Tsebo ea kelello ea boko le boits'oaro ba bocha: moelelo oa mathata a sebelisoang ke lithethefatsi (2010)

J Am Acad Ngoana Litaba tsa kelello. 2010 Dec; 49 (12): 1189-201; lipotso 1285.
 
Casey BJ, Jones RM.

mohloli o moholo

Sackler Institute for Developmental Psychobiology, Weill Cornell Medical College, New York, NY 10065, USA. [imeile e sirelelitsoe]

inahaneloang

MORERO:

Nako ea bocha ke nako ea nts'etsopele e kenyelletsang liphetoho tse kholo mokhoeng o nkang kotsi le teko ea joala le lithethefatsi. Ho utloisisa hore na kelello e fetoha joang nakong ena e amanang le bongoana le ho ba motho e moholo le hore na liphetoho tsena li fapana joang ho batho ka bomong ho bohlokoa ho rera kotsi ea tlhekefetso ea morao-rao ea lithethefatsi le ho its'epahalla.

METHODO:

Tlhatlhobo ena e tšohla monahano oa batho oa morao-rao le mosebetsi oa liphoofolo maemong a pono e hlahellang ea bocha e tšoauoa ke tsitsipano lipakeng tsa litsamaiso tsa "tlase-up" tsa pele tse hlahisang ho fetella ho fetelletseng ho susumetsa le ho holisa libaka tsa "top-down" tsa taolo ea kelello. . Bopaki ba boits'oaro, kliniki le neurobiological bo tlalehiloe ka ho arola mekhoa ena e 'meli ka mokhoa o ntlafatsang. Lingoliloeng tse mabapi le litlamorao tsa joala le thepa ea eona e khotsofatsang bokong li tšohloa maemong a lits'ebetso tsena tse peli.

LIKOTSO:

Ka kopanelo, lithuto tsena li bonts'a nts'etsopele ea curvilinear ea boits'oaro bo susumetsang le likarolo tse ka tlasa kelello tsa subcortical, ka leseli le phahameng ho tloha 13 ho isa lilemong tsa 17. Ka lehlakoreng le leng, libaka tsa pele, tse bohlokoa taolong ea boits'oaro bo botle, li bonts'a mohlala oa nts'etsopele ea ho ba motho e moholo ea tšoanang le lintho tse bonoang lithutong tsa boits'oaro ba ho se ts'oanelehe.

CONCLUSIONS:

Phapang kapa ho se leka-lekane pakeng tsa lits'ebetso tsena tse ntseng li hola nakong ea bocha ho ka etsa hore lits'ebetso tsa taolo ea kelello li hlaselehe habonolo ho feto-fetohang ho theosa le ho eketsa ts'ebeliso ea matla a ts'ebetso ea joala le lithethefatsi. Kahoo, liphephetso tsa boits'oaro tse hlokang taolo ea kelello sefahlehong sa litabatabelo tsa lijo li ka sebetsa e le matšoao a bophelo bo botle ba ho tseba esale pele hore na bacha ba ka ba kotsing e kholo ea ts'ebeliso ea joala le lithethefatsi ke eng.

Copyright © 2010 American Academy of Child and Adolescent Psychiatry. E phatlalalitsoe ke Elsevier Inc. Litokelo tsohle li sirelelitsoe.

Selelekela

Bokhachane ke nako ea phetoho ha ho e-na le liphetoho tse ngata tse etsahallang ka nako e le 'ngoe, ho kenyeletsoa le ho holofala' meleng, ho ikemela bakeng sa boipuso, ho eketseha ha ts'ebelisano 'moho le lithaka, le kholo ea kelello 1-3. Nako ena ea nts'etsopele hape ke nako e tšoauoang ke ho kenella mekhoeng e kotsi e kenyeletsang ho leka lithethefatsi le joala, ts'ebetso ea botlokotsebe le thobalano e sa sireletsehang. Ho utloisisa motheo oa neural ea boits'oaro bona bo kotsi ho bohlokoa ho khetholla hore na ke bacha bafe ba ka bang kotsing ea litlamorao tse mpe, joalo ka ho its'etleha ha lintho le tlhekefetso.

Ho fanoe ka litlatsetso tse ngata bakeng sa hore na hobaneng bacha ba ka etsa boits'oaro bo kotsi le bo kotsi. Litlaleho tsa setso tsa bocha li fana ka maikutlo a hore ke nako ea nts'etsopele e amanang le katleho e tsoelang pele ea matla a taolo ea kelello. Ts'ebetso ena ho taolo ea kelello e hlalosoa e le ho its'etleha holima nako ea "cortex" e tlang pele ho nako, joalo ka ha ho bonahala 4-7 le lithuto tsa setopo8-10 e bonts'a nts'etsopele e tsoelang pele ea sebopeho sa tikoloho ena ho fihlela e le motho e moholo.

Taolo e ntlafalitsoeng ea temohisiso le nts'etsopele ea cortex ea pele e lumellana le keketseho ea mola ho bokhoni bona ho tloha bongoaneng ho ea ho motho e moholo. Leha ho le joalo liqeto le liketso tse nyane tse bonoang lilemong tsa bocha li bontša tlhahiso 11 seo se ikhethile ho tloha bongoaneng kapa ho ba motho e moholo, joalo ka ha ho netefalitsoe ke Setsi sa Naha sa Lipalopalo tsa Bophelo boits'oarong ba bocha le ho shoa ha bona 12. Haeba taolo ea kelello le "cortex" e tlang pele ho nako e ne e le motheo oa boitšoaro bo ikhethileng bo le bong, bana ba lokela ho shebahala ba ts'oana kapa ba bobe haholo ho feta bacha, ha ba fuoe bokhoni ba bona bo sa ntlafalitsoeng ba bokhoni ba pele. 2. Tlhahlobo ena e sebetsana le potso ea mantlha ea hore na boko bo fetoha joang nakong ea bocha bo ka hlalosang inflections ka boits'oaro bo kotsi le bo sa susumetseng. Ntle le moo, re fana ka mehlala ea kamoo tšebeliso ea joala le lithethefatsi nakong ena ea nts'etsopele li ka eketsang liphetoho tsena le ho ka lebisa tlhekefetsong le ho its'etleha ka morao ho moo.

Ho nka liphetoho tsa kelello le tsa neurobiological ka nepo lilemong tsa bocha, nako ena e lokela ho tšoaroa e le phetoho ho fapana le ho thunyana ka nako e le 'ngoe ka nako. 3. Ka mantsoe a mang, ho utloisisa nako ena ea nts'etsopele, phetoho ho tsoa le ho tsoa bongoaneng e hlokahala bakeng sa ho khetholla litšobotsi tse ikhethang tsa nako ena tse amanang le lintlha tse ling tsa nts'etsopele. Ka hona, tlhaiso-leseling e matla e thehileng li-trajectories tsa nts'etsopele ho tloha bongoaneng ho fihlela ho ba motho e moholo bakeng sa lits'ebetso tsa kelello le boitsebahatso li bohlokoa molemong oa liphetoho tsena mme ho bohlokoa haholo ho hatella litlhaloso ka phetoho ea bokong kapa boits'oong bongoaneng.

