J Behav Addict. 2019 Dec 1; 8 (4): 692-702. doi: 10.1556 / 2006.8.2019.75.
Dong GH1,2, Wang M1, Zhang J3, Du X4, Potenza MN5,6,7.
inahaneloang
MOSEBETