Mokhoa oa ho hopola le ho ba le boloetse ba motlakase o atamela ho ithuta boitšoaro ba lijo le ho thibela le ho sebetsana le mathata a ho ja le botenya (2015)

D. Val-Laillet,^a,⁎ E. Mabaka,^b B. Weber,^c M. Ferrari,^d V. Quaresima,^d LE Stoeckel,^e M. Alonso-Alonso,^f M. Audette,^g CH Malbert,^h 'me E. Linokoⁱ

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Ts'ebetso e sebetsang, ea limolek'hule le liphatsa tsa lefutso e totobalitse ho ba teng ha liphoso tsa boko le lintlha tsa ho hlaseloa ka neural tse amanang le botenya le mathata a ho ja a joalo ka ho itlopa lijo kapa ho ipolaisa tlala. Haholo-holo, ho fokotseha ha metabolism ea basal ka pele ho cortex le striatum hammoho le liphetoho tsa dopaminergic li hlalositsoe lithutong tse tlotsitsoeng, hammoho le ts'ebetso e eketsehileng ea libaka tsa boko ba moputso ho arabela likelellong tsa lijo tse fumanehang habonolo. Karabelo e phahamisitsoeng ea moputso sebakeng se ka tsosang takatso ea lijo le ho bolela bokamoso bo boima. Sena se bula tsela ea ho thibela lithuto ho sebelisa li-neuroimaging tse sebetsang le tsa molek'hule ho etsa liteko tsa pejana le ho hlahisa lithuto tse kotsing ka ho hlahloba mehato e fapaneng ea khetho ea lijo le mekhoa ea khothatso. Karolong ea pele ea tlhahlobo ena, melemo le meeli ea mekhoa ea neuroimaging, joalo ka ts'ebetso ea matla a ho sebelisa matla a matla a sefahleho (fMRI), positron emission tomography (PET), Photon emission computer tomography (SPECT), fMRI ea pharmacgenetic le tšebetso e haufi le infrared spectroscopy ( fNIRS) ho tla tšohloa taba ea mosebetsi oa morao-rao o sebetsanang le boitšoaro ba ho ja, 'me ho shebane haholo le botenya. Karolong ea bobeli ea tlhahlobo, ho tla hlahisoa maano a sa hlaseleng a ho feto-fetoha le ts'ebetso ea kelello e amanang le lijo le mesebetsi. Bokapele ba theknoloji e sa hlokeng botsitso ea theknoloji ke "neurofeedback" ea nako ea sebele, e leng sesebelisoa se matla sa ho utloisisa mathata a likamano tsa boko ba motho. rtfMRI, e le 'ngoe kapa ha e kopantsoe le mekhoa le lisebelisoa tse ling tse kang EEG le kalafo ea kelello, e ka sebelisoa ho fetola polasetiki ea neural le boits'oaro bo ithutileng ho ntlafatsa le / kapa ho khutlisa boits'oaro bo botle le boits'oaro ba ho ja. Mekhoa e meng e ts'episang e sa hlaseleng ea neuromodulation e ntseng e phenyekolloa ke phetisetso ea phetisetso ea matla a khoheli a (transcanial magnetic stimulation (rTMS)) le transcranial directly-current stimulation (tDCS). Ho fana ka bopaki ho supa boleng ba mekhoa ena e sa hlaseleng ea ho sebelisa mekhoa ea ho ja le ho phekola mafu a eona. Litsela tsena ka bobeli li tla tšoantšoa le mosebetsi o sa tsoa etsoa lefapheng lena, ha ho ntse ho buuoa le lipotso tse sebetsang. Karolo ea boraro ea tlhahlobo ena e tla inehela ho maano a hlaselang a neuromodulation, joalo ka tsusumetso ea methapo ea methapo ea vagus (VNS) le tšusumetso e matla ea bokong (DBS). Ho kopantsoe le mekhoa ea neuroimaging, mekhoa ena e tšepisa lisebelisoa tsa liteko tsa ho hlakola likamano tse rarahaneng lipakeng tsa potoloho ea kelello ea homeostatic le hedonic. Ho tla buisanoa ka menyetla ea bona e le lisebelisoa tse ling tsa ho phekola ho loants'a botenya kapa mathata a ho ja ka thata, ho latela liphephetso tsa tekheniki, ts'ebetso le melao ea boitšoaro. Puisanong e akaretsang, re tla beha bokapele ba mantlha ba lipatlisiso tsa mantlha, thibelo le kalafo maemong a botenya le mathata a ho ja. Taba ea mantlha, re tla tšohla monyetla oa ho khetholla matšoao a mabe a tlhaho a tšebetso ea boko. Taba ea bobeli, re tla totobatsa menyetla ea neuroimaging le neuromodulation ho meriana e ikhethileng.

2.1. Ho bolela esale pele phaello ea boima ba nako e tlang le tokiso motheong oa karabelo ea neural le ts'ebetso

Kutloisiso e ntlafalitsoeng ea lits'ebetso tsa likotsi tse fanang ka ts'ebetso ea boima bo feteletseng e lokela ho tataisa moralo oa mananeo a atlehang haholo a thibelo le kalafo, ho bohlokoa hobane ts'ebetso e tlatselletsang, ntle le ts'ebetso ea bongaka e sebetsanang, e na le katleho e fokolang. Theorists ba tsepamisitse maikutlo ho li-circry tsa moputso hobane ho ja lijo tse fumanehang habonolo ho eketsa ts'ebetso libakeng tse kenyellelitsoeng moputsong ho batho le liphoofolo tse ling, ho kenyelletsa le ventral le dorsal striatum, midbrain, amygdala, and orbitofrontal cortex (OFC: Tse nyenyane le al., 2001; Avena et al., 2006; Berridge, 2009; Stice et al., 2013) mme e baka tokollo ea dopamine (DA) ka dorsal striatum, le palo e lokollotsoeng e tsamaellana le monate oa lijo (Tse nyenyane le al., 2003) le letsoalo la lijo tsa caloric (Ferreira et al., 2012) bathong. Ka bobeli thepa ea ts'ebeliso e ntle ea tšebeliso ea lijo tse matlafatsang (tlhasimollo ea maikutlo) le ho kenella ka kotlolloho ka kotloloho ea lijo tse matla tsa khalori tse khothalletsang ho lokolloa ha DA libakeng tse nang le moputso lithutong tsa batho le tsa liphoofolo (Avena et al., 2006; Tellez et al., 2013).

2.2. Dopaminergic imaging

Joalokaha ho hlahlojoa ka holimo, dopamine (DA) e bapala karolo ea bohlokoa boits'oarong ba ho ja. Ho utloisisa mekhoa le methapo e sebelisang DA ho susumetsa boits'oaro ba ho ja ho bohlokoa bakeng sa ho bolela esale pele, thibelo le (pharmacological) kalafo ea botena. Ho kenya letsoho ho kenella ts'ebetsong ea dopaminergic, ho bohlokoa ho lekanya ts'ebetso ea DA. Liphumano tsa metabolism e eketsehang kapa phallo ea mali sebakeng sa sepheo sa dopaminergic ha se bolele hore DA e ameha ka kotloloho. Mohlala, ts'ebetso ho striatum e ka bonts'a modumo ea opioid ea hedonic 'rata' sebakeng sa dopaminergic modulation ea 'ho batla' (Berridge, 2007). Mona, re tla hlahlobisisa lintlha tse mabapi le liphetho tsa lipatlisiso tse entsoeng ka kotloloho ho DA.

2.2.1. Menahano ea nyutlelie ea nyutlelie

Mekhoa ea ho nahana ka lintho tsa nyutlelie e kang positron emission tomography (PET) le single Photon emission computer tomography (SPECT) e sebelisa li-tracers tse nang le radio radio le ho lemoha lits'oants'o tsa gamma ho tsepamisa likelello tsa lisele tsa limolek'hule tsa phaello (mohlala, li-receptor tsa DA). PET le SPECT li na le karabelo e tlase haholo ea nakoana (mashome a metsotsoana ho isa ho metsotso), hangata e hloka sebopeho se le seng sa ho nahana ka ntlha e le 'ngoe ea data, e fokotsa mofuta oa lipotso tsa lipatlisiso tse ka lebisoang le mekhoa ena.

Lethathamo 1 e fana ka kakaretso ea lithuto tsa dopaminergic PET le SPECT tse ileng tsa lekola liphapang e le ts'ebetso ea BMI ho batho. Tumellanong le ho fokotseha ha dopamine ho supa ka botenya ke kamano e pakeng tsa bokhoni bo tlase ba dopamine syntheseng ea dorsal striatum le BMI e phahameng.Wilcox et al., 2010; Wallace et al., 2014) le "receptor" e tlase ea DA D2 / D3Wang et al., 2001; Haltia et al., 2007; Volkow et al., 2008; de Weijer et al., 2011; Kessler et al., 2014; van de Giessen et al., 2014). Leha ho le joalo, ba bang ba fumane likamano tse ntle pakeng tsa striatal D2 / D3 receptor binding le BMI (Dunn et al., 2012; Caravaggio et al., 2015), kapa ha ho setsoalle (Eisenstein et al., 2013). Ho tsoa lithutong tse boletsoeng ka holimo ho boetse ha ho hlake hore na liphapang tsa ts'ebetso ea DA li bontša sesosa kapa litholoana tsa BMI e eketsehang. Ba bang ba amohetse potso ena ka ho hlahloba liphetoho tse etsahalang ho DA D2 / D3 receptor binding kamora ho buuoa ka bariatric le ho theola boima ba 'mele. Ha thuto e le 'ngoe e fumanoe e eketseha ebe e' ngoe e fumanoe e fokotseha ho receptor binding ka mor'a ho buuoa (Dunn et al., 2010; Steele et al., 2010), phuputso e entsoeng ka sampole e kholo ha e fumane liphetoho tse kholo (de Weijer et al., 2014).

 

Tafole 1

Kakaretso ea lithuto tse sebelisang SPECT kapa PET bakeng sa ho nahanisisa ka dopaminergic ho litekanyetso tsa batho tse boima, tse nonneng kapa tse batenya haholo.

Mokhoa o mong oa ho etsa lipatlisiso mabapi le ho nka karolo ha DA bothateng ke ho lekola liphetoho maemong a DA a hlahisoang ke psychostimulant kapa phephetso ea lijo (bona bothata Lethathamo 1). Lithutong tse joalo tsa phephetso, ho kopanya li-receptor tse tlase ho hlalosoa e le tokollo e kholo ea DA ea semmuso e lebisang tlholisanong e kholo le radioligand ho li-receptors. Boithuto ba phephetso bo hlokometse hore keketseho ea lijo-kapa psychostimulant-e susumetsang ea li-striatal DA tse amanang le kantle ho naha li amahanngoa le BMI e tlase (Wang et al., 2014), BMI e phahameng (Kessler et al., 2014), kapa ha u fumane karohano lipakeng tsa lihlopha tsa BMI (Haltia et al., 2007).

Ka kakaretso, liphetho tsa lithuto tsa nyutlelie tse batlisisang liphapang tsamaisong ea DA e le tšebetso ea BMI ha li lumellane haholo. Boitekong ba ho fetohela khopolong e le 'ngoe ea ts'ebetso ea dopaminergic ka botenya, bangoli ba fapaneng ba sebelisitse litlhaloso tse fapaneng bakeng sa liphetho tsa bona. Mohlala, DA D2 / D3 bind receptor e fetoletsoe ho bonts'a ho fumaneha ha li-receptor tsa DA (mohlala, Wang et al., 2001; Haltia et al., 2007; Volkow et al., 2008; de Weijer et al., 2011; van de Giessen et al., 2014), Kamano ea DA receptorCaravaggio et al., 2015), kapa tlholisano le DAE ea mehleng (Dunn et al., 2010; Dunn et al., 2012). Motheong oa data, hangata ha ho hlake hore na phapang e joalo ea ho toloka e nepahetse. Ntle le moo, patlisiso ea morao-rao e entsoeng ke Karlsson le basebetsi-mmoho e bonts'itse phokotso ea bohlokoa ea "op-opioid receptor" e fumanehang ka bongata ha e bapisoa le basali ba boima, ntle le liphetoho ho phumaneho ea D2-receptor, e ka ba mocha o eketsehileng o ka hlalosang liphetho tse sa lumellaneng ho lithuto tse ling tse ngata (Karlsson le al., 2015).

2.3. Tlatsetso ea ts'ebetso ea haufi le infrared spectroscopy (fNIRS)

Ho fapana le mekhoa e meng ea neuroimaging, joalo ka PET le fMRI, fNIRS ha e hloke hore lihlooho li be boemong bo phahameng mme ha e thibele ho sisinyeha ha hlooho ka tsela eo, ka hona e lumella ho amohela mesebetsi e mengata e fapaneng ea liteko e loketseng ho batlisisa hantle mathata a ho ja le ho ja lijo. / susumetsa. Ntle le moo, fNIRS e sebelisa sesebelisoa sa theko e tlase (ka nako ea mehlala ho ea ka tatellano ea ms le qeto ea sebaka se ka etsang 1 cm). Ka lehlakoreng le leng, leha EEG e le mokhoa o sebetsang oa motlakase oa motlakase, qeto ea eona e tlase haholo ea sebaka e etsa hore ho be thata ho tseba hantle libaka tse sebetsitsoeng tsa boko, ho fokotsa ts'ebeliso ea eona lipotsong tse khethehileng tsa lipatlisiso tse amanang le mathata a ho ja (Jauregui-Lobera, 2012). Haufinyane, ho sebetsana le bothata bona EEG e kopantsoe ka katleho le fMRI ho hlola meeli ea sebaka sa EEG le meeli ea nakoana ea fMRI, ba sebelisa likarolo tsa bona tse tlatsetsang (Jorge et al., 2014). Tšebeliso e ts'oanang kapa e latellanang ea EEG le fMRI lithutong tse amanang le lijo li ka fana ka leseli le eketsehileng ho li-cascade tsa neural processing. Leha ho le joalo, lithuto tse amanang le lijo tsa EEG-fMRI ha li e-so tlaleheloe. Qetellong, melemo eohle e boletsoeng ka holimo ea ho sebelisa fNIRS le EEG e fana ka tšepiso e kholo ea ho hlahloba mesebetsi e amanang le tatso e amanang le tatso e hlokang ho etsoa le ho kenyelletsa lijo / lino tse tahang tlasa maemo a tlhaho.

2.3.2. Ts'ebeliso ea fNIRS bakeng sa ho etsa likarabo tsa batho tsa cortical maemong a bakoang ke lijo le lijo le mathata a ho ja.

Ts'ebeliso ea fNIRS maemong a lithuto tsa khatello ea lijo / ho ja le ho ja e emela ts'ebeliso e ncha, joalo ka ha ho pakiloe ke palo e lekanyelitsoeng ea lingoliloeng: 39 lilemong tse 10 tse fetileng. Lethathamo 2 ka kakaretso lithuto tsena. Liphetho tse amanang le FNIRS li kenyelletsa haholo: 1) ts'ebetso e tlase e ka pele ea ts'ebetso ea kelello ho bakuli ba fapaneng ba maemo a fapa-fapaneng a bakuli ba nang le ED, le 2) mekhoa e fapaneng ea ts'ebetso holima maemo a fapaneng a pele le a susumetsang (ke hore tatso ea lijo, tatso ea lijo , likarolo tsa lijo tse nkhang hamonate, phepo e nepahetseng / motsoako oa lijo le litšoantšo tsa lijo) lithutong tse phetseng hantle. Ho fihla joale, ke mefuta e fokolang ea ED e ntseng e hlahlojoa ke fNIRS. Ke phuputso e le 'ngoe feela e tlalehileng karabo ea PFC ho susumetso ea pono ho bakuli ba AN (Nagamitsu et al., 2010). Lithuto tse ling tse amanang le 4 ED tse tlalehiloeng ka Lethathamo 2, le lingoliloeng tse batsi tsa fMRI (bona García-García et al., 2013 tlhahlobo e akaretsang lithuto tsa 86) e fana ka maikutlo a ho ba teng ha liphapang tsa neural lipakeng tsa boits'oaro bo tloaelehileng le bo sa tloaelehang ba ho ja ka lebaka la ho bona lijo. Haufinyane, Bartholdy et al. (2013) e sekasekile lithuto tseo ho tsona neurofeedback e kopantsoeng le mekhoa ea neuroimaging, ho fana ka tlhahiso ea ts'ebeliso e ka bang teng ea fNIRS bakeng sa ho hlahloba kalafo ea ED. Leha ho le joalo, tlhaloso ea liphetho tsa fNIRS e kanna ea thatafatsoa ke sebaka se selelele sa scalp-to-cortex ho bakuli ba bang ba nang le AN e tebileng ka lebaka la phetoho ea boko ba bona kamora ho fokotsoa ha molumo oa taba le / kapa mokelikeli oa mokokotlo oa "cerebrospinal fluid" (Bartholdy et al., 2013; Ehlis et al., 2014). Ka hona, tekolo ea hore na cortical atrophy le scalp perfusion e ka ama maikutlo a fNIRS ho bohlokoa joang ho hlahloba bohlokoa ba mokhoa ona pele e le sesebelisoa sa ho etsa lipatlisiso ho bakuli ba nang le AN e matla.

 

Tafole 2

lithuto tsa ts'ebetso ea kelello ea fNIRS ho bakuli ba nang le mathata a ho ja, hammoho le lithuto / bakuli ba phetseng hantle lijong tsa bona kapa lijo tse ba susumetsang.

Lithuto tse mashome a mararo a metso e mene tsa lithuto tsa 39 li entsoe feela lithutong tse phetseng hantle ((Lethathamo 2). Liphuputso tse mashome a mabeli tsa tsona li bonts'itse kamoo li-fNIRS li ka fanang ka monehelo o sebetsang ho ntlafatso ea tatso ea 'mapa haholo-holo sebakeng sa preortal cortex (lPFC). Lithuto tse leshome le motso o mong li amana le tšebeliso ea li-fNIRS lithutong tsa ho kenella ka phepo e nepahetseng lithutong tsa phetisetso e matla le e sa foleng (Jackson le Kennedy, 2013; Sizonenko et al., 2013 bakeng sa litlhahlobo). Lithuto tsena li khothalelitse hore fNIRS e khona ho bona phello ea limatlafatsi le likarolo tsa lijo ts'ebetsong ea PFC.

Ka bomalimabe, boholo ba lithuto li tlalehiloe Lethathamo 2 li entsoe ka mohlala o monyane oa sampole, mme papiso lipakeng tsa bakuli le taolo hangata e ne e sa lekana. Ntle le moo, ke patlisiso e le 'ngoe feela ea fNIRS, e entsoeng ho sebelisoa sesebelisoa se theko e phahameng sa fNIRS se thehiloeng ho pono e rarollotsoeng ke nako, e tlaleha litekanyetso tse phethahetseng tsa mahloriso tsa O₂Hb le HHb.

Boholo ba lithuto tse tlalehiloeng, lipatlisiso tsa fNIRS li koahetse feela likarolo tsa bokapele ba bokapele. Ka hona, ho ameha ha libaka tse ling tsa cortical ho kenyelletsa libaka tsa parietal, cyland-temporal le occipital, tse ka amanang le ts'ebetso ea pono, tlhokomelo, le marang-rang a mang a hlokolosi, ha lia ka tsa batlisisoa. Ntle le moo, liphuputso tse ngata li tlalehile liphetoho ho O₂Hb ho etsa papiso le fMRI ho fumanoe ho le thata.

Lithuto tsena tsa pele li bonts'a hore, ha e sebelisoa lithutong tse entsoeng hantle, fNIRS neuroimaging e ka ba sesebelisoa se thusang ho hlakisa litlamorao tsa tšebeliso ea phepo / tlatsetso. Ntle le moo, fNIRS e ka amoheloa habonolo bakeng sa: 1) ho hlahloba ts'ebetso ea mananeo a kalafo a ED le mananeo a koetliso ea boitšoaro, le 2) ho etsa lipatlisiso taolong ea thibelo ea dlPFC ho litekanyetso tsa lijo tse teng lithutong tse phetseng hantle le ho bakuli ba ED.

