L Maayan,2,4 * C Hoogendoorn,1* V Monate,1 le A. Convit1,3,4
LINKA HO ETSA TLHOTSO TSE FELENG
Botenya: 2011 Phupu; 19 (7): 1382-1387.
1 Lefapha la Psychiatry, Sekolo sa Bongaka sa New York University of Medicine, 550 First Avenue, New York, NY 10016, USA.
2 Lefapha la Psychiki ea Bana, Sekolo sa Bongaka sa New York University, 550 First Avenue, New York, NY 10016, USA.
3 Lefapha la Bongaka, Sekolo sa Bongaka sa New York University of Medicine, 550 First Avenue, New York, NY 10016, USA.
4 Setsi sa Nathan Kline sa Patlisiso ea Psychiatric, 140 Old Orangeburg Rd. Orangeburg NY 10962, USA
Ho batho ba baholo, botenya bo amahantsoe le ho ja lijo tse thibelitsoeng, ho fokotseha molumo oa taba ea bohloeki, le ts'ebetso e tlase litekong tsa kelello. Ha ho tsejoe letho ka likamano tsena lilemong tsa bocha ebile ha ho na lithuto tse hlahlobang mekhoa ea boits'oaro, ea kelello le ea methapo sehlopheng se le seng sa barupeluoa. Phuputso ena e ile ea hlahloba kamano pakeng tsa botenya, ts'ebetso e kholo, disinhibition, le bokong bo boholo ho bacha ba phetseng hantle. Barupeluoa ba kenyellelitse bacha ba 54 le bacha ba 37 ba bacha. Barupeluoa ba ile ba fumana betri e nang le temohisiso, lipotso tsa mekhoa ea ho ja, le monahano oa matla a matla a khoheli (MRI). Liteko tsa Neuropsychological li kenyelletsa mesebetsi e lebisang ts'ebetsong ea lobe ea pele. Mekgwa ya ho ja e ne e ikemiseditse ho sebedisa Potso e Ntle ea Motsoako oa Batho ba bararo (TFEQ), mme li-MRIs tse entsoeng ka sebopeho li entsoe ho 1.5 T Nokia Avanto MRI System (Nokia, Erlangen, Jeremane) ho khetholla boholo ba litaba tsa bohlooho. Bacha ba mahlale a matle le ba batenya haholo ba ne ba tšoaneloa ke lilemo, thuto, bong le boemo ba bophelo ba sechaba. E amanang le lilemong tsa bocha tse tsitsitseng, barupeluoa ba batenya haholo ba ne ba e-na le litekanyetso tse phahameng haholo tsa thibelo holima TFEQ, ts'ebetso e tlase litekong tsa tlhokomeliso, le bonyata bo tlase ba "cortex". Disinhibition e tsamaellana haholo le 'mele oa Mass Mass Index, lintlha tsa Stroop Colour-Word, le bophahamo ba orbitofrontal cortex. Ena ke tlaleho ea pele ea mekhatlo ena ho bacha 'me e supa bohlokoa ba ho utloisisa likamano lipakeng tsa bofokoli ba methapo ea methapo le botenya.
Mantsoe a bohlokoa: Botenya, Bacha, Disinhibition, MRI, Frontal Lobe, Kelello, Orbitofrontal Cortex
Selelekela
Ho ata ha botenya ba bana le ba lilemong tsa bocha tsa US ho eketsehile makhetlo a mararo ho tloha 1970. Leha bopaki ba morao-rao bo bontša hore e kanna eaba botena ba bongoana bo theohile, litheko tse phahameng tsa hona joale li bolela esale pele ka bothata bo tlang ba bophelo bo botle ba sechaba bo amanang le bokuli ba pelo le endocrine (1).
Disinhibition ho ja mokhoa oa ho ja, o khetholloang ka karolo e le mokhoa oa ho ja ka mokhoa o nepahetseng ka ho arabela mekhoa ea tikoloho, ke nako e telele e amanang le botenya ho bacha le ho batho ba baholo (2). Ho sitoa ho laoloa ke taolo ea "caloric intake" e lebisang ho ho nona haholo ho ka etsahala maemong a mangata bokong ho kenyeletsa hypothalamus (3) le, ho latela mosebetsi oa morao-rao, ho cortex ea "4). Letoto la lithuto tse atlehileng tsa batho ba mafolofolo le ba batenya ho feta ba linaha tse lapileng le tse fepehileng li bontšitse libaka tse fapaneng tsa cortical ho kenyeletsoa karolo ea bohloela ea pele, e fanang ka maikutlo a mantlha.5), insula, posterior cingulate, temporal le orbitofrontal cortices (6) ho etsoa ka mokhoa o fapaneng ho latela boemo ba satiety le BMI, ho fana ka maikutlo a ho nka karolo ha bona ho taolo ea tšebeliso ea caloric. Kutloisiso ea OFC joalo ka sebaka sa bohlokoa sa ho thibela boitšoaro e se e le maemong a Phineas Gage, ka bomalimabe 19th mosebeletsi oa seporo oa lekholong la pele la lilemo ea ileng a phonyoha kotsi e neng e ka senya tselana ea hae ea mokokotlo, e ileng ea fella ka liphetoho tsa botho le ho eketseha ha bohlasoa (7).
Liphetho tse fumanehang ka nepo li boetse li hokahane le Body Mass Index (BMI). Phuputsong e nyane ea basali ba nang le lilemo tsa 55 le ho feta, ba neng ba sebelisa li-voxel-based morphometry (VBM), BMI e ile ea hokahanngoa hampe le litheko tsa taba e putsoa libakeng tse 'maloa tse ka pele ho kenyelletsa orbitofrontal, frontal frontal, le gyri ea pele ho lehare ho ea libakeng tse ling ho kenyelletsa "" cerebellum "e nepahetseng hammoho le sebaka se seholo sa kamora letsoho le letona se kenyelletsang parahippocampal, fusiform le lingy gyri (8). Phuputso e kholo ea batho ba baholo ba 1,428 e fumane khokahano e mpe ho banna ba pakeng tsa BMI le taba ea bohlooho ka kakaretso le libaka tse ikhethang tsa boko tse kang li-lobes tsa moea oa nakoana oa moea oa moea oa moea oa nakoana, lobes ea methapo, lobes ea ka pele, li-precuneus, mpa ea bohareng le sethoathoa sa ka pele sa cerebellum (9). Phuputso e 'ngoe ea VBM e bonts'a hore batho ba baholo ba batenya ba na le bothata bo tlase ba bohlooho libakeng tse kang operculum ea pele, gyrus e bohareng ba bohare, gyrus ea morao-rao, hammoho le putamen (10). Sehlopha sa rona se hlalositse ho senyeha hoa litlolo tsa botšehali har'a bacha ba batenya ka ho feteletseng ba nang le lefu la tsoekere la lefu la tsoekere la 2 (T2DM) (26), empa tsebong ea rona ha ho likoli tse joalo tse hlalositsoeng har'a bacha ba batenya ntle le T2DM.
Ntle le liphumants'o tsa sebopeho, litlhahlobo tsa tlhaiso-leseling li bonts'itse hore ts'ebetso e phahameng ea ts'ebetso le tšitiso ea karabelo li ka fokotsoa ho batho ba baholo le ba batenya ba lilemong tsa bocha. Phuputso e 'ngoe e sebelisang positron emission tomography (PET) le liteko tsa tlhahlobo ea kelello li fumane hore batho ba baholo ba nang le botenya ba fokotsehile molemong oa "metabolism" ea "glucose" ea mantlha hammoho le ts'ebetso e fokotsehileng mosebetsing oa Stroop, teko ea tlhokomelo e ikhethileng le ts'ebetso ea botsamaisi (11). Lithuto tse ling tsa ts'ebetso ea botsamaisi le tšitiso ea karabelo ho batho ba baholo li bontšitse mokhatlo o mobe oa mefuta eo ea BMI (12-14). Ho feta moo, bacha ba batenya haholo ba bonts'a ho fokotseha hoa ts'ebetso ea mesebetsi e mengata ho bapisoa le ya data e tloaelehileng (15).
Re khothalelitse hore ho lumellana le liphumano tse fetileng re sebelisa bukana e meraro ea ho ja lijo (TFEQ), bacha ba batenya ho feta tekano ba ka ba le litekanyetso tse phahameng tsa boits'oaro bo tlalehiloeng boitsebisong ba ho ja. Re boetse re khothaletsa hore bacha ba batenya ba ka natefeloa ke litheko tse tlase tsa tlhahlobo ea ts'ebetso le ho fokotsa bots'epehi mehatong ea methapo ea methapo ea letsoho (litaba tsa bohlooho tse amanang le bohlooho ba MRI le lintlha tsa boko ba tikoloho). Ntle le moo, re hlahisitse hore disinhibition ho TFEQ e tla amahanngoa hampe le lintlha tse bonts'ang masimong a amehang hammoho le litekanyo tse thehiloeng ho MRI tsa libaka tsa ts'ebetso ea boko tse kenyelletsang karabo ea taolo le taolo e phahameng.
mekhoa
Barupeluoa le Mekhoa ea Ts'ebetso
Mocha ea mashome a robong a motso o mong (14-21y / o), 37 lean (BMI <25 kg / m2 kapa Waist to Height ratio <0.5) le 54 botenya (BMI≥30 kg / m2 kapa> 95 percentile bakeng sa BMI ea lilemo le bong) ba nkile karolo thutong. Mashome a robeli a motso o mong ho bana (36 lean, 45 obese) o fumane MRI. Bacha ba leshome ha baa ka ba amohela MRI ka mabaka a latelang: ba babeli ha baa ka ba boloka likopano tsa bona, e mong o ne a le moimana mme re ile ra khetha ho etsa liphoso ka lehlakoreng la polokeho, e mong a sitoa ho mamella MRI (claustrophobia), mme ba tšeletseng ba ne ba na le BMI> 50 lik'hilograma / m2 mme e feta boholo ba mmele bo ka amoheloang ke sekenara.
Barupeluoa ba Lean ba ne ba le lilemo tse mpe tsa 17.3 ± lilemo tsa 1.6 le lilemo tse ngata tsa 17.5 tsa 1.6 ± lilemo tsa 2. Lihlopha tsena ka bobeli li ne li boetse li bapisoa le lilemo tsa thuto, bong, le boemo ba moruo 'me kaofela li ne li le maemong a tloaelehileng. Bopaki ba methapo ea kutlo, bongaka (ntle le dyslipidemia, ho hanyetsoa ha insulin ha T2DM, lefu la ovary polycystic, kapa khatello ea mali), kapa mafu a kelello (ho kenyelletsa khatello ea maikutlo le joala kapa tlhekefetso e 'ngoe ea lithethefatsi) bokuli bo qheletsoe ka thoko ho batho ba nkang karolo ho ithuteng. TXNUMXDM le eona e qheletse batho ka thoko ho nka karolo. Barupeluoa le batsoali ba bona ba ile ba fana ka tumello e ngotsoeng ba ngolisitsoe ka nako ea bona le tšitiso. Protocol ena ea ho ithuta e amohetsoe ke Boto ea Sekolo sa Tlhatlhobo ea Setsi sa Bongaka sa New York University.
Barupeluoa bohle ba liphuputso ba bile le sampole ea mali e nkiloeng kamora hora ea 10-hora e potlakileng bakeng sa tlhahlobo ea tsoekere, insulin, lipid, le tšoaetso ea tšoaetso (maemo a phahameng a C-Reactive Protein; hs-CRP). Glucose e lekantsoe ho sebelisoa mokhoa oa glucose oxidase (VITROS 950 AT, Amersham, England), insulin ka chemiluminescence (Advia Centaur, Bayer Corporation), 'me CRP e ile ea lekanngoa ka plasma e sebelisa enzymatic immunoassay (Vitros CRP slide, Ortho Clinical Diagnostics). Boikutlo ba insulin bo ne bo hakanngoa ho sebelisa Homeostasis Model Tlhahlobo ea Insulin Resistance (HOMA-IR).
Litekanyetso
Tlhahlobo ea Neuropsychological
Re entse tlhahlobo e pharalletseng ea ts'ebetso ea methapo ea kutlo, ho kenyeletsoa katleho ea kelello, mohopolo oa morao-rao, mohopolo o sebetsang, tlhokomelo le ts'ebetso ea phethahatso. Re nahanne hore ho tla ba le liphapang mesebetsing e ka pele ea lobe lipakeng tsa bacha ba mahlahahlaha le ba batenya ka ho fetesisa ka hona ra thibela litlhahlobo tsa rona litekong tsa methapo ea kutlo tse bonts'ang bots'epehi ba lobe bo ka pele le mesebetsi e sa sebetseng ea botsamaisi, e leng Controlled Oral Word Association Test (COWAT), likarolo tsa Teko ea ho etsa liteko tsa A & B, Stroop Task, Index / Attribution / Concentration Index ea Tekolo e Pharalletseng ea ho Ithuta le ho Hopola (WRAML) le Working Memory Index ea WRAML. Ntle le WRAML le Stroop, tse fanang ka lintlha tse lokisitsoeng ka lilemo, ho tlalehiloe lintlha tse tala. Liteko tsohle tse tsamaisoang ke lisebelisoa tse tloaelehileng tsa methapo ea kutlo e hlalositsoeng ka botlalo libakeng tse ling (16).
Lipotso tse tharo tsa ho ja tsa bohlokoa (TFEQ)
Litšobotsi tsa boitšoaro ba ho ja li ile tsa hlahlojoa ka ho sebelisa TFEQ. TFEQ ke sesebelisoa sa 51-element, se nang le likarolo tse tharo tsa thibelo e lekanyelitsoeng (ke hore, taolo ea kelello ea boitšoaro ba ho ja; lintho tsa 21), disinhibition (ke hore, monyetla oa ho ja ka lebaka la lintlha tsa maikutlo le litakatso tsa maikutlo; Lintho tsa 16), le tlala (ke hore, monyetla oa ho ja ka lebaka la maikutlo a tlala; Lintho tsa 14). TFEQ e ile ea tsamaisoa hoo e ka bang hora e le 'ngoe ka mor'a hore liithuti li jele lijo tsa mots'eare.
