Am J Psychiatry. 2009 Jun; 166 (6): 702-10. doi: 10.1176 / appi.ajp.2008.08081201. Epub 2009 Mots'eanong 1.
Pizzagalli DA, Holmes AJ, Dillon DG, Goetz EL, Birk JL, Bogdan R, Tlhompho DD, DV ea Iosifescu, Rauch SL, Fava M.
mohloli o moholo
Lefapha la Psychology, Univesithi ea Harvard, 1220 William James Hall, 33 Kirkland St., Cambridge, MA 02138, USA. [imeile e sirelelitsoe]
MORERO:
Mathata a maholo a sithabetsang maikutlo a tšoauoa ka ts'ebetso ea meputso e sa sebetseng, mohlomong ka lebaka la ho se sebetse hantle ho basal ganglia. Leha ho le joalo, lithuto tse fokolang tsa neuroimaging tsa khatello ea maikutlo li khethollotse pakeng tsa mekhahlelo e lebelletsoeng le e nyane ea ts'ebetso ea moputso. Sebelisa MRI e sebetsang (fMRI) le mosebetsi o khethollang methati e lebelletseng le e khotsofatsang ea ts'ebetso ea moputso, bangoli ba ile ba leka maikutlo a hore batho ba nang le khatello e kholo ea maikutlo ba tla bonts'a likarabo tse amanang le moputso meahong ea basal ganglia.
METHODO:
Mosebetsi oa ho lieha oa tšusumetso ea chelete o ile oa hlahisoa ho batho ba 30 ba sa hlophisehang ba nang le bothata bo tebileng ba ho sithabela le lithuto tse 31 tse hantle ha li bapisoa nakong ea ho hlahlojoa ha fMRI Boithuto ba kelello ka botlalo bo shebile karabo ea neural ho litekanyetso tse boletsoeng esale pele tsa moputso le sephetho se khotsofatsang (ke hore, phaello ea chelete). Sekolo sa bobeli se shebisisa kamano e pakeng tsa matšoao a anhedonite le palo ea basal ganglia.
LIKOTSO:
E amanang le lithuto tsa papiso, barupeluoa ba nang le khatello ea maikutlo e kholo ba bonts'itse karabelo tse fokolang haholo ho fihlella ho bokellane ba li-nucleus tse setseng le kahare kahare. Phapang ea sehlopha literekeng tsena e ne e khethehile litlamorao tse ntle ebile ha ea ka ea akaretsa sephetho se seng kapa se fosahetseng, leha likarabelo tse fokolang tsa likotlo tsa lichelete sehlopheng se seholo sa khatello li hlahile libakeng tse ling tsa Caudate. Ka lehlakoreng le leng, bopaki ba liphapang tsa sehlopha nakong ea tebello ea moputso bo ne bo fokola, leha barupeluoa ba nang le khatello e kholo ea maikutlo ba bonts'itse ts'ebetso ea ho putsa likhamphani tse ngata lekaleng le lenyenyane la pososele ea morao. Sehlopheng se seholo sa khatello ea maikutlo, matšoao a anhedonic le ho tepella maikutlo ho ne ho amana le ho fokotseha ha palo ea caudate ka bonngoe.
CONCLUSIONS:
Liphetho tsena li bonts'a hore ho se sebetse hantle ha basal ganglia ho tepella maikutlo ho hoholo ho ka ama karolo ea ho phethoa ha meputso. Ho feta moo, liphetho tsa morphometric li fana ka maikutlo a hore anhedonia khatellong e kholo ea bophelo e amana le bophahamo ba caudate.
Selelekela
Anhedonia-ho haella ha reaccius ho monyaka o monate-ke letšoao la mantlha la khatello e kholo ea khatello ea maikutlo (MDD) (1-2). Se amanang le taolo e phetseng hantle, batho ba tepelletseng maikutlo ba bonts'a khethollo e ntle ea maikutlo (3), e mpe e amehang ha e arajoa ka lebaka la maikutlo a monate (4), le karabelo ea moputso karabelo (5). Neuroimaging e bonts'a hore mefokolo ena e ka bonts'a ho se sebetse hantle ho basal ganglia, ho kenyelletsa le striatum (nucleus accumbens, caudate, putamen) le globus pallidus (6-11). Leha ho le joalo, bohlokoa ba ts'ebetso ea ts'ebeliso ea basal ganglia dysfunction ho MDD e ntse e sa utloisisoe hantle. Ka ho khetheha, hore na ho se sebetse hantle ho amana haufi-ufi le bofokoli molemong oa ho lebella moputso ha ho hlake.
Ho arola likarolo tsena ho bohlokoa ka mabaka a mabeli (12). Taba ea pele, li bontša maemo a fapaneng a kelello: ho lebella ho tšoauoa ka boitsoaro bo tataisoang ke sepheo, athe ho emisa ho kenyelletsa boiphihlelo ba ho natefeloa (13). Taba ea bobeli, ba fana ka menehelo e arohaneng ea boits'oaro bo tataisitsoeng (14). Maemong a khale ao e seng a batho, meputso e sa lebelloang e phahamisa ho phatloha ha phasic ho dopamine neurons e qalileng ho tloha mpeng ho ea ho basal ganglia (14). Leha ho le joalo, menyakoe e fetoha qetellong meputso e isoa mekhoeng e boletsoeng esale pele ea moputso. Hobane basal ganglia ba bohlokoa bakeng sa taolo ea makoloi (15), ena ke mochini oo litloaelo tsa ho bolela moputso li ka tsosang boitšoaro bo susumetsang. Ho fanoa ka litlolo tsa dopamine ho MDD (16), khatello ea maikutlo e ka kenyelletsa ho senyeha ha likarolo tse lebelletsoeng le / kapa tse kopanyang mochine ona.
Ho sebetsana le bothata bona, phuputso ea morao-rao e sebelisitse mosebetsi oa ho lieha ho potlakisa chelete ho fuputsa maemo a lebelletseng a phepelo ea moputso ho barupeluoa ba MDD ba 14 le taolo ea 12 (17). Ho makatsang ke hore ho ne ho se na phapang pakeng tsa likarabo tsa basal ganglia bakeng sa moputso. Ntle le moo, leha lithuto tsa MDD li bonts'itse karabelo tse fokotsehileng tsa bophelo bo kopaneng, ha ho karohano e amanang le sephetho e hlahang ka har'a li-ruble kapa ka thipa, libaka tse kentsoeng ts'ebetsong ho fana ka maikutlo a moputso (18, 19), haholoholo ha phano ea moputso e sa lebelloa20). Leha ho le joalo, hape ho ne ho se na phapang ea sehlopha ka boitšoaro. Kahoo, liphetho tsena tse nyane li kanna tsa bonts'a ts'ebetso e ntle ea moputso mohlaleng o itseng oa MDD le / kapa matla a fokolang a lipalo.
Thutong ea hona joale, re sebelisitse mosebetsi o ts'oanang ho fumana likarolo tse lebelletsoeng le tse phethahetseng tsa ts'ebetso ea moputso sehlopheng se seholo sa batho ba tepelletseng ba sa imetsoeng (N = 30) le taolo e phetseng hantle (N = 31). Ho lumella sebopeho se leka-lekaneng, mosebetsi o ile oa fetoloa joalo ka hore 50% ea moputso le liteko tsa tahlehelo li felile molemong oa chelete le likotlo, ka ho latellana (21). Fuoa karolo ea dopamine le basal ganglia ka tebello ea moputso (22), re boletse esale pele hore batho ba tepelletseng maikutlo ba tla bonts'a likarabo tse sa nepahalang bakeng sa ho putsa likamo, haholoholo maemong a tšohanyetso. Leha ho le joalo, ho ipapisitse le liphumano tse fetileng (17), hape hobane meputso e tlisitsoe feela ho 50% ea liteko tsa moputso (20), re fane ka maikutlo a hore lithuto tsa MDD li ka bonts'a likarabo tse sa nepahalang tsa litlamorao liphumatsong tse monate. Qetellong, ka lebaka la mosebetsi oa morao-rao (23), re boletse esale pele hore matšoao a maholo a anhedonic a ne a tla amahanngoa le bonyata bo nyane ba caudate.
mekhoa
barupeluoa ba
Lihlooho tsa khatello ea maikutlo li ile tsa nkuoa ho tsoa thutong ea kalafo ho bapisa katleho ea tlatsetso ea lijo tsa S-adenosyl l-methionine le escitalopram. Lithuto tsa papiso li ile tsa nkuoa sechabeng. Barupeluoa ba MDD ba ne ba e-na le tlhahlobo ea DSM-IV ea MDD (24) le palo ≥16 ho Hamilton Depression Rating Scale ea 21 (HRSD; 25). Litekanyetso tsa ho kenyelletsa li kenyelletsa meriana ea psychotropic libekeng tse peli tse fetileng (fluoxetine: libeke tse 2; lithethefatsi tsa dopaminergic kapa li-neuroleptics: likhoeli tse 6), nalane ea hona joale kapa ea nakong e fetileng ea MDD e nang le likarolo tsa psychotic, le ho ba teng ha tlhahlobo e ngoe ea bophelo ba Axis I (ho kenyelletsa ts'ebeliso ea lisebelisoa tsa bophelo le ts'ebeliso ea lithethefatsi. mathata a selemong se fetileng), ntle le mathata a ho tšoenyeha. Litaba tsa ho bapisa li tlalehiloe hore ha ho na bokuli ba bongaka kapa ba methapo, ha ho na psychopathology ea hona joale kapa e fetileng (24), hape ha ho na meriana ea kelello. Lihlooho tsohle li ne li fuoa letsoho le letona.
Mohlala oa hoqetela o kenyelletsa li-MDD tse 30 le lithuto tse lekanang le tsa batho ba 31 (Lethathamo 1). Lithuto tsa MDD li ne li tepelletse maikutlo ka mokhoa o ikhethileng, joalo ka ha ho hlahlojoa ke Beck Depression Inventory-II (BDI-II; 26) (27.48 ± 10.60) le lintlha tsa 17S HRSD (17.97 ± 4.19). Lihlooho tse 3 tsa MDD li ne li e-na le bothata ba ho tšoenyeha hona joale, 'me tse 11 li ne li e-na le matšoao a tlase a ho tšoenyeha. Har'a lithuto tsa MDD, 37 (16%) e ne e e-so ka e amohela li-antidepressant mme 53 (3%) e tlaleha ts'ebeliso ea ts'ebeliso ea khatello ea maikutlo pele ho nako; tlhahisoleseling mabapi le kalafo ea kalafo ea khatello ea maikutlo e ne e sa fumanehe ho batho ba bararo. Ke bakuli ba bararo feela ba ileng ba tlaleha ho hanyetsa ho antidepressant ea pele. Barupeluoa bohle ba ile ba fana ka tumello e ngotsoeng e nang le tsebo ho protocol e amohetsoeng ke li-IRB tsa lehae.
Lintlha tsa Sociodemographic le Clinical ho MDD (N = 30) le Lipapiso (N = 31)
Mosebetsi oa ho lieha ho etsa chelete
Mosebetsi o hlalositsoe pele (21). Liteko li ile tsa qala ka cue (1.5 s) e bonts'a sephetho se ka bang teng (moputso: + $; tahlehelo: - $; ha ho khothaletso: 0 $). Kamora nako e fapaneng ea maqhubu a pakeng (3-7.5 s), ho ile ha hlahisoa sekwere se khubelu se khubelu, seo lithuto li ileng tsa arabela ka ho tobetsa konopo. Kamora ho lieha ha bobeli (4.4-8.9 s), maikutlo a pono (1.5 s) a bonts'a sephetho sa teko (phaello, kotlo, ho se fetohe). Nako e fapaneng (3-12 s) e arohantse liteko. Mosebetsi o ne o kenyelletsa li-block tse hlano le liteko tsa 24 (8 / cue), ho fana ka liteko tse 40 le 20 tsa tlhahlobo e amanang le cue- le sephetho, ka ho latellana.
Barupeluoa ba ile ba laeloa hore likarabo kapele li eketsa menyetla ea bona ea ho fumana phaello le ho qoba likotlo. Leha ho le joalo, phaello le likotlo li hlile li fanoa ka mokhoa o reriloeng pele ho lumella sebopeho se leka-lekaneng. Sebakeng ka seng, halofo ea liteko tsa moputso e hlahisitse phaello ea chelete ($ 1.96-2.34; bolela: $ 2.15) le halofo e felile ka maikutlo a sa fetoheng. Ka mokhoa o ts'oanang, halofo ea liteko tsa tahlehelo e ile ea fana ka kotlo ea chelete (bophara: $ 1.81-2.19; bolela: $ 2.00), mme halofo e ile ea fella ka phetoho. Liteko tse senang khothatso li lula li fela ka karabo e se nang liphetoho. Ho eketsa kholo ea tlaleho Ntle le moo, linako tse fihletsoeng li ne li fuoa likarolo ka kotloloho ho ipapisitse le lintlha tsa nako ea ho itsoara nakong ea thupelo (Tlhahisoleseling ea tlatsetso).
Tsamaiso
Ho bokelloa ha data ho etsahetse pele ho qala kalafo. Kamora liboloko tse peli le tse 'ne, barupeluoa ba ile ba lekanya karabelo ea bona e lumellanang le litheko le liphetho tsa valence (1 = e mpe haholo, 5 = e ntle haholo) le e tsosang (1 = botebo bo tlase, 5 = botebo bo phahameng). Barupeluoa ba ile ba buseletsoa ($ 80) bakeng sa nako ea bona 'me ba “fumana” $ 20-22 mosebetsing oo.
Tlhahlobo ea Dintlha
Lintlha li ne li bokelletsoe ho Scan 1.5m Symphony / Sonata scanner (Motorola Medical Systems; Iselin, NJ) mme e ne e kenyelletsa thepa ea MPRAGE e boima ba T1 (TR / TE: 2730 / 3.39 ms; FOV: 256 mm; boholo ba voxel: 1 × 1 × 1.33 limilimitara tse 128) le linepe tse hlakileng tsa echo T2 * tse bobebe tsa echoplanar, tse fumanoeng li sebelisa tatellano e ntlafalitsoeng ea moholi (21) (TR / TE: 2500 / 35ms; FOV: 200 mm; voxel: 3.125 × 3.125 × 3 mm; 35 cm e kenelletseng).
Phokotso ea data le lipalo
Nako ea ho arabela le litekanyetso tse amehang
Kamora ho tlosa barekisi (likarabo tse fetisang bolele ± 3SD), data ea nako ea karabelo e ile ea kenngoa ho Group x ka tatello x Thibela ANOVA. Bakeng sa bosholu, feela litlamorao tse kenyelletsang Group or ka tatello ho tlalehiloe. Liphetho tse amehang li ile tsa lekanyetsoa litekanyetso tse peli mme tsa kenella Group x ka tatello or Group x Phello ANOVA.
MRI ea Sebetsa le e Rekang
Ho ile ha etsoa tlhahlobo ho sebelisoa FS-FAST (http://surfer.nmr.mgh.harvard.edu) le FreeSurfer (27). Ho e lokisa pele ho nako ho ne ho kenyelletsa nako ea selae le khalemelo ea motsamao, ho tlosa mekhoa e metle e tsamaeang butle, matla a tloaelehileng, le boreleli ba sebaka (6mm FWHM); sefahleho se soeufatsang sa nakoana se sebelisitsoe ho lokisa li-autocorrelation leratong. Lintlha tsa lithuto tse 'ne tsa MDD li lahlehile ka lebaka la ho sisinyeha ho feteletseng (> 5 mm), ho siea papiso ea 31 le lihlooho tsa MDD tse 26 bakeng sa tlhahlobo ea fMRI. Pele ho tlhahlobo ea sehlopha, lintlha li ile tsa etsoa sampole hape sebakeng sa MNI305 (2 mm3 melaetsa).
Lintlha tsa ts'ebetso li ile tsa hlahlojoa ho sebelisoa mofuta oa kakaretso oa mela. Karabelo ea hemodynamic e entsoe e le ts'ebetso ea gamma mme e khothatsoa ka ho qala ka tšusumetso; litekanyetso tsa ho sisinyeha li kenyelelitsoe joalo ka li-regressor tsa nuisance. Lipapiso tse tsoang lipakeng tsa sehlopha ka kakaretso tsa karo-karolelano li ne li etselitsoe Tebello ea Moputso (moputso cue vs. no-incentive cue) le Moputso Phello (fumana temoso ea karohano mabapi le liteko tse senang khothalletso). Hlokomela hore, ka lebaka la ho khaola habeli, lihlopha tse fetang palo ea lintho li bonts'a bohlokoa Group x boemo tšebelisano. Litlhahlobo tsa bobeli tsa lipapatso tse amanang le tahlehelo li tlalehiloe ho Tlatsetso ea Litaba. Ka lebaka la a priori likhopolo-taba mabapi le basal ganglia, limmapa tsa ts'ebetso li ne li thibetsoe ho sebelisoa lintlha tsa tlhoro ea voxel ea p <0.005 e nang le sehlaku se tlase sa li-voxels tse 12; Lipapiso tsa Monte Carlo li ile tsa etsoa ho netefatsa hore liphetho tsa mantlha tse tšoaretsoeng kamora khalemelo bakeng sa papiso e mengata (Supplemental Material). Liphetho tse hlahang kantle ho basal ganglia li lokela ho nkuoa e le tsa pele. Ho lekola hore na liphumano ho a priori libaka li ne li ikhethile bakeng sa meputso, kamoso Group x boemo Li-ANA li ne li etsoa ho litekanyo tse betere tsa beta (ho kenyeletsoa le likotlo) ho tlositsoe lihlopheng tse bonts'ang liphapang tsa sehlopha.
MRI ea sebopeho
Morphometric e lekola tšebeliso ea mokhoa oa ho ikatisa oa FreeSurfer27, 28; Lintho tse tlatsetsang, Letlapa la S1) hape e tsepamisitse maikutlo ho basal ganglia. Ho ikarabella ka phapang ea boholo ba cranial, volumes e ile ea aroloa ka bophahamo ba litaba tsa intracranial, 'me ea kenngoa ka har'a a Group x Hemisphere x sebakeng (li-nucleus accumbens, caudate, putamen, globus pallidus) ANOVA. Ho ile ha lateloa litlamorao tsa bohlokoa ka liteko tsa post-hoc. Bakeng sa barupeluoa ba MDD, likhokahano tsa Pearson le li-registions tsa hierarchical (tse laoloang lilemo le bong) li ile tsa etsoa ho lekola likamano lipakeng tsa lipalo le matšoao a anhedonic kapa khatello ea maikutlo. Joalo ka mosebetsing oa pele (29), anhedonia e ile ea hlahlojoa ka ho kenya k'hamphani ea "anhedonic" BDI-II (tahlehelo ea thabo, thahasello, matla, le libido; ts'ebelisano ea ts'epo: α = 0.85).
Results
Nako ea Reaction (RT)
Phello e ka sehloohong ea ka tatello hlahile (F = 30.15, df = 2,118, p <0.0001), e bonts'a karabelo e susumetsang (e khuts'oane ea RT) mabapi le liteko tsa moputso le tahlehelo ha li bapisoa le liteko tse se nang khothatso. Phello e kholo ea Group e ne e se bohlokoa (F = 0.17, df = 1,59, p> 0.68), ho bontša hore papiso (350.38 ± 68.91) le lihlooho tsa MDD (357.01 ± 75.60) li bontšitse RT ka kakaretso (Supplemental Material). Liphetho tsena li ne li tšoaneleha ka bohlokoa Group x ka tatello ho sebelisana (F = 3.98, df = 2,118, p <0.045). Joalokaha ho bonahala ho Setšoantšo sa 1ATs'ebelisano e bonts'itse liphapang tse nyane tsa RT ho liteko tsa khothatso le ho se susumetse lithutong tsa MDD Ha e bapisoa le litaba tsa papiso, sehlopha sa MDD se bonts'itse molumo o fokolitsoeng o amanang le moputso (RT no-incentive - RT award; t = -2.09, df = 59, p <0.047), e nang le tloaelo e ts'oanang ea molumo oa RT o amanang le tahlehelo (t = -1.97, df = 59, p = 0.053) (Setšoantšo sa 1B). Leha ho le joalo, ha ho na liphapang tsa sehlopha ho RT tse hlahileng bakeng sa moputso, tahlehelo, kapa liteko tse se nang tšusumetso (ps> 0.21). Ho feta moo, lihlopha tsena ka bobeli li bontšitse RT e khutšoane haholo ho putsa mekhoa, e lateloa ke tahlehelo le mabaka a se nang khothatso (ps <0.002).
Liphumano tsa boits'oaro nakong ea mosebetsi oa ho lieha oa tšusumetso ea chelete lithutong tsa MDD (N = 30) le lipapiso (N = 31).
Ho hlwaya khaello ea Group phello ho RTs e bokelitsoeng nakong ea ho hlahlojoa, lihlopha ha lia ka tsa fapana ka linako tse boletsoeng tse amanang le sephetho se atlehileng kapa se sa atleheng, se khethiloeng ho latela RT nakong ea boikoetliso (Tlhahisoleseling ea Tlatsetso). Ho boetse ho ne ho se na liphapang tsa sehlopha liperesenteeng tsa liteko tsa moputso tse qetellang ka katleho kapa liteko tsa tahlehelo tse qetellang ka likotlo, kapa ho chelete eohle e fumanoeng (Supplemental Material, Letlapa la S2). Ka hona, liphetho tsa fMRI ha lia ka tsa soetseha ke liphapang tsa sehlopha ka thata ea mosebetsi.
Lintlha tse amehang
Lintlha tsa litekanyetso li bonts'a hore lintlha le sephetho li hlahisitse likarabo tse boletsoeng (Tlhahisoleseling ea tlatsetso, Setšoantšo sa S1). Ka bomalimabe, sehlopha sa MDD se tlalehiloe ka kakaretso se fokotsitseng phello e ntle kameho ka karabo ea cue ka bobeli (Group: F = 5.62, df = 1,58, p <0.021) le maikutlo (Group: F = 12.26, df = 1,59, p <0.001), le ho fokotsa ho tsosoa ha maikutlo ho arabela maruo (p <0.045) empa eseng kotlo kapa maikutlo a se nang phetoho (ps> 0.42), Group x Phello Tšebelisano, F = 3.20, df = 2,118, p <0.045.
Datha ea Mosebetsi o sebetsang
Tebello ea Moputso (Moputso oa cue-No-incentive cue)
Lenane le felletseng la libaka tse bonts'ang phapang ea sehlopha le fanoe ho Supplemental Material (Letlapa la S3). Ho makatsang ke hore, lihlopha tsena ka bobeli li bontšitse likarabo tse matla tsa basal ganglia ho putsa likopo (Setšoantšo sa 2A). Leha ho le joalo, sehlopha sa MDD se bonts'itse ts'ebetso e fokolang ho "posterior putamen" (Setšoantšo sa 2B / C).
Ts'ebetso e lebelletsoeng e amanang le moputso ho li-MDD (N = 26) le lipapiso (N = 31).
Sephetho sa Meputso (Fumana karabelo-Ha ho phetoho)
E amanang le lithuto tsa papiso, sehlopha sa MDD se bonts'itse likarabo tse fokolang haholo tsa ho fumana karabo mabapi le ho se feto-fetohe phetisong ea li-nucleus tse setseng le li-dorsal caudate tse kenyelletsang, ho kenyelletsa likarolo tse peli tse ka tlase ho caudate e 'meli le tse peli ka lehlakoreng le letšehali (Setšoantšo sa 3A / B). Lihlahisoa ka bobeli ka har'a caudate e nepahetseng le e 'ngoe ka ho leqeleng le letšehali li ile tsa lula li le bohlokoa kamora ho khalemeloa lipapiso tse ngata (Supplemental Material, Letlapa la S4); ka hona, liphapang tse bokellaneng tsa nucleus li lokela ho nkuoa e le tsa pele. Ho lekola hore na liphapang tsa sehlopha li ne li etselitsoe ho fumana moputso, ho bolela hore boima ba beta bo tsoa sehlopheng ka seng ebe ba kenella ho sona Group x boemo (phaello, likotlo, ho se fetole maikutlo) ANOVA; bakeng sa ROI ea caudate, sesosa Boikokobetso e ile ea eketsoa. Bakeng sa bosholu, feela litlamorao tse kenyelletsang Group ho tlalehiloe.
Ketso e amanang le moputso e amanang le moputso ho li-MDD (N = 26) le lithuto (N = 31).
Ho li-accumbens (Setšoantšo sa 3C), phello e ka sehloohong ea boemo (F = 3.46, df = 2,110, p <0.040) e ile ea tšoaneleha ka mokhoa oa Group x boemo tšebelisano (F = 2.94, df = 2,110 p = 0.063); phello e ka sehloohong ea Group e ne e se bohlokoa (p> 0.085). Ka lebaka la a priori mehopolo malebana le liqoqiso, 'me u fuoe bohlokoa Group x boemo tšebelisano tlhahlobisong eohle ea boko, liteko tsa ho etsa lipatlisiso li ile tsa etsoa ho hlakisa mohloli oa tšebelisano. Mabapi le lihlooho tse bapisoang, lihlooho tsa MDD li bontšitse likarabo tse fokolang haholo ho maruo (p <0.005) empa eseng likotlo kapa maikutlo a se nang phetoho (ps> 0.57). Ntle le moo, liteko tsa kahare ho lihlopha li bonts'itse hore le ha lithuto tsa papiso li arabetse ka matla ho maruo le likotlo tse peli (p <0.004) le maikutlo a seng phetoho (p <0.001), lithutong tsa MDD tse setseng ts'ebetso ea li-accumbens ha ea ka ea etsoa ka boemo (ps> 0.39 ).
Ka thipa (Setšoantšo sa 3D), ANOVA e hlahisitse litlamorao tsa bohlokoa tsa Boikokobetso, Boemo, 'me Group (ps <0.013), ea bohlokoa boemo x Boikokobetso tirisanommoho, mme, haholoholo, ke ya bohlokwa Group x boemo ho sebelisana (F = 7.89, df = 2,110, p <0.002). Tšebelisano ena e ne e bakoa ke ts'ebetso e kholo haholo ea ho bapisa le lihlooho tsa MDD ho arabela maruo (p <0.0002), empa eseng likotlo (p> 0.11) kapa maikutlo a se nang khothatso (p> 0.45). Ntle le moo, ha lihlooho tsa papiso li bonts'a ts'ebetso e eketsehang ea caudate ka bobeli ho arabela melemo le tahlehelo (ps <0.0002) e amanang le maikutlo a se nang phetoho, lithuto tsa MDD li ile tsa hloleha ho bonts'a molumo o itšetlehileng ka karabelo ea maikutlo (ps> 0.17). Ha ho likamano tse ileng tsa hlaha lipakeng tsa putamen ea leqele, li-accumbens tse setseng, kapa ts'ebetso ea caudate le matšoao a anhedonic sehlopheng ka seng.
Lintlha tsa Morphometric
The Group x Hemisphere x sebakeng ANOVA ha ea senola liphapang tsa sehlopha (ps> 0.18; Lisebelisoa tsa Tlatsetso, Letlapa la S5). Har'a barupeluoa ba MDD, likamano li ne li tsamaisoa lipakeng tsa (i) li-accumbens tse lekanang tsa leqele le lipalo tse peli tsa caudate, le (ii) matšoao a anhedonic le ho tiea ha khatello ea maikutlo. Bakeng sa li-accumbens tsa leqeleng, ha ho litlamorao tse hlahileng. Bakeng sa caudate ea letsohong le letšehali le le letona, molumo o ne o amana ka ho felletseng le BDI e felletseng (ka ho le letšehali: r = -0.489, p <0.015; ka ho le letona: r = -0.579, p <0.002) le anhedonic BDI (ka ho le letšehali: r = -0.553, p < 0.004; ka ho le letona: r = -0.635, p <0.0001) subscores (Setšoantšo sa 4). Ka mokhoa o makatsang, palo ea caudate ka bobeli le ka ho le letona e boletse esale pele lintlha tse felletseng tsa BDI le lipalo tsa anhedonic tsa BDI kamora ho fetoloa bakeng sa lilemo le bong (kakaretso ea BDI: caudate leftR2= 0.203; le letona la caudate ΔR2= 0.309; anhedonic BDI subsidy: leqeleng la caudate ΔR2= 0.281; le letona la caudate ΔR2= 0.387; tsohle ΔF> 6.09, ps <0.025).
Kamano pakeng tsa matšoao a kliniki le bophahamo ba caudate har'a lithuto tsa MDD (N = 26).
Ts'ebetso ea taolo (Litaba tse tlatsetsang)
Ha ho shejoa liphapang tsa sehlopha lipakeng tsa litekanyetso tsa meputso, le boemo bo hloahloa le litekanyetso tse khahlisang bakeng sa phaello, taolo e lekola hore na ho se tšoane ha likarabelo tsa moputso oa sehlopha se setseng le tse setseng li setseng ka mor'a ho laola litheolelo. Bohlahlobisisi ba khatello bo tiisitse hore ho joalo. Ntle le moo, liphapang tsa sehlopha ho li-accumbens le ho fumana likarabo tsa caudate li ile tsa sala kamora ho laola boholo ba meaho ena le liphapang tsa sehlopha mohloling o amanang le moputso oa RT. Ntle le moo, ha ho khokahano ea bohlokoa lipakeng tsa li -vuzo tse amanang le moputso le ts'ebetso ea caudate le bophahamo ba libaka tsena li hlahileng. Qetellong, ho ne ho se na phapang ea ts'ebetso ea basal ganglia bakeng sa lithuto tsa MDD tse nang le (N = 14) vs. (N = 16) matšoenyeho a comorbid.
Puisano
Boithuto bona bo fuputse likarolo tse lebelletsoeng le tse matla tsa ts'ebetso ea moputso maemong a sithabetsang. Ka boitsoaro, sehlopha sa MDD se bonts'itse bopaki ba ho anhedonia, ho tlaleha ka kakaretso se fokotsitseng ts'usumetso e ntle ho tlisa meputso le mehopolo e fokolang kamora ho fumana thabo. Liphumano tsena li bonts'itsoe ke liphapang tsa sehlopha ho likarabo tsa basal ganglia ho litlamorao tse atlehileng, ha barupeluoa ba MDD ba bonts'a likarabo tse fokolang liphumatsong tse kopaneng tsa li-caudate le li-nucleus accumbens. Ka lehlakoreng le leng, ho ne ho se na bopaki bo fokolang ba liphapang nakong ea tebello ea moputso. Lihlopheng ka bobeli li bonts'itse karabo ea basal ganglia ea ho fumana moputso, mme le ha lithuto tsa papiso li ne li kenya tšebetsong karolo e ka morao ea leqhetsoana ho feta lithuto tsa MDD, boholo ba sehlopha seo e ne e le nyane. Hape, lihlopha ha lia ka tsa fapana nakong ea karabelo joalo ka ts'ebetso ea cue, leha ho fokotsoa ha molumo o fokolang ka moputso ho lithuto tsa MDD (bona lintlha tsa phapang). Kamora nako, ho hokahana ho fosahetseng pakeng tsa matšoao a anhedonic (le khatello ea maikutlo) le bophahamo ba caudate bo hlahang lithutong tsa MDD. Liphumano tsena li fana ka litlaleho tsa pejana tsa ho hloka kelello ha basal ganglia ho MDD (6-11, 30), fana ka maikutlo a hore ho se sebetse hona ho amana haholo le ho senyeha ho e-na le bofokoli bo lebelletsoeng, mme o hatelle karolo ea karolo ea voludate bophahamo ho anhedonia.
Karabelo e fokotsoang ea Basal Ganglia ho Liphetho tse Putsa ho MDD
Karabelo e matla ea ho ba le maikutlo a matla lithutong tsa papiso e tšoanela motho (18, 20, 31) le phoofolo (32) lithuto tse bonts'ang boikemisetso ba sebopeho sena ho fumana tlhaiso-leseling e amanang le moputso. Taba ea bohlokoa ke hore, caudate e arabela haholo ha meputso e sa lebelloa (mohlala, ha e fanoa ho 50% ea liteko tsa moputso, joalo ka ha li etsoa mona) mme lithuto li lumela hore liphetho li its'etleha liketsong tsa bona (31). Ka hona, phapano ea mahareng a sehlopha e fana ka maikutlo a kamano e sa bonahaleng ea sephetho le / kapa karabelo tse fokolang meputsong e sa lebelloang ea khatello ea maikutlo.
Bopaki ba tlhaloso ea pele bo tsoakiloe. Leha lihlopha li ne li sa tšoane ka moputso o amanang le moputso oa nako ea karabelo (bongata ba karabelo ea linako tsa karabelo), ho ne ho se na phapang lipakeng tsa liteko tsa moputso mme lihlopha ka bobeli li ile tsa arabela ka potlako litekong tsa moputso ho feta tahlehelo ea tahlehelo kapa che. Kahoo, lihlopha tsena ka bobeli li ile tsa itšoara joalokaha eka likarabo tsa tsona li susumetsa monyetla oa ho fumana phaello. Ntle le moo, litlamorao tsa katleho li kanna tsa fokola lithutong tsa MDD. Sena se lumellana le 'nete ea hore lithuto tsa MDD li tlaleha likarabo tse sa sebetseng ka botlalo le ho fokotsa thabo. Ntle le moo, liphapang tsa sehlopha li boetse li bonoe karolong e ka letsohong le letšehali la nkoe, e leng sebaka se arabelang ka matla ho khothatsong e khotsofatsang (33). Habohlokoa, ts'ebetso ea ho bokella ho bonahala e le ho lekola boleng ba liphetho tsa hedonic (31, 34). Kahoo, le ha phapang ea sehlopha likarabo tsa "caudate" e bonts'a bofokoli bo amanang le khatello ea maikutlo mabapi le boits'oaro bo lebisitsoeng ho sepheo, ho fumana lipokello ho bonts'a bofokoli ba mantlha ho khouteng ea hedonic. Liphetho tsena li lumellana le bopaki bo bonts'ang hore ts'usumetso e tebileng ea boko ho li-accumbens (35) le "capral capule / stralatum"36) fokotsa haholo matšoao a tšoaetso le anhedonia ho bakuli ba MDD ba hananang le kalafo. Ka kopanelo, liphumano tsena li bonts'a hore ho se sebetse hantle literekeng tse arolang matla a hedonic (li-drabens) le ho tiisa liketso (caudate) li bapala karolo ea bohlokoa ho pathophysiology ea MDD.
Phapang pakeng tsa sehlopha likarabo tsa lipotso li khahla molemong oa litlaleho tsa bokhoni bo fokotsehileng ba ho fetola boitšoaro e le ts'ebetso ea meputso ea nakoana ho MDD (5). Re sebelisa moputso o ikhethang, re fumane hore lithuto tse tepelletseng maikutlo, haholoholo tse tlalehang matšoao a anhedonic, li bonts'a karabelo e fokolang mabapi le taolo e khahlisang khafetsa mabapi le taolo. Ntle le moo, taolo e phetseng hantle e nang le khethollo e sa nepahalang mosebetsing oa mokokotlo e boetse e hlahisa likarabo tse fokolang tsa basal ganglia ho fihlella ho mosebetsi oa fMRI o sebelisitsoeng mona (37). Maikutlo ana a fana ka maikutlo a hore likarabelo tse fokolang tsa basotho ganglia meputsong e sa lebelloang li ka tlatsetsa ho ithuteng hampe maemong a lietsahala tsa meputso ho MDD.
Intal Basal Ganglia e Arabela Likarabo tsa Meputso ho MDD
Ho makatsang ke hore, lihlopha tsena ka bobeli li bontšitse likarabo tse matla tsa basal ganglia ho putsa likhau. Leha ho le joalo, ho fapana le thuto ea pejana (17), sehlopha sa MDD sa hajoale se bonts'itse karabelo ea nakoana e amanang le moputso le likarabelo tse amanang le meputso e amanang le moputso e amanang le lithuto tse bapisoang. Ka hona, bopaki ba boits'oaro ba bofokoli ba ho lokisa moputso bo ka hokahana le likarabo tsa bohlokoa tsa basal ganglia ho litekanyetso tse bolelang esale pele tsa moputso.
Hore na karabelo e hlakileng ea basal ganglia ho moputso oa lithuto tsa MDD ha e tsejoe joang. Lits'ebetsong tsa ho lieha ho khothaletsa, ts'ebetso ea litabatabelo tsa nakoana e nkoa e le e amanang le lets'oao la dopamine le bonoang karabong ea moputso lithutong tsa electrophysiological (38). Maemong a seng a batho, lets'oao lena le hlahisoa ke meputso e sa lebelloang 'me e khutlela ho li-cuces feela ha ho ithutoa ka tšohanyetso ea sephetho sa tlhaiso-leseling (14). Thutong ea rona, lithuto tsa papiso li bonts'itse karabo ea basal ganglia e matla ho feta litheko ho feta lithuto tsa MDD, leha ho le joalo lihlopha tsena tse peli li bontšitse phapang e fokolang ho arabeleng moputso. Sena se fana ka menyetla e 'meli: (i) monyetla o sa lebelloang oa hore lets'oao la dopamine le tsamaee ho tsoa ho litefiso (karolo ea tumellano) ho ea li-cues (karolo e lebelletsoeng) ka potlako ho lithutong tsa MDD, kapa (ii) menyetla e kholo ea hore moputso o hlaha. karabelo ea moea ea boits'oaro ka bo bona e neng e ts'oana ho lihlopha tsohle mme mohlomong e le ntle le phetisetso ea lets'oao la dopamine e hlahisitsoeng ke phaello. Monyetla ona ha o nkuoe hangata lithutong tse sebelisang mesebetsi ea ho lieha ho khothaletsa, empa hobane barupeluoa ba tseba hore menyetla ea meputso e ka lebisa ho katleho, ho ka etsahala hore litheko li ka etsa ts'ebetso ea ts'ebetso ea ts'ebetso ho tloha qalong. Leha ho le joalo, le haeba ho le joalo, ho ka lebelloa phapang ea sehlopha karabelong ea boemo ba tharollo ea litheko.8). Boithuto ba nako e tlang moo barupeluoa ba ithutang mekhatlo ea moputso oa moputso ka nako e ea hlokahala ho etsa lipatlisiso ka taba ena.
Bukana ea Fokotsa Caudate le Anhedonia
Ho pheta liphetho ka lithuto tseo e seng tsa bongaka (23), Lithuto tsa MDD tse nang le matšoao a phahameng a anhedonic li bontsitse bophahamo ba likarolo tse peli tsa caudate. Kamano ena e fana ka tšusumetso ea ho etsa lipatlisiso tse tsoelang pele tsa li-endophenotypes tse nyahamisang (1, 2), hobane ha ho hlake hore na molumo oa caudate o fokotsoeng o etsa hore motho a be le khatello ea maikutlo kapa o matla kapa, kapa ho e-na le hoo e emela karolo e amanang le 'muso ea matšoao ana.
sheba mefokolo ea
Ho lokela ho hatisoa meeli e 'maloa. Taba ea pele, leha e hlakile a priori hypotheses mabapi le li-bokellane tsa nucleus (8, 10, 11), ea Group x boemo tšebelisano-'moho tikolohong ena e hlahile ho p <0.005, mme phapang ena e ne e se bohlokoa kamora ho lokisa bakeng sa lipapiso tse ngata ka lebaka la boholo ba sehlopha (Supplemental Material). Ho feta moo, ha ho likamano lipakeng tsa ts'ebetso ea striatal le matšoao a anhedonic a hlahileng. Ka lebaka leo, lithuto tsa nako e tlang lia hlokahala ho netefatsa karolo ea bokello ea li-nucleus ho se sebetse ha moputso ho MDD. Ho fanoe ka thahasello e ntseng e eketseha ea karolo ea li-accumbens ho pathophysiology ea MDD, joalo ka ha ho bontšitsoe ke lithuto tsa morao-rao tse matlafatsang tsa boko tse lebisang sebakeng sena (35, 36), sepheo sa hajoale sa likarabo tse fokotsitsoeng tse amanang le moputso le ha e le se makatsang. Taba ea bobeli, khokahano lipakeng tsa bophahamo ba caudate le khatello ea maikutlo e bakile BDI, empa eseng HRSD. Leha lebaka la phapang ena le sa hlaka, ho ka etsahala hore ebe lintho tse 'maloa tsa BDI tse thellang anhedonia e kanna ea kenya letsoho ho fumanoeng hona. Ntle le meeli ena, thuto ena e bonts'a hore anhedonia - karolo ea mantlha ea MDD - e ka bonts'a likarabo tse fokolang tsa moputso mokhatlong oa basal, haholo-holo li-nucleus tse bokellanang le caudate, mme li amana le boholo bo tlase ba caudate.
Boitsebiso bo Eketsehileng
tlatsetsa
Tobetsa mona ho sheba.(1.0M, tokomane)
lumela hore baa fokola
Liphatlalatso le kananelo. Dr. Pizzagalli o fumane ts'ehetso ea lipatlisiso ho GlaxoSmithKline le Merck & Co, Inc. Dr. Dougherty o fumane tšehetso ea lipatlisiso ho tsoa ho Forest, Eli Lilly, Medtronic, Cyberonics, Northstar Neuroscience, Cephalon, le McNeil. O fumane honararia ho tsoa ho Cyberonics, Medtronic, Northstar Neuroscience, le McNeil mme o sebelitse joalo ka moeletsi ho Jazz Pharmaceuticals le Transcept Pharmaceuticals. Dr. Iosifescu o fumane tšehetso ea lipatlisiso ho Aspect Medical Systems, Forest Laboratories, Janssen Pharmaceutica, le honariaaria ho tsoa ho Aspect Medical Systems, Cephalon, Gerson Lehrman Group, Eli Lilly & Co, Forest Laboratories le Pfizer, Inc. Dr. Rauch o fumane lipatlisiso tšehetso e tsoang ho Medtronics, Cyberonics, le Cephalon, le honariaaria ho tloha Novartis, Neurogen, Sepracor, Primedia, le Medtronics, Inc. Dr. Fava o fumane tšehetso ea lipatlisiso ho tsoa ho Abbott Laboratories, Alkermes, Aspect Medical Systems, Astra-Zeneca, Bristol-Myers Squibb Khamphani, Cephalon, Eli Lilly & Company, Forest Pharmaceuticals Inc., GlaxoSmithKline, J & J Pharmaceuticals, Lichtwer Pharma GmbH, Lorex Pharmaceuticals, Novartis, Organon Inc., PamLab, LLC, Pfizer Inc, Pharmavite, Roche, Sanofi-Aventis, Solvay Pharmaceuticals, Inc., Synthelabo, le Wyeth-Ayerst Laboratories. O amohetse litefiso tsa boeletsi / boeletsi ho Abbott Laboratories, Amarin, Aspect Medical Systems, Astra-Zeneca, Auspex Pharmaceuticals, Bayer AG, Best Practice Project Management, Inc., Biovail Pharmaceuticals, Inc., BrainCells, Inc. Bristol-Myers Squibb Company , Cephalon, CNS Response, Compellis, Cypress Pharmaceuticals, Dov Pharmaceuticals, Eli Lilly & Company, EPIX Pharmaceuticals, Fabre-Kramer Pharmaceuticals, Inc., Forest Pharmaceuticals Inc., GlaxoSmithKline, Grunenthal GmBH, Janssen Pharmaceutica, Jazz Meriana, J & J meriana , Khampani ea Knoll Pharmaceuticals, Lorex Pharmaceuticals, Lundbeck, MedAvante, Inc., Merck, Neuronetics, Novartis, Nutrition 21, Organon Inc., PamLab, LLC, Pfizer Inc, PharmaStar, Pharmavite, Precision Human Biolaboratory, Roche, Sanofi-Aventis, Sepracor , Solvay Pharmaceuticals, Inc., Somaxon, Somerset Pharmaceuticals, Synthelabo, Takeda, Tetragenex, Transcept Pharmaceuticals, Vanda Pharmaceuticals Inc, le Wyeth-Ayerst Laboratories. Ho feta moo, Dr. Fava o fumane litefiso tsa ho bua ho tsoa ho Astra-Zeneca, Boehringer-Ingelheim, Bristol-Myers Squibb Company, Cephalon, Eli Lilly & Company, Forest Pharmaceuticals Inc., GlaxoSmithkline, Novartis, Organon Inc., Pfizer Inc, PharmaStar, Primedia, Reed-Elsevier le Laboratories tsa Wyeth-Ayerst. Kamora nako, Dr. Fava o na le likabelo tsa lichelete ho Compellis le MedAvante, mme o ts'oara likopo tsa patent bakeng sa SPCD le bakeng sa motswako oa azapirones le bupropion ho MDD, mme o amohela meputso ea litokelo tsa litokelo bakeng sa MGH CPFQ, DESS, le SAFER. Mong Holmes, Dr. Dillon, Mme Goetz, Mong Birk, le Monghali Bogdan ba tlaleha hore ha ba na tlholisano.
Morero ona o ts'ehelitsoe ke Grant Number R01 MH68376 (DAP) ho tsoa National Institute of Mental Health (NIMH) le Grant Numbers R21 AT002974 (DAP) le R01 AT1638 (MF) ho tsoa Setsing sa Naha sa Tlatsetso le Meriana e Ntle (NCCAM). Likateng tsa eona ke boikarabello ba bangoli feela 'me ha ho hlile ha bo supe maikutlo a semmuso a NIMH, NCCAM, kapa National Institutes of Health. Bangoli ba leboha Allison Jahn le Kyle Ratner ka thuso ea bona mathoasong a morero ona, ho James O'Shea le Decklin Foster bakeng sa thuso ea bonono, le Nancy Brooks, Christen Deveney, Deborah Shear, Judith Katz, Adrienne Van Nieuwenhuizen , Carrie Brintz, Sunny Dutra, le Mariko Jameson bakeng sa thuso ea ho hira thuto.
Nomoro ea ClinicalTrials.gov: NCT00183755
Mongolo o botlaaseng ba leqephe
Tlhahiso e fetileng.
Lintlha tse fumanehang pampiring ena li hlahisitsoe ka mokhoa oa pele ho Seboka sa 22 sa selemo le selemo sa Mokhatlo bakeng sa Patlisiso ho Psychopathology, Pittsburgh, Pennsylvania, USA, ka la 25 Loetse, 28.
References
1. Hasler G, Drevets WC, Manji HK, Charney DS. Ho sibolla li-endophenotypes tsa khatello e kholo ea maikutlo. Neuropsychopharmacology. 2004; 29: 1765-1781. [E fetotsoe]
2. Pizzagalli DA, Jahn AL, O'Shea JP. Tabeng ea sepheo sa sebopeho sa anhedonic phenotype: Mokhoa oa ho khetholla Matšoao. Psychology ea Biol. 2005; 57: 319–327. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
3. Joormann J, Gotlib IH. Tlhokomelo e khethehileng ea lifahleho tsa maikutlo ka mor'a ho hlaphoheloa kelellong. J Abnorm Psychol. 2007; 116: 80-85. [E fetotsoe]
4. Berenbaum H, Oltmanns TF. Phihlelo ea maikutlo le polelo ho schizophrenia le khatello ea maikutlo. J Abnorm Psychol. 1992; 101: 37–44. [E fetotsoe]
5. Pizzagalli DA, Iosifescu D, Hallett LA, Ratner KG, Fava M. Phokotso ya matla a hedonic ho Meferefere e Meholo ea Tlhatlhobo: Bopaki bo tsoang mosebetsing oa moputso oa probabilistic. J Psychiatr Res. 2009; 43: 76-87. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
6. Drevets WC, Videen TO, Theko JL, Preskorn SH, Carmichael ST, Raichle ME. Phuputso e sebetsang ea anatomical ea khatello ea maikutlo ea unipolar. J Neurosci. 1992; 12: 3628–3641. [E fetotsoe]
7. Elliott R, Sahakian BJ, Michael A, Paykel ES, Dolan RJ. Karabelo e sa tloaelehang ea neural karabelo mabapi le ho hlophisa le ho hakanya mesebetsi ho bakuli ba nang le khatello ea maikutlo e sa reroang. Psychol Med. 1998; 28: 559-571. [E fetotsoe]
8. Epstein J, Pan H, Kocsis JH, Yang Y, Butler T, Chusid, Hochberg H, Murrough J, Strohmayer E, Stern E, Silbersweig DA. Ho haella ha karabelo ea maikutlo ea moea molemong oa ho ba le maikutlo a khothatsang le lithuto tse tloaelehileng. Ke J Psychiatry. 2006; 163: 1784-1790. [E fetotsoe]
9. Keedwell PA, Andrew C, Williams SCR, Brammer MJ, Phillips ML. Litumellano tsa neural li amana le anhedonia ho Major Depression Disorder. Psychology ea Biol. 2005; 58: 843-853. [E fetotsoe]
10. Kumar P, Waiter G, Ahearn T, Milders M, Reid I, Steele JD. Phapang e sa tloaelehang ea nakoana ea moputso-lipontšo tsa ho ithuta maemong a sithabetsang. Boko. ka khatiso.
11. Steele JD, Kumar P, Ebmeier KP. Karabelo e fifalitsoeng ea tlhaiso-leseling ea karabo ho bokuli bo sithabetsang. Boko. 2007; 130: 2367–2374. [E fetotsoe]
12. Berridge KC, Robinson TE. Karolo ea dopamine moputsong ke efe: tšusumetso ea hedonic, ho ithuta ka moputso, kapa ho hlohlona? Brain Res Brain Res Rev. 1998; 28: 309-369. [E fetotsoe]
13. Gard DE, Majeremane Gard M, Kring AM, John OP. Lintho tse khahlisang le tse khothatsang tsa boiphihlelo ba monyaka: boithuto ba ntlafatso e kholo. J Motho. 2006; 40: 1086-1102.
14. Schultz W. Lipontšo tse ngata tsa moputso bokong. Nat Rev Neurosci. 2000; 1: 199–207. [E fetotsoe]
15. Alexander GE, DeLong MR, Strick PL. Mokhatlo o lumellanang oa lipotoloho tse arohaneng tse hokahanyang basal ganglia le cortex. Annu Rev Neurosci. 1986; 9: 357-381. [E fetotsoe]
16. Dunlop BW, Nemeroff CB. Karolo ea dopamine ho pathophysiology ea khatello ea maikutlo. Psychology ea Arch Gen. 2007; 64: 327–337. [E fetotsoe]
17. Knutson B, Bhanji JP, Cooney RE, Atlas LY, Gotlib IH. Likarabo tsa Neural ho likhothaletso tsa lichelete maemong a khatello e kholo ea maikutlo. Psychology ea Biol. 2008; 63: 686-692. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
18. Delgado MR, Nystrom LE, Fissell C, Noll DC, Fiez JA. Ho latela likarabo tsa hemodynamic ho fumana moputso le kotlo ho striatum. J Neurophysiol. 2000; 84: 3072-3077. [E fetotsoe]
19. Delgado MR, Locke HM, Stenger VA, Fiez JA. Likarabo tsa dorsal striatum ho fumana moputso le kotlo: litlamorao tsa bophahamo le bokhopo bo boholo. Utloisisa Chenjera le Behav Neurosci. 2003; 3: 27–38. [E fetotsoe]
20. Delgado MR, Miller MM, Inati S, Phelps EA. Boithuto ba fMRI ba ho ithuta ka bokamoso bo amanang le moputso. NeuroImage. 2005; 24: 862-873. [E fetotsoe]
21. Dillon DG, Holmes AJ, Jahn AL, Bogdan R, Wald LL, Pizzagalli DA. Ho arohana ha libaka tsa neural tse amanang le likarolo tse lebelletsoeng tsa ts'usumetso ea ts'usumetso. Psychology. 2008; 45: 36–49. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
22. Knutson B, Cooper JC. Monahano o sebetsang oa boloi o sebetsang oa ho bolela moputso esale pele. Curr Opin Neurol. 2005; 18: 411–417. [E fetotsoe]
23. Harvey PO, Pruessner J, Czechowska Y, Lepe M. Liphapang tse fapaneng bathong ba mofuta: thuto ea lipono tsa sebopeho le tšebetso ea matla a lipono tsa mahlale a morao-rao lithutong tseo e seng tsa bongaka. Khoele ea kelello. 2007; 12: 767-775. [E fetotsoe]
24. MB ea pele, Spitzer RL, Gibbon M, Williams JBW. Puisano e hlophisitsoeng ea Kliniki bakeng sa Lits'oaetso tsa DSM-IV-TR Axis I, Mofuta oa Lipatlisiso, Khatiso ea Bakuli. (SCID-I / P) Patlisiso ea Li -ometri, Setsi sa Psychiatric sa New York State; New York, NY: 2002.
25. Hamilton M. Tekanyo ea tekanyo ea khatello ea maikutlo. J Neurol Neurosurg Psychiatry. 1960; 23: 56-62. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
26. Beck AT, Steer RA, Brown GK. Buka ea Beck Depression Inventory Manual. 2nd ed. Mokhatlo oa Psychological; San Antonio, TX: 1996.
27. Fischl B, Salat DH, Busa E, Albert M, Dieterich M, Haselgrove C, van der Kouwe A, Killiany R, Kennedy D, Klavere S, Montillo A, Makris N, Rosen B, Dale AM. Karolo e felletseng ea bokong: mongolo o hlophisitsoeng oa likarolo tsa neuroanatomical bokong ba motho. Neuron. 2002; 33: 341–355. [E fetotsoe]
28. Tae WS, Kim SS, Lee KU, Nam EC, Kim KW. Ho netefatsoa ha likarolo tsa hippocampal tse lekantsoeng ho sebelisoa mokhoa oa ho ngola le mekhoa e 'meli e ikemetseng (FreeSurfer le IBASPM) ho sa foleng ho hoholo ha khatello ea maikutlo. Neuroradiology. 2008; 50: 569-581. [E fetotsoe]
29. Pizzagalli DA, Goetz E, Ostacher M, Iosifescu D, Perlis RH. Bakuli ba Euthymic ba nang le Bipolar Disorder ba fokotse thuto ea moputso mosebetsing oa moputso oa probabilistic. Psychology ea Biol. 2008; 64: 162-168. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
30. Tremblay LK, Naranjo CA, Graham SJ, Herrmann N, Mayberg HS, Hevenor S, Busto UE. Likarolo tse sebetsang tsa neuroanatomical subaching tsa meputso e fetotsoeng moferefereng o moholo o sithabetsang o senotsoeng ke projeke ea dopaminergic. Psychology ea Arch Gen. 2005; 62: 1228–1236. [E fetotsoe]
31. Tricomi EM, Delgado MR, Fiez JA. Modular ea mosebetsi oa caudate ka maemo a tšohanyetso. Neuron. 2004; 41: 281-292. [E fetotsoe]
32. Kawagoe R, Takikawa Y, Hikosaka O. Tebello ea litefiso tsa moputso e etsa lipontšo tsa tlhokomeliso ho sehlopha sa basal ganglia. Nat Neurosci. 1998; 1: 411–416. [E fetotsoe]
33. Berns GS, McClure SM, Pagnoni G, Montague PR. Predictability modula karabelo ea kelello ea motho ea moputso. J Neurosci. 2001; 21: 2793–2798. [E fetotsoe]
34. O'Doherty J, Dayan P, Schultz J, Deichmann R, Friston K, Dolan RJ. Karolo e khahlano le karolo ea "ventral le dorsal striatum" maemong a ts'ebeliso. Mahlale. 2004; 304: 452-454. [E fetotsoe]
35. Schlaepfer TE, Cohen MX, Frick C, Kosel M, Brodesser D, Axmacher N, Joe AY, Kreft M, Lenartz D, Sturm V. Ho tsitsisa ha kelello ho fana ka moputso oa potoloho ho fokotsa ho tepella ho hoholo ha maikutlo. Neuropsychopharmacology. 2008; 33: 368–377. [E fetotsoe]
36. Malone DA, Jr, Dougherty DD, Rezai AR, Carpenter LL, Friehs GM, Eskandar EN, Rauch SL, Rasmussen SA, Machado AG, Kubu CS, Tyrka AR, Price LH, Stypulkowski PH, Giftakis JE, Rise MT, Malloy PF, Salloway SP, Greenberg BD. Ts'usumetso e tebileng ea bokong ba "ventral capsule /" "ventral striatum" e fanang ka khatello ea maikutlo. Psychology ea Biol. 2008 Oct 6; Epub pele ho khatiso.
37. Santesso DL, Dillon DG, Birk JL, Holmes AJ, Goetz E, Bogdan R, Pizzagalli DA. Phapang e fapaneng le e 'ngoe thutong ea ho matlafatsa: Behavioral, electrophysiological, and neuroimaging correlates. NeuroImage. 2008; 42: 807-816. [Tlhahiso ea mahala ea PMC] [E fetotsoe]
38. Knutson B, Gibbs SE. Li-nucleus tse hokahanyang li bokella dopamine le oxygenation ea mali. Psychopharmacology. 2007; 191: 813-822. [E fetotsoe]
;