3.1. Nako ea sebele ea fMRI neurofeedback le kalafo ea kelello

3.1.1. Selelekela sa neurofeedback ho hlahlobisiseng tlhalohanyo

Ho hlahloba botjha ke leano le hlakileng la taolo ea maikutlo e kenyelletsang ho fetoloa ha mekhoa ea kelello ho fetola tsela le / kapa boholo ba karabelo ea maikutlo (Ochsner et al., 2012). Lits'ebetso tsa boko tse hlahisang le ho sebelisa maano a boithuto bocha li kenyelletsa pele, dorsal anterior cingulate (dACC), le infortal parietal cortices (Ochsner et al., 2012). Litereke tsena li sebetsa ho fetolela karabo ea maikutlo ho amygdala, ventral striatum (VS), insula, le ventromedial prefrontal cortex (vmPFC) (Ochsner et al., 2012; Feie. 1). Kamora nako, ts'ebeliso ea maano a tlhahlobo ea kelello a bonoang a bonts'oa ho laola likarabo tsa lijo tse fumanehang lijong tse matlafatsang ka mekhoa e tšoanang ea neural (Kober et al., 2010; Hollmann et al., 2012; Siep et al., 2012; Yokum le Stice, 2013).

 

Setšoantšo sa 1

Mohlala oa taolo ea kutloisiso ea maikutlo (MCCE). (A) Setšoantšo sa mehato ea ts'ebetso e kenyelletsang ho hlahisa maikutlo le litsela tseo ts'ebetso ea taolo ea kelello e ka sebelisoang ho li laola. Joalokaha ho hlalositsoe temaneng, litlamorao ...

Neurofeedback e sebelisang data e sebetsang ea matla a resonance imaging (fMRI) ke mokhoa o sa hlaseleng o sebelisetsoang ho fetola polasetiki ea neural le boits'oaro bo ithutileng ka ho fa batho leseli la nnete mabapi le ts'ebetso ea bona ea boko ho ts'ehetsa boitaolo ba ho ithuta ba mosebetsi ona oa neural (Sulzer et al., 2013; Stoeckel et al., 2014; Feie. 2). Ho kopanya nako ea sebele ea fMRI (rtfMRI) neurofeedback le mekhoa ea tlhahlobo ea kelello ea boiketsetso ke leano le se nang moeli la ho fetolela tsoelo-pele ea morao-rao ho neuroscience, psychology ea bongaka, le theknoloji ho sesebelisoa sa kalafo se ka ntlafatsang ho ithuta (Birbaumer et al., 2013), neuroplasticity (Sagi et al., 2012), le sephetho sa bongaka (deCharms et al., 2005). Mokhoa ona o tlatselletsa theknoloji e meng e teng ea neurotherapeutic, ho kenyelletsa bokong bo tebileng le ho hlohlelletsa, ka ho fana ka mofuta o mong o sa hlaselleng bakeng sa mathata a bokong mme o ka eketsa boleng ka holimo ho psychotherapy feela, ho kenyeletsa le kalafo ea boits'oaro bo hlokolosi, ka ho fana ka tlhahisoleseling mabapi le hore na liphetoho li teng hokae ho baka liphetoho mesebetsing ea boko (Adcock et al., 2005).

 

Setšoantšo sa 2

Schematic of real-time functional magnetic resonance imaging (rtfMRI) loop control. Ka tloaelo, litšoantšo tsa echo planar imaging (EPI) li nkoe ho sehatisi sa makenete sa maqhubu (MR) marang-rang, li hlahlojoa ke software ea motho oa boraro, ebe li hlahisoa hape ...

Ho bonahala ho na le tlhekefetso ts'ebelisong ea maano a boithuto ba kelello le lits'ebetso tsa ts'ebetso ea boko tse li sebelisang ho tlatsetsa ho tsitsipaneng hoa boitšoaro ba ho ingestive, ho kenyelletsa AN, BN, BED, botenya, le ts'ebeliso ea lithethefatsi (Kelley et al., 2005b; Aldao le Nolen-Hoeksema, 2010; Kaye et al., 2013). Ntle le mathata ana, hangata ho ba le ho se sebetse hantle lits'ebetsong tse peli tse kholo tsa boko tse nang le likarolo tsa bohlokoa ho hlahlobeng bocha: e 'ngoe e kenyelletsa hypersensitivity ho cueitive cards (mohlala, VS, amygdala, anterior insula, vmPFC ka holim'a lijo kapa lisebelisoa tse ling tsa lintho tse ling (mohlala, anterior cingulate, cortex e tlang pele ho nako - lPFC, ho kenyelletsa le dorsolateral prefrontal cortex - dlPFC). Ho kenella ha novel e reretsoeng ho tobisa maano a ho se sebetse hantle maikutlong le mekhoa ea tšebetso ea neural e ka fana ka tataiso e ncha le tšepo bakeng sa mathata ana a thata ho phekola.

3.2. Ts'usumetso ea matla a khoheli a Transcranial (TMS) le tshusumetso e tobileng ea hona joale (tDCS)

3.2.1. Kenyelletso ho TMS le tDCS

Mekhoa ea li-neuromodulation e sa hlaseleng e lumella tšebeliso ea kelello ea motho ea kantle ka mokhoa o bolokehileng, ntle le tlhokahalo ea ts'ebetso ea methapo ea kutlo. Lilemong tse mashome a mabeli tse fetileng ho bile le thahasello e ntseng e eketseha ts'ebelisong ea methapo ea methapo e sa hlaselengheng ho ts'ebetso ea methapo le kelello, e susumetsoang ke khaello ea kalafo e sebetsang. Mekhoa e tloaetseng ho sebelisoa ke transcranial magnetic stimulation (TMS) le transcranial ngqo simulation (tDCS). TMS e ipapisitse le tšebeliso ea matla a matla a khoheli a fetohang ka potlako a isitsoeng ka coil e kentsoeng ka polasetiki e behiloeng holim 'a letlalo la sehlooho (Feie. 3A). Maqhubu ana a sa tšoaneng a matla a khoheli a baka ho kenella ha maqhubu a bobeli karolong e haufi ea cortex e ka bang matla ka ho lekaneng ho baka ts'ebetso ea methapo ea methapo (Barker, 1991; Pascual-Leone et al., 2002; Hallett, 2007; Ridding le Rothwell, 2007). TMS e ka tsamaisoa ka pulses e le 'ngoe kapa e mengata, eo hape e bitsoang pheta-pheta TMS (rTMS). Tabeng ea li-tDCS, maqhubu a DC a bonolo (hangata ka tatellano ea 1-2 mA) a sebelisoa ka kotloloho hloohong ka lipara tsa eleketrode tse nang le letsoai tse hokahantsoeng le sesebelisoa se kang sa betri (Feie. 3B). Hoo e batlang e le 50% ea hona joale e hlahisoang ke tDCS e kenella sekeng mme e ka phahamisa kapa ea fokotsa matla a ho phomola a bokaholimo ba li-neurons libakeng tse tlasa (tshusumetso ea anodal kapa cathodal tDCS, ka ho latellana), e baka phetoho ea ho thunya ka mokhoa o ikemetseng (Nitsche et al., 2008). li-rTMS le li-tDCS li ka baka liphetoho tse liehang / tsa nako e telele tseo ho lumeloang hore li tsamaisana le liphetoho ka matla a synaptic. Kakaretso e akaretsang ea mekhoa le mekhoa ea bona ea ts'ebetso e fetang moeli oa karolo ena mme e ka fumanoa kae kapa kae (Pascual-Leone et al., 2002; Wassermann et al., 2008; Stagg le Nitsche, 2011). Lethathamo 3 e hlahisa kakaretso ea liphapang tsa bohlokoa lipakeng tsa TMS le tDCS. Ha TMS le li-tDCS e ntse e le mekhoa e atileng tšimong, ho ntse ho entsoe mefuta e meng kapa tse fetotsoeng tsa li-neuromodulation lilemong tsa morao tjena mme li ntse li le mafolofolo tlasa lipatlisiso, joalo ka TMS e tebileng (dTMS) (Zangen et al., 2005), li-tDCS tsa boleng bo phahameng (HD-tDCS) (Datta et al., 2009), transcranial alternate lipapiso tsa morao-rao (tACS) (Kanai et al., 2008), kapa transcranial lerata la tšusumetso ea lerata (tRNS) (Terney et al., 2008). Mekhoa e meng ea neuromodulation ke e hlaselang (cf. Karolo ea 4), joalo ka tšusumetso e matla ea bokong (DBS), kapa tse lebisang methapo ea kutlo, e kang ho tsofala ha vagus nerve (VNS).

 

Setšoantšo sa 3

Litšoantšo tsa (A) li-coils tsa serurubele bakeng sa tšusumetso ea matla a khoheli a transcranial (TMS) le (B) le betri bakeng sa transcranial Direct hona joale ea susumetso (tDCS).

 

Tafole 3

Ho bapisoa pakeng tsa TMS le tDCS.

Lilemong tse mashome a mabeli tse fetileng ho bile le tsoelo-pele e makatsang kutloisisong ea rona ea boitšoaro ba ho ja, botenya le mathata a ho ja. Lithuto tse 'maloa tsa thuto ea neuroimaging le neuropsychology li thathamisitse mofuta oa lipakeng tsa moputso le kelello e le karolo ea mantlha taolong ea boitšoaro ba ho ja le boima ba' mele ho batho (Alonso-Alonso le Pascual-Leone, 2007; Wang et al., 2009a; Kober et al., 2010; Hollmann et al., 2012; Siep et al., 2012; Vainik et al., 2013; Yokum le Stice, 2013). Ha patlisiso e ntse e tsoela pele lefapheng lena, tsebo e fumanehang e etsa hore ho khonehe ho qala ho hlahloba lits'ebetso tse tlohang ho boits'oaro ho ea ho ts'ebetso ea methapo e le sepheo sa mantlha. Ka kakaretso, mekhoa ea neuromodulatory e ka tlisa kutloisiso ea bohlokoa le menyako e bulehileng ea kalafo boemong bona bo bocha bo behang methapo ea kutlo e le karolo ea mantlha ea boits'oaro ba batho ba ho ja.