Ho Fumana MRI le Tlhahlobo ea Litšoantšo
Lithuto tsohle li ile tsa ithutoa ho sistimi e tšoanang ea 1.5 T Nokia Avanto MRI, e nang le bophara ba li-inch tsa 65 le tafole e loketseng motho e mong ho fihlela 400 pound. Re fumane litšoantšo tse nang le boima ba "T1" tse nang le boima ba 'mele ba ho hlophisa thepa kapele (MPRAGE; TR 1300 ms; TE 4.38 ms; TI 800 ms; FOV 250 × 250; slice thick 1.2 mm; NEX 1; Flip angle 15 °; matrix size 256 °; 256; mela ea 192 ea coronal).
Tlhahlobo ea WM / GM Volumetric
Sepheo sa boemo ba sepakapaka le likarolo tsa MPRAGE li sebelisitse mekhoa e ikemetseng joalo ka ha ho hlalositsoe ho (17) software ea lipalo-palo tsa 'mapa oa parametric (SPM5). Litšoantšo tsa MPRAGE li ile tsa lokisoa pele bakeng sa ho se ts'oane ho sa ts'oaneng le ho hlophisoa ka nepo ho template e tloaelehileng ea T1 Montreal Neurological Institute. Re sebelisa algorithm ea classical algorithm ho SPM5, re ile ra khetha litšoantšo tse tloaelehileng tsa MPRAGE ka har'a li-grey tsa bona (GM), taba e tšoeu (WM), le li-fluid tsa cerebro-spinal fluid (CSF), e leng limmapa tse emelang monyetla oa voxel e ngoe le e ngoe e khethiloeng e le GM, WM kapa CSF. Likarolo tsena tse arotsoeng li ile tsa hlophisoa ka mokhoa o fapaneng ka morao ho litempele tsa bona tse tloaelehileng. Ntle le ho etsa tlhahlobo eohle ea boko, 'me re fuoe hore nakong ea bohlano ba bongoana myelination e ntse e tsoela pele, re sebelisitse litempele tse peli tse fapaneng ho fumana likarolo tsa khahleho (ROI) ka pele ho lobe. Tsena e ne e le SPM Automatic Anatomic Labeling (AAL) (18) template le mokhoa oa rona oa ho qaqisa mekhoa ea tšohanyetso ea lobe19). Template ea AAL e ne e sebelisetsoa ho fumana setšoantšo sa lobe ka pele, sebaka se kantle le khubung ea sebaka se haufi. Mokhoa oa rona oa parcelation o sebelisitsoe ho fumana sebaka sa pele (pele-lobe minus the supplementary motor region). Re lekantsitse boholo ba likarolo tsa WM, GM, CSF bokong ka bophara le likarolong tse ka pele boemong ba linyeoe ka ho etsa 'mapa oa likarolo ho karolo e' ngoe le e 'ngoe e arotsoeng ebe re potoloha lintlha ka boleng ho lihlopheng ka bomong.
Lipatlisiso tsa Statistical
Re tsamaisitse mehlala e ikemetseng e mehatla e 'meli ho hlahloba liphapang tsa sehlopha lipalo-palo tsa batho, tlhaiso-leseling ea endocrine, tlhaiso-leseling e fumanehang, le meqolo ea boko hammoho le likamano tsa Pearson lipakeng tsa lintlha tsa TFEQ tsa thibelo le BMI, Stroop color word score, le orbitofrontal cortex grey taba ea bophahamo. Lintlha tse neng li fetile mekhoa e fapaneng e fapaneng ea 2 ho tloha molemong oa sehlopha bakeng sa phapano eo ha lia kenyelletsoa. Kaha ho na le phapang ka bomong meqolong ea boko ba tikoloho e amanang le boholo ba hlooho, re ile ra lekanya boholo ba motho ka mong oa intra-cranial vault (ICV) mme ra sebelisa boleng ba ICV ho lokisa bophahamo ba boko ba tikoloho. Ka hona, ho lumella ho bapisoa le lithuto tse ling le ho fa 'mali kutloisiso ea boholo ba libaka tsa boko tse ithutoang, tafole e hlalosang meqolo ea boko ba tikoloho e bonts'a meqolo e tala (e sa salang). Leha ho le joalo, papiso ea lipalo-palo le bohlokoa le boholo ba tšebetso bakeng sa litšoantšo tsohle tse hlahisitsoeng li sebelisitse meqolo e ntlafalitsoeng (e setseng) ea boholo ba boko.
Results
Demographics le Endocrine Datha
Lihlooho tsa lithuto li ne li tsamaisana le lilemo, bong, maemo a sekolo, le boemo ba moruo le maemo a moruo a Hollingshead. Barupeluoa ba Obese ba ne ba hlalositsoe ka bongata ho BMI, joalo ka ha ho lebelletsoe hore ba na le khatello e phahameng ea mali le li-diastolic, li-insulin tse potlakileng le tsoekere (empa kaofela li le maemong a standardoglycemic) hammoho le tlhahlobo ea homeostatic ea ho hanyetsa insulin (HOMA-IR ), triglycerides, density lipoprotein (LDL) cholesterol e tlase, le protheine e phahameng ea kutlo (CP) e sebetsang. Lintho tse neng li buuoa ka bongata le tsona li ne li e-na le litekanyetso tse phahameng haholo tsa lefu la letsoalo le phahameng haholo (HDL). Ka kopo sheba Lethathamo 1.
| Lethathamo 1 Palo ea batho ba bangata le Libopeho tsa Endocrine tsa Lihlopha tsa Bacha ba Lean and Obese |
Lintlha tse tharo tsa ho ja tsa bohlokoa
Bacha ba nang le botenya haholo ba fuoe lintlha tse phahameng haholo ho feta barupeluoa ba its'epileng ka lebaka la ts'oaetso ea lipotso tsa lipotso tse tharo tsa ho ja lijo (6.85 ± 3.55 vs. 3.91 ± 1.96, p <0.000, cohen's d (d) = 1.07), hammoho le tlala (6.60 ± 3.37 vs. 4.68 ± 2.84, p = 0.008, d = 0.81) le tšitiso ea kutlo (9.19 ± 4.30 vs. 6.78 ± 4.11, p = 0.012, d = 0.57). Ka kopo hlokomela hore re phetile litlhahlobo tsena bakeng sa seteishene sa barupeluoa ba 81 ba nang le MRI mme liphetho li ne li sa fetohe (data e sa bontšitsoeng).
Mehato ea Temoho
E amanang le bacha ba lilemong tsa bocha, bacha ba batenya haholo ba bile le ts'ebetso e hlokolosi ho feta ts'ebetsong e 'ngoe le e' ngoe ea pele, ba tsebahala haholo ka Stroop (mokhoa o itseng oa thibelo), le Working Memory Index ea WRAML, leha re ne re laola IQ. Ka kopo sheba Lethathamo 2.
| Lethathamo 2 Phapang e Utloisisang lipakeng tsa Li-group tsa Lean and Obese Adolescent |
Hobane lithuto tsa 10 li sa ka tsa fumana tlhahlobo ea MRI (bakeng sa lintlha ka kopo sheba moamoheli le likarolo tsa ts'ebetso tse kaholimo), re phetetse lihlahlobo tsa rona bakeng sa sehlotshwana sa bacha ba 81 ba neng ba le MRI le tataiso le bohlokoa ba sephetho sa temohisiso se ile sa lula se sa fetohe (data ha e bontšoe).
Pono ea boko
Frontal lobe grey factor volume (ka li-cubic centimeter) e etselitsoe e nyane, leha e se maemong a bohlokoa ba lipalo, hara bacha ba batenya haholo (265.3 ± 29.5 vs. 269.6 ± 26.7; 0.00369 id 0.018312 ± 0.00609 vs..NNXX, p = 0.014076, p = 0.139, p = 0.35, p = 32.3, p = 3.68, p = 33.3, p = 3.99, p = 0.00781, p = 0.024944, p = 0.01227, p = 0.018947. d = 0.005). Ka kopo elelloa hore leha phapang e phethahetseng lipakeng tsa libuka tsena e ne e le nyane, tlhahlobo e ile ea etsoa kamora ho ikatisa ho ICV le boleng ba bohlokoa le boholo ba phello bo bonts'a lipatlisiso tsena. Ntle le moo bakeng sa ho laola bakeng sa litlamorao tsa tsoelo-pele ea botsofaling ho ea pele le likomong tsa mokokotlo re boetse re sebelisitse tlhahlobo ea rona ho fapana bakeng sa lilemo. Re fumane lintlha tse tlase haholo tsa bohlooho tsa bo-ntate ba botenya ho orbitofrontal cortex (0.66 ± XNUMX vs. XNUMX ± XNUMX; residualised XNUMX ± XNUMX vs. −XNUMX ± XNUMX, p = XNUMX, d = XNUMX). Phapang ea sehlopha sa boholo ba OFC e ne e sa fetoloe ka mor'a ho laola khatello ea mali ea systolic kapa HOMA-IR. Likarolo tse ling tsa boko tse hlahlojoang, ho kenyelletsa cortex ea pele le cortex ea ka ntle li ne li sa fapana haholo pakeng tsa bankakarolo ba batenya le ba bobebe. Ho fapana ka lilemo ha hoa ka ha fetola kamano efe kapa efe ea likamano tsena.
litloaelano
Re fumane mekhatlo e bohlokoa lipakeng tsa TFEQ le mehato ea kutlo, BMI le MRI. Haholo-holo, lintlha tsa sesosa sa likokoana-hloko ho TFEQ li bonts'a kamano e kholo le BMI (r (81) = 0.406, p <0.001), lintlha tsa Stroop Colour-Word (r (77) = -0.272, p = 0.017), le OFC grey bophahamo ba modumo (r (71) = -0.273, p = 0.021). Bakeng sa ho utloisisa haholoanyane kamano lipakeng tsa bophahamo ba modumo le thibelo ea meriana ea OFC re ile ra lekola mokhatlo ka thoko bakeng sa lihlopha tsena tse peli. Re fumane hore ho ne ho se na kamano lipakeng tsa likokoana-hloko le molumo oa OFC bakeng sa batho ba batenya haholo (r (40) = -0.028, p = 0.864), athe ho ne ho na le mokhatlo o matla oa sehlopha se omeletseng (r (31) = -0.460, p 0.009). Mekhatlo e pakeng tsa lintlha tsa "disinhibition factor" le "BMI" le "Stroop" e ile ea lula e le bohlokoa bakeng sa seteishene sa batho ba nang le MRI (data e sa bontšoang).
Puisano
Joalokaha ho lebelletsoe, bacha ba batenya haholo ba bile le litekanyetso tse phahameng haholo tsa thibelo ea tlala, tlala le thibelo ea kelello ho TFEQ. Le ha lithibelo tse phahameng tsa boithuto ho bacha ba batenya li ka bonahala li sa sebetse, li lumellana le mohlala o hlalositsoeng oa “thibelo e thata” eo motho ea nang le mokhoa oa ho ja a sa thibeloang le ho ithiba ho itseng a ka bang le lithibelo tsa lijo maemong a mang empa a hoenya ba bang ho feta tekano ho ba bang. (20).
Liphetho tsa rona tsa nalane tse kenang lipakeng tsa bacha ba batenya haholo li lumellana le se fumanoeng lingoliloeng tsa batho ba baholo (8, 9) Ho bonts'a phokotso ea lihlooho tse putsoa. Mohlaleng oa rona oa bocha litheko tsena li ne li tšoailoe haholo bakeng sa orbitofrontal cortex, e leng sebaka sa boko se bohlokoa taolong ea tšusumetso, empa hape se bontšitse mokhoa o fokolang oa 'mele oa pele. Re hakanya hore phokotso e poteletseng haholoanyane e teng likarolong tse ling tsa boko har'a bacha ba batenya haholo e kanna ea fihlella bohlokoa ba lipalo mohlaleng o holisitsoeng.
Habohlokoa bakeng sa tlaleho ena, re fumane sehlopha se na le boima bo feteletseng ba ho se be le lintlha tse phahameng tsa ts'oaetso ho TFEQ feela, empa ts'ebetso e tlase litekong tsa kelello tse bonts'ang mesebetsi ea boko e nahanoang e le karolo ea boits'oaro bo bobebe, leha e laoloa bakeng sa IQ. Ho tsoa libakeng tse ka pele tsa lobe le mesebetsi eo re e lekantseng, re ne re hlile re thahasella ho netefatsa kamano e teng lipakeng tsa disinhibition factor tsa TFEQ le OFC, e leng sebaka sa boko se bohlokoa haholo bakeng sa boits'ireletso ba boitšoaro (taolo ea tšusumetso). Re khethile Stroop hobane ke eona feela e 'ngoe ea mesebetsi ea rona ea pele ea lobe (ho kenyelletsa le tse etsang liteko tsa ts'ebetso) tse lekang bokhoni ba ho thibela likarabo tse ikemetseng. Ona ke papiso e tobileng ea sebopeho (disinhibition factor of TFEQ) le sebaka sa boko (OFC) le se amehang ho sitiseng likarabo tse itlhahelang feela. Thahasello ea rona e ne e le ho netefatsa tšebetso (Stroop vs. mesebetsi e meng e ka pele e sa lekanye karabelo ea karabelo) le boits'oaro ba anatomic (OFC) ba lintho tseo re li fumaneng le kamano ea tsona ho karolo ea disinhibition ea TFEQ.
Re fumane le litumellano tsa bohlokoa lipakeng tsa li-disinhibition factor lintlha le bophahamo ba BMI le OFC. Ha kamano e pakeng tsa disinhibition le bophahamo ba OFC e hlahlojoa ka thoko ho barupeluoa ba morusu le ba batenya, re fumane setsoalle se matla se seng feela ho sehlopha se iketlileng. Ho ka etsahala hore batho ba batenya ho feta tekano ba se ba bile le boemo ba bohlokoa ba ts'oaetso ea disinhibition- (eo re e bonts'itseng e amana le BMI), moo lithibelo tse ling li sa hlahisoeng ka mokhoa o hlakileng ka liphetoho tse ling tsa OFC, empa mohlomong libakeng tse fapaneng tsa boko kapa marang-rang a sa hlahlojoang. e le karolo ea thuto ena. Monyetla o mong oa liphetho tsena tse fapaneng bakeng sa sehlopha ka seng sa boima ba 'mele ke hore ha lihlopha li na le maemo a holimo a tlisoang ke ntho e itseng, li ka ba le monyetla oa ho bua ka litakatso tsa setjhaba ka hona li ka ba monyetleng oa ho tlaleha ka botlalo boemo ba tsona boitshwaro ba bona bo bobe ba ho ja dijong, bo fedisa mokgatlo sehlopheng sena. Qetellong, ho ka etsahala hore thibelo ea mefuta, e leng, phapang ea litheolelo e fokotseha ha phapang e fokotseha joalo ka ha ho etsahala ha re arola sampole ea rona ka bobeli e kanna ea ama sephetho sa rona.
Le ha thuto ea rona e fumana hore disinhibition ho fepa boitšoaro e amana le ho fokotsa ts'ebetso ea motsamaisi le litaba tsa bohlooho bo ka pele, sebopeho sa sebopeho sa rona ha se re lumelle ho sebetsana le bothata ba ho tsamaisoa kapa ho ferekanngoa. Ha ho se ho buuoa, ho na le likhopolo tse ngata tse hlakileng mabapi le tataiso ea mekhatlo ena.
Monyetla o mong ke oa hore bofokoli ba mantlha kapa bo sebetsang ba boko bo lebisa ho setseng ho jeoang le ho fokotsa mesebetsi ea methapo. Mokhoa ona oa ho beha mabaka o ts'ehetsoa karolo e itseng ke mosebetsi o bonts'ang ts'oaetso ea ho ja lijo ho ja pele o eketsa ho ja "21) le botenya (22). E boetse e tsamaisana le mosebetsi oa ho nahana oa batho o bonts'a hore batho ka bomong ba arabelang lijo tse matlafalitsoeng ba bonts'a ts'ebetso e fokolang ea li-circuits tsa moputso oa boko, ba kotsing e kholo ea ho eketsa boima ba nako e tlang (23); mohlomong ba hloka khothatso e kholo (lijo tse ling) ho fumana karabelo e tšoanang.
Tlhaloso e 'ngoe e ka etsahalang ke hore bofokoli ba sebopeho sa boko bo tšoanang le bo bontšitsoeng phuputsong ena bo hlahisoa ke botena le insulin e amanang le eona. Monyetla ona o tšehetsoa ke thuto ea nako e telele ea 24 e bonts'ang ho eketseha ha BMI ho tloha lilemong tse mahareng tse hokahantsoeng le palo e theohileng ea lobe ea nakoana nakong ea bophelo ba morao (24). Ho ts'ehetsa taelo ena ea phello ke mosebetsi oa rona ho batho ba baholo moo re fumanang hore maqhubu a hippocampal a ne a amahanngoa le ho senyeha ha mamello ea glucose (25) hammoho le ho bacha ba nang le T2DM, moo re fumanang ho senyeha le ho fokotsa litšebeliso maemong a lobe e ka pele le botšepehing ba litaba tse tšoeu (26). Re ikemela hore ho hanyetsa insulin ho amanang le botenya bo bonts'itsoeng ke sehlopha sa rona sa bacha ka boima bo feteletseng ho ka kenya letsoho ho fokolleng ts'ebetso ea botsamaisi le bofokoli ba sebopeho. Re hlalositse mofuta o ka etsahalang bakeng sa litlamorao tsena (27) eo ho eona re fang maikutlo a hore ho hanyetsa insulin ho amahanngoa le ho fokotsoa ha methapo ea methapo ea kelello e amanang le ho se sebetse hantle ha endothelial dysfunction. Rea tseba hore nakong ea ts'ebetso ea boko, joalo ka ha ho etsoa mosebetsi oa kelello, ho na le keketseho ea ts'ebetso ea synaptic sebakeng sa boko se amehang. Ka bokong bo tloaelehileng hona ho fella ka vasodilation ea potoloho mme ka hona keketseho ea phallo ea tsoekere sebakeng seo ho ts'ehetsa tlhokahalo e eketsehileng ea kelello (28). Ka hona, vasacacacacacation, e bohlokoa bakeng sa phallo ea mali a khoheli e hlophisitsoeng hantle, ke senotlolo sa ho boloka tikoloho e nepahetseng ea li-neuronal nakong ea ts'ebetso ea boko (29). Patlisiso e bonts'ang ho se sebetse hantle hoa bana ba batenya haholo, le pele ho nts'etsopele ea lefu la tsoekere.30), hape e ts'ehetsa taba ena. Ntle le moo, protheine e nang le tšoaetso ea C-reactive (CRP) e ile ea phahamisoa lilemong tsa bocha ba botona ba botšehali. Boithutong bo hlahlobang lihlahisoa tse kholo tsa batho ba baholo, bafuputsi ba fumane litheko tse matla tsa "cytokines" tse fokolisang batho ba nang le metabolic syndrome (31-34). Mokhoa o ka khonehang bakeng sa litlamorao tsena tsa kelello o fanoa ke datha ea liphoofolo e bonts'ang hore li-cytokin tse ngata tse sa foleng li ka fokotsa ts'ebetso ea nako e telele (LTP), ke ts'ebetso e utloisisitsoeng e le ea bohlokoa ho kopaneng memori ho hippocampus. Li-cytokines tse nang le tšoaetso li ka boela tsa baka ho senyeha ho neurogeneis le neuroplasticity, lits'ebetso tsa bohlokoa ho thehoeng ha mehopolo le ho boloka botšepehi ba sebopeho sa neural.
Monyetla oa boraro ke hore litlamorao tsena ke tsa tlhaho tse ka fokotsang botenya, tse ka amang likarolo tse mpe tsa bokong tse ikarabellang bakeng sa ts'ebetso e kholo le thibelo ea tšebeliso ea caloric, ka hona, ea baka ho se sebetse hantle. Monyetla ona oa boraro o ka thusa ho hlalosa hore na hobaneng ho le thata hakana hore batho ba fokotse boima ba 'mele ha bo se bo fumanehile.
Re khothatsoa ke taba ea hore har'a libaka tse 'maloa tsa boko tseo re li hlahlobileng, OFC, e leng sebaka sa boko se bontšitsoeng e le sa bohlokoa ho thibelo ea boitšoaro lithutong tsa liphoofolo le tsa batho, e bile le phokotso ea boleng bo holimo ho bacha ba batenya. Seo re se fumaneng, ho kenyelletsa ts'ebetso e tlase litekong tsa kelello tse nahanoang hore li hloka tšebetso ea OFC, hammoho le ho fokotsoa ha molumo sebakeng sena se amanang le boits'oaro ba taolo ea boits'oaro mabapi le bohlokoa ba eona bo ka bang boima ba 'mele.
Boithuto bona bo na le meeli e hlakileng. Taba ea mantlha, ke pono e arohaneng e sa re lumelle ho fana ka maikutlo mabapi le lisosa tse hlakileng. Taba ea bobeli, ha re fuoa boholo ba sampole ea rona bo bobebe re lekanyelitse litekanyo tsa rona libakeng tsa boko tseo lithutong tse fetileng ho neng ho fumanoe hore li amahanngoa le botenya kapa lithibela-mafu, kapa tseo re nang le mabaka a utloahalang a ho lumela hore li ka ameha. Ka hona, ho ka etsahala hore ho na le libaka tse ling tsa boko, tseo re sa kang ra li hlahloba, le tsona li ka amehang. Moeli oa boraro oa thuto ea rona ke hore re na le boima ba "barupeluoa ba hajoale 'me re ke ke ra fana ka maikutlo ka nako ea botena; sampole eo re ithutileng eona e kanna ea ba le phapang e kholo nakong ea botenya le ho hanyetsoa ha insulin. Leha ho le joalo, thuto ea rona e na le matla a maholo, ho kenyeletsoa ho bapisa ka hloko lipakeng tsa lihlopha, liteko tse entsoeng tse fapaneng, le mekhoa e se nang leeme ea MRI e sebelisitsoeng tlhahlobisong ea tlhaiso-leseling ea MRI.
Ho utloisisa hantle litaba tse hlalositsoeng mona, mosebetsi oa nako e tlang o lokela ho lekola lithuto nako le nako, o ntse o lekola nts'etsopele ea botenya ka nako eohle ha o ntse o lekanya liphetoho tsa kelello, boits'oaro le neurostructural. Ntle le moo, kutlwisiso ea rona e ka ntlafatsoa ka boithuto bo reretsoeng ho lekola litlamorao tsa kalafo e atlehileng ea botenya (mohlala, ts'ebetso ea bongaka ea bariatric), 'me ka hona re tsebe hore na tse ling tsa bofokoli bona li ka fetoloa. Ntle le moo, mosebetsi oa nakong e tlang o lokela ho lekola lintlha tse ling tse ka amanang le tsona tse kang li-cytokine tsa pro-and-anti-inflammatory le ho sebelisa mekhoa e mahlonoko ea MRI e joalo ka infusion tensor imaging (DTI).
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| Setšoantšo sa 1 Kopano lipakeng tsa 'mele Mass Index le Disinhibition |
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| Setšoantšo sa 2 Mokhatlo lipakeng tsa OFC Gray Matter Volume le Disinhibition ho Adolescents (Lean and Obese) |
Liteboho
Boithuto bona bo tšehelitsoe ke lithuso ho tsoa ho National Institutes of Health R21 DK070985 le RO1 DK083537 mme, e tšehelitsoe ka karolo ke thuso eaX1UL1RR029893 e tsoang Setsing sa Naha sa Mehloli ea Lipatlisiso. Bangoli ba lakatsa ho amohela bana le malapa a nkileng karolo phuputsong ena hammoho le Po Lai Yau le Valentin Polyakov mabapi le ho bokella le ho hlophisa lintlha le thuso ea Allison Larr ha a ntse a hlophisoa.
Mongolo o botlaaseng ba leqephe
Litlhaloso tsa lichelete:
Ha ho na bangoli ba bang ba nang le lithahasello tsa lichelete / tse hanyetsanang tseo ba ka li senolang
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