Phello ea ho labalabela ho itšunya-tšunya ha mekhoa ea methapo ea neural ea takatso e bakoang ke ho khahloa ke lipapali Inthaneteng (2016)

• Jin-Tao Zhang^{a, b},
• Yuan-Wei Yao^a,
• Marc N. Potenza^{c, d},
• Cui-Cui Xia^e,
• Jing Lan^f,
• Lu Liu^f,
• Ling-Jiao Wang^a,
• Ben Liu^a,
• Shan-Shan Ma^a,
• Xiao-Yi Fang^f,,

 Hlahisa ho feta

http://dx.doi.org/10.1016/j.nicl.2016.09.004

Lintlha-khōlō Tsa

• Lithuto tsa IGD li bonts'itse ts'ebetso e ntlafalitsoeng ea ts'ebeliso ea maikutlo libakeng tse amanang le moputso.

• Lihlooho tsa IGD li ile tsa fokotsa matšoao a IGD ka mor'a CBI.

• Lithuto tsa IGD li bonts'itse ts'ebetso e phahameng ea ts'ireletso kamora CBI.

• Lithuto tsa IGD li bontšitse khokahano e tlase ea insula-lingual gyrus / precuneus kamora CBI.

inahaneloang

Mathata a lipapali tsa inthanete (IGD) a tšoauoa ka maemo a phahameng a takatso ea lipapali tsa inthanete le lintlha tse ling tse amanang le tsona. Kaha lits'oants'o tse amanang le ts'ebeliso ea lithethefatsi li ka baka ts'ebetso e eketsehileng libakeng tsa boko tse amehang ts'ebetsong le ts'ebetsong ea moputso mme li ka baka boits'oaro ba papali kapa tsa baka ho khutlela morao, ho matlafatsa takatso e susumetsoang ke mohopolo e kanna ea ba sepheo se ts'episang bakeng sa mehato ea IGD. Phuputso ena e bapisitse ts'ebetso ea neural pakeng tsa 40 IGD le 19 lihlooho tse laoloang tsa bophelo bo botle (HC) nakong ea ts'ebetso ea papali ea papali ea papali ea inthanete mme ea fumana hore lithuto tsa IGD li bonts'itse ts'ebetso e matla libakeng tse ngata tsa boko, ho kenyeletsoa le dorsal striatum, brainstem, substantia nigra, le anterior cingulate cortex, empa ts'ebetso e tlase ho insula e ka morao. Ntle le moo, lithuto tse mashome a mabeli a metso e meraro tsa IGD (sehlopha sa CBI +) li nkile karolo kalafong ea sehlopha ea boits'oaro ba boits'oaro (CBI), athe lithuto tse setseng tsa 17 IGD (sehlopha sa CBI) ha lia ka tsa kenella, 'me lithuto tsohle tsa IGD li ile tsa hlahlojoa ka nako e ts'oanang likhaohano. Sehlopha sa CBI + se bonts'itse ho fokotseha ha takatso ea IGD le takatso e susumetsoang ke maikutlo, ts'ebetso e ntlafalitsoeng kantle ho kantle le ho fokotsa khokahano ea kahare le gyrus ea puo le precuneus kamora ho amohela CBI. Liphuputso tsena li fana ka maikutlo a hore CBI e sebetsa hantle ho fokotsa takatso le ho tiea ho IGD, mme e ka hlahisa litlamorao ka ho fetola ts'ebetso ea insula le khokahano ea eona le libaka tse amehang ts'ebetsong ea pono le leeme.

Keywords

• Bothata ba ho bapala Inthanete;
• fMRI;
• Cue reactivity;
• Ho lakatsa;
• Ho kenella

1. Selelekela

Mathata a lipapali tsa inthanete (IGD) ke bothata bo tebileng ba bophelo bo botle ba kelello lefats'eng ka bophara, bo hlokang lipatlisiso tse ling, joalo ka mohlala oa ho kenyelletsoa karolong ea 3 ea Diagnostic and Statistical Manual of Mental Disorders, Khatiso ea 5 (DSM-5) e le sehlooho se lokeloang ke lipatlisiso tse ling (Mokhatlo oa Mahlale oa Amerika, 2013 'me Potenza, 2015). Ho lakatsa ke tšobotsi e tsebahalang ea mathata a lemalloang (Courtney et al., 2016 'me Engelmann et al., 2012), Ho kenyeletsoa IGD (Han et al., 2010a 'me Ko et al., 2009a). Joalo ka lithethefatsi tse lemalloang (mohlala, tse susumetsang), papali e ka baka ho lokolloa ha dopamine, haholo litseleng tsa mesocorticolimbic (Han et al., 2007, Kim et al., 2011, Koepp et al., 1998 'me Tian et al., 2014). Ho hlahisa maikutlo mabapi le lipapali tse amanang le papali ho ka eketsa botsitso ba lipapali tse amanang le papali le ho khothaletsa takatso, eo le eona e ka khothalletsang nts'etsopele ea IGD le ho mpefatsa matšoao a eona (Ko et al., 2009a 'me Ko et al., 2013a). Ha ho nahanoa ka litlamorao tse khotsofatsang le tse susumetsang tsa takatso e hlohlellelitsoeng ke takatso, ho nahanoa hore ke sepheo se ts'episang bakeng sa mehato ea IGD (Dong le Potenza, 2014 'me King le Delfabbro, 2014).

Mesebetsi ea cue-reactivity e emela mehato e nepahetseng le e ts'epahalang ea ho lekola takatso ea (Wilson et al., 2004) le ho fana ka leseli la bohlokoa mabapi le ho hlohlelletsa le ho putsa mathata a bakoang ke ho lemalla (Courtney et al., 2016). Liphuputso tse 'maloa li sebelisitse mesebetsi ea cue-reactivity ho lekola litakatso tse hlohlellelitsoeng ke IGD mme li bonts'itse hore litšoantšo tsa papali li kenya libaka tsa boko tse ikarabellang bakeng sa moputso le ts'ebetso ea ts'usumetso, joalo ka striatum le insula, lithutong tsa IGD (IGDs) ha li bapisoa le litaba tsa taolo ea bophelo bo botle. (Li-HCs) (Han et al., 2010a, Ko et al., 2009a 'me Ko et al., 2013b). Liphuputso tsena li tsamaellana haholo le maikutlo a ho itšetleha ka lithethefatsi le papali ea chelete.Engelmann et al., 2012 'me Goudriaan et al., 2013) Le ho fana ka maikutlo a hore ho kanna ha ba le likaroloana tsa neural tse arolelanoeng lipakeng tsa IGD le lithethefatsi tse lingKuss le Griffiths, 2012). Ntle le moo, leha bopaki bo totobetseng lebaleng la IGD bo ntse bo haella, lithuto tsa mathata a ts'ebeliso ea lintho li hokahanya takatso le katleho ea mehato, ka karabelo e le selelekela se matla sa ho oela hape, leha e le lilemo kamora ho phethela mehato (Courtney et al., 2016 'me Killen et al., 1992). Liphuputso tsena li fana ka maikutlo a hore ho matlafatsa takatso e susumetsoang ke maikutlo le ho fetola boikarabello ba li-substrate tsa neural tse ka tlase li ka fihlela litholoana tse ts'episang tsa kalafo.

Mesebetsi ea cue-reactivity e fana ka tsela e tšepahalang ea ho fuputsa mekhoa ea methapo eo mehato e ka sebetsang ka eona; leha ho le joalo, ho latela tsebo ea rona, ke lithuto tse peli feela tse hlahlobileng hore na mehato ea ho kenella e hlahisa litlamorao joang ts'ebetsong ea ts'ebeliso ea kelello ho IGD. Haholo-holo, phuputso e 'ngoe e bontšitse hore kalafo ea libeke tse 6 tse nang le bupropion e fokotse takatso le ts'ebeliso ea matla ho leqele le holimo le kaholimo ho le letšehali ho li-IGD (Han et al., 2010a), athe phuputso e 'ngoe e fumane hore kalafo ea malapa e ekelitse bonngoe ba lelapa le ho fokotsa ts'ebetso ea kelello e susumetsoang ke lipapali lipapaling tse ka pele le tsa occipital (Han et al., 2012). Leha ho le joalo, ha ho na phuputso ea fMRI e seng e batlile hore na boits'oaro bo kopaneng ba boits'oaro bo shebaneng le takatso bo sebetsa joang maemong a neural. Boitšoaro ho fapana le boits'oaro ba litlhare bo ka sehloohong lithutong tsa IGD, leha tšimo ena e ntse e le ncha ebile ho hlokahala bopaki bo bongata (King le Delfabbro, 2014, Winkler et al., 2013, E monyenyane, 2011 'me E monyenyane, 2013). Ntle le moo, boits'oaro ba boits'oaro bo kopanyang maano a mangata (mohlala, ho ba le kelello, tokiso ea kelello) ho ka fokotsa takatso e ntle ho feta maano afe kapa afe feela (Potenza et al., 2011 'me E monyenyane, 2011). Ka lebaka lena, lithuto tse lekolang litlamorao tsa ho kena-kenana le boits'oaro bo kopaneng bo lebisang litakatsong lia hlokahala lebaleng la IGD kaha li ka khothaletsa kutloisiso e ntlafalitsoeng ea metheo ea IGD le ho fana ka temohisiso ka mekhoa e ka bang teng ea ho ntlafatsa katleho ea kalafo.

Thutong ea hajoale, sepheo sa mantlha e ne e le ho lekola litlamorao tsa ho kenella boits'oarong ba boits'oaro (CBI), e ntlafalitsoeng ho fokotsa takatso ea papali, ka takatso e susumetsoang ke takatso le ts'ebeliso ea methapo ea kutlo libakeng tse amehang moputsong le ts'ebetsong ea ts'usumetso. Ntle le moo, re ne re ikemiselitse ho etsa lipatlisiso tsa khokahano e sebetsang ea libaka tse fetotsoeng ke CBI le libaka tse ling ho lekola marang-rang a neural ao CBI e ka sebetsang ho ona. Ho ipapisitse le liphuputso tse fetileng, re ile ra nahana hore, ha ho bapisoa le li-HC, li-IGD li tla bonts'a ts'ebetso e matla ea boko libakeng tse amanang le moputso (mohlala, ventral striatum, dorsal striatum, insula, anterior cingulate cortex, posterior cingulate cortex, substantia nigra) tse amehileng. ka takatso e susumetsoang ke maikutlo (Engelmann et al., 2012, Jasinska et al., 2014 'me Meng et al., 2014). Re boetse ra nahana hore CBI e ka hlahisa litlamorao tsa eona ka ho fokotsa ts'ebetso ea bokooa libakeng tse amehang ho sebetsaneng le moputso le ho ntlafatsa ts'ebetso ea bokooa libakeng tse amehang taolong ea kutloisiso (mohlala, dorsolateral prefrontal cortex) (Konova et al., 2013 'me Yalachkov et al., 2010).

2. Lisebelisoa le mekhoa

2.1. Polelo ea boitšoaro

Phuputso ena e ile ea latela Phatlalatso ea Helsinki. Barupeluoa bohle ba fane ka tumello e ngotsoeng e nang le tsebo mme ba lefelletsoe ka lichelete ka nako ea bona. Leano lena le ile la amoheloa ke Boto ea Tlhahlobo ea Setheo ea Laboraro la Naha la Naha la Cognitive Neuroscience le Learning, Beijing Normal University.

2.2. Barupeluoa

Phuputso ena e ne e le karolo ea boithuto bo boholoanyane ba ho nts'etsapele le ho lekola ts'ebetso e sebetsang ea kelello ea boits'oaro ba IGD. Barupeluoa ba ile ba hiroa ka lipapatso tsa inthanete le ka molomo mme ba khethoa ka lipotso tsa inthanete le tlhaiso ea sebopeho sa motho ka mong. Kakaretso ea li-IGD tsa 44 le li-HC tse 22 li nkile karolo ho fMRI cue-reactivity task ho ipapisitse le boikemisetso ba bona le ho tšoaneleha ha fMRI, mme bankakarolo bohle e ne e le banna ba letsoho le letona. Hobane li-4 IGD le li-HC tse 3 li ile tsa qheleloa ka thoko ka lebaka la motsamao o feteletseng oa hlooho; ka hona, lintlha tse tsoang ho li-40 tsa li-IGD le li-HC tse 19 li kentsoe tlhahlobisong ea hoqetela.

Barupeluoa ba khethiloe ho latela nako ea bona ea beke le beke ea ho bapala Inthaneteng le lintlha tse sekala sa Chen Internet's addiction (CIAS; Chen le al., 2003). CIAS e na le lintho tsa 26 sekaleng sa Likert sa 4 (lintlha: 26-104). Mekhoa ea ho kenyelletsa li-IGD e ne e ts'oana le liphuputsong tse fetileng (Liu et al., 2016, Yao et al., 2015, Zhang et al., 2016a 'me Zhang et al., 2016b1) mme e kenyelelitsoe: 67) lintlha tsa XNUMX kapa tse phahameng ho Chen Internet Addiction Scale (CIAS) (Chen le al., 2003 'me Ko et al., 2009b); 2) ho nka karolo lipapaling tsa inthanete ho feta 14 h ka beke bonyane selemo se le seng; le, 3) ho tlaleha e 'ngoe ea lipapali tsa inthanete tse tummeng ka ho fetesisa e le tšebetso ea bona ea mantlha inthaneteng (Cross Fire: 4, Defense of the Ancient version 1: 11, Defense of the Ancient version 2: 2, League of Legends: 21, World of Ntoa ea ntoa: 2).

Mekhoa ea ho kenyelletsa li-HC e ne e le: 1) lintlha tsa 60 kapa tse tlase ho CIAS; le 2) ho se kopanele le ka mohla kapa ka linako tse ling (<2 h ka beke) papaling ea inthanete. Ko et al. (2009b) fana ka maikutlo a hore li-HC tsa 63 kapa tse tlase li khetholla li-HC. Re sebelisitse moeli oa CIAS o hlokolosi haholoanyane (60 kapa ka tlase) le moeli oa nako bakeng sa papali ea beke le beke ho netefatsa hore li-HC ha li na IGD (Yao et al., 2015, Zhang et al., 2016a 'me Zhang et al., 2016b).

Barupeluoa ba tlalehileng hajoale kapa nalane ea ts'ebeliso ea lintho tse seng molaong le boiphihlelo bofe kapa bofe ba papali ea chelete (ho kenyeletsoa papali ea chelete ea inthaneteng) ba ile ba qheleloa ka thoko ka lebaka la tlolo ea molao ea papali ea chelete Chaena. Mekhoa e meng ea ho qheleloa ka thoko e ile ea lekoa ka tlhahlobo ea semmuso ea motho ka mong, e lumellanang le lithuto tse fetileng tsa IGDYao et al., 2015 'me Zhang et al., 2016a). Mekhoa ea ho khetholla e kenyelelitse: (1) nalane efe kapa efe e itlalehileng ea lefu lefe kapa lefe la kelello kapa methapo; le, (2) ts'ebeliso ea hajoale ea meriana ea psychotropic.

Li-IGD tse mashome a mabeli a metso e meraro (sehlopha sa CBI +) li ne li ikemiselitse ho nka karolo sehlopheng sa libeke tsa 6 tsa CBI mme li ile tsa hlahlojoa pele le ka mor'a CBI. Li-IGD tsa 17 tse setseng (CBI - sehlopha) ha lia ka tsa amohela thuso 'me li ile tsa hlahlojoa habeli, ka likhaohano tse tšoanang lipakeng tsa skena le sehlopha sa CBI +.

2.3. Ho lakatsa boits'oaro ba boits'oaro (CBI)

CBI e kopaneng e ntlafalitsoe motheong oa likhopolo tsa boits'oaro ba boits'oaro (Dong le Potenza, 2014), moralo oa takatso ea maemo a moeli (McCarthy et al., 2010), le phethahatso ea litlhoko tsa kelello bakeng sa ts'ebeliso ea Marang-rang (Suler, 1999). Kaha takatso e ka ama haholo ntlafatso le tlhokomelo ea IGD, mekhoa e thusang bafo ho sebetsana ka katleho le ho fokotsa takatso e ka ntlafatsa litlamorao tsa kalafo le ho thibela ho khutlela morao (Brand et al., 2014 'me Dong le Potenza, 2014). CBI e ne e etsoa beke le beke ka lithuto tsa 8 ho isa ho 9 tsa IGD sehlopheng ka seng. Sehlooho sa thuto ka 'ngoe e ne e le: 1) ho lemoha takatso e ikemetseng; 2) ho amohela le ho leka litumelo tse sa utloahaleng mabapi le takatso; 3) ho fumana takatso le ho imolla maikutlo a mabe a amanang le takatso; 4) koetliso ea ho sebetsana le litakatso le ho fetola phethahatso ea bankakarolo ea litlhoko tsa kelello; 5) taolo ea nako ea ho ithuta le koetliso ea boiphihlelo bakeng sa ho sebetsana le takatso; 6) ho lekola, ho ikoetlisa le ho kenya tšebetsong litsebo. Ho phaella moo, koetliso ea kelello e kenyelelitsoe thutong ka 'ngoe.

2.4. Lipotso

Boemo ba hajoale ba khatello ea maikutlo le khatello ea maikutlo bo ile ba hlahlojoa ho sebelisoa Beck Depression Inventory (Beck et al., 1961) le Lenane la Beck Anxcare Inventory (Beck et al., 1988ka ho latellana. Ts'ebeliso ea sakerete le joala li tlalehiloe, le Teko ea Fagerstrom bakeng sa Bokooa ba Nicotine (Fagerstrom, 1978) le lipotso tsa tšebeliso ea joala ho tsoa ho Teko ea Boitsebiso ba Mathata a Tšebeliso ea Joala (Bush et al., 1998) li ne li sebelisetsoa ho lekola ho itšetleha ha nicotine le ts'ebeliso e mpe ea joala, ka ho latellana.

2.5. Mosebetsi oa FMRI-reactivity

Mosebetsi oa block-design cue-reactivity o ile oa nkuoa lithutong tse fetileng (Han et al., 2010a 'me Han et al., 2010b). Barupeluoa ba ile ba botsoa hore ba shebe mefuta e meraro ea livideo ba be ba lekanye takatso ea bona hang kamora sekhechana se seng le se seng sa video ba sebelisa sekala sa pono ea 7-point. Likoto tsa video tsa papali ea metsotsoana e 30 (G) e ne e le likhetho tse khethiloeng liwebosaeteng tsa semmuso kapa liforamu tsa lipapali ke libapali tse ling tsa 10 tsa lipapali tsa inthanete (libapali tse 2 bakeng sa e 'ngoe le e' ngoe ea tse 5 tse latelang lipapali tse tummeng tsa inthanete: Cross Fire, Defense of the Ancient version 1, Defense of mofuta oa khale oa 2, League of Legends, World of Warcraft) ea sa kang a nka karolo kamora thuto ea fMRI le boithuto. Mofuta oa likoto tsa papali o ne o etselitsoe papali ea mantlha ea li-IGD mme o neoa li-HC tse neng li sa bapale lipapali tsa inthanete.

Likoto tsa video tsa taolo e tšoanang (C) li ile tsa khethoa papaling e sa rateheng ea inthanete e neng e sa tsejoe kapa e bapaloa ke bankakarolo ba bang thutong. Li-clip tsena li ile tsa patoa hape (joalo ka ha ho bonts'itsoe ho Feie. 1) e le hore barupeluoa ba sitoe ho lemoha litaba le lintlha tsa likarolo tsena. Re sebelisitse mekhoa e joalo ho laola litlamorao tse ka bang teng tsa motsamao le 'mala lipapaling tsa papali. Ntle le moo, litšoantšo tse tšeletseng tsa metsotsoana e 30 tse tšoeu tse sefapano se sefubelu / se botšo (Fixation, F) li sebelisitsoe e le motheo. Taelo ea likoto e tsitsitsoe: GFC GCF CFG CGF FCG FGC. Sekhechana se seng le se seng se ne se lateloa ke skrini sa lintlha tsa metsotsoana e 4. Mosebetsi ona o ile oa hlahisoa ke E-Prime 2.0 mme oa nka 620 s. Moralo oa lits'oants'o tsa mosebetsi o bonts'itsoe ho Feie. 1.

Setšoantšo sa 1. 

Papiso ea boqhekanyetsi ea li-block tsa 2 tsa mosebetsi oa ho bapala-papali oa fMRI inthaneteng.

Mokhoa oa ho khetha

2.6. Ho nahana ka ho fumana le ho etsa esale pele

Lintlha li fumanoe ho sebelisoa sesebelisoa sa 3.0 T SIEMENS Trio Setsing sa Imaging bakeng sa Patlisiso ea Boko, Univesithi e Tloaelehileng ea Beijing. Ho ile ha fumanoa tatellano ea gradient-echo echo-planar imaging (EPI) (TR = 2000 ms; TE = 25 ms; flip angle = 90 °; matrix = 64 × 64; resolution = 3 × 3 mm²; lilae = 41). Lilae li ne li sekamisitswe 30 ° ka lehlakoreng le leng ho tloha sefofaneng sa AC-PC ho fumana matšoao a betere libakeng tse ka pele. Sesepa sa sagittal se boima ba T1 se fumanoe bakeng sa litšupiso tsa anatomical le data ea EPI (TR = 2530 ms, TE = 3.39 ms, TI = 1100 ms, FA = 7 °, FOV = 256 × 256 mm², voxel size = 1 × 1 × 1.3 limilimithara³, selae = 144).

Lintlha tsa ho nahana li ile tsa sebetsoa pele ho sebelisoa SPM8 (http://www.fil.ion.ucl.ac.uk/spm/software/spm8). Lintlha tse sebetsang li ile tsa hlophisoa bocha, tsa ngolisoa ka botebo le litšoantšo tsa sebopeho, tsa aroloa bakeng sa ho tloaela sebaka se tloaelehileng sa MNI, 'me tsa ntlafatsoa ka kernel ea 5-mm Gaussian ka bophara bo felletseng ka halofo ea boholo (FWHM). Lihlooho tse tsamaeang ka hlooho> 3 mm kapa 3 ° ha lia kenyelletsoa tlhahlobong e tsoelang pele (4 IGD le 3 HCs ha li a kenyelletsoa)

2.7. Tlhahlobo ea lintlha tsa boits'oaro

Lintlha tsa boits'oaro li ile tsa hlahlojoa ho sebelisoa mofuta oa SPSS 20.0. Liphapang tsa palo ea batho ba mantlha, litsobotsi tsa papali ea inthanete (lintlha tsa CIAS, linako tsa papali ea beke le beke), le takatso e susumetsoang ke maikutlo lipakeng tsa li-IGD le li-HC li ile tsa hlahlojoa ho sebelisoa ikemetseng t-liteko. Liphello tsa CBI litakatsong tse lakalitsoeng ke takatso le papali ea papali ea inthanete li ile tsa hlahlojoa ho sebelisoa litlhahlobo tsa phapang (ANOVAs) ka mehato e phetoang le sehlopha (CBI + le CBI -) e le sesosa se pakeng tsa sehlooho le seboka (liteko tsa mantlha le tsa bobeli) joalo ka kahare ho sehlooho. Boemo ba bohlokoa e ne e le P <0.05.

2.8. Tlhahlobo ea data ea fMRI

Lintlha tsa ho nahana li ile tsa hlahlojoa ho sebelisoa SPM8. Li-regressor tse tharo li ile tsa khetholloa: livideo tsa papali le taolo le likhahla tsa takatso. Li-regressor li hahiloe ka ho kholisa li-ons tsa li-stimuli tsena ka tšebetso ea canonical hemodynamic reaction. Ho ile ha kenyelletsoa mekhahlelo e tšeletseng ea tokiso ea thepa hape e le li-regress tsa ho se thahaselle. Ho ile ha sebelisoa sefahleho se phetheselang se phahameng (128 Hz) ho tlosa leqhubu la maqhubu a tlase. Tlhatlhobong ea litla-morao tsa boemo ba pele, setšoantšo se fapaneng sa lipapali> livideo tsa taolo li hahiloe ho lekola ts'ebeliso ea kelello e hlohlellelitsoeng. Ho bapisa ts'ebetso e susumetsoang ke likhoka lipakeng tsa li-IGD le li-HC maemong a mantlha, litšoantšo tse fapaneng li kentsoe tlhahlobisong ea litlamorao tsa maemo a bobeli ho sebelisoa mehlala e 'meli t-teko. Ho lekola sehlopha (CBI + le CBI -) ka setlhopha se kopaneng (liteko tsa mantlha le tsa bobeli) tšebelisanong le ts'ebeliso ea maikutlo, linepe tse fapaneng li kentsoe tlhahlobisong ea litlamorao tsa maemo a bobeli ho sebelisoa moralo oa maemo. Ho lekola khokahano e sebetsang lipakeng tsa libaka tse amanang le cue reactivity (lipapali> likoto tsa taolo) tse fetohileng lipakeng tsa liboka tse peli, re ile ra etsa tlhahlobo ea psychophysiological interaction (PPI) ho CBI + le li-CBI - lihlopha tse sebelisang moralo o hlophisehileng oa fektheri. Boemong ba sehlopha, tlhahlobo ea boko bo felletseng e ile ea etsoa ho bapisa ts'ebetso ea mantlha ea ts'ebeliso ea kelello lipakeng tsa li-IGD le li-HC mme ea lokisoa ka Gaussian Random Field Theory (GRFT) e nang le voxel-level P <0.001 le boemo ba sehlopha P <0.05 ho fella ka sekhahla sa phoso ea lelapa se bohlale sa 5%. Bakeng sa ho fuputsa, tšebelisano-'moho ea sehlopha ka nako ka ts'ebetso ea ts'ebetso le khokahano e sebetsang e ile ea lokisoa ke tekanyetso ea tokoloho (boemo ba voxel P <0.005 le boemo ba sehlopha P <0.05). Liphetho li bonts'itsoe ho sebelisoa BrainNet Viewer (Xia et al., 2013) le DPABI (http://rfmri.org/dpabi).

3. Liphetho

3.1. Lipalo tsa palo ea batho le palo ea lipapali tsa inthanete li a hlahlojoa

Joalokaha ho bontšitsoe ho Lethathamo 1, Li-IGD le li-HC ha lia ka tsa fapana ka lilemo, thuto, kapa ts'ebeliso ea joala le lisakerete. Tumellanong le litekanyetso tsa kenyelletso, li-IGD li ile tsa fumana lintlha tse holimo ho CIAS mme tsa tlaleha takatso e phahameng bakeng sa lipapali le taolo ea likoto le tokiso ha li bapisoa le li-HC. Ntle le moo, li-IGD li bontšitse maemo a holimo a khatello ea maikutlo le khatello ea maikutlo.

Tafole 1.

Palo ea batho le lipapatso tsa inthanete tsa li-IGD le li-HC maemong a mantlha.

IGDs = Litaba tsa bothata ba ho bapala inthaneteng; Li-HC = lihlooho tse laoloang hantle; SD = ho kheloha ho tloaelehileng; CIAS = Tekanyo ea tlatsetso ea inthanete ea Chen; AUDIT-C = lipotso tsa tšebeliso ea joala ho tsoa Teko ea Boitsebiso ba Mathata a Tšebeliso ea Joala; FTND = Teko ea Fagerstrom ea ho itšetleha ka nicotine; BAI = Beck Matšoenyeho Inventory; BDI = Beck khatello ea maikutlo.

a

Cohen's d boleng ba t-liteko le boleng ba Cramer's V bakeng sa χ² teko.

b

n = 3.

c

n = 30.

d

n = 13.

e

n = 4.

Litlhahlobo tsa lipapali

3.2. Liphello tsa CBI mehatong ea boitšoaro

Li-CBI + le li-CBI - lihlopha li ne li lekana hantle ka lilemo, thuto, matšoenyeho le matšoao a khatello ea maikutlo maemong a mantlha (Lethathamo 2). Li-ANOVA tse nang le mehato e phetoang ho lintlha tsa CIAS, (phello e kholo ea seboka: F_(1,38) = 77.83, P <0.001, e leeme η² = 0.67; phello e kholo ea sehlopha: F_(1,38) = 1.15, P = 0.29, leeme η² = 0.03; sebedisana sebediswa: F_(1,38) = 22.65, P <0.001, e leeme η² = 0.37), linako tsa papali ea beke le beke (phello e kholo ea nako: F_(1,38) = 12.57, P = 0.001, leeme η² = 0.25; phello e kholo ea sehlopha: F_(1,38) = 5.58, P = 0.02, leeme η² = 0.13; sebedisana sebediswa: F_(1,38) = 4.34, P = 0.04, leeme η² = 0.10), le takatso e amanang le papali (phello e kholo ea nako: F_(1,38) = 25.77, P <0.001, e leeme η² = 0.40; phello e kholo ea sehlopha: F_(1,38) = 4.40, P = 0.04, leeme η² = 0.10; sebedisana sebediswa: F_(1,38) = 5.73, P = 0.02, leeme η² = 0.13) e bontšitse liphetho tse tšoanang.

Tafole 2.

Palo ea batho le lipapatso tsa inthanete tsa CBI + le CBI - lihlopha.

CBI + = lihlooho tse nang le bothata ba ho bapala Inthaneteng tse amohetseng takatso ea boits'oaro; CBI - = lihlooho tse nang le bothata ba papali ea inthanete bo sa amohelang takatso ea boits'oaro; SD = ho kheloha ho tloaelehileng; CIAS = Tekanyo ea tlatsetso ea inthanete ea Chen; BAI = Beck Matšoenyeho Inventory; BDI = Beck khatello ea maikutlo.

Litlhahlobo tsa lipapali

Joalokaha ho bontšitsoe ho Lethathamo 2, Papiso e le 'ngoe bakeng sa seboka e bontšitse hore li-CBI + le li-CBI - lihlopha ha lia fapana haholo ho lintlha tsa mantlha tsa CIAS, linako tsa papali ea beke le beke le takatso e amanang le papali, empa sehlopha sa CBI + ha se bapisoa le sehlopha sa CBI se bontšitse phokotso e kholo ho tsena mehato tekong ea bobeli. Ho feta moo, papiso e le 'ngoe ea sehlopha e bontšitse hore sehlopha sa CBI + se bonts'itse liphokotso tse kholo ho lintlha tsa CIAS (t₍₂₂₎ = 9.49, P <0.001, d = 2.34), linako tsa papali ea beke le beke (t₍₂₂₎ = 6.88, P <0.001, d = 1.69), le takatso e amanang le papali (t₍₂₂₎ = 5.21, P <0.001, d = 1.38), empa sehlopha sa CBI se bonts'itse phokotso e kholo ho lintlha tsa CIAS ka boholo bo fokolang ba phellot₍₁₆₎ = 3.16, P <0.001, d = 0.84) tekong ea bobeli ha e bapisoa le motheo (Feie. 3).

3.3. Liphetho tsa fMRI

Pele, re ile ra etsa mehlala e 'meli t-teko lipakeng tsa lihlotšoana tse peli tsa IGD (CBI + le CBI -) qalong. Kaha ha ho khethollo ea bohlokoa lipakeng tsa lihlopha tsa CBI + le tsa CBI, re li kopantse le sehlopha sa IGD bakeng sa litlhahlobo tse latelang tsa mantlha. Ha u bapisa ts'ebetso ea kelello e sebetsanang le papali lipakeng tsa li-IGD le li-HC maemong a mantlha ho sebelisoa mehlala e 'meli t-liteko, li-IGD ha li bapisoa le li-HC li bonts'itse ts'ebetso e kholo libakeng tse ngata tsa boko ho kenyelletsa le dorsal striatum (caudate), brainstem, substantia nigra, anterior cingulate cortex, le posterior cingulate cortex; ts'ebetso e tlase e ne e bonoa karolong e ka morao ea sehlekehleke se nepahetseng ( Lethathamo 3 'me Feie. 2). Re tsoetse pele ho etsa litlhahlobo tsa khokahano lipakeng tsa boleng bo bolelang ba beta ba lihlopha tsena le liphapang tsa takatso ea matla bakeng sa lipapali le lipapali tsa taolo mme ra fumana mokhatlo o motle o motle ho MTG (r = 0.34, P = 0.035).

Tafole 3.

Liphetho tsa tlhahlobo ea fMRI.

P_GRFT <0.05 ea tlhahlobo ea bong bo felletseng.

IGDs = Litaba tsa bothata ba ho bapala inthaneteng; Li-HC = lihlooho tse laoloang hantle; PPI = ts'ebelisano ea psychophysiological; BA = sebaka sa Brodmann; MNI = Setsi sa Mahlale sa Montreal; SN = substantia nigra; PCC = posterior cingulate cortex; ACC = anterior cingulate cortex; IPL = parietal lobule e tlase; MTG = gyrus ea nakoana ea bohareng; STG = gyrus e phahameng ea nakoana; IFG = gyrus e tlase e ka pele; MFG = gyrus e ka pele e bohareng.

a

Cohen's d boleng ba t-liteko le leeme η² boleng ba F liteko.

Litlhahlobo tsa lipapali

Setšoantšo sa 2. 

Papiso ea sehlopha sa boko bo felletseng lipakeng tsa li-IGD le li-HC ts'ebetsong ea ts'ebetso ea kelello e sebetsanang le papali. 'Mapa oa ts'ebetso oa 3D o manehiloe holim' a moea o sebelisang BrainNet Viewer, athe limmapa tsa ts'ebetso tsa 2D li manehiloe setšoantšong sa T1 ho sebelisoa DPABI.

Mokhoa oa ho khetha

Tekong ea litlamorao tsa CBI ts'ebetsong ea ts'ebetsong ea boko, ts'ebelisano e kholo lipakeng tsa sehlopha (CBI + le CBI -) le setulo (liteko tsa mantlha le tsa bobeli) li ile tsa bonoa karolong e ka pele ea insula e nepahetseng. Papiso ea sehlopha se le seng e bontšitse hore sehlopha sa CBI + se bonts'itse ntlafatso e kholo ts'ebetsong ea insula e nepahetseng ea kantle (t₍₂₂₎ = - 2.20, P = 0.04, d = - 0.47), athe bakeng sa sehlopha sa CBI, mokhoa o fapaneng o ile oa bonoa (t₍₁₆₎ = 3.01, P = 0.008, d = 1.08) (Feie. 3). Ntle le moo, re entse tlhahlobo ea likamano ho lekola botsoalle lipakeng tsa liphetoho matleng a takatso ea lipapali tsa lipapali le liphetoho ts'ebetsong ea kantle ho naha sehlopheng sa CBI +; leha ho le joalo, ha ho kamano e bohlokoa e ileng ea bonoa (r = - 0.10, P = 0.66).

Setšoantšo sa 3. 

Panel A: Lintlha tsa CIAS, linako tsa papali ea beke le beke, le takatso ea lipapali tsa lipapali ho pholletsa le lihlopha le mananeo. Panel B: Ts'ebetso e sebetsanang le papali ea inthanete e kenang ka har'a insula e nepahetseng ea kahare ho lihlopha le mananeo. Panel C: Khokahano e sebetsang (lipapali le lipapali tsa taolo) lipakeng tsa insula e ka pele e nepahetseng le gyrus ea leleme le letona (ka ho le letona) le le letona le nepahetseng la gyrus (ka ho le letšehali) ho pholletsa le lihlopha le mananeo. CIAS = Tekanyo ea tlatsetso ea inthanete ea Chen; R = ka ho le letona; L = ka ho le letšehali

Mokhoa oa ho khetha

Re ile ra tsoela pele ho etsa tlhahlobo ea PPI le li-insula tse nepahetseng joalo ka sebaka sa peo (se fumanoeng tlhahlobisong e fetileng) ho lekola khokahano ea eona e sebetsang le libaka tse ling tsa boko tse fumanoeng ho fapana le lipapali tsa papali le taolo. Re fumane tšebelisano e bohlokoa lipakeng tsa sehlopha le setlhopha se amanang le gyrus ea lipuo tse peli le precuneus e nepahetseng. Papiso ea sehlopha se le seng e bontšitse hore sehlopha sa CBI + se bonts'itse khokahano ea mofu ea sehlekehleke se nepahetseng le lihlopha tsena tse peli (t₍₂₂₎ = 3.89, P = 0.001, d = 0.66, le t₍₂₂₎ = 3.05, P = 0.006, d = 0.57), athe sehlopha sa CBI se bontšitse mokhoa o fapaneng (t₍₁₆₎ = - 3.24, P = 0.005, d = - 0.90, le t₍₁₆₎ = - 2.83, P = 0.01, d = - 0.87) (Lethathamo 2 'me Feie. 3).

4. Puisano

Ho latela tsebo ea rona, thuto ena ke litlamorao tsa pele tsa ho lekola tsa CBI papaling e hlahisoang ke ts'ebetso ea kelello ho IGD. Re fumane hore, ha e bapisoa le li-HC, li-IGD li bonts'itse ts'ebetso e phahameng ea papali ea papali ea papali ea lipapali libakeng tse ngata tsa boko ho kenyeletsoa libaka tse amanang le moputso, ntle le ts'ebetso e tlase ea insula e ka morao. Ntle le moo, sehlopha sa CBI + se bonts'itse ts'ebetso e eketsehang haholo setsing se nepahetseng sa kantle ka mora ho qeta CBI, athe sehlopha sa CBI se bontšitse mokhoa o fapaneng. Ntle le moo, sehlopha sa CBI +, ha se bapisoa le sehlopha sa CBI, se bonts'itse khokahano e sebetsang e fokotsehileng lipakeng tsa kantle ea kantle le kantle ho naha ea lingural gyrus le precuneus e nepahetseng. Liphetho tsena li fana ka maikutlo a hore CBI e ka hlahisa litlamorao tsa eona ka ho fetola ts'ebetso ea kantle ea kantle le khokahano ea eona le libaka tsa boko tse neng li ameha pejana ho ts'ebetso ea pono le tlhokomelo ea sebaka.

Tumellanong le khopolo-taba ea rona, li-IGD thutong ena li bontšitse takatso e matla e matlafalitsoeng ea papali le ts'ebetso ea bokooa libakeng tse mahlonoko tse fumanehang mesocorticolimbic (mohlala, anterior cingulate cortex) le nigrostriatal (mohlala, caudate, substantia nigra) litsela ha li bapisoa le li-HCs. Litsela tsa mesocorticolimbic le nigrostriatal ke mehloli e 'meli e meholo ea ho lokolloa ha dopaminergic mme e kenya letsoho ho matlafatseng litlamorao tsa lintlha tse amanang le bokhoba. (Jasinska et al., 2014, Koob le Volkow, 2010 'me Robinson le Berridge, 1993). Ntle le moo, li-IGD li bonts'itse ts'ebetso e kholo ea parietal cortex (mohlala, precuneus) e bileng le tšusumetso ho tlhokomelo ea maikutlo le ho khutlisa mohopolo oa li-episodic (Cavanna le Trimble, 2006). Hammoho, liphetho tsena ka bobeli li pheta liphetho tsa lithuto tse fetileng ho IGD (Han et al., 2010a, Ko et al., 2009a 'me Liu et al., 2016) le lithethefatsi tse ling (Engelmann et al., 2012, Goudriaan et al., 2013 'me Jasinska et al., 2014) Mme o fana ka maikutlo a hore li-IGD li kanna tsa ba le maikutlo a tlase lipapatsong tse amanang le papali tse ka etsang hore ts'ebetso ea methapo e matla e kenelle libakeng tsa boko tse amehang moputsong le tlhokomelong.

E sa tsamaellaneng le mohopolo oa rona oa mantlha, li-IGD li bonts'itse ts'ebeliso ea matla ea sehlahisoa se ka morao se nepahetseng ha se bapisoa le li-HC. Leha ho le joalo, ho sibolloa hona ho tšoana haholo le liphetho tsa lithuto tsa nakong e fetileng tsa IGD tse sebelisang lits'oants'o tsa papali joalo ka lintlha tse amanang le papali le ts'ebeliso e akaretsang ea marang-rang e sa amaneng le papali (mohlala, skrini sa puisano ea inthaneteng) joalo ka taolo ea taolo (Liu et al., 2016). Tlhahiso ena e boetse e kopana le ba tsoang meta-analysis ea ts'ebetso ea boko bo bakoang ke ho nona haholo (Brooks et al., 2013). Ntle le moo, kamano e mpe lipakeng tsa takatso ea hau e itlalehileng le botenya ba cortical ea insula e nepahetseng e tlalehiloe ho batho ba tsubang (Morales et al., 2014). Leha ho le joalo, ho na le bopaki bo bonahalang bo ikhanyetsa bo teng mme bo supa hore ts'ebeliso e bakoang ke cue ka har'a insula e matla ho batho ba lemaletseng ho amana le li-HC (Ko et al., 2009a 'me Luijten et al., 2011). Liphetho tse tsoakaneng li kanna tsa amana le phapang ea mokhoa (mohlala, taolo e fapaneng ea taolo) kapa phapang ea maemo a batho ba ithutoang (mohlala, mabapi le ho batla kalafo). Ntle le moo, joalo ka ha insula e le sebopeho sa mefuta e mengata moo karolo e ka pele e ka amehang haholo ho lemoheng masapo le taolo ea kutloisiso, athe karolo e ka morao e kanna ea kenella haholo ts'ebetsong e kenelletseng ea maikutlo le ho kenyelletsa tlhaiso-leseling ho tsoa lits'ebetsong ka bobeli (Cauda et al., 2011, Paulus le Stewart, 2014 'me Zhang et al., 2016b), Liphapang tsa liphuputso liphuputsong li kanna tsa amana le libaka tsa insula tse amehang. Hypoactivation ea posterior insula e fumanoang thutong ea hajoale e ka bonts'a hyposensitivity ho satiety ka ho shebella feela lipapali tsa lipapali (ho fapana le ho bapala lipapali) ho li-IGD.

Mabapi le litlamorao tsa CBI, sehlopha sa CBI +, ha se bapisoa le sehlopha sa CBI, se bonts'itse ts'ebetso e ntlafalitsoeng ea neural sebakeng se nepahetseng sa ka hare le ho fokotsa khokahano ea insular le gyrus ea lipuo tse peli le precuneus e nepahetseng kamora ho amohela CBI. Kaha mehato ea boits'oaro (mohlala, ho thuisa ka kelello, hape ke karolo ea bohlokoa ea CBI) e fumanoe e eketsa bophahamo ba molumo oa taba ea bohlooho ea insula e nepahetseng ea ka pele (Hölzel et al., 2008) le ho ntlafatsa ts'ebetso ea taolo ea kutloisiso (Tang et al., 2015), ho ka etsahala hore CBI e ka hlahisa litlamorao tsa eona ka ho ama ts'ebetso ea kantle ho naha ho ntlafatsa taolo ea ts'ebeliso ea kelello ka mochini o holimo-limo. Ho feta moo, gyrus ea puo le precuneus li kenya letsoho habohlokoa ho sebetsong sa pono le tlhokomelo (Cavanna le Trimble, 2006 'me Hopfinger et al., 2000) 'Hanlon et al., 2014). Likamano tse fokotsehileng lipakeng tsa kantle ea kantle ea kantle le libaka tsena li kanna tsa amana le ho sibolloa ha masapo le ho fana ka tšusumetso ea pono (Naqvi et al., 2014 'me Paulus le Stewart, 2014), leha monyetla ona o hloka lipatlisiso tse otlolohileng. Liphuputso tsena li fana ka maikutlo a hore CBI e ka hlahisa litlamorao tsa eona ho fokotsa litakatso tse susumetsoang ke papali eseng feela ka ho fetola ho hiroa ha libaka tse ikhethileng tsa boko empa hape le ka ho fokotsa khokahano lipakeng tsa lipotoloho tse khethehileng tsa methapo.

Phuputso ea rona e bonts'itse hore CBI e ile ea fokotsa litakatso tse bakoang ke ho hloaea le ho tiea ha IGD maemong a boitšoaro. Boemong ba methapo ea kutlo, leha ho le joalo, ha ea ka ea tloaela ts'ebetso e sa tloaelehang ea ts'ebeliso ea kelello e fumanoeng ho tsoa papisong ea mantlha, empa e ile ea lebisa tlhokomelo sebakeng se seng (insula ea kantle) e neng e sa bontše liphapang molemong oa mantlha ho li-IGD le li-HC, ho fana ka maikutlo a hore CBI e kanna ea libaka tsa boko tse hlophisitsoeng tse kenyellelitsoeng ts'ebetsong ea ts'ebetso ea kelello e batlang e phahame ho fapana le ho fetola ka kotloloho ba amehang ho matlafatseng. Leha e le likhopolo-taba, liphumano tsa rona li fana ka maikutlo a hore insula (mme mohlomong likarolo tsa eona tse ka pele le tse kamorao) li ka emela sepheo se hlokolosi sa ho kenella, mme ho lebisa likarolo tse fapaneng tsa insula ho ka fihlela litlamorao tse fapaneng tsa kalafo. Leha ho le joalo, ho kanna ha makatsa hore ebe CBI ha e bonts'a litlamorao tse kholo libakeng tse ling tse mahlonoko ka har'a sistimi ea moputso (mohlala, ventral striatum), mme re etsa tlhahiso ea hore mehato ea nako e tlang e kopanyang CBI le lits'ebetso tsa litlhare (Potenza et al., 2011Tsamaiso e seng e hlaselang joalo ka transcranial magnetic stimulation (Hayashi et al., 2013), kapa lits'ebetso tse hlaselang joalo ka ts'usumetso e tebileng ea boko (Luigjes et al., 2012) e sebetsanang ka kotloloho le ventral striatum kapa libaka tse ling tse ka kenang ho cue-reactivity li ka hlahlojoa molemong oa ho fihlela sephetho se nepahetseng.

