikotini e ka ba litheko tse tsamaisang lithethefatsi tse boima tsa kelello tse kang heroin le cocaine. [73]. Hona joale rea tseba hore nicotine e baka "hyperacetylation" bokong mme e fetola polelo ea FOSB, e leng sesosa sa bokhoba ba tahi. Hape hoa khoneha hore ts'ebetso ea histone deacetylase (HDAC) e kanna ea ba le molemo oa ho phekola bokhoba hobane ka ho etsa joalo e ka fokotsa polelo ea FOSB ho arabela cocaine. Ha re ntse re fetola li-activator tsa HDAC hore li shebane ka kotloloho le striatum e ka ba ntho e lakatsehang ka ho fetesisa, re tlameha ho tseba hore kalafo ea sistimi le li-activator tsa HDAC kapa histone acetyltransferase inhibitors e ka ba kotsi haholoholo ho tseba. Ntle le moo, koae ea e-e ka ba kotsi ka tsela e ts'oanang le ho tsuba, ntle le bokhoni ba mofets'e, hobane e na le nicotine e hloekileng mme ka hona e ka sebetsa e le monyako. Lintlha tsena li na le kamano ea sebele le sechaba se hlaphoheloang kaha se amana le ts'ebeliso e tsoelang pele ea ho ithiba ka lebaka la ho hlophisa boko ho khutlisetsa joala kapa laesense e 'ngoe e hlekefetsang kapa lintho tse seng molaong ka mochini o tsebahalang oa neuro epigenetic.
Phehisano
Bakeng sa litlhaloso Harvard Moprofesa George Vaillant, ka mokhoa o makatsang ha a ka a fumana bopaki ba katleho ea lenaneo la AA le amanang le taolo e se nang kalafo ea AA.
Vaillant o phethile ka hore:
“AA e kanna ea ba e tšoanelehang le e loketseng batho ba 'maloa ba nang le bothata ba joala, boholo ba batho ba nang le mathata a joala ho bonahala ba sebetsa hantle ka mokhoa o fapaneng. Re ka thabela ho bona boithuto ba hore na hobaneng batho ba bangata ba tlohetse ho AA. Re nahana hore sena se ka bakoa ke taba ea hore likhopolo tsa thuto ea bolumeli tsa AA tsa ho hloka matla ha botho le tlhoko ea Molimo ea pholosang ha li ratehe ho batho ba bangata ba sa lumeleng hore Molimo o teng le ba sa lumeleng hore Molimo o teng empa le hoo e ka bang ho batho bohle bao e seng balateli ba Calvin hape ”.
Ho feta moo Vaillant o fana ka maikutlo a ipapisitseng le lipatlisiso tsa hae tsa hore: "Hape ho kanna ha ba joalo hore filosofi ea AA ea" ho hloka matla "ka joala le mapetjo a kang" seno se le seng, tahi e le 'ngoe "," e le' ngoe e ngata haholo 'me sekete ha e lekane "hape" joala bo mano, bo makatsa ebile e matla ”ha e le hantle e hlophisetsa batho ho itlopa joala ho fapana le ho sebelisa taolo ea ts'enyo ha ba thella mme ba hloleha ho noa joalo ka ha ho reriloe. Lintlha tse ling ka taba ena li hlile lia hlokahala ”.
Kakaretso ea Valliant's:
• AA ke ntho e nepahetseng bakeng sa palo e nyane ea batho ba nang le mathata a joala mme e ba thusa ho ithiba.
• AA ke boemo bo sa nepahalang bakeng sa batho ba bangata ba nang le mathata a joala mme bo ka etsa hore batho ba bang ba mpefale.
• AA e molemo ho theheng "balumeli ba 'nete" ho feta ho felisa bothata ba ho noa.
• Hore na AA e nepahetse kapa che, motho ha a na letho le amanang le hore na motho o noa hakae kapa palo ea mathata a amanang le joala ao motho a nang le ona-taba ea bohlokoa ke mofuta oa botho.
• AA e loketse batho ba nahanang hantle le ba basoeu ba amohelang bopaki ka matla.
• AA ke boemo bo sa nepahalang bakeng sa batho ba nahanang ka moriti oa bohlooho mme ba batla bopaki ba liteko le bopaki ba mahlale.