Taba ea bobeli, lipontšo tse nepahetseng tsa bocha li hloka ntlafatso ho sebopeho sa phenotypic sa nako ena. Mohlala, boemong ba boits'oaro, hangata bacha ba khetholloa e le batho ba ipehang kotsing ea ho beha kotsing le litlatsetso tsena tse sebelisoang ka mokhoa o tšoanang. Leha ho le joalo, matsoalloa ana a ikhethile 'me ho utloisisa phapano ena ho bohlokoa bakeng sa ho hlalosa mekhahlelo ea bona ea nts'etsopele ea' mankhonthe le nts'etsopele ea neural. Re fana ka bopaki ba boits'oaro, ba bongaka le ba likokoana-hloko bo bonts'ang hore ho nka kotsi ho kopantsoe le kutloelo-bohloko haholoanyane mabapi le litšusumetso tsa tikoloho (takatso ea maikutlo) ha ho susumetsoa ho amana le taolo e tlase ea taolo e tlase.

Ha re theha mabaka a matla, re fana ka mohlala o hlakileng oa bongoana 'me re fana ka maikutlo a hore nts'etsopele nakong ena e ka lebisa tlokotsing ea tlhekefetso ea joala le lithethefatsi. Morero oa tlhahlobo ena ha se ho khothatsa bongoana, empa ho e-na le hoo ke ho hlalosa hore na hobaneng bacha ba bang empa eseng ba bang ba kotsing ea tlhekefetso ea lithethefatsi. Kahoo, re leka ho fumana matšoao a tlhaho le a boits'oaro bakeng la ho khetholla le ho hlahloba litlhahlobo tsa ho kenella.

Eya ho:

Mohlala oa Neurobiological oa Bocha

Mohlala oa neurobiological oa kholo ea lilemong tsa bocha 2 e hahang mefuteng ea litoeba 13, 14 le lithuto tsa morao-rao tsa ho nahana ka bongoana 6, 7, 15-20 e hlahisoa Setšoantšo sa 1. Mohlala ona o bontša kamoo libaka tse tlase li lokelang ho nkuoa hammoho ka potoloho. Cartoon e bonts'a mekhoa e fapaneng ea nts'etsopele ea ho supa libaka tsena, ka lipehelo tsa maiketsetso tse ntlafalitsoeng pejana ho libaka tse laoloang pele. Ho ea ka mohlala, mocha o khethoa ka leeme ke setho sa "ccicalical" se potolohileng lilemong tsa bocha (ke hore, ho se leka-lekane ha ts'ebetso ea ts'ebetso), ha a bapisoa le bana, bao karolo ena ea pele e ntseng e ntlafala; le ho bapisoa le batho ba baholo, bao lits'ebetso tsena li holileng ka botlalo ho bona. Ka nts'etsopele le boiphihlelo, bohokahanyo bo sebetsang pakeng tsa libaka tsena bo matlafatsoa le ho fana ka mokhoa oa ho feto-fetoha ho tlase ha lits'ebetso tsa subcortical 7. Ka hona ke potoloho ea pele-pele, hammoho le matlafatso ea ts'ebetso ea khokahano kahare ho potoloho ena, e ka fanang ka mochine oa ho hlalosa liphetoho maikutlong le ho etseng menyetla ea tlokotsi holima nts'etsopele.

Setšoantšo sa 1

Moetso oa katuni oa tšebelisano-'moto le tšubuhlellano ea "cortex" ea PFP nakong ea kholo. 'Mala o tebileng o supa ho bonts'a tikoloho e kholo. Mohala o emela khokahano e sebetsang, ka mola o tsitsitseng o bonts'ang khokahano e holileng tsebong le mohala oa matšoao ...

Moetso ona o lumellana le tse fetileng 21-24 ka hore e fana ka motheo oa inflections e sa tsejoeng kahare ho boits'oaro ho tloha bongoaneng ho fihlela motho e moholo, ka lebaka la ho hola ha linako tsa morao-rao tsa likhakanyo tsa subcortical tse amanang le tse sa holiseng pele ho tsa pele. Ka ho khetheha, mohlala oa boraro 21 fana ka maikutlo a hore boitšoaro bo susumetsang bo na le li-circuits tse tharo tse fapaneng (mokhoa oa ho qoba, oa ho qoba le oa taolo). Sisteme ea mokhoa e laoloa haholo ke ts'ebetso ea ventral striatum, thibelo ea tsamaiso ke amygdala mme qetellong, tsamaiso e laoloang ke cortex ea pele. 25. Moetso oa hona joale o fapana haholo le ba bang ka hore e thehiloe ho bopaki bo matla ba liphetoho tsa boko eseng feela phetohong ea ho tloha bohlankaneng ho ea ho motho e moholo, empa ho fetoloang ho kena bocha ho tloha bongoaneng le hamorao tsoa bocha e be motho e moholo. Ntle le moo, mohlala ha o fane ka maikutlo a hore bo-striatum le amygdala ba ikemiselitse ho atamela le ho qoba boits'oaro bo fuoeng boithuto ba morao-rao bo bonts'ang boikemelo ba boikemelo ba likarolo tsena. 26, empa ho na le ke lits'ebetso tse bohlokoa ho khetholleng litšusumetso tse nang le tlhoko ea maikutlo tikolohong e ka khethollang boitšoaro. Thutong ena, re hlalosa bopaki ba morao-rao bo tsoang lithutong tsa boits'oaro tsa batho ba lilemong tsa bocha le boemong ba mohlala oa rona bo bontšang phetoho ea ho tloha bongoaneng ho ea ho motho e moholo.

Eya ho:

Tšobotsi ea Phenotypic ea Bocha

Bokhoni ba ho hanela moleko molemong oa lipheo tsa nako e telele ke mofuta oa taolo ea kelello. Bofokoli ba bokhoni bona bo akantsoe hore bo ka sehlohlolong sa boits'oaro bo bobe ba lilemong tsa bocha 27. Taolo ea kelello, e kenyeletsang ho hanela moleko kapa ho lieha ho khotsofala hang-hang e ithutile molemong oa psychology ea sechaba, nts'etsopele le kelello. Nts'etsopele, bokhoni bona bo lekantsoe ka ho lekola hore na ngoana ea lilemong tse tlase a ka hanyetsa moputso oa kapele hakae (mohlala, cookie) molemong oa moputso o moholo hamorao (mohlala, li-cookie tse peli) 28. Leha batho ka bomong ba sa tšoane ka bokhoni bona leha e le batho ba baholo, liphuputso tsa nts'etsopele li fana ka maikutlo a hore nts'etsopele e ka ba teng ha motho a ka ba mothating oa ho hoheloa ke liteko. Bokhoni bona bo hlalositsoe e le mokhoa oa taolo ea tšusumetso 29 'me e na le likarolo tse ngata 30, 31, empa e ka hlalosoa ka ts'ebetso e le bokhoni ba ho etsa boits'oaro bo tataisoang ke sepheo ha u shebana le litlatsetso le liketso. 32.

Ka nalane, lithuto tsa nts'etsopele li bonts'itse ntlafatso e tsitsitseng ea bokhoni ba taolo ea kelello ho tloha boseeng ho ea ho motho e moholo 33. Pono ena e tšehetsoa ke letlotlo la boits'oaro bo tsoang ho liteko tsa liteko tse fumanehang maemong a laboratori a kenyelletsoang ho kenyelletsa lintlha tse kang mosebetsi oa Go-NoGo, Simon task, le li-paradigms tse fetolang mosebetsi tse hlokang hore barupeluoa ba fetole karabelo e potlakileng ho fihlella e nepahetseng 32, 34. Leha ho le joalo, ha ho le molemo ho hatella karabelo ho mekhoa e amanang le ts'usumetso, taolo ea kelello e na le bothata 20. Taolo ena e fokotsehileng e bonahala haholo nakong ea boroetsana, ha likhetho tse nyane ho tsa boitšoaro bo amanang le thobalano le lithethefatsi li fihla sehlohlolong 3, 11, 12, 14. Boitlhotlhollo bona bo fana ka maikutlo a hore li-trajectories tsa nts'etsopele ea taolo ea kelello li rarahane ebile li ka fetoloa ka maikutlo le ho tiisa maemo (mohlala, litšebelisano tsa sechaba le tsa thobalano), moo taolo ea kelello e batlang ho sebelisana le lits'oants'o tsa ts'ebetso kapa lits'ebetso.

Ho susumetsa ho ka fetola taolo ea kelello ka bonyane ka litsela tse peli. Taba ea pele, ho putsoa ka ho etsa mosebetsi o itseng ho ka etsa hore batho ba sebetse ka thata mme qetellong ba sebetse hantle ho feta ha ba sa putsoa 17. Taba ea bobeli, bokhoni ba ho fana ka taolo bo ka qholotsoa ha ho hlokahala ho hatella menahano le liketso ho litakatso tse khahlisang 20. Boithuto ba morao-rao ba nts'etsopele ea bohlankana bo se bo qalile ho bapisa bokhoni ba taolo ea kelello maemong a batlang a sa nke lehlakore le a susumetsang. Lithuto tsena li fana ka maikutlo a phetoho ea kutloisiso mabapi le mekhoa ea tikoloho, haholo e thehiloeng moputsong lintlheng tse fapaneng nts'etsopele, 'me e fana ka maikutlo a tšusumetso e ikhethang ea ts'usumetso ea maikutlo nakong ea bocha.

Karolong e latelang, re totobatsa tse ling tsa lipatlisiso tsa morao-rao tsa hore na boitšoaro ba bocha bo khetholloa ka tsela e fapaneng joang maemong a amanang le batho ba baholo.

Mohlala, Ernst le basebetsi mmoho 35, 36 e hlahloba ts'ebetso ho mosebetsi oa antisaccade ka tšepiso ea moputso oa chelete bakeng sa ts'ebetso e nepahetseng litekong tse ling empa eseng tse ling. Liphetho li bonts'itse ts'episo ea moputso, e nolofalitseng boitšoaro ba taolo ea lilemong tsa bocha ho feta ho batho ba baholo, sepheo se 'nileng sa phetoa 17 mme haufinyane e atolosoa ho fumana meputso ea sechaba (mohlala lifahleho tse thabileng 20).

Le ha mehlala e fetileng e fana ka maemo a ntlafatso ea ts'ebetso ho bacha ba nang le tšusumetso, meputso e ka fokotsa ts'ebetso ha e hatella likarabo ho meputso e lebisang phaellong e phahameng. Mohlala, ho sebelisa ts'ebetso ea papali ea chelete eo ho eona ho fanoang ka maikutlo a moputso hang hang ha ho etsoa liqeto (tse "chesang" tse phahamisitseng motho ea tsosang takatso) kapa a emisoa ho fihlela kamora qeto (liteko tse “liehang” tsa ho etsa liqeto), Figner le basebetsi mmoho 37 e bontšitse hore bacha ba beha lits'oants'o tse kotsi haholo ha ba bapisoa le batho ba baholo empa ba le maemong a "chesang". U sebelisa mosebetsi o tšoanang, Iowa Gask Task, Cauffman le basebetsi mmoho 38 e bonts'itse hore maikutlo ana a meputso le litakatso li hlile li nyoloha nakong ea bohlankana, ka keketseho e tsitsitseng ho tloha bongoaneng ho fihlela bohlankaneng ba tloaelo ea ho bapala ka likarete tse ntle tsa likarete ebe ho theoha ho latelang ho ba bohlankana ho fihlela e ba motho e moholo. Liphumano tsena li bonts'a ts'ebetso e mpe pakeng tsa 13 le 17, 'me joale ea fokotseha 27. Le ha lipatlisiso tsa pejana le mosebetsi oa ho bapala papali ea Iowa li bonts'itse keketseho ea ho sebetsa le lilemo 39, lithuto tsena ha lia ka tsa sheba lilemo li sa feleng ebile ha lia ka tsa hlahloba liteko feela ka likarete tse ntle tsa likarete.

Boithuto ba morao-rao bo bonts'itse hore maemo a bophelo, haholo lithaka, le ona a ka sebetsa e le tšusumetso 'me a ka fokotsa taolo ea kelello nakong ea bocha. Ho bontšitsoe hore tekanyo eo bacha ba lilemong tsa bocha ba sebelisang lintho ka eona e tšoana hantle le palo ea joala kapa lintho tse seng molaong tseo mocha a tla li sebelisa. 40. U sebelisa mosebetsi oa ho khanna o qapiloeng, Gardner le basebetsi mmoho 41 e bontšitse hore bacha ba etsa liqeto tsa riskier ka pel'a lithaka ho feta ha ba le bang le hore liqeto tsena tse kotsi li fokotseha hantle le lilemo 23, 40.

Ha li kopantsoe hammoho, liphuputso tsena li supa hore nakong ea bohlankana, mekhoa ea ts'ebetso ea meputso e ka bang teng ka ho khetheha mme e ka lebisa ts'ebetsong e ntlafalitsoeng ha e fanoa e le sephetho sa sephetho kapa moputso, empa likhetho tsa riskier kapa likhetho tse nyane ha li fanoa joalo ka setšoantšo. Maemong a morao, thupa e susumetsang e ka nyenyefatsa boits'oaro bo sebetsang ba sepheo. Ntle le moo, lithuto tsena li fana ka maikutlo a hore kutloisiso ea moputso le boits'oaro ba ho batla maikutlo bo fapane le ho susumetsoa ka mekhoa e fapaneng ea ntlafatso (ts'ebetso ea curvilinear le mosebetsi oa mola, ka tatellano). Phapang ena e bonahala haholoanyane thutong ea morao tjena e entsoeng ke Steinberg et al. 42 sebelisa mekhoa ea ho itlaleha ea ho batla le ho hoheleha. Ba ile ba leka hore na mefuta-futa e kopaneng ea maikutlo a ho batla maikutlo le ho ts'oaroa ha e tsoele pele ho latela linako tse fapaneng ho batho ba ka bang 1000 lipakeng tsa 10 le 30. Liphetho li bonts'itse hore phapang ea ho batla maikutlo le lilemo e latela mokhoa o fetelletseng, ka tlhalo ea maikutlo-e batla e eketseha pakeng tsa lilemo tsa 10 le 15 mme ea fokotseha kapa ea lula e tsitsitse kamora moo. Ka lehlakoreng le leng, phapang ea lilemo ho impulifity e ile ea latela mohlala, 'me ea fokotseha habonolo le botsofaling ka tsela ea mola (bona. Setšoantšo sa 2 phanele A). Liphumano tsena hammoho le lipatlisiso tse thehiloeng laboratoring li fana ka maikutlo a hore batho ba ka ba kotsing ea ho kena lilemong tsa bocha "ho ka bakoa ke ho kopana le litšekamelo tse phahameng haholo tsa ho batla nyakallo le bokhoni bo sa tsitsang ba boitaolo bo tšoanang le ba nako ena ea nts'etsopele" 42.

Setšoantšo sa 2

Papiso ea lithuto tse fapaneng tsa nts'etsopele ea maikutlo le maikutlo a ho susumetsa. Panel A. Lethathamo la ho batla maikutlo le ho se ts'oenyehe joalo ka ts'ebetso ea lilemo (e fetotsoe ho tloha 42). Panel B. Lethathamo la mekhahlelo ea liketsahalo libakeng tsa boko tse amehang ka moputso ...
Eya ho:

Neurobiology ea Bacha

Joalokaha ho hlalositsoe mohlaleng oa rona oa bohlankana, libaka tse peli tsa bohlokoa tse amehang boikutlong le tlhotlheletsong ke cortex e tlang pele, e tsejoang e le bohlokoa bakeng sa taolo ea kelello 43 le sepheo sa mantlha sa ho sibolla le ho ithuta ka lipale tse ncha le tse khotsofatsang tikolohong 44. Re totobatsa mosebetsi oa morao-rao oa liphoofolo le oa motho oa liphetoho tsa neurobiological tse ts'ehetsang lits'ebetso tsena tse susumetsang le tse kelello ho ntlafatseng maemo a liphumano tse fetileng tsa boithuto mabapi le nts'etsopele ea ho batla maikutlo le ho ts'oaroa. Re sebelisa mokhoa o hlalositsoeng oa ho leka-lekana oa nts'etsopele ea methapo ea libaka tse holimo pele ho sebaka se amanang le ts'ebetso ea curvilinear bakeng sa nts'etsopele ea libaka tse tlase tsa boemo bo phahameng tse kenyelletsang ho sibolla lintlha tsa bohlokoa tikolohong ho theola se fumanoeng. Bohlokoa ba ho lekola potoloho ho fapana le liphetoho tse ikhethang tsa tikoloho, haholoholo makaleng a pele a boits'oaro bo ikhethileng bo fapaneng. Pono ena e etsa hore tšimo e hole le tlhahlobo ea hore na sebaka ka seng se ikhula joang hore se ka ikamahanya le maemo a lipotoloho tse hokahaneng.

Mosebetsi oa liphoofolo le oa semmuso o bonts'a tsela eo litereke tsa litonanahali le tsa litonanahali li bopehang ka kotloloho boitsong ba bona 7, 27, 37, 38, 44. Ho sebelisa lirekoto tsa yuniti e le 'ngoe ho litšoene, Pasupathy & Miller 45 e bonts'itse hore ha ho ithuta bonolo ba maemo a meputso, ts'ebetso ea mantlha setsing sa mantlha e fana ka motheo oa mekhatlo e thehiloeng moputsong, athe hamorao, ho sebelisoa mekhoa ea boipheliso e le ho boloka sephetho se ka ntlafatsang melemo e meholo, liphumano tsena li na le e phetoa lithuto tsa lesion 46-48. Karolo ea ts'ebetso ea ho ts'oarana ha litokollo tsa nakoana tsa mekhatlo ea moputso pele ho ts'ebetso ea ts'ebetso libakeng tsa pele le eona e atolositsoe ho batho 49. Liphumano tsena li fana ka maikutlo a hore ho utloisisa tšebelisano lipakeng tsa libaka (hammoho le mesebetsi ea karolo ea tsona); kahare ho li-circryriatryryry li bohlokoa bakeng sa ho theha mofuta oa taolo ea kelello le e susumetsang bongoaneng.

Li-circuits tsa Frontostriatal li ntlafatsoa haholo nakong ea bocha 50-53 tse ikhethang haholo tsamaisong ea dopamine. Litlhōrō tsa letsoalo la li-receptor tsa dopamine, D1 le D2 ho striatum li etsahala pele ho nako ea bocha, ebe li lateloa ke tahlehelo ea li-receptors tsena ke batho ba baholo. 54-56. Ho fapana le hoo, cortex ea pele ha e bontše tlhoro ea D1 le D2 receptor density ho fihlela nakong ea bocha le ho ba motho e monyane lilemong. 57, 58. Liphetoho tse tšoanang tsa nts'etsopele li bonts'itsoe lits'ebetsong tse ling tse amanang le moputso ho kenyelletsa li-receptor tsa cannabinoid 59. Ho ntse ho sa hlaka hore na liphetoho lits'ebetsong tsa dopamine li ka amana joang le boitšoaro bo susumetsoang kaha khang e lula e le hore na maikutlo a moputso a fetoloa ke lits'ebetso tsa dopamine (mohlala, 60, 61) le hore na ke ka lebaka la lits'ebetso tse fokolang tse sebetsang kapa hypersensitive dopamine (mohlala, 62, 63). Leha ho le joalo, ha ho fanoa ka liphetoho tse makatsang tsa dopamine rich circry nakong ea bocha, ho ka etsahala hore li amana le liphetoho tsa maikutlo a meputso tse khetholloang ho tloha bongoaneng kapa ho ba motho e moholo 50, 64. Ntle le liphetoho tse bohlokoa tsa li-receptor tsa dopamine, ho boetse ho na le liphetoho tse makatsang tsa li-hormone tse etsahalang nakong ea bocha tse lebisang kholong ea thobalano, le ho susumetsa tšebetso ea tšebetso makaleng a pelehi a pelehi. 65, leha ho le joalo, puisano e qaqileng e feta mohloli oa pampiri ena. Bona 66, 67 bakeng sa litlhahlobo tse qaqileng mabapi le taba ena.

Lithuto tsa ho nahana ka batho li se li qalile ho fana ka tšehetso ea ho matlafatsa likhokahanong tsa dopamine richostostatityalryry potoloho. U sebelisa monahano oa tensor imaging le tšebetso e sebetsang ea matla a khoheli (fMRI), Casey le basebetsi mmoho 68, 69 le ba bang 70 ba bontšitse matla a maholo ho khokahano ea libaka ka hare ho lipotoloho tsena ho fihlela nts'etsopele 'me ba hokahantse matla a khokahano lipakeng tsa pele le lits'ebetso tse nang le bokhoni ba ho kenya letsoho taolong ea kelello ho batho ba tloaelehileng le ba ntlafalitsoeng ka boiphihlelo. 68, 69. Lithuto tsena li bonts'a bohlokoa ba ho supa lipakeng tsa "corticostriatal circry" tse ts'ehetsang bokhoni ba ho nka karolo taolong ea kelello.

Ka mokhoa o ts'oanang, ho na le bopaki bo ntseng bo eketseha bo tsoang lipatlisisong tse sebetsang tsa batho mabapi le hore na litsamaiso tsa subcortical tse kang striatum le preortalal cortex li sebelisana joang ho fana ka boitšoaro bo kotsi bo bonoang ho bacha. 71. Boholo ba lithuto tse nahannoeng li lebisitse ho nqa e le ngoe kapa tse ling tse bonts'ang hore cortex ea pele, e nahanoang ho boloka ntlafatso e amanang le lilemo taolong ea kelello 72-78 o lieha ho kena 'meleng 4, 79, 80 ha litereke tsa linaha tse nang le bokhoni ba ho tseba lintho tse ncha le tse fanang ka meputso li hlaha pejana 74, 81. Lihlopha tse 'maloa li bontšitse hore bacha ba bonts'a ts'ebetso ea ts'ebetso ea "ventral striatum" ka tebello le / kapa ho fumana moputso ha ba bapisoa le batho ba baholo. 6, 15, 17, 18, empa ba bang ba tlaleha karabelo 82.

E 'ngoe ea lithuto tsa pele tsa ho hlahloba lits'ebetso tse amanang le moputso holima nts'etsopele e felletseng ea kholo ho tloha bongoaneng ho fihlela ho ba motho e moholo e phethetsoe ke Galvan le basebetsi 6 ka 6 ho isa ho ba lilemo tsa 29. Li bonts'itse hore ts'ebetso ea moea oa ts'ebetso ea machabeng e tsotella meputso e mengata e fapaneng 49 le hore karabelo ena e ile ea eketsoa nakong ea bohlankana, e amanang le bana le bacha 6 (bona Setšoantšo sa 3), letšoao la ho eketseha ha matšoao 6 kapa ts'ebetso e tsitsitseng 83. Ho fapana le sebopeho se kahare sa "cyral striatum" kapa libaka tse tlang pele ho naha, se bontšitse nts'etsopele e tsoetseng pele lilemo tsena kaofela (Setšoantšo sa 2b).

Setšoantšo sa 3

Ketsahalo ea Ventral Striatal ho putsa le ho tloaelana le batho ba kotsing. Localization ea li-ventral striatum ka sefofane sa axial (phanele e ka letsohong le letšehali), e sebetsang ka moputso (phanele e bohareng) mme e hokahane le ho nka kotsi (sebaka se nepahetseng) (se fetotsoe ho tsoa 6, 16)

Empa, ntlafatso ee ea ho supa matšoao ho "ventral striatum" e amana joang le boitšoaro? Thutong e latelang, Galvan le basebetsi mmoho 16 e ile ea hlahloba setsoalle lipakeng tsa tšebetso ea litho tse kenang ka hare ho naha ho ea moputsong o moholo oa chelete ka mekhoa ea botho ea ho ipeha kotsing le ho nkeha maikutlo kapele. Likala tse sa tsejoeng tsa ho itlaleha tsa boitšoaro bo kotsi, pono le kotsi li fumanoe mohlaleng oa hae oa 7 ho bana ba lilemo tsa 29. Galvan et al. e bontšitse kamano e ntle lipakeng tsa tšebetso ea boemo ba moea ho fihlela moputso o moholo le monyetla oa ho etsa boitšoaro bo kotsi (bona Setšoantšo sa 3) Liphumano tsena li tsamaellana le lithuto tsa batho ba baholo tse bontšang ts'ebetso ea bongoana ka likhetho tse kotsi 84, 85.

Ho ntšetsa pele ts'ehetso ea kamano lipakeng tsa boits'oaro bo kotsi ba bacha le ho ba le kutlo ea ho putsa joalo ka ha e bontšitsoe ke karabo e fetelletseng ea karabelo ea moea, Van Leijenhorst le basebetsi-'moho le eena. 18 o ile a leka mokhatlo ona a sebelisa papali ea papali ea chelete. Mosebetsi ona o ne o kenyelletsa mabenyane a Low-Risk ka monyetla o moholo oa ho fumana moputso o fokolang oa chelete le likotsi tse phahameng tsa kotsi ka monyetla o monyane oa ho fumana moputso o moholo oa chelete. Liphetho tsa fMRI li netefalitse hore likhetho tse phahameng tsa likotsi li ne li amahanngoa le ho bokelloa ha litho tsa moea ha likhetho tse tlase-kotsi li ne li amahanngoa le ts'ebetso ho "cortex" ea "ventral" ea pele "pele". Liphumano tsena li lumellana le monahano oa hore boitšoaro bo kotsi lilemong tsa bocha bo amahanngoa le ho se leka-lekane ho bakoang ke mefuta e fapaneng ea nts'etsopele ea moputso oa subcortical le libaka tsa pele tsa taolo ea kelello tse lumellanang le mohlala oa rona oa bongoana.

Ha ho ntse ho bonahala ho na le kamano lipakeng tsa boits'oaro bo nkang kotsi le ts'ebetso ea ts'ebetso ea bohlasoa, thutong ea Galvan 16 ha ho tumellano e tlalehiloeng pakeng tsa ts'ebetso ea moea oa kahare ka ho kenella. Ho fapana le moo, litekanyetso tsa ho iketelletsa pele li ne li tsamaellana le lilemo, li lumellana le lithuto tse ngata tsa ho nahana tse bontšang tsoelo-pele ea morao-rao le botsofaling ba ho bokella pele ho kotlo ea bokhoni nakong ea mesebetsi e laoloang pele 7, 75, 77 (hape sheba maikutlo ka 34, 86). Ntle le moo, liphuputso tsa morao tjena li bonts'itse hore litekanyetso tsa ho iketelletsa pele li lumellana hantle le molumo oa "cortex" ea "ventral medial prefrontal campex" mohlala oa bashanyana ba phetseng hantle (7-17yrs) 87. Kamora nako, lithuto tsa palo ea batho ba fanang ka thuso ea bongaka tse bonts'itsoeng ke mathata a ho hloka ts'ebetso joaloka ADHD, li bonts'a taolo e sa tsitsang ea ts'ebetso le ts'ebetso e fokotsehileng libakeng tse tlang pele ho bapisoa le taolo. 88, 89 empa o se bonts'e likarabo tse phahamisitsoeng ho litheko 90.