Lintho tse fumanoeng thutong ea hajoale li tsamaellana haholo le mehlala ea likhopolo (Brand et al., 2014, Dong le Potenza, 2014 'me Ko et al., 2014tse hlahisang karolo ea mantlha ea ho lakatsa papali kapa lipapali tse amanang le tsona ho boloka le ho hlaphoheloa ho tsoa ho IGD, le libaka tsa boko tse amehang ho sebetsaneng le moputso (mohlala, striatum, PCC), taolo ea phethahatso (mohlala, DLPFC), kapa lits'ebetso ka bobeli (mohlala , insula, ACC) e sebelisana 'moho hammoho le cortex ea kutlo e tlatsetsang ho lakatseng papali ea IGD (Brand et al., 2014, Dong le Potenza, 2014 'me Meng et al., 2014), Ho tšoana le se fumanoeng mefuteng e meng ea tahi kapa maemo a amanang le maikutlo (mohlala, botenya) (Brooks et al., 2013, Engelmann et al., 2012, Hanlon et al., 2014 'me Jasinska et al., 2014). Ntle le moo, liphuputso tsena li fana ka maikutlo a hore insula le khokahano ea eona e sebetsang le li-cortices tse bonoang le tsa parietal li kenya letsoho ho bohlokoa takatsong e susumetsoang ke papali mme e kanna ea sebetsa e le sepheo se ka kenang, se lumellanang le likhopolo tsa kalafo tsa hore mehato ea kelello e ka ntlafatsa taolo ea holimo holimo tlase mekhoa e ntlafatsang takatso (Konova et al., 2013 'me Potenza et al., 2011). Ha e le hantle, liphuputso tsa rona li kanna tsa se felle feela ho IGD mme e kanna ea akaretsa mefuta e meng ea boitšoaro bo hlephileng, joalo ka ts'ebeliso e nang le bothata ba litšoantšo tsa bootsoa inthaneteng, hobane li aha li ka arolelana mekhoa e ts'oanang ea boits'oaro le methapo e amanang le takatso e bakoang ke takatso (Brand et al., 2016). Boithuto ba nako e tlang bo ka fuputsa ka kotloloho hore na ho kenella ho fetolang ts'ebetso ea li-insula ho ka fokotsa takatso e bakoang ke takatso ho IGD mme mohlomong le mekhoa e meng ea boitšoaro.

Seo re se fumaneng se lokela ho talingoa ho latela meeli e meng. Taba ea mantlha, li-CBI + le li-CBI - lihlopha ha lia ka tsa abeloa feela empa li ipapisitse le boikemisetso ba li-IGD tsa ho nka karolo ho CBI, mme sehlopha sa CBI ha sea ka sa nka karolo ketsahalong e ngoe. Ka lebaka lena, re ke ke ra qhelela ka thoko lintho tse ka ferekanyang tse kang boikemisetso ba ho amohela ho kenella kapa litlamorao tsa mosebetsi o fapaneng ho pholletsa le lihlopha, 'me liphetho tsa hajoale li lokela ho netefatsoa liphuputsong tse sebelisang liteko tse laoloang ke li-placebo tse sa sebetseng. Taba ea bobeli, ho tloaela lipapali le taolo ea likarolo tse fapaneng ho ka ama tšebetso ea barupeluoa ho mefuta e fapaneng ea tšusumetso, haholo-holo bakeng sa li-IGD. Boithuto ba nako e tlang bo ka arola tšusumetso e amanang le papali ho tloha papaling e le 'ngoe ho ea likarolong tse phahameng le tse tlase tsa takatso ho sebetsana le bothata bona. Taba ea boraro, karohano (4) lipakeng tsa lipapali le taolo ea likotoana e batla e le khuts'oane. Le ha lithuto tse nang le linako tse tšoanang kapa tse khuts'oane li le teng ha ho batloa IGD (Han et al., 2010a, Ko et al., 2009a, Liu et al., 2016 'me Letsatsi le al., 2012), 'Me li-block tsa 6 tse sebelisitsoeng thutong ena li ka nkuoa joalo ka linako tsa metsotsoana e 30, lithuto tsa nako e tlang li khothalletsoa ho sebelisa linako tse nang le nako e telele ho fokotsa tšilafalo e ka bang teng lipakeng tsa maemo. Qetellong, thuto ea hajoale e hlahlobile litlamorao tsa hanghang tsa CBI. Ha ho nahanoa ka sekhahla se phahameng sa ho khutlela morao ho IGD, litlamorao tsa nako e telele tsa mehato li lokela ho hlahlojoa mme li ka fana ka tlhaiso-leseling ea bohlokoa mabapi le ho ntlafatsa katleho ea mehato ea ho kenella (King le Delfabbro, 2014).

Ka kakaretso, phuputso ena e fana ka leseli le lecha mabapi le litlamorao tsa CBI mabapi le takatso e bakoang ke takatso ea IGD. Liphetho tsena li fana ka maikutlo a hore li-IGD li bonts'itse ts'ebetso e matlafatsang ea ho bapala lipapaling libakeng tsa boko tse amehang ts'ebetsong ea moputso le ts'ebetsong ea ts'ebetso e phahameng, mme CBI e ka hlahisa litlamorao ka ho matlafatsa taolo ea kutloisiso le ho fokotsa botsitso ba lintlha tse amanang le papali ka ho fetola ts'ebetso ea kantle ho naha le khokahano ea eona e sebetsang le sebaka sa bokong se amehang ho sebetsong sa pono. Liphuputso tse joalo li ntšetsa pele kutloisiso ea rona ea metheo ea CBI mme li ka thusa ho ntlafatsa mehato ea IGD.

Khohlano ea thahasello

JTZ, YWY, CCX, JL, LL, LJW, BL, SSM, le XYF li phatlalatsa hore ha li na likhohlano tsa phaello.

MNP e rerile le ho eletsa Lundbeck, Ironwood, Shire, INSYS, River Mend Health, Opiant / Lakelight Therapeutics, Jazz Pharmaceuticals le Pfizer; e fumane tšehetso ea lipatlisiso ho tsoa ho Mekhatlo ea Sechaba ea Bophelo, Mohegan Sun Casino, e Setsi sa Naha sa Papali e Ikarabellang, 'me Pfizer meriana; e fana ka tlhokomelo ea bongaka Lefapheng la Connecticut la Bophelo bo Botle ba kelello le Litšebeletso tsa Lithethefatsi Lits'ebeletso Lenaneo la Litšebeletso tsa Ho becha; e phethile litlhahlobo tsa lithuso bakeng sa Mekhatlo ea Naha ea Bophelo le mekhatlo e meng; o fane ka lipuo tsa thuto maemong a maholo, liketsahalo tsa CME le libaka tse ling tsa bongaka kapa tsa mahlale.

Karolo ea mohloli oa lichelete

Phuputso ena e ne e tšehelitsoe ke Motheo oa Naha oa Saense ea Tlhaho ea China (Che. 31170990 le No. 81100992), EOM (Lekala la Thuto Chaena) Morero oa Botho le Saense ea Sechaba (No.15YJA190010), Le Lichelete tsa Motheo tsa Patlisiso bakeng sa Liunivesithi tsa Bohareng tsa China (Che.2015KJJCA13). Ho nka karolo ha MNP ho tšehelitsoe ke Mekhatlo ea Sechaba ea Bophelo (R01 DA035058, P50 DA09241), ea Setsi sa Naha sa Lithethefatsi le Tlhekefetso ea Lithethefatsi, Le Setsi sa Naha sa Papali e Ikarabellang. Maikutlo a ngotsoeng ka letsoho a bonts'a a bangoli eseng hakaalo a mekhatlo ea lichelete.

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