Re tiisa hore ho ka etsahala nakong e tlang ho etsa liteko tsa mefuta e khethehileng e ka bapisang batho ka kotloloho le ho amohela lithuto tsa AA [74]. Ho na le mehlala ea hore na hobaneng AA e sa sebetse motho e mong le e mong [75]. Ho khahlisang ke hore patlo ea PUBMED (9-5-14) e sebelisang mantsoe "hobaneng makhoba a tahi a sa tsejoeng a sa sebetse" ha ea ka ea fumana litholoana. Leha ho le joalo, Kelly [75] A bontša hore:
“Mabapi le batho ba bangata, bopaki ba hajoale bo fana ka maikutlo a hore batho bao eseng balumeli kapa bao eseng balumeli ba rua molemo haholo lihlopheng tsa ho ithusa kaha batho ba bangata ba bolumeli le basali ba kenella le ho rua molemo joalo ka banna. Leha ho le joalo, ho nka karolo, le litlamorao tse tsoang ho, lihlopha tsa setso tsa ho ithusa bakeng sa bakuli ba fumanoeng ke lingaka li ka fokotsoa ka mofuta oa mafu a kelello. Bacha ba bang ba bonahala ba una molemo, empa ba lula ba sa ithuta. Sekhahla sa ho tlohela sekolo le sa batho ba sa baleheng se phahame, leha ho na le likhothaletso tsa bongaka tsa ho ba teng.
Beyound Vaillant
Kaha Valliant e hlahlobile bokhoni ba mehato ea 12 ho fokotsa ho oela hape, ho bile le litlaleho tse ngata ho fapana le ho senola bohlokoa ba ho thuisa, botho, ho fetela, ho ba le kelello le bomoea. Ha e le hantle, laboratori ea rona e sa tsoa tlaleha hore ha tumelo ea bomoea e phahama ho motho ka mokhoa o joalo le ts'oarelo ea tlhekefetso ea lithethefatsi [76]. Ho bile le lithuto tse lebisitsoeng kutloisisong ho tsoa boemong ba li-neurotransmitter ka liphetho tse tsoakaneng. Moo, bo-rasaense ba Mafinnishe ha baa ka ba fumana setsoalle pakeng tsa li-receptors tsa 5-HT-1A le liphihlelo tsa moea ho bakuli ba nang le khatello e kholo ea maikutlo le taolo e phetseng hantle. [77], ba bang ba fumane botsoalle. Ka ho khetheha, Borg et al. [78] e fumane hore kamohelo ea moea e amana haholo le ho fumaneha makhetlo a 'maloa a 5-HT-1A receptor density mme "e ka hlalosa hore na hobaneng batho ba fapana haholo ka cheseho moeeng". Ka mokhoa o ts'oanang, ho fumanoe hore bashanyana le banana ba nang le kopanyo ea boteng ba 5-HTTLPR e khuts'oane, le homozygosity bakeng sa mofuta o molelele oa AP-2beta o fumane lintlha tse tlase haholo ho Boithati le Kamohelo ea Moea. [79].
Mosebetsi o mong oa sehlopha sa Davidson mabapi le ho beha kelello kelellong o senola bohlokoa ba puisano mabapi le ts'ebeliso ea kelello ea potoloho ea moputso. Ba fumane hore Litsebi tsa Meditator li sebelisitse Stroop Word-Colour Task (SWCT) ea StMop, e hlokang tlhokomelo le tšusumetso ea maikutlo ha e bapisoa le li-novice. Ho utloisisa sena ho ka fana ka maikutlo a hore ho thuisa ho kopaneng le tumelo e matlafatsang moeeng ho ka etsa hore DA e lokolloe VTA le ho qhekella gyrus e ka fetolelang liphetho tse ntle tsa kliniki le ho fokotsa ho khutla hape. [80, 81].
Ehlile liphatsa tsa lefutso li na le seabo ho tlhekefetso ea tšebeliso ea lithethefatsi le lithahasello tsa boits'oaro 'me lintho tsena tse ka tlasana tsa RDS li bonahala li sa fumanehe. Leha ho le joalo, RDS ha se bothata ba monogenetic bo nang le gene e le 'ngoe e bakang boemo bona bo thata ba kelello. Ke polygenic e nang le litlamorao tse ngata tse sa sebetseng tsa epigenetic ka sebopeho le tšebetso ea DNA chromatin. Belcher et al. [82] li supile litšobotsi tse phahameng tse tharo tse bonahalang li tlameletsoe libakeng tse ikhethileng tsa boko le liphatsa tsa lefutso. Ho hlakile hore li-polymorphism tsena li susumetsa le ho ama tšebetso ea libaka tsena tsa boko mme qetellong li bonahatsa botho ba motho [83] esita le tsamaiso ea tumelo. Sena se ka fetolela ho se be kotsing kapa ho inehela ho ntlafatseng RDS.
Ha ho pelaelo hore libaka tse ngata tsa kalafo li ka amohela lenaneo la 12-mohato ho kenyelletsa molao-motheo oa mothusi [84] empa karolo ea eona e le eona feela khetho ea kalafo e botsoa. Ntle le taba ea hore ts'ebeliso ea Mat ha e atisoe hangata ke AA / NA kapa mekhatlo e ts'oanang, Chappel le Dupont [47] ha ea amohela feela mohato oa 12 oa ho hlaphoheloa ba lemaletseng empa e boetse ea fana ka maikutlo a bohlokoa ba meriana ea kalafo e laetsoeng ka molao hape, haholo bakeng sa maemo a kopaneng a kelello. Ba boetse ba supa bohlokoa ba ho nka karolo ha Galanters ha litho tsa malapa le metsoalle kalafong ea marang-rang ho thibela ho oela hape. Joalokaha ho khothalelitsoe ke Scott A. Teitelbaum bukeng ea hae "Addiction: A Family Affair (2011) kaha ho se na" pheko "e tsebahalang ea bokhoba, ho bohlokoa hore thibelo e tlameha ho qala ka lelapa. Qetellong Galanter et al. [85] e tlaleha hore bakuli ba sekametseng moeeng ho feta setsoalleng sa pele sa bolumeli ho litho tse ling tsa mohato oa 12 (ho tsosa moeeng) ho amanang le litekanyetso tse tlase tsa boits'oaro ba ho batla lithethefatsi.
Bopaki bo ntse bo tsoela pele ho hlaha mabapi le kutloisiso ea rona ea ts'ebetso ea boko haholo-holo ts'ebetso ea meputso le boits'oaro bohle ba ts'ebetso le baoki ba khothalletsoa ho hlahloba lingoloa tse ling tse khethiloeng tsa molek'hule leurogenetic. [86-105].
Kakaretso ea Molek'hule ea Neurobiology ea Mehato ea 12
Kakaretso ea kamoo methapo ea kutlo ea molek'hule e amang mohato o mong le o mong e boletsoeng ka botlalo ho Blum et al. [46]. Mona re fana ka poleloana e khuts'oane ea molaetsa oa mantlha o hokahaneng mohato ka mong (bona Lethathamo 2 le litšupiso).
Mohato 1-Re amohetse hore ha re na matla ho feta joala-hore maphelo a rona a se a sa laoloe.
Le ha mohopolo oa BOPHELO bo matla bo ka baka likhang lebaleng, mohato oa pele oa ho amohela ho hloka matla ha motho ka lebaka la bokhoba o ts'ehetsoa ke mekhoa ea nnete e amehang lipotolohong tsa methapo ea kutlo ea boko ba rona. Ts'oaetso ea lefutso ea ho lemalla joala le boits'oaro bo qobelloang, bo ekelitsoeng ke likarolo tsa tikoloho tse susumetsoang ke epigenetically. Ho imeloa kelellong le litlamorao tse chefo tsa lithethefatsi li baka liphetoho ho neuroanatomy, neurophysiology, le neurochemistry ea boko e fetolang molumo oa hedonic, ho itšetleha ka 'mele, takatso le ho khutlela mokhoeng hape. Ha e le hantle, ke nnete hore ehlile motho ha a na matla. Motho ea lemaletseng joala ha a na taolo ea ho batla lithethefatsi le mekhoa e meng e kotsi le ha ba hana ho laoloa ke taolo ea ts'ebeliso e mpe ea lithethefatsi le menahano e fosahetseng mabapi le "matla a bona a bohata" holima boitšoaro ba bona bo sa batleheng.
Leha liphatsa tsa lefutso li bapala karolo ea bohlokoa haholo ts'ebetsong ea bokhoba ba tahi mme haholo ba kotsing ea ho ba le boits'oaro ba ho itšetleha ka moputso, joalo ka ha re bona ho tsoa litekong tse phatlalalitsoeng kaholimo ho lintho tsena tse matla li na le litlamorao tse matla tsa epigenetic tsa. Liphetho tseo li senya mohopolo oa homeostasis haholo 'me li baka takatso e ke keng ea laoloa ea ho iketsetsa lithethefatsi tsa tlhekefetso. Takatso e sa laoleheng e iponahatsa e le ho hloka matla, ho se khone ho laola boitšoaro bo susumetsang karolo e ngoe le e ngoe ea bophelo ba motho.
Mohato 2-O ile oa ho lumela hore Matla a maholo ho re feta a ka re khutlisetsa bohlaleng.
Bohloeki (kahlolo e utloahalang) kapa bohlanya (boits'oaro bo pheta-phetoang leha ho le kotsi) bo kanna ba holofala leha bo hlaha 'me e ka ba ka lebaka la ho haelloa ke mosebetsi oa ho potoloha bokong haholoholo ho hlahisang tšobotsi ea hypodopaminergic. Kahlolo ena e fosahetseng e kanna ea ba sesosa sa boits'oaro ba ntho e sa sebetseng ha o tobane le kotsi. Liqeto tse fosahetseng li kopantsoe ke mabaka a tikoloho a kenyelletsang ho fumaneha ha lithethefatsi, batsoali ba sa hlokomeleng, meroalo ea sechaba le moruo le khatello ea maikutlo. Haholo-holo bokhoni ba ho itšoara ka mokhoa o hloekileng bo ka angoa ke kamano ea motho le motho ea matla ho ba feta. Mabapi le ho khutlela morao, hoa tsebahala hore preortal cortex le cingate gyrus ke libaka tsa bohlokoa tsa boko tse amehang ho taolo ea ho khutlela morao. Kahlolo e fosahetseng e bakoang ke ho senyeha hoa tšebetso ea methapo ea methapo ea libaka tsena ka lebaka la liphatsa tsa lefutso le / kapa lintho tse chefo le / kapa boits'oaro bo sitisa ho hlaphoheloa le ho baka ho khutla hape. Ho utloisisa biology ea molek'hule ea moputso oa boko (liphatsa tsa lefutso le tikoloho) ho totobatsa bohlokoa ba tlatsetso e ntle ho tsoa mananeong a kopanelo (thuso ea hau) le mekhoa e meng ea kalafo. Tlatsetso e ntle e tsoang botsoalleng e ka koala polelo ea liphatsa tsa lefutso e sa batleheng, ea phahamisa moea, mme ea thusa ho thusa motho ho fihlela boemo ba bohlanya le ho etsa liqeto tse nepahetseng.
Mohato 3-O entse qeto ea ho fetola thato ea rona le maphelo a rona tlhokomelong ea Molimo joalo ka ha re mo utloisisa.
Thato ea matla e thata ho laoloa, haholo ho batho ba tsoetsoeng ba na le moputso, le maemo a tlase a li-endorphin. Batho ba khetholloang ke liphatsa tsa lefutso ba batla lithethefatsi tse kang joala, heroine, cocaine, nicotine, esita le tsoekere. Lintho tsena kaofela li kenya tšebetsong likaroloana tsa meputso (joalo ka serotonin, enkephalins, GABA le litsela tsa DA) hape li fana ka maikutlo a maiketsetso a boiketlo ba nakoana (hoo ho bitsoang "tloaelo"). Boikemisetso bo ipapisitse le ho sebelisana ha liphatsa tsa lefutso le likarolo tsa tikoloho sechabeng. Ho imeloa kelellong ha u le motho e moholo ebile ho makatsa nakong ea bokhachane ke likarolo tsa tikoloho. Ho imeloa kelellong hona ha pele ho ka baka mathata a ts'ebeliso ea lithethefatsi bophelong ba batho ba baholo joalo ka ha ho bonoa ka litlamorao tsa epigenetic ho Glucocorticoid receptor express. Kaha ho thata ho loants'a likhoele tse thata tsa boko ba rona ba moputso, ho lemalla ho hlaphoheloa ho bonahala ho hlakile ho batla moputso kantle ho mofuta oa rona oa lefutso (joala, lithethefatsi, thobalano le lijo).