Liphumano tsena li fana ka tšehetso ea maikutlo a neurobiological bakeng sa karohano ea lihlahisoa tse amanang le ho nka kotsi le ho putsa kutloelo-bohloko ea ho se ts'oenyehe ka motho ea neng a bonts'a mokhoa o mobe le mokhoa oa morao-rao oa tšebelisano (bona Setšoantšo sa 2 B). Kahoo likhetho le boits'oaro ba bongoaneng li ke ke tsa hlalosoa ka ho qobelloa kapa ho nts'etsopele hoa "cortex" ea pele feela. Ho fapana le moo, libaka tse susumetsang tse lokelang ho nkuoa li tlameha ho nkuoa ho hlakisa hore na hobaneng boitšoaro ba bocha bo sa fapana le batho ba baholo feela, empa le ho bana. Kahoo, ho bonahala eka boemo ba moea bo kenyelletsa karolo ea maemo a nyakallo 82, 91 le tse amang tse ntle 15 ha o amohela meputso, hammoho le botebo ba ho batla maikutlo le ho ipeha kotsing 16, 91. Habohlokoa le ho feta, liphumano tsena li fana ka maikutlo a hore nakong ea bocha, batho ba bang ba ka ba le tšekamelo ea ho etsa lintho tse kotsi ka lebaka la liphetoho tse bang teng ponong le khokahano mokhoeng oo motho a ikemiselitseng ho o etsa ka mokhoa o kotsi, ho fapana le liphetoho tse bonolo.

Sebaka sa mahlale se amohetseng tlhokomelo e nyane se lekola hore na taolo ea kelello le lits'usumetso tsa ts'usumetso li sebelisana joang nakong ea kholo. Joalokaha ho boletsoe pejana, Ernst le basebetsi mmoho 35, 36 e bonts'itse ts'episo ea moputso oa chelete e nolofalletsang boitšoaro ba taolo ea lilemong tsa bocha ho feta ho batho ba baholo. Geier et al. 17 Haufinyane tjena ho qaqisitsoe likarolo tse nyane tsa poleloana ena ea kelello e sebelisang mofuta oa mosebetsi oa antisaccade nakong ea monahano oa kelello o sebetsang. Bacha le ba baholo, liteko tseo chelete e neng e le kotsing li ile tsa sebetsa ka potlako mme tsa nolofatsa ho nepahala, empa phello ena e ne e le kholo ho bacha. Kamora ho bontša hore nyeoe e latelang e tla putsoa, ​​bacha ba bontšitse ts'ebetso e kholo mokhatlong o hlophisitsoeng oa moea ha ba ntse ba itokisetsa le ho etsa antisaccade hamorao. Karabelo e fetelletsang e ile ea bonoa lilemong tsa bocha kahare ho libaka tse pela pele ho sebata sa pele, tse bohlokoa bakeng sa taolo ea ho sisinyeha ha mahlo, ho fana ka maikutlo a mabapi le melaoana e amanang le moputso libakeng tse laoloang.

Meputso, joalo ka ha ho boletsoe kaholimo, e ka ntlafatsa le ho fokotsa boitšoaro bo lebisitsoeng ho sepheo. Ho bona hore bacha ba ipeha kotsing e kholo ha litabatabelo tsa bona tsa lijo li le sieo nakong ea mesebetsi ea papali ea chelete. 37). Thutong ea morao-rao ea monahano 20, Somerville et al. e thathamisitse likarolo tse tlase tsa taolo ea tlase ea libaka tse laoloang ka litakatso tsa takatso. Somerville et al. ba etsa liteko tsa bana, bacha le ba baholo ha ba ntse ba etsa ntho e nyane ka ho khahlisoa ke ho etsa lintho tse ntle (lifahleho tse thabileng) le mekhoa e sa nke lehlakore. Ts'ebetso ea mosebetsi ho litloaelo tse sa nke lehlakore e bonts'itse ntlafatso e tsitsitseng le lilemo mosebetsing ona oa taolo ea tšusumetso. Leha ho le joalo, litekong tseo motho ka mong a ileng a tlameha ho li hana tse atamelang takatso ea lijo, bacha ba ile ba hloleha ho bonts'a ntlafatso e lebelletsoeng ho latela lilemo. Phokotso ea ts'ebetso ena nakong ea bocha e ne e bapisoa le ketsahalo e ntlafalitsoeng ho striatum. Ka lehlakoreng le leng, ts'ebetso ho "gyrus" e tlase e ne e amahanngoa le ho nepahala ka botlalo mme e bonts'a mokhoa o hlakileng oa phetoho le lilemo bakeng sa liteko tsa nogo le tsa. Ha li kopantsoe hammoho, liphumano tsena li hlahisa sesupo sa maikutlo a fetelletseng a takatso ea bana ba lilemong tsa bocha ntle le karabelo ea taolo ea kelello e holileng.

Ka kakaretso, lintlha tsena li fana ka maikutlo a hore le ha bacha e le sehlopha ba nkuoa e le batho ba ipehang kotsing 41, bacha ba bang ba tla ba bonolo ho feta ba bang ho etsa lintho tse ka ba behang kotsing, ba be beha kotsing e kholo ea litlamorao tse mpe. Liphumano tsena li hatisa bohlokoa ba ho nahana ka phapang ea motho ka mong ha ho hlahlojoa likamano tse rarahaneng tsa boits'oaro bo amanang le ho ipeha kotsing le ho se kenelle ho batho ba hola. Ho feta moo, liphapang tsena tsa motho ka mong le tsa tsoelo-pele li ka thusa ho hlalosa ho ba kotsing ea batho ba bang ho nkeng kotsi e amanang le ts'ebeliso ea lithethefatsi, 'me qetellong, bokhoba ba tahi. 64.

Eya ho:

Tšebeliso e mpe ea lithethefatsi le tlhekefetso ho bacha

Nako ea bocha e tšoaea nako ea liteko tse eketsehileng tsa lithethefatsi le joala 92, ka joala e leng eona e hlekefetsang ka ho fetisisa lintho tse seng molaong ke bacha 11, 93, 94. Tšebeliso ea mantlha ea lintho tsena, joalo ka joala, ke moetapele ea ka tšeptjoang oa ho itšepa le ho hlekefetsoa hamorao 95. Ha ho fanoa ka ts'ebetso ea ts'ebeliso ea ts'ebeliso ea lino tse tahang lipakeng tsa bocha le ho ba motho e moholo tse sa lekanang mohatong ofe kapa ofe oa kholo 96, re shebana haholo le tlhahlobo e khethiloeng mona ea tšebeliso le tlhekefetso ho bacha le thepa e khothalletsoang.

Joala hammoho le lintho tse ling tsa tlhekefetso, ho kenyelletsa cocaine le cannabinoids, li bontšitsoe li na le thepa e matlafatsang. Lintho tsena li susumetsa phetisetso ea mesolimbic dopamine ka ts'ebetso e matla ea li-neurons ho li-circolimbic circry tse ruileng ka dopamine, ho kenyelletsa le ventral striatum 97-99. Joalokaha ho bontšitsoe ke Hardin le Ernst (2009) 92, ts'ebeliso ea lintho tsena e ka mpefatsa karabelo ea "cyri striatum" e seng e ntse e ntlafalitsoe ka sepheo sa ho phahamisa kapa ho matlafatsa thepa ea matlafatso ea lithethefatsi. Robinson le Berridge 61, 63, 100 ba khothalelitse hore lithethefatsi tsena tsa tlhekefetso li ka "ts'oara" lits'ebetso tse amanang le ts'usumetso ea lithethefatsi joalo ka ts'ebetso ea "ventral striatum", ka hona, ba laola libaka tse holimo tsa taolo ea pele.