3.2.2. Kakaretso ea lithuto tsa tliliniki ho fetola mekhoa ea ho ja le mathata a ho ja

Boitšoaro ba ho ja ke ts'ebeliso ea morao-rao lebaleng la li-neuromodulation tse sa hlaseleng, ka thuto ea pele e qalileng morao 2005 (Uher et al., 2005). TMS le tDCS ke tsona feela mekhoa e sebelisitsoeng moelelong ona. Lethathamo 4 e fana ka kakaretso ea lithuto tse hlophisitsoeng, tse laoloang, tse fanang ka bopaki ba mohopolo. Ho fihlela joale, lithuto tsena li lekile litlamorao tse matla, tsa nako e le 'ngoe feela, ntle le likhetho tse peli: phuputso e le' ngoe le rTMS ho bakuli ba bulimic (libeke tse 3), le phuputso ea haufinyane le li-tDCS ho banna ba phetseng hantle (matsatsi a 8). Sebaka se shebiloeng, dorsolateral prefrontal cortex (dlPFC), ke sebaka se rarahaneng sa boko se amanang le mesebetsi ea phethahatso e ts'ehetsang taolo ea kutloisiso ea phepelo ea lijo. Ka kakaretso, khopolo-taba ea mantlha ke hore ho ntlafatsa ts'ebetso ea dlPFC ho ka fetola teka-tekano ea moputso ho tataisa taolo ea kutloisiso le mohlomong ho hatella mekhoa e amanang le moputso e tsamaisang takatso ea lijo le ho ja ho tlōla. Mekhoa e ikhethileng ea ts'ebeliso ea dlPFC e anngoeng ke rTMS kapa tDCS le ho tsepamisa mohopolo litlamorao tsa boitšoaro e ntse e sa tsejoe haholo. Menyetla e kenyelletsa liphetoho mokhoeng oa ho lekola moputso (Camus et al., 2009), khethollo ea maikutlo (Fregni et al., 2008), kapa taolo ea inhibitory (Lapenta et al., 2014). Lithuto tsa rTMS li shebile dlPFC ea leqele feela, ka li-protocols tsa thabo (10 le 20 Hz). Lithuto tsa tDCS li shebile ka ho le letona le le lets'ehali dlPFC, ka mekhoa / montage e fapaneng hanyane. Boholo ba lithuto - kaofela li na le li-tDCS 'me e' ngoe e na le rTMS - li hlahlobile litlamorao ho takatso ea lijo, takatso ea lijo le takatso ea lijo. Ka kakaretso, ba lula ba fumane khatello e matla litakatsong tse ngata tsa boithati tsa takatso ea lijo le takatso ea lijo e lekantsoeng ke litekanyetso kapa sekala sa analogue (VAS). Ho na le sesupo sa hore litlamorao tsa li-tDCS li kanna tsa totobala haholoanyane bakeng sa takatso ea lipompong. Liphetoho tsa ho ja lijo ha li lumellane le seboka se le seng sa rTMS kapa tDCS. Phuputsong e telele ho fihlela joale le li-tDCS (matsatsi a 8), bangoli ba fumane phokotso ea 14% ea ts'ebeliso ea likhalori (Jauch-Chara et al., 2014). Monyetla oa bohlokoa lithutong tse ling ke tšebeliso ea mokhoa oa sham ntle le phallo ea hona joale e le taolo, sebakeng sa tšusumetso ea sham libakeng tse sa amaneng le tlhoko ea lijo ka mohlala. Kaha ka linako tse ling ts'usumetso e ka bonoa ke mokuli, re ke ke ra khetholla litlamorao ho tse ling.

 

Tafole 4

Kakaretso ea lithuto le TMS le li-tDCS lefapheng la boitšoaro ba batho ba ho ja.

Lithuto tse nang le bakuli ba nang le bothata ba ho ja ho fihlela joale ba sebelisitse rTMS feela. Litlaleho tse 'maloa tsa linyeoe (Kamolz et al., 2008; McClelland et al., 2013b) le thuto e bulehileng ka lebitsoVan den Eynde et al., 2013) (e sa kenyelelitsoe tafoleng) e fana ka tlhahiso ea monyetla oa ho ba le RTMS ho anorexia mothosa, empa liphetho li lokela ho phetoa litekong tse laoloang ke placebo. Bakeng sa BN, tlaleho ea nyeoe ea pejana e khothalelitse melemo e ka bang teng ka RTMS (Hausmann et al., 2004), empa sena ha sea netefatsoa tekong e latelang ea bongaka e sebelisitseng mokhoa ona ho feta libeke tse 3 (Walpoth et al., 2008). Phuputso ea linyeoe tsa haufinyane e tlalehile litlamorao tse sebelisang 10 Hz rTMS e sebelisitsoeng holima sepheo se fapaneng, dorsomedial prefrontal cortex, ho mokuli ea sa tsitsang ea nang le BN (liboka tsa 20, libeke tsa 4) (Downar et al., 2012). Sebaka sena sa boko se bonts'a sepheo se ts'episang se fuoeng karolo ea sona e akaretsang ea taolo ea kelello, haholo-holo ho lekola ts'ebetso le khetho ea liketso (Bush et al., 2000; Krug le Carter, 2012), le sehokelo sa eona le thupelo ea bongaka ea AN le BN (McCormick et al., 2008; Goddard et al., 2013; Lee le al., 2014).

4.1. Kakaretso ea maano a phello ea methapo ea kutlo e mabapi le tšebeliso ea lijo le taolo ea boima ba 'mele

4.1.2. Litlamorao tsa ho hlohlona ha vagal

Ho hlohlelletsa setho sa botšehali sa setho sa botšehali se amoheloang bakeng sa khatello ea maikutlo e thibelang kalafo le lefu la ho akheha ho sa feleng ho European Union, United States le Canada. Bakuli ba lefu la sethoathoa ba tlaleha phetoho khafetsa mokhoeng oa ho ja ka phetoho lithahasellong tsa lijo (Abubakr le Wambacq, 2008). Litlaleho tsena li hlahisitse lipatlisiso tse ling, qalong ka ho serendipity e hloekileng, eo hamorao e ileng ea sebelisa mehlala ea liphoofolo ho lekola litlamorao tsa VNS ho ja lijo le taolo e amanang le boima (bakeng sa litafole tsa maiketsetso lithutong tsa VNS, ka kopo bona Val-Laillet et al., 2010; McClelland et al., 2013a). Lithuto tsa mantlha ho 2001 ea Roslin le Kurian (2001) ka lintja le tse ling ho tloha Krolczyk et al. (2001) litotong ho khothalelitse ho fokotseha ha boima ba 'mele kapa ho theola boima ba' mele nakong ea ha o ts'oaroa ke ho hlasimoloha ha vagal. Ho makatsang ke hore, leha ho bile le mekhoa e fapaneng ea ho buuoa, liphetho tse bontšitsoeng ke lingoli tsena li ne li ts'oana. Ka 'nete, Roslin le Kurian (2001) o sebelisitse sethala se kopaneng sa kahare ho thorax (ka hona a tsosa likutu tsa ka tlung le tsa kahare) Krolczyk et al. (2001) o sebelisitse sethala sa setho sa botona ka ho le letšehali hore a tšoane le setsi sa bongaka sa sethoathoa. Ho tloha lithutong tsena tsa bo-pula-maliboho, lihlopha tse 'maloa tsa lipatlisiso, ho kenyelletsa le rona, li phatlalalitse liphetho tse ntle li sebelisa libaka tse fapaneng tsa li-electrodes, li-electrodes sethal up le li-paramure tsa stimulation. Boiteko ba pele ba ho lekola sebaka se lekaneng sa li-elektrone bakeng sa taolo ea ho ja lijo bo entsoe ke Laskiewicz et al. (2003). Ba bontšitse hore VNS ea linaha tse ling e sebetsa hantle ho feta tsusumetso e le 'ngoe. Re sebelisa mohlala o moholo oa tlhahlobo ea liphoofolo pele ho moo, re sebelisitse mofuta o mongata oa setho sa botšehali ka popelong e telele ka ho fetisisa e entsoeng ho fihlela joale. Re bontša hore ts'usumetso ea methapo ea methapo e sa foleng ea fokotseha e fokotsehe ho eketsa boima ba 'mele, tšebeliso ea lijo le takatso e monate ea li-minipigs tsa batho ba baholo (Val-Laillet et al., 2010). Ho feta moo, ho fapana le lithuto tse ling tse etsoang mehlaleng e nyane ea liphoofolo, katleho e ntlafala ha nako e ntse e le ka tsela e tšoanang le e seng e bontšitsoe ho bakuli ba nang le lefu la sethoathoa (Arle le Shils, 2011).

Ka bomalimabe, litlamorao tse ntle tse bonoang hoo e batlang e le lithuto tsohle tsa pele ho tlholeho ea liphoofolo ha lia tiisoa ho batho. Ka lebaka la lithibelo tse laoloang, lithuto tsohle tsa batho li entsoe li sebelisa cuffical vagal cuff feela ka li-stimulation setaele tse ts'oanang kapa tse ts'oanang hantle le tse sebelisoang bakeng sa khatello ea maikutlo kapa lefu la sethoathoa. Leha a sebelisa tšusumetso ea nako e telele, ho theola boima ba 'mele ho fumanoe hoo e ka bang halofo ea lithuto (Burneo et al., 2002; Pardo et al., 2007; Verdam et al., 2012). Hona joale, ha ho na tlhaloso e hlakileng bakeng sa lihlooho tsena tse sa arabeng e ka fanoang. Phuputso ea morao tjena ke Bodenlos et al. (2014) e fana ka maikutlo a hore batho ba bangata ba BMI ha ba arabele VNS hofeta batho ba hlokang leeme. Ho joalo, thutong ea bona, VNS e hatelletse phepo ea lijo ho bakuli ba nang le mafua feela.

Bangoli ba 'maloa ba fuputse motheo oa' mele oa VNS ka ho bua ka ho khetheha ka boemo ba motlakase ba li-electrode. Vijgen et al. (2013) li bontšitse tlhahlobisong e ntle e kopanyang monahano oa PET oa mofuta oa brown adipose tiske (BAT) le sehlopha sa bakuli ba nang le sethoathoa sa VNS hore VNS e eketsa ts'ebeliso ea matla haholo. Ntle le moo, phetoho ea tšebeliso ea matla e ne e amana le phetoho ea ts'ebetso ea BAT e bonts'a karolo ea BAT keketseho ea lits'enyehelo tsa matla. VNS e bontšitsoe hore e fetola tšebetso ea boko ho pholletsa le chisi eohle (Conway et al., 2012) le ho feto-fetola mekhoa ea monoaminergic (Manta et al., 2013). Ho batho, VNS ea leqele e hlohlellelitse rCBF (phallo ea methapo ea methapo ea boko) e fokotseha ka lehlakoreng le letšehali le le letona la OFC mme e tlohetse lobe ea nakoana e tlase. Keketseho ea bohlokoa e fumanoe hape ka lehlakoreng le letona la mokokotlo o ka pele, leoto le letšehali le kamorao la "capsule / medial putamen" ea kahare, gyrus e nepahetseng ea nakoana. Leha e le bohlokoa ba bohlokoa ba libaka tsena mabapi le taolo ea phepelo ea lijo le khatello ea maikutlo, ha ho kamano e fumanoeng lipakeng tsa ts'ebetso ea boko le sephetho sa lintlha tsa khatello ea maikutlo kamora likhoeli tse 12 tsa kalafo ea VNS. Ka hona, ho ntse ho lokela ho bonts'oa hore liphetoho tse bonoeng ke ts'ebetso ea boko ke lisosa tsa ho hlalosa litlamorao tsa VNS. Pontšo ea likhoto hore VNS e hlophisa mohopolo o amanang le bohloko bo amanang le bohloko (Zhang et al., 2013) e kanna ea emela tsela e 'ngoe e ka hlalosang litla-morao tse ntle tse bonoang ke bakuli. Lithuto tsa rona tsa pele mabapi le ts'ebetso ea ts'ebetso ea boko ka mor'a ho etsoa ke juxta-abdominal bilatal VNS e entsoeng ho likolobe tse ntseng li hola (Biraben et al., 2008) Ho sebelisa setšoantšo se le seng sa Photon gamma scintigraphy e bile eona ea pele ea ho hlahlobisisa litlamorao tsa VNS bokong bo sa sebetseng. Re bonts'itse ts'ebetso ea likhokahano tse peli. Ea pele e amahanngoa le bulb ea olkidory le libaka tsa mantlha tsa olgicory. Ea bobeli e kenyelletsa libaka tse bohlokoa ho kopanya leseli la gastro-duodenal mechanosensory (hippocampus, pallidum) kahoo ho fana ka boleng ba hedonic ho tsena. Liphetho tse tšoanang li tlalehiloe litekong ebang ke PET (Dedeurwaerdere et al., 2005) kapa MRI (Reyt et al., 2010). Ho fapana le litlamorao tsa boits'oaro tse nkang libeke tse 'maloa ho tsejoa, liphetoho ho metabolism ea boko e fumanoeng ke litšoantšo tsa PET li ne li le teng bekeng ea 1 feela kamora ho qala ha kalafo ea VNS. Mofuteng oa rona oa porcine oa juxta-ka mpeng VNS, cingulate cortex, putamen, caudate nucleus le substantia nigra / tegmental ventral sebakeng seo, ke hore moputso o moholo oa li-meso-limbic dopaminergic network, e hlahisitse liphetoho bokong ba metabolism (Malbert, 2013; Divoux et al., 2014) (Feie. 4). Ts'ebetso e kholo ea marang-rang a moputso qalong ea ts'usumetso e sa foleng e fana ka maikutlo a hore monahano oa kelello o ka sebelisoa e le sesebelisoa sa ho ntlafatsa likarolo tsa ts'usumetso ea vagal.

 

Setšoantšo sa 4

Liphetoho ho metabolism ea glucose e bonoang ka positron emission tomography (PET) imaging ka mor'a ho entetsoa ¹⁸FDG (fluorodeoxyglucose), lipakeng tsa liphoofolo tse ts'oaroang ke mosali le mosali. N = 8 minipigs ea Yucatán lihlopheng ka bobeli. VNS (vagus methapo ...

Joalo ka litlhare tse ling tse 'maloa, katleho e fokolang ea VNS ho batho ba batenya e ka hlalosoa ka kutloisiso e sa lekanang ea ketso ea VNS marang-rang a boko a laolang ho ja lijo. Ho fetoleloa hoa mefuta ea liphoofolo ts'ebetsong ea bongaka e ne e le kapele hape ntle le liteko tse mabapi le ts'ebetso e tloaelehileng ea ho susumetsa. Mohlala, joalo ka ha ho boletsoe kaholimo, lithuto tsa pele tsa batho li ile tsa etsoa ka ts'usumetso e le 'ngoe ea setho sa botšehali leha lithuto tsohle tsa liphoofolo li boletse hore sebaka se ka mpeng sa juxta-ka mpeng bakeng sa li-cuffs tse tsosang maikutlo se ne se nepahetse haholo. Ntle le moo, re ntse re hloka lintlha tse qalang tsa ho ntlafatsa litšobotsi ntle le ho emela liphetoho bakeng sa boima ba 'mele. Ho ka nahanoa hore mekhoa ea ho nahana ka bokong hammoho le mofuta oa computational oa VNS (Helmers et al., 2012) e ka ba thuso e kholo mabapi le tlhokahalo ena ea bongaka.

4.2. Boemo ba tsebo ea ho susumetsa ka matla bokong (DBS) le monyetla oa eona oa ho sebetsana le botenya le mathata a ho ja

4.2.1. Kakaretso ka boemo ba bonono ho DBS

4.2.1.1. Lisebelisoa tsa kalafo tsa hona joale tsa DBS

Ho hlohlelletsa bokong bo tebileng (DBS) ke mokhoa o ipapisitseng le li-electrode tse kentsoeng bakeng sa ho phekola mathata a neuromotor joalo ka lefu la Parkinson (PD), le lefu la sethoathoa, ha a ntse a bontša ts'episo ea mathata a kelello joalo ka khatello ea maikutlo e sa thibeleng kalafo (TRD) le mathata a qobelloang a qobelloang ( OCD) (Perlmutter le Mink, 2006).

Subthalamic nucleus (STN) e tloaetse ho lebisoa ho PD, athe anterior nucleus ea thalamus (ANT), subgenual cingulate (Cg25), le nucleus accumbens (Nac) ka ho khetheha li lebisitsoe ho lefu la sethoathoa, TRD le OCD (Feie. 5). Ho kenella ha DBS, bakuli ba 10,000 ba ka bang selemo ka bophara, ha ho bapisoe le ho ata ha lefu la kalafo la PD, lefu la sethoathoa, le mafu a kelello (bona hanehane.net; TRD: Fava, 2003; PD: Tanner et al., 2008; OCD: Denys et al., 2010). Karolo ena e reretsoe ho supa nts'etsopele ea mahlale le bokhoni ba bona ba ho loants'a botenya le mathata a ho ja.

 

Setšoantšo sa 5

Sepheo sa DBT: (A) subthalamic nucleus (pono ea coronal, tshehla, e ngotsoeng "STN"); (B) bokantle ba thalamus (3D e hlahisang, e putsoa ka lefifi, e ngotsoeng "ka ntle"); (C) tlhaho e kenang kantle ea cingate (pono ea maikutlo, sebaka se phahameng ...

4.2.1.2. Morero oa bongaka ba setso ho DBS

Lenaneong la setso le tebileng la 'mele (DBT), ts'ebetso ea ts'ebetso ea ts'ebetso ea boko e fumanoa,' me e ts'oaroe ho mokuli, ea hlahang ka tlhahlobo ea CT, 'me mokhoa oa ho kenya o thehiloe ho latela mekhoa e ngolisitsoeng le kholo ea kelello e tebileng. ka mokhoa o hatisitsoeng (Sierens et al., 2008). Moralo ona o beha lithibelo khetho ea mofufutso, mme ho rala ho kenyeletsa ho kenyeletsa kelello e batsi ke ngaka e buoang. Mokhoa oa sejoale-joale oa DBS o itšetleha ka lirekoto tse sebetsang tsa microelectrode (MER) bakeng sa netefatso li tla ka litšenyehelo tsa linako tse telele tsa ts'ebetso le monyetla o moholo oa mathata (Lyons et al., 2004). Le ha ts'ebeliso ea MER e tloaelehile ho PD, maikutlo mabapi le katleho e fumanehang ha a khonehe bakeng sa likotsi tse ngata tse seng tsa koloi.

4.2.1.3. Mathata a ka bang teng a DBS

Ka mekhoa ea setso le tataiso e tataisoang ke setšoantšo, ho lebisa tlhokomelo ha ho na phetoho ea phetoho ea boko, 'me ho se tsotelle hona ho lebisa kotsing e kholo ea mathata. Le ha phetoho ea boko e ka ba e sa tsotelleng tlas'a maemo a mang (Petersen et al., 2010), lithuto tse ling li bontša hore liphetoho tse ka bang 4 mm li ka etsahala (Miyagi et al., 2007; Khan et al., 2008). Kotsi e mpe ka ho fetesisa ke complication ea cerebrovascular, haholo ha ho sebelisoa li-trajectories tse ngata nakong ea tlhahlobo (Hariz, 2002). Ho feta moo, kotsi ea ho kenella ha lebota la ventricular ke taba ea bohlokoa (Gologorsky et al., 2011), e amanang hantle le lefu la methapo ea kutlo. Leha ho na le se boletsoeng ka holimo, DBS e ntse e na le sekhahla se tlase sa complication ha se bapisoa le opereishene ea bariatric (Gorgulho et al., 2014) le litlhahiso tsa morao-rao tsa DBS li tla ntlafatsa polokeho le ho nepahala ha ts'ebetso ena ea bongaka.

5.1. Mabapi le matšoao a moko a tlhaho?

"Ho bohlokoa haholo ho tseba hore na lefu le na le lefu lefe ho feta hore na motho o na le lefu lefe." Qotsulo ena e tsoang ho Hippocrates e fana ka quintessence ea meriana ea thibelo. Ho joalo, ho bolela esale pele le ho thibela ts'ebetso hantle ke sepheo sa mantlha bophelong ba sechaba. Ka mokhoa o ts'oanang, tlhahlobo e nepahetseng ea lefutso, phallo ea kalafo le kalafo li bohlokoa bakeng sa tloaelo e ntle ea bongaka. Empa tsena tsohle li ka se fihlelloe ntle le tsebo e ntle ea bophelo bo botle ba 'mele le ba kulang (kapa ba kotsing), tse ka fihlelwang ka tlhaloso le netefatso ea matšoao a lumellanang a tlhaho.

Boithuto ba kelello bo hlalositse ka botlalo matšoao a bona hammoho le lisosa tsa tlokotsi ea tikoloho le boits'oaro bo tlase ho ED, ha botenya bo hlalositsoe ka lilense tsa khalemelo e mengata e le lefu le nang le mathata a mangata. Leha ho na le tsebo ena kaofela, li-biomarkers tse nepahetseng kapa litekanyetso tsa bongaka li ntse li haella 'me li-indices tse sa sebetseng (joalo ka BMI) li ntse li sebelisoa lefats'eng lohle ho hlalosa le ho arola bakuli. Empa, joalo ka ha ho hopotsoa ke Denis le Hamilton (2013), Batho ba bangata ba khetholloang e le batenya ho feta (BMI> 30) ba phetse hantle 'meleng' me ha baa lokela ho tšoaroa le ho aroloa ka mafu a kulang. Ho fapana le moo, lithuto tse sa nkuoeng li le kotsing ka mekhoa ea bongaka ea bongaka li ka bonts'a ts'oaetso ea 'nete e nang le matšoao a nepahetseng, joalo ka ha ho hlalositsoe ho TOFI sub-phenotype (ke hore, o otile ka ntle, o mafura-ka-kahare ), ho khetholla batho ba nang le ts'oaetso e eketsehileng ea 'mele ka' mele o tloaelehileng, BMI le selikalikoe sa letheka, empa ka ho ba le mpa le mafura a ectopic hore MRI le MRS phenotyping li ka thusa ho fumana (Thomas et al., 2012). Maemong a neuroimaging, mabaka a ho ba kotsing ea neural a ka thusa ho bolela kotsi ea ho eketsa boima ba 'mele kapa ho ba le monyetla oa ho ba le kamano ea likhang le lijo, joalo ka ha ho hlalositsoe ho Burger le Stice (2014). Bakeng sa mabaka a hlakileng le a moruo, mokhoa ona o ne o ka se sebelisoe ho hlahlojoa ka mokhoa o hlophisehileng, empa o kanna oa fuoe malebela a kotsing e kholo ka lebaka la sebaka se sa lokelang sa liphatsa tsa lefutso kapa tikoloho. Kaha li-biomarkers tse amanang le botenya tse amanang le botenya li fumanoe li amana le tsebo ea methapo ea kutlo (Miller et al., 2015), ho lemoha ha bona ho ka buella ho bokella li-biomarkers tse ling tse sebetsang maemong a bokong mme tsa kenya letsoho ho hlahlobeng mohato ka mohato. Ho supa mabaka a kotsi ea neural ho batho ba kotsing, haholo nakong ea bongoana, ho ka tsamaisa lipuisano tse ling (mohlala, kalafo ea kelello) bakeng sa kalafo ea matšoao a botenya kapa mathata a ho ja. Mohlala, moputso oa sensitivity phenotype e ka laea sepheo sa kalafo ho latela phetoho ea boko ba sepheo (ke hore, litheko tsa meputso e eketsehileng / e fokotsehileng ka lebaka la bofokoli bo tsamaeang le phenotypes, ka ho latellana). Mohlala o mong ke oa bakuli ba hlahisang matšoao a tloaelehileng ho maloetse a fapaneng le ao ho hlokahalang liphuputso tse khethehileng. Malwetse a mang a ka mpeng a tloaetse ho tšoantšoa le mathata a ho ja, a khothalletsang mooki ho nahana ka tlhahlobo e pharalletseng ha a hlahloba mokuli hore o na le bothata ba ho ja (Bern le O'Brien, 2013). Matšoao a macha a amanang le neuropsychiatric a tla thusa ho tsebahatsa lefu mme a tlameha ho eketsoa ka betri ea mekhoa ea liqeto e fumanehang.

Litsela tsa Omics li bua ka sethaleng sa theknoloji e ncha joalo ka liphatsa tsa lefutso, genomics, liprotheine, le metabolomics, li ka fana ka tlhaiso-leseling e felletseng eo moelelo ona o ka lebisang ho hlahisoeng ha li-biomarkers tse ncha bakeng sa ho bolela le ho tsebahatsa (Katsareli le Dedoussis, 2014; Cox et al., 2015; van Dijk et al., 2015). Empa khokahano lipakeng tsa maqhubu a li-omics le a imaging e lokela ho hlahisa tlhaloso ea li-biomarkers tsena, ka ho tsebahatsa li-metabolism tse ikhethang (haholo-holo tse amanang le boko) le lisosa tse amanang le mafu.Hannukainen et al., 2014). Joalokaha ho hlalositsoe karolong ea pele ea tlhahlobo ena, mabaka a ho ba kotsing ea neural a ka hlaha pele ho ho qaleha ha mathata a boima ba 'mele kapa a boima, a totobatsa ho ba teng hoa li-preliminal tse boletsoeng esale pele tse ka bonts'ang kelello ea kelello feela.

Radiomics ke taeo e ncha e lebisang ho ntšitsoeng le ho hlahlobisisoa ha likarolo tse ngata tsa menahano e mengata e tsoetseng pele e nang le litšoantšo tse ngata tse tsoang litšoantšong tsa bongaka tse fumanoeng ka tomografiti ea PET, kapa MRI ea sebopeho le tšebetso (Kumar et al., 2012; Lambin et al., 2012). Radiomics e qalile e ntlafalitsoe hore e khetholle tumor phenotypes (Aert et al., 2014), ho kenyelletsa le maqhubu a bokong (Coquery et al., 2014), empa e ka sebelisoa maemong a mang a bongaka ho fapana le oncology, joalo ka mathata a ho ja le botenya. Joalokaha ho hopotsoe Karolo ea 2.2, motsoako oa mekhoa ea ho nahana o na le monyetla oa lithuto tsa nako e tlang ho hlakisa mekhoa ea methapo ea methapo ea lefu kapa pherekano. Radiomics (kapa li-neuromics ha e sebelisoa monahanong oa bokong) e ka kopanya motho a le mong tlhaiso-leseling e mabapi le ts'ebetso ea boko le ts'ebetso ea kelello (ka fMRI, fNIRS, PET kapa SPECT) (bona Karolo ea 2.1), ho fumaneha ha li-neurotransmitters, baeti kapa li-receptor (ka PET kapa SPECT) (bona Karolo ea 2.2), liphapang tse hlakileng tsa "anatomy anatomy" (ka voxel-based morphometry - VBM) kapa khokahanyo (ka ho nka lifono tsa sensusor tensor - DTI) (Karlsson le al., 2013; Shott et al., 2015), boemo ba ts'oaetso ea boko (ka PET kapa MRI) (Cazettes et al., 2011; Amhaoul et al., 2014), joalo-joalo motheong oa tlhaiso-leseling ena ea li-multimodal, li-neuromics li ka hlahisa 'mapa oa maiketsetso oa maiketsetso ho fana ka temohisiso e kopanyang / e akaretsang mabapi le liphapang tsa boko tse amanang le tahlehelo ea taolo ea lijo kapa ED. Ho feta moo, motsoako ona oa tlhaiso-leseling o ka thusa ho hlakisa ho se lumellane lipakeng tsa lithuto, kapa liphumano tse sa lumellaneng tse kang tse hlakisitsoeng ho lingoliloeng tse amanang le BMI le lets'oao la DA ka mohlala. Ho joalo, liphapang tsena li ka 'na tsa itšetleha ka ho hlalosoa ha lithuto tse shebileng likarolo tse fapaneng tsa lets'oao la dopamine, kapa le ho bapisa lits'ebetso (tse amanang le mesebetsi ea kelello) tse neng li sa bapisoe.

Li-biomarkers tsena li ka sebelisoa ho phenotype bakuli ba nang le lefu la ho ba le botenya le / kapa ED, hammoho le ho theha tlhabollo ea maiketsetso e khethehileng. Li ka sebelisoa hape mananeong a thibelo ho khetholla lithuto tse nang le mabaka a tšoaetsanoang a neural le ho fana ka likhothaletso ho thibela ho qala ha mathata a boitšoaro le a bophelo bo botle. Mabapi le kalafo, li-radiomics / neuromics li ka boela tsa sebelisoa pele ho khethoa sepheo sa boko (s) bakeng sa neuromodulation, hobane tlhahisoleseling e bokelletsoeng ka mokhoa ona e ka thusa ho bolela esale pele litlamorao tsa ts'ebetso ea ts'ebetso ea ts'ebetso ea marangrang ea neural kapa ho feto-fetoha ha methapo ea kutlo.

5.2. Neuroimaging le neuromodulation maemong a meriana e ikhethileng

Mokhoa oa motho ka mong (kapa oa motho ka mong) ke mohlala oa bongaka o hlahisang tlhahiso ea bongaka ea bophelo ka ho sebelisa tlhaiso-leseling, tlhahlobo le tikoloho tse fumanehang, ka liqeto tsa bongaka, litloaelo le / kapa lihlahisoa tse amanang le mokuli ka mong. Joalokaha ho hopotsoe Cortese (2007), meriana e ikhethileng e maemong a bohlokoa phetohong ea tlhokomelo ea bophelo ba naha le ea lefats'e lekholong la 21st, mme polelo ena e bohlokoa haholo bakeng sa mafu a amanang le phepo le mafu, ka lebaka la moroalo oa sechaba le moruo o emeloang ke botenya lefatšeng ka bophara le ho rarahana le ho fapana ha li-phenotypes tsa mononoBlundell le Pholile, 2000; Pajunen et al., 2011). Tsoelo-pele ea matla a ho bala le ho nahana ka bongaka e bula tsela bakeng sa kalafo ea motho ka mong e nahanang ka litšobotsi tsa liphatsa tsa lefutso tsa mokuli, anatomical le 'mele. Ntle le litekanyetso tsena, litekanyo tsa kutloisiso li amana le boitšoaro ba ho ja (bona Gibbons et al., 2014 bakeng sa tlhahlobo) e lokela ho sebelisoa hammoho le monahano oa boko hobane ho hokahanya data ea lits'oants'o le lits'ebetso tsa kelello (kapa mehato ea bioloji) e ka baka matla le tlhahlobo le matla a khethollo.

Hang ha mokuli le lefu li hlahisitsoe hantle, ho hlaha potso ea kalafo e loketseng. Ho joalo, nalane ea motho ka mong (mme haholo, liteko tsa kalafo tse sa atleheng) e bohlokoa haholo. Ho na le lengolo le boima lithutong tsa lefu lena le bosholu ba mekhoa ea kalafo e fumanehang (Feie. 6A). Ho hlakile hore litlhoko tsa mantlha tsa bophelo bo botle (ke ho ja ka tsela e leka-lekaneng, ho ikoetlisa hanyenyane, ho robala hantle le bophelo bo botle ba sechaba, joalo-joalo) ka linako tse ling ho thata ho li fihlella bakeng sa batho ba bangata, 'me ha ho mohla ho lekanang bakeng sa ba ileng ba fetela ka n particular'ane ho phallo ea lefu lena. . Morero oa kalafo ea kalafo ea mofuta oa classical o kenyelletsa ts'ebetso ea kelello le phepo e nepahetseng, kalafo ea meriana le, ho bakuli ba pharmacorefractory, mohato o latelang ke ho buuoa ka bariatric (bakeng sa botenya bo feteletseng) kapa ho kena sepetlele (bakeng sa mathata a ho ja haholo). Maano ohle a neuroimaging le neuromodulation a hlahisitsoeng tlhahlobisong ena a ka kenella morerong oa phekolo o ka etsahalang maemong a fapaneng, ka hona, maemong a fapaneng a lefu, ho tloha ho khethollotsoeng ea mekhoa ea ts'oaetso ea neural ho ea kalafong ea mefuta e matla ea lefu lena (Feie. 6A). Ho feta moo, joalo ka ha ho bonts'itsoe Feie. 6B, mekhoa eohle ea li-neuromodulation e hlahisitsoeng ha e lebise meetso ea marang-rang a tšoanang kapa marang-rang. PFC, e leng eona sepheo sa mantlha sa maano a transcranial neuromodulation (mohlala, TMS le tDCS), e romela likhakanyo tsa inhibitory ho marangrang a orexigenic empa e boetse e na le karolo e kholo ho feto-fetoha ha maemo, boleng ba tlhotlheletso ea lijo, mekhoa ea ho etsa liqeto, jj. shebisa sebaka leha e le sefe sa boko se leka-lekaneng, lithuto tse teng li shebile haholo ho PFC, e leng ventral striatum, empa le cingex cortex, e bohlokoa haholo lits'ebetsong tsa tlhokomelo. Khabareng, maemong a khaello ea phepo e nepahetseng, DBS ka boeona e ka lebisa likarolo tse fapaneng haholo tsa boko, joalo ka moputso kapa libaka tsa homeostatic (Feie. 6B). Ka lebaka leo, khetho ea leano la methapo ea kutlo e ke ke ea lula molemong o le mong (mohlala, teka-tekano lipakeng tsa ho teba ha lefu - mohlala, BMI e phahameng e nang le comorbidities - le tlhaselo ea kalafo), empa litekanyetsong tse ngata tsa tlhahlobo, tseo tse ling tsa tsona e leng e amanang ka kotloloho le phenotype ea mokuli le tse ling tse amanang le tšebelisano lipakeng tsa khetho ea mokuli le ea kalafo (Feie. 6C). Bakeng sa bakuli ba bang ba batenya haholo, ho susumetsa hypothalamus ka DBS ka mohlala ho kanna ha se sebetse kapa ho ba le phello e mpe haeba boemo ba bona bo ka mela ka liphoso tsa potoloho ea moputso oa boko. Ka hona ho na le kotsi e kholo (bonyane ke ho senya nako le chelete, ho mpe ka ho fetesisa ho mpefatsa boemo ba mokuli) ho ho hlahloba methapo ea kutlo ho bakuli pele a tseba hore na ho latela melao efe ea tsamaiso - mme haeba mokuli a hlile a ba le liphoso tsa iatrogenic neurobehaisheral anomalies tse amanang le ts'ebetso ena.

 

Setšoantšo sa 6

Boemeli ba Schematic bo bonts'ang hore na maano a amanang le "neurotherapeutic" a ka kenyelletsoa joang morerong oa kalafo bakeng sa bakuli ba nang le botenya le / kapa mathata a ho ja. (A) Morero o bonolo oa kalafo ea kalafo o arola tse fapaneng ...

Bokamosong, mefuta ea kh'amera e kopaneng ea boko e lokela ho bapala karolo ea bohlokoa ho kopanya, ho aha bocha, ho hlophisa likhomphutha, ho kopanya le ho bolela datha tsa sebopeho le tšebetso ho tsoa mefuteng e fapaneng ea ho nahana, ho tloha ka lithuto ka bomong ho isa bathong bohle ba kliniki. Mefuta e joalo e ka kopanya functionalities bakeng sa ho hlophisa bocha bohokahanyo bo tsoang ho data ea tractographic, lipalo tsa methapo ea methapo ea neural e hokahantsoeng ke paramente ea nnete, kopanyo ea litekanyo tse ikhethileng tse sebelisitsoeng mohopolong oa kelello ea motho le pono ea bona ea mahlale ea 3D ea websaete (mohlala, Brain ea Virtual, Jirsa et al., 2010), e lebisang qetellong molemong oa ts'ebetso ea pele ho ts'ebetso le ho bolela esale pele lefapheng la kalafo ea methapo ea methapo.

5.3. Melao ea boitšoaro e amanang le lisebelisoa tse fumanehang tsa ho hlahloba le ho phekola

Joalokaha ho hlalositsoe pampiring ena, ntoa ea ho loants'a botenya le mathata a ho ja e hlahisitse nts'etsopele ea lintho tse ngata tse sa tšoaneng. Litlhare tsa nalane tse sa hlaselleng (ha li bapisoa le ho buuoa ka kalafo ea bariatric ea mohlala) li ka har'a tlhahlobo ea lipatlisiso le litliniki. Le ha ho le joalo, maikutlo a makatsang a mabapi le mekhoa ena ea lipale a lokela ho bolokoa haholo pele ho ts'ebeliso ea bongaka. Joalokaha ho hopotsoe Karolo ea 3.2, le mekhoa e sa hlaselleng ea "neuromodulation" ha e bapale (Bikson et al., 2013), Mme e ka ba le litlamorao tsa methapo ea kutlo e seng anodyne. Ka lebaka la ho hloleha ha rona hajoale ho utloisisa ho rarahana ha liphetoho tsa boko le litlamorao tsa tsona lits'ebetsong tsa kutloisiso, boits'oaro ba ho ja le ts'ebetso ea 'mele, ho bohlokoa ho hopola aphorism e ngoe ea Hippocrates: "pele u se ke oa ntša kotsi". Lithuto tse ling tsa pele ho mehla ea liphoofolo tse loketseng (mohlala, mefuta ea kolobe, Sauleau et al., 2009a; Clouard et al., 2012; Ochoa et al., 2015) ka hona ke tlamo, hammoho le mananeo a tebileng a ho nahana ka bokong ho senola liketsahalo le nalane e le 'ngoe (Feie. 6D) e ka bopang mananeo a thibelo mme mohlomong a lokafatsa tšebeliso ea kalafo ea methapo ea kutlo.

Ho kengoa ts'ebetsong morerong oa kalafo ea kalafo khahlanong le botenya le mathata a ho ja, maano a neuromodulation a tlameha ho ba le lintlha tse phahameng tsa tlhahlobo ho feta khetho ea mantlha, 'me tlhahlobo ena e tlameha ho kopanya mekhoa e fapaneng e kang ho amoheloa, ho hlaseloa, mofuta oa tekheniki (ke hore, mahlale a theknoloji le litsebo tse hlokahalang), phetisetso, theko, katleho, ho ikamahanya le maemo 'me qetellong, ho lekana le mokuli (Feie. 6C). Melemo ea mantlha ea mekhoa ea neuromodulation ha e bapisoa le ts'ebetso ea bongaka ea bariatric ke: ho hlaseloa habonolo (ka mohlala, DBS ha e hloke tšebetso ka kakaretso) mme e lebisa ho li-comorbidities tse fokolang ho feta ho fetela ka mpeng), phetoho e phahameng (neuromodulation e ka emisoa hang-hang haeba e le bothata - esita le leha ho kenyelletsoa ha li-electrodes tse tebileng tsa boko ho ka etsa hore ho be le liso tse setseng maseleng ohle, ho fetoha le maemo (ho tsepamisa mohopolo le / kapa li-paramente tsa ts'ebetso li ka fetoloa habonolo le kapele). Empa melemo ena ha ea lekana. Lenyehelo / monyetla oa mokhoa o mong le o mong o lokela ho ithutoa ka nepo, le ho sebetsa hantle (bohareng ba ho sebetsa hantle le boemo ba letsete, joalo ka nako, chelete, matla) ea mokhoa o mong oa ho ntlafatsa nako ea bophelo o tlameha ho hlolisana le mekhoa ea khale. Mekhoa e sa hlaselleng le e sa theko e tlase ebile e sa theko e tlase e lokela ho fumana thahasello e itseng hobane e tla lumella ho kenella ho hoholo le ho pharalletseng ho lits'ebeletso tsa bophelo bo botle le lipalo. Re fane ka mohlala oa fNIRS le li-tDCS e le mahlale a sa hlaseleng, a theko e tlase ebile a nkehang, ha re bapisa mekhoa e meng ea ho nahana le ea neuromodulation e theko e boima, e itšetlehileng ka litheko tse phahameng tsa theknoloji, 'me ka lebaka leo ha e fumanehe habonolo. Hape, ho bohlokoa ho hopotsa hore, maemong a ho buuoa ka bariatric, sepheo ha se ho lahleheloa ke boima bo fetang bo teng empa ke ho fokotsa lefu le comorbidities e amanang le botenya. Mekhoa e meng ea kalafo e ka ba e sa sebetseng hantle ho feta ts'ebetso ea bongaka ea bariatric ho theola boima ba 'mele kapele empa e ka ba e sebetsang (kapa e bileng e leng betere) ho ntlafatsa bophelo bo botle ka nako e telele, ho bolelang hore ka linako tse ling litekanyetso tsa katleho tsa liteko tsa kliniki li lokela ho nchafatsoa kapa e matlafalitsoe ka mekhoa e amanang le ntlafatso ea lits'ebetso tsa methapo le boitšoaro ba taolo, ho fapana le ho theola boima ba 'mele (e leng hangata ho etsahalang).

Hape, batho ba bangata ba batenya haholo ba khotsofetse ka bophelo / maemo a bona (ka linako tse ling ka phoso) mme batho ba bang ba mabe haholo ba phetse hantle. Ha e le hantle, liketsahalo tsa morao-rao tsa maemo a bophelo, haholo Amerika Leboea, li lebisitse ho hlaheng ha mekhatlo e amohelang mafura (Kirkland, 2008). Ketsahalo e joalo e hole le ho ba anecdotic kapa nyane ho latela tšusumetso ea kahisano lipolotiking le lits'ebetsong tsa tlhokomelo ea bophelo, hobane e shebile tlhokomeliso ea litokelo tsa botho, boithatelo le khethollo, ke hore, lipotso tse amang batho ba bangata ka kotloloho (USA, likarolo tse peli ho tse tharo tsa baahi ba nonne haholo, karolo ea boraro e nonne). Taba ea mantlha, batho ba bang ba kanna ba bona thibelo le ts'oaetso e thehiloeng ho neuroimaging e le lisebelisoa tse nyenyefatsang, tse hlokang ho tsepamisa maikutlo puisanong ea mahlale ka sepheo sa mantlha sa mokhoa ona, ke hore, ho ntlafatsa bocha ba ts'oaetso le tharollo ea tlhokomelo ea bophelo. Taba ea bobeli, ho sa tsotelehe mokhoa o sebelisitsoeng, ho fetoloa hoa tšebetso ea boko ha se ntho e sa reng letho, hobane ho kenella ho ka fetola mesebetsi ea ho tseba le ho se tsebe letho, boits'oaro le lits'ebetso tsa ho etsa liqeto, tse fapaneng haholo le ho lokisa mesebetsi ea makoloi joalo ka DBS le Lefu la Parkinson. Lekhetho la soda le mehato e meng e khahlisang ea ho loants'a botenya hangata ha e ratehe ebile ea khalemeloa, hobane ka linako tse ling e nkuoa e le bo-ntate le ho hlekefetsa boithaopo (Parmet, 2014). Empa ha re nahaneng ka neuromodulation: Sebakeng sa ho eketsa boleng ba chelete ea lijo tse hlabosehang, sepheo sa neuromodulation ke ho fokotsa boleng ba hedonic boo batho ba bo hlahisang lijong tsena, Ka hare boko ba bona. Re tlameha ho bona esale pele hore theknoloji e ka fetolang kapa ea lokisa lits'ebetso tsa kelello e tla tsitsisa qabang e kholo ho li-biioethics, ka mokhoa o ts'oanang le ho li-cloning, lisele tsa stem, likokoana-hloko tse fetotsoeng liphatsa tsa lefutso, le kalafo ea liphatsa tsa lefutso. Bo-rasaense, litsebi tsa kahisano le litsebi tsa bioethicist ba tlameha ho ikemisetsa ho araba lipotso tsena hobane lisebelisoa tse ncha tse hlahlobang le kalafo li ke ke tsa fumana sebaka sa tsona ntle le ho amoheloa maemong ohle a sechaba, ke hore mokuli ka mong, balaoli ba bongaka, lipolotiki le maikutlo a sechaba. Le ha qeto ea ho fuoa phekolo e itseng e le ea mokuli, liqeto tsa motho ka mong li lula li susumetsoa ke mehopolo e hlahisoang maemong ohle a sechaba, mme balaoli ba tsa bongaka ba tlameha ho amohela litlhare tsohle. Koranteng ea morao tjena, Petersen (2013) e boletse hore nts'etsopele e potlakileng ea mahlale a bophelo le mahlale a amanang (ho kenyeletsoa le neuroimaging) e totobalitse mefokolo ea likhopolo tsa bioethics le mabaka a ho araba lipotso tse hlahang tse tloaelehileng. Sengoli se kopa molemong oa thuto e tloaelehileng ea kahisano e ka ruang molemo ho melao-motheo ea toka ea, molemo 'me nonmaleficence, hammoho le mohopolo oa litokelo tsa botho (Petersen, 2013). Le ha mekhoa e meng e sa hlasimolohe, e ka ba kotsi kelellong le mahlaleng.

5.4. Qetello

Mahlale le mehopolo tse hlahisitsoeng pampiring ena li kopanya polelo le sephetho sa Schmidt le Campbell (2013), ke hore kalafo ea mathata a ho ja le botenya ha e khone ho lula e sena kelello. Mokhoa oa biomarker o kopantseng liphatsa tsa lefutso, neuroimaging, kelello le mehato e meng ea bioloji e tla nolofalletsa nts'etsopele ea kalafo e phethahetseng e nepahetseng (Insel, 2009; Insel et al., 2013), mme o sebeletse thibelo le bongaka ka bomong. Le ha lipatlisiso tsa saense tsa morao-rao le theknoloji e ncha li hlahisa tsela ea lits'ebetso tse ncha tsa bongaka, tsebo ea rona ea methapo ea methapo e laolang mokhoa oa ho ja le ho rata ho hlaha ha lefu e sa ntse e le embryonic. Patlisiso ea mantlha ea mehlala ea liphoofolo le mokhoa o thata oa biology ke tlamo bakeng sa saense e ntle ea phetolelo lefapheng lena.

Sehlooho sena sa tlhahlobo se hlahisitsoe ke NovaBrain International Consortium e thehiloe ka 2012 ka sepheo sa ho khothaletsa lipatlisiso tse ncha ho lekola likamano lipakeng tsa ts'ebetso ea boko le boits'oaro ba ho ja (Mohokahanyi: David Val-Laillet, INRA, France). Litho tse thehileng NovaBrain Consortium e ne e le: Institut National de la Recherche Agronomique (INRA, France), INRA Transfert SA (France), University of Wageningen (Netherlands), Institute of Agriculture and Food Research le Technology (IRTA, Spain), University Sepetlele Bonn (Jeremane), Institut Européen d 'Administration des Affaires (INSEAD, France), University of Surrey (UK), Radboud University Nijmegen, The Netherlands, Noldus Information Technology BV (The Netherlands), University of Queensland (Australia), Oregon Setsi sa Lipatlisiso (USA), Setsi sa Patlisiso sa Biomedical Research (USA), Center National de La Recherche Scientifique (CNRS, France), Old Dominion University (USA), Stichting Dienst Landbouwkundig Onderzoek - Lijo le Patlisiso e Ikhethang, Netherlands, Aix-Marseille University (Fora), i3B Innovations BV (Netherlands), Jožef Stefan Institute (Slovenia), Univesithi ea Bologna (Italy). Litokisetso le likopano tsa pele tsa NovaBrain Consortium li ne li tšehelitsoe ka lichelete ke INRA le Lebatooa la Brittany (Fora) maemong a Lenaneo la Europe la FP7. Dr. Alonso-Alonso ke moamoheli oa lithuso ho tsoa Boston Nutrition and Obesity Research Center (BNORC), 5P30 DK046200, le Nutrition Obesity Research Center e Harvard (NORCH), P30 DK040561. Dr. Eric Stice o ruile molemo ho lithuso tse latelang tsa lipatlisiso tse boletsoeng mona: Roadmap Supplement R1MH64560A; R01 DK080760; le R01 DK092468. Bernd Weber o ne a tšehelitsoe ke Grant ea Heisenberg ea Lekhotla la Patlisiso la Jeremane (DFG; Re 4427 / 3-1). Dr. Esther Aarts o ne a tšehelitsoe ke thuso ea VENI ea The Netherlands Organisation for Scientific Research (NWO) (016.135.023) le mokhatlo oa AXA Research Fund (Ref: 2011). Luke Stoeckel o fumane tšehetso ea lichelete ho tsoa ho Mekhatlo ea Naha ea Bophelo (K23DA032612; R21DA030523), Norman E. Zinberg Fellowship in Addiction Psychiatry at Harvard Medical School, Charles A. King Trust, McGovern Institute Neurotechnology Program, le lichelete tsa poraefete ho Lefapha la Massachusetts General Hospital la Psychiatry. Liphuputso tse ling tse hlahisitsoeng pampiring ena li entsoe ka karolo ea Setsi sa Athinoula A. Martinos sa Biomedical Imaging ho McGovern Institute for Brain Research Setsing sa Theknoloji sa Massachusetts. Bangoli bohle ba re ha ba na khohlano ea lithahasello tse amanang le buka ena e ngotsoeng ka letsoho.

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