Mohato 4-Re iketsetse lethathamo la boits'oaro le bo sa tšabeng
Lethathamo la boits'oaro bo hlokang tšabo le tlameha ho kenyelletsa sethethefatsi sa boikhethelo le boits'oaro bo bong bo amanang le RDS hobane phenotype ha se sethethefatsi kapa boitšoaro bo itseng; ehlile ke RDS. Leha ho le joalo, lenane leo motho a le qetang le ke ke la "nepahala" kapa "le fosahetse," hobane ke boitlhahlobo ba hae le lenane la ho hlonama. Ho feta moo, Buka e Kholo e re (Kamoo e Sebetsang Kateng, Leqephe la 60), “Ha ho motho hara rona ea tsebileng ho boloka melao-motheo ena hantle. Taba ke hore re ikemiselitse ho hola moeeng. Melao-motheo eo re e behileng ke litataiso tsa tsoelo-pele. Re batla tsoelo-pele ea moea ho e-na le ho ba ba phethahetseng moeeng. ” Ho ka nkuoa "mehato e mene" ea motho ka mong nakong ea ho hlaphoheloa kelellong. Ho feta moo, ho batla ho sa khonehe ho makhoba a ho hlaphoheloa kapele, ho amohela Mohato oa 4. Ho senyeha ha mekhahlelo ea moputso oa boko ho nts'etsopele le ho matlafatsoa nakong ea ho tlohela le ho hlaphoheloa kapele, mohlala, ho makhoba a tahi, heroine le makhoba a k'hok'heine. Ka bomalimabe, sena se ka bakoa ke tlhekefetso e sa foleng ea lintho tsena tse matla joalo ka liketsahalo tsa epigenetic, hape, le meputso e ka futsitsoeng ea liphatsa tsa lefutso tse hlahang nakong ea tsoalo. Ho 'nile ha nahanoa hore sepheo se le seng sa kalafo se kenyelletsa ts'ebetso e tsoelang pele ea tlhaho ea DA D2 joalo ka ha ho bonts'itsoe lipatlisisong tsa pele tsa fMRI tse ntseng li etsoa Chaena ho sebelisoa KB220Z [106].
Mohato 5-Ho amoheloa ho Molimo, ho rona le ho motho e mong mofuta o nepahetseng oa liphoso tsa rona.
Mohato ona o kenyelletsa ho nahanisisa ka litaba tsa rona ka "ho phahama", hape, le litlamorao tsa chefo ea ho pepesehela lintho tsena tse matla khafetsa. Kameho ea bona ho marang-rang a moputso oa boko ke 'mele (mohlala, keketseho ea boko ba DBI). Liphetoho tsa 'mele li ka baka litlamorao tsa kelello (ho tšoenyeha le ho ba mabifi) tse ka morao ho boits'oaro bo nang le litlamorao tse kotsi ebile ka linako tse ling li ka bolaea eseng ba hau feela empa le ba bang.
Mohato 6-Ba ne ba itokisitse ka botlalo hore Molimo a tlose liphoso tsena tsa motho.
Le ha ho khonahala ho hlalosa semelo ka mokhoa oa boits'oaro, ho thata haholo ho fana ka boikarabello bakeng sa bofokoli ba semelo le liqeto tse fosahetseng le litlamorao ho tloha ha semelo se bopehile ka matla a lefutso (a ho iphetola hoa lintho) matla a fetang taolo ea motho. Ka sena ho boletsoe ho boleloa hore likarolo tsa tikoloho haholo-holo bongoaneng le tsona li ka hloka ho nahanoa bocha ka molato kapa esita le thoriso ea ketso ea motho ka mong. Mohopolo ona o tšehetsa mohopolo mohatong oa botšelela oa hore ho tlosoa ha liphoso tsa semelo ke profinse ea matla a holimo. Lingaka li lokela ho tseba hore molemong oa motho ka mong, ho fihlela mohato ona ho hloka tlhahlobo e tebileng ea semelo, ho hlokomela bohloko, le bokhoni ba ho ikarola (hona joale) ho tloha nakong e fetileng. Hape hoa lokela ho hlokomeloa hore bajari ba liphatsa tsa lefutso tsa liphatsa tsa lefutso tsa DRD2 (kotsi ea ho lemalla lithethefatsi) ba tla ba le bothata bo boholo ba ho tšepahala.
Mohato 7-Ka boikokobetso o ile a mo kopa hore a tlose mefokolo ea rona.
Ho ikokobetsa ho tlameha ho tsamaea le teboho le mohau. Taba ea ho e `` fetola '' 'me re lumelle MOLIMO hore a tlose mefokolo ea rona ha e fihlellehe habonolo. Ho ikokobetsa ho tšoana le ho ba le teboho bakeng sa lintho tseo re nang le mohopolo oa ho ea pele. Lipolelo tsa tumelo ea semoea le boikokobetso li phephetsa motho ea hlaphoheloang ho tobana le taba ea hore boikemisetso bo botle le boikitlaetso bo tšepahalang li ke ke tsa atleha kamehla ho mo fumanela se batloang bophelong. Ka lehlakoreng le leng, mme e ts'ehetsoa ke tšekamelo ea liphatsa tsa lefutso, sena se ka lebisa ho khatello ea maikutlo e sa foleng le ho khutlela morao. Leha ho le joalo, lenaneo la mehato e 12 le lineano hammoho li kopa motho hore a lumele hore bobe le bokhopo, ho hloka toka le bokhopo li ke ke tsa hlola qetellong. Ho ikokobetsa le ho ba le tumelo, ha e buelle ho se tsotelle kapa ho hloka tšepo; ho fapana le moo, ba bontša tumelo ea hore mefokolo ea rona e ka tlosoa ke boikemisetso ba rona ba ho lumela hore lintho li ka sebetsa hantle molemong oa nako e telele. Ho ba le maikutlo a matle ka MOLIMO ho fetolela li-epigenetics tse ntle tse ntlafatsang menyetla ea hore re ka tlosa mefokolo ea rona ka ho hlahisa liphatsa tsa lefutso tse "ntle" ho fapana le liphatsa tsa lefutso tse "mpe".
Mohato 8-O entse lenane la batho bohle bao re ba utloisitseng bohloko, 'me a ikemisetsa ho khutlisetsa bohle ho bona.
Ha ho bonolo ho lokisa litaba haholo-holo ho batho bao e seng metsoalle ea rona feela empa le batho bao re ba ratang. Mohato oa 8 ha o tle kapele ho ho hlaphoheloa ha motho empa o tla feela kamora linako tsa ho hloeka le ho hlaphoheloa kelellong. Leha ho le joalo, hang ha motho a phethile mosebetsi ona o boima o tla khona ho ea pele tseleng ea pholiso. Mabapi le ho hokahanya matheba, ho bohlokoa hore lingaka li lemohe polelo ea khale ea "Linonyana tsa masiba li bokana hammoho" e ka ba tšusumetso ea mokhatlo oa lefutso. Ka lebaka la metsoalle e batlang metsoalle, e seng feela e nang le litšobotsi tse tšoanang (mohlomong le ho noa, ho sebelisa lithethefatsi le ho ja), empa li-genotypes tse tšoanang, joalo ka DRD2 A1 allele E le hore ha lekhoba la tahi, ka mohlala, le botsoa ho lokisa le felisa metsoalle e meng e neng e ke ke ea thusa ho hlaphoheloa ha bona, re hloka ho tseba ho khahlano le lithollo. Kahoo, boemong ba limolek'hule tsa methapo ea kutlo, ho bonolo ho e bua empa ha e etsoe habonolo. Mofuta oa thabo ke hore batho ba lula marang-rang a phutholohileng. Ho lokisa litaba ho ka 'na ha se ke ha hlola ho theha tšepo hape empa ho ka thusa ho kokobetsa letsoalo le lihlong. Mona ho ka ba molemo ho sheba sebopeho sa malapa ho boits'oaro ba RDS.
Mohato oa 9-Made o tobile o lokisa batho ba joalo kae kapa kae moo ho khonehang, ntle le haeba ho etsa joalo ho tla ba utloisa bohloko kapa ho utloisa ba bang bohloko.
Ha ho bonolo ho fihlella thabo le khotso haholoholo ha lekhoba la tahi kapa le lemaletseng ho tobana le ho nka boikarabello ba ho utloisa ba bang bohloko bao a neng a kile a ba le likamano le bona ha a ntse a noa kapa a sebelisa lithethefatsi. Mohloli o totobetseng oa likotsi likamanong tse bakoang ke ho lemalla lithethefatsi ke "ho lahla" molekane kapa ntho e 'ngoe ea bohlokoa bakeng sa joala le / kapa lithethefatsi. Mahlasipa a RDS a tlameha ho jara boikarabello ba ho lahla baratuoa bana. Ntle le moo, ba lemalloang e kanna eaba ba ne ba ba hlekefetsa haholo ('meleng le maikutlong) nakong ea bokhoba ba bona bo matla. Mohato oa 8 pele ho ka etsoa liphetoho, motho ea lemaletseng joala o kopuoa ho ngola lenane la batho bohle ba lemetseng, le ka hlahisang maikutlo a tebileng a molato le lihlong habonolo. E boetse e hloka ho hlola ho hana le ho ikemisetsa ho lokisa litaba. Mohato oa 9, katleho ea ho lokisa (ntle le moo ho etsa joalo ho ke keng ha baka kotsi e ngoe) ho latela likamano liphatseng tsa lefutso, botsoalle le likamano. Joalokaha ho boletsoe lipatlisisong tse akaretsitsoeng kaholimo, likamano le thabo li thehiloe ho wiring e thata ea methapo, 'me sena se hlahisa phephetso e kholo le ho hlaka mabapi le mokhoa oa ho fihlela pholiso nakong ea ho fola. Tekanyo eo motho a ka lokisang ba bang ho eona (ntle le kotsi kapa kotsi) e ts'oana le ho fola ka nepo, mme habohlokoa, ke ho fumana thabo. Ho etsa liphetoho ho ka tsamaisoa ke tokollo ea tlhaho ea DA e sebetsang litsing tsa moputso tsa boko.
Mohato 10-Nka tlhaiso ea hau ea botho 'me u lumelle hore e fosahetse
Mohato oa leshome e ka ba sephahla sa khatello ea khatello. Ba lemaletseng lithethefatsi ba sebetsa mohato ona ha likhahla le likhahla tsa letsatsi li ntse li le ncha kelellong. Ba thathamisa seo ba se entseng mme ba leka ho se lokafatse liketso tsa bona. Ntho ea pele eo ba lokelang ho e etsa ke ho emisa! Joale ba tlameha ho ipha nako ea ho itumella ka monyetla oa ho nahana. Ba sebetsa mohato ona khafetsa. E fana ka mokhoa oa ho qoba mesarelo. Motho o lekola maikutlo, maikutlo, litoro le liketso. Ka ho lula ba shebile lintho tsena ba ka khona ho qoba ho pheta liketso tse ba utloisang bohloko (Narcotics Anonymous Basic Text, Khaolo ea 4 / Mohato oa 10). Mohato oa 10 ke tlhokomelo ea Mehato ea 4 le ea 5 mme "e khothaletsa ho nka lethathamo la libuka tsa batho, leo, bakeng sa batho ba hlaphoheloang, e lokelang ho ba ts'ebetso ea letsatsi le letsatsi". Ho bohlokoa hore batho ba lemalloang ba elelloe hore haeba ba na le kotsi ea liphatsa tsa lefutso, mohlala, DRD2 A1 e na le 30- 40% ka tlase ho segokanyipalo sa D2, ho nka lethathamo le ho ikutloa hantle ka eona ke "dopamine fix" ea nakoana. Kahoo, ba lemalloang ba tlameha ho tsoelapele ho "sebetsa mehato" letsatsi le letsatsi ho tlatsa DA.
Mohato 11-O batloa ka thapelo le ho thuisa ho ntlafatsa kamano ea rona le Molimo, joalo ka ha re ne re mo utloisisa, re rapela feela hore re tsebe thato ea hae le matla a ho etsa seo.
Ho etsa mosebetsi o hlokoang mohatong oa 11 khafetsa ka ts'ebetso ea ho thuisa le thapelo ho eketsa tokollo ea DA boemong ba synaptic. Ntle le moo, ho sebetsa Mohato oa 11 letsatsi le leng le le leng ho tla felisa "ts'ebetso ea kelello ea hypodopaminergic" ka ho ntšetsoa pele ha DA ho synapse. Keketseho ea DA e tla baka keketseho e latelang ea li-receptor tsa DA D2 leha e le ho bajari ba DRD2 A1 allele le meputso e meng ea liphatsa tsa lefutso. Keketseho ea li-receptor tsa D2 e fetolela ts'ebetsong ea DA e ntlafalitsoeng, e tla qetella e khothaletsa boits'epo bo fetelletseng ho lekhoba le hlaphoheloang, e leng ho nolofalletsang kutloisiso e ntlafetseng ea lentsoe le ngotsoeng la kopano ea mehato e leshome le metso e 'meli. Sena se tla lebisa phelisong e khahlano le khatello ea maikutlo mme ka hona ea fokotsa menyetla ea ho oela hape haholo malapeng a sa sebetseng le a ts'epahaneng.
Mohato 12-Kaha re bile le tsoho ea moea ka lebaka la mehato ena, re lekile ho isa molaetsa ona ho lino tse tahang le ho sebelisa melaoana ena litabeng tsohle tsa rona.
Mohato oa 12 o hlaha ha motho ea neng a hlaphoheloa a ne a entse mosebetsi, mme o utloisisa mehato eohle e fetileng lenaneong. Ho boletsoe hore ho sebetsa mehato eohle ho tla lumella motho ho ba le tsoho moeeng. Re supa hore ho batho ba lemaletseng bokhoba ba tahi ba ipapisitse le liphatsa tsa lefutso le maemo a tikoloho, ho fumana ho tsosa ho ka ba thata le ho feta. E 'ngoe ea liphihlelo tse khotsofatsang ka ho fetesisa tseo motho a ka li fumanang ke ho arolelana maikutlo le ba bang haholoholo ha ho amana le ho isa molaetsa oa kopano ho ba bang ba lemalloang. Ho bohlokoa ho hlokomela hore boiphihlelo bona bo ka angoa ke ho qaptjoa le ho lokolloa ha k'hemik'hale ea boko oxytocin. Ka bomalimabe, ntle le tšebetso ea liphatsa tsa lefutso, joala le li-opiate li senya tšebetso ea pele le ho lokolloa ha neuropeptide ena ea bohlokoa. Kamora nako, baoki ba lokela ho hlokomela hore phetoho efe kapa efe ea bophelo e angoa haholo ke liphatsa tsa lefutso tsa polymorphic le liketsahalo tse bohloko.
Le ha e ntse e le khang tsela e le 'ngoe ea ho akaretsa melemo ea lenaneo la bohato ba 12 le botsoalle li kentsoe' me li bonts'oa lipolelong tsena ke litsebi tse lemalang tse sebetsang lefapheng la bongaka ba bokhoba. (bona setšoantšo sa 5).
fihlela qeto e
Le ha ho ka ba bonolo ho bolela hore batho bohle ba lemalloang ba tla una molemo lithutong tse 12 tsa mohato, ho kanna ha se be joalo. Ebile ha ho tluoa bomoeeng ho na le liphatsa tsa lefutso tse 'maloa le lipolomofomu tse amanang tse kenang litumelong tsa motho tse amanang le MOLIMO [46, 74, 79, 137, 287-289]. Setho se seng se itse "Lenaneo le phethahetse ebile ha le hlōlehe-batho ba tla etsa joalo." (Ha a tsejoe). Joalokaha re boletse pejana "Ho fumana thabo ho kanna ha se ke hoa lula liphatseng tsa lefutso feela empa ho kanna ha ameha ke mekhoa e metle ea ho thuisa, kelello e ntle, kamohelo ea moea, lerato la ba bang le boithati, le ho ipapisa le rona ka letsatsi le le leng" [46].
lumela hore baa fokola
Bangoli ba leboha tšehetso ea Mary Hauser, Lisa Marzili le Chris Campanella oa Dominion Diagnostics, LLC.
Lithuso tsa lichelete
Ho ngoloa ha pampiri ena ho ile ha tšehetsoa ka chelete e tsoang ho Likolo tsa Naha tsa Bophelo, NIAAA (RO1- AA07112 le K05-AA00219) le Ts'ebeletso ea Lipatlisiso tsa bongaka ea Lefapha la Litaba tsa Veterans (MOB). Bangoli ba leboha thuso ea bongoli ba Margaret A. Madigan le Paula J. Edge. Univesithi ea Florida Foundation e tšehetsa lipatlisiso tse teng hona joale. Rajendra D. Badgaiyan o tšehelitsoe ke National Institutes of Health Grants 1R01NS073884 le 1R21MH073624; le VA Merit Review Awards CX000479 le CX000780. Kenneth Blum ke moamoheli oa thuso ho PATH FoundATION NY, ke Life Extension Foundation, Ft / Lauderdale, Florida.
Khohlano ea Thahasello
Kenneth Blum, PhD ke mookameli oa likhatiso tse 'maloa tsa US le kantle ho naha tse ntšitsoeng le tse ntseng li emetse tse amanang le Nutrigenomics le Nutraceuticals. Ka IGENE LLC., Dr. Blum o ile a fana ka laesense ea genetic Addiction Risk Score (GARS) ™ ho Dominion Diagnostics, LLC. Ngaka Blum hape ke ofisiri le mohoebi oa thepa ea IGENE, LLC ebile ke moeletsi ea lefuoang oa Dominion Diagnostics, LLC, IGENE, Setsi sa Pholoso ea Malibu. Ngaka Blum ke moeletsi ea lefuoang oa Setsi sa Pholoso sa Malibu. Dr. Blum ke setho sa boto ea boeletsi ea saense ea Dominion Diagnostics, LLC ebile ke Moeletsi ea ka Sehloohong oa Saense ea Dominion Diagnostics, le Chief Science Science Officer oa RDSolutions and Victory Nutrition International, LLC.
Tlatsetso ea Bangoli
Buka e ngotsoeng ka letsoho ea pele e ngotsoe ke KB, JG, MSG, ST, MOB, JF. Tlhahlobo ea bongaka ke DES, AKR, ZD, GA le JF. Bangoli bohle ba ananetse sengoloang pele ho tlhahiso. MAM (Margaret A. Madigan) o fane ka mongolo oa ho qetela le liphetoho.
Boinehelo
Ho "li-Docs tse nang le kelello e ts'oanang" tsa ASAM.
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