Boholo ba mosebetsi o matla oa tšebeliso ea lino tse tahang lilemong tsa bocha li entsoe liphoofolong, ho fanoa ka lits'itiso tse nepahetseng tsa ho etsa lithuto tse joalo ho bacha ba batho. Mefuta ea liphoofolo ea ethanol e boetse e fana ka bopaki bo matla ba litlamorao tse fapaneng tsa joala ho bacha ba amanang le batho ba baholo mme e lumellana le liphetho tsa batho ba lilemong tsa bocha ba nang le ho se tsotelle litlamorao tsa ethanol. Spear le basebetsi-mmoho ba bonts'itse hore likhoto tsa bongoana tse amanang le batho ba baholo, ha li tsotelle botsoalle, likoloi, ts'ebetso, ho khaola haholo le "litlamorao tse mpe" tsa ethanol 101-103. Liphumano tsena li bohlokoa molemong oa hore litlamorao tse ngata li sebetsa e le mekhoa ea ho fokotsa palo ea batho ba baholo 11. Ka mokhoa o ts'oanang ha bacha ba sa ts'oenyehe ka mekhoa e ka thusang ho fokotsa tahi ea bona, tšusumetso e ntle ea joala joalo ka ts'ebetso ea sechaba e ka khothaletsa tšebeliso ea joala haholo. 104. Boitšoaro bo kotsi haholo ho batho- ho kenyeletsa ho sebelisa joala hampe- bo hlaha maemong a boiketlo ba sechaba 23, e ka susumetsang bacha ho sebelisa ts'ebeliso e kholo ea joala le lithethefatsi ha boitšoaro bona bo ratoa ke lithaka tsa bona.

Boko bo fetoloa joang le tšebeliso e mpe ea joala le tlhekefetso bongoaneng? Le ha bacha ba sa tsotelle tse ling tsa litlamorao tsa bokhoba ba tahi, ba bonahala ba tsotella tse ling tsa litlamorao tsa neurotoxic 94. Mohlala, lithuto tsa 'mele (mohlala, 105) bonts'a ethanol e kholo e hlahisitsoeng ea bokhoni ba NMDA-mediated synaptic le tšebeliso ea nako e telele likhatisong tsa hippocampal ho bacha ho feta ho batho ba baholo. Ho pepesetsoa khafetsa litekanyetso tse tahang tsa ethanol le hona ho hlahisa bofokoli bo boholo ba memelo ea hippocampal 106, 107 'me ho pepesetsoa ha ethanol nako e telele ho amana le boholo ba mokokotlo oa dendritic 108. Liphumano tsena tsa morao-rao tsa liphetoho tsa mokokotlo oa dendritic li bontša ho hlophisoa ha ho potoloha ha boko ho ka etsang hore motho a be le boitšoaro bo bobe. 94.

Tlhahiso-leseling e tsoang liphuputsong tsa ho nahana ka bokong e fana ka bopaki bo tšoanang ho batho ba litlamorao tsa joala ba joala bokong. Liphuputso tse ngata li tlalehile sebopeho sa boko le ts'ebetso ho bacha ba lemaletseng joala kapa ba tahi kapa ba baholo lilemong ha ba bapisoa le batho ba phetseng hantle. Lithuto tsena li bonts'a likarolo tse nyane tsa pele le tsa hippocampal, li fetole litaba tse tšoeu tse tšoeu le memori e sotlehileng 109-113. Ho feta moo, lithuto tsena li bonts'a botsoalle bo nepahetseng pakeng tsa lipalo tsa hippocampal le lilemo tsa ts'ebeliso ea pele 109 e fana ka tlhahiso ea hore boroetsana ba pele e ka ba nako ea ho ipeha kotsing ea ho lemala. Nako, e kopantsoeng hampe le molumo oa hippocampal, e ka mpefatsa phello ena.

Hajoale, ke lithuto tse fokolang feela tse ileng tsa hlahloba tšebetso e sebetsang ea boko ho lithethefatsi kapa joala bo amanang le joala (ke hore litšoantšo tsa joala) ho bacha. 114, leha sena e le sebaka sa lipatlisiso tsa nako e tlang (bona 115). Boithuto ba batho ba kotsing e kholo (mohlala, mojaro oa lelapa oa ho ts'epa joala) bo supa ho senyeha hoa ts'ebetso ea ka pele ho bonahala pele ho tšebeliso ea lithethefatsi (mohlala. 116, 117) hape o khona ho bolela tšebeliso ea morao-rao ea lithethefatsi 118, 119. Leha ho le joalo, thutong ea morao-rao ea boits'oaro ka litlamorao tsa joala ho 8 ho bashanyana ba lilemo li 15 ba kotsing e tlase le e phahameng ea malapa 120, sepheo sa bohlokoa ka ho fetesisa e ne e le hanyane haeba phetoho ea boits'oaro kapa bothata litekong tsa botahoa - esita le kamora ho fuoa litekanyetso tse nooang ho batho ba baholo li ile tsa bonoa. Litlamorao tsena tsa neurotoxic hammoho le kutloisiso e eketsehileng ea litlamorao tsa joala le bopaki ba taolo e futsanehileng ea pele pele ho ts'ebeliso ea pele le tšebeliso ea ts'ebeliso ea lithethefatsi. 116 e ka theha thuto ea nako e telele ea joala le tšebeliso e mpe ea lithethefatsi ntle le nako ea bocha 118, 119.

Eya ho:

Nahanisisa

Ka bobeli, lithuto li hlalositse pono ea kholo ea bongoana ea bongoana joalo ka pherekano lipakeng tsa li-system tsa "tlase-up" tse hlahisang ts'ebeliso e fetelletseng ea maemo a susumetsang mme hamorao a holisa libaka tse "tlase-tlase" tsa taolo ea kelello. Sistimi ena e tlase e amanang le boits'oaro ba ho batla maikutlo le ho ipeha kotsing butle-butle e lahleheloa ke tlholisano ea eona le tlhaiso e tsoelang pele ea molao oa "holimo-tlase" (mohlala, 2, 7, 15, 23, 64, 121-123). Ho se leka-lekane pakeng tsa lits'ebetso tsena tse ntseng li hola nakong ea bocha ho ka lebisa tlokotsing ea boits'oaro bo nkang kotsi le ho eketsa monyetla oa ho susumetsoa ke lintho tsa tlhekefetso.

Tlhahlobo ena e fana ka bopaki ba boits'oaro, ba bongaka le ba neurobiological ba ho khetholla lits'ebetso tsena tsa subcortico-cortico ntshetsopele. Lintlha tsa boitšoaro mabapi le mesebetsi ea laboratori le litekanyetso tsa boits'oaro tse fuoang bana, bacha le batho ba baholo (mohlala, 18, 20, 37, 42) khothaletsa nts'etsopele ea curvilinear ea ho batla maikutlo le ka tlhaselo ea tlhoro e lipakeng tsa 13 le 17 lilemo, ha ts'usumetso e fokotseha ho hola ka hofitisisa ho tloha bongoaneng ho isa ho motho e monyane lilemong. Lithuto tsa ho nahana ka batho li bonts'a mekhoa ea ts'ebetso libakeng tse sa sebetseng hantle tsa boko tse amanang le moputso. Ka ho khetheha, ba bonts'a mokhoa o tsoileng taolong oa ntlafatso libakeng tsena mme boholo ba karabelo ea bona bo amahanngoa le boits'oaro bo nkang kotsi. Ka lehlakoreng le leng, libaka tsa pele, tsa bohlokoa kaholimo ho taolo ea boits'oaro, li bonts'a mohlala oa nts'etsopele o ts'oanang le o bonoang lithutong tsa boits'oaro ba ho susumetsoa. Ho feta moo, mathata a bongaka a nang le mathata a taolo ea tšusumetso a bonahala a sa sebetse pele ho nako, a hokahanya likarolo tse ka tlase tsa neurobiological le kaho ea phenotypic ea impulsivity.

Khohlano e lipakeng tsa libaka tse tlasa sebaka sa nakoana nakong ena e ka sebetsa e le mokhoa oa ho beha likotsi tse ngata, ho kenyeletsoa tšebeliso e mpe ea tahi le lithethefatsi. Bacha ba bangata ba lekile joala 93, empa sena ha se hlile se lebisa tlhekefetsong. Batho ba nang le taolo e tlase-tlase ba ka ba kotsing ea tšebeliso e mpe ea joala le lithethefatsi joalo ka ha ho khothalelitsoe ke liphuputso tsa batho ba kotsing e kholo ba bonts'ang mathata a ts'ebetsong ea pele ho ts'ebeliso ea joala le lithethefatsi (mohlala. 116, 117). Boemong ba mofuta oa rona oa bongoana oa bocha, batho bana ba ka ba le ho se leka-lekane ho feta taolong ea cortico-subcortical. Liphumano tsena li boetse li ipapisitse le liphumano tsa kliniki bathong ba ADHD ba bonts'ang mesebetsi e fokotsehileng ea pele 'me ba na le menyetla e mene ea ho ba le bothata ba tšebeliso ea lithethefatsi ha bo bapisoa le taolo e phetseng hantle. 124. Ho se leka-lekane ha taolo ea cortico-subcortical ho ka eketsoa le ho feta ke ho hloka matla ha bohlankana ho litlamorao tsa joala le tse ka thusang ho fokotsa ts'ebetso, le litšusumetso tse ntle tsa joala ho tsamaisong ea sechaba tse ka khothalletsang tšebeliso ea joala haholo. 104. Joalokaha ho bontšitsoe ke Steinberg le basebetsi mmoho 23, 41, boits'oaro bo kotsi haholo- ho kenyelletsa joala le tšebeliso e mpe ea lithethefatsi- li hlaha maemong a sechaba. Kahoo tšebeliso ea joala le lithethefatsi e ka khothaletsoa le ho hlokomeloa ke lithaka ha boitšoaro bona bo ananeloa.

E 'ngoe ea liqholotso mosebetsing o amanang le tšebeliso ea lithethefatsi ke ho ntlafatsa matšoao a bophelo bo botle bakeng sa ho khetholla kotsi ea tlhekefetso le / kapa tlhahlobo ea sephetho bakeng sa ho kenella / kalafo. Seo re se fumaneng se fana ka maikutlo a hore liphephetso tsa boits'oaro tse hlokang taolo ea kelello ka bobeli ba litekanyetso tse lintšing tsa takatso e ka ba matšoao a matle. Mohlala oa mekhoa e joalo ea boits'oaro e kenyelletsa mesebetsi ea papali ea chelete e nang le kotsi e kholo le e tlase kapa maemo a "chesang" le a "batang" a hlalositsoeng tekong ena 18, 37 kapa mesebetsi e bobebe ea taolo e hlokang ho hatella karabo ho sejoalo se opang / se hohelang 20. Mesebetsi ena e re hopotsa ho lieha ha mosebetsi oa ho khotsofatsa o hlahisitsoeng ke Mischel 125. Ebile, ts'ebetso ea mesebetsi e bonolo ea taolo e kang ena ho bacha le ho batho ba baholo e amana le ts'ebetso ea bona e le bana ba thobalano mosebetsing oa ho khotsofatsa. 28, 29. Mischel le basebetsi-mmoho ba bonts'itse boemo bo phahameng ba botsitso le boleng ba ponelo-pele ea mosebetsi ona bophelong ba kamoso. E amanang le tšebeliso e mpe ea lithethefatsi, e bonts'itse hore bokhoni ba ho lieha ho khotsofatsa joalo ka ngoana, bo boletse esale pele tšebeliso e mpe ea lithethefatsi (mohlala, cocaine) hamorao bophelong 126. Mosebetsing oa rona oa hajoale, re se re qala ho sebelisa motsoako ona oa mesebetsi ho khetholla likarolo tse ka tlase tsa bokhoni bona ba ho utloisisa lintlha tse ka bang kotsi tsa tlhekefetso ea lithethefatsi.

Ka kakaretso, lintlha tsena li fana ka maikutlo a hore le ha bacha e le sehlopha ba nkuoa e le ba kotsing 41, bacha ba bang ba tla ba bonolo ho feta ba bang ho etsa lintho tse ka ba behang kotsing, ba be beha kotsing e kholo ea litlamorao tse mpe. Leha ho le joalo, ho ipeha kotsing ho ka fetoha maemong a nepahetseng. Kahoo ho fapana le ho leka ho felisa boits'ebetso ba ho beha bacha kotsing eo e seng khoebo e atlehileng ho tla fihlela joale 23, leano le hahang haholo e ka ba ho fana ka phihlello ea mesebetsi e kotsi le e thabisang (mohlala, kamora mananeo a sekolo ka ho hloa ka lebota ka tlung) tlasa maemo a laoloang le ho fokotsa menyetla e behang likotsi kotsing. Ha kelello ea mocha e bonts'a liphihlelo, ka menyetla ena e behang bophelo kotsing, mocha a ka theha boits'oaro ba nako e telele ka ho hokahanya likhokahano lipakeng tsa libaka tse laolang taolo e tlase le lipalo tse tlase tsa kholo ea potoloho ena. Maano a mang a atlehileng ke mekhoa ea boits'oaro ea kelello e shebileng bokhoni ba ho hana, kapa taolo ea kelello, ho fokotsa boitšoaro bo kotsi 127. Se fumanoeng se hlakisa bohlokoa ba ho nahana ka phapang ea motho ka mong ha ho hlahlojoa likamano tse rarahaneng tsa boko le boits'oaro tse amanang le ho ipeha kotsing le ho se kenelle ho batho ba hola. Ho feta moo, liphapang tsena tsa motho ka mong le tsa tsoelo-pele li ka thusa ho hlalosa ho ba kotsing ea ho itšireletsa ho batho ba bang ka ho beha kotsing ea ts'ebeliso ea lithethefatsi, 'me qetellong, ho lemalla.

Eya ho:

Liteboho

Mosebetsi ona o tšehelitsoe ke karolo ea NIDA R01 DA018879, NIDA Pre-Doctoral Training Aid David007274, lelapa la Mortimer D. Sackler, letlole la Dewitt-Wallace, le Seill Cornell Medical College Citigroup Biomedical Imaging Center le Imaging Core.

Eya ho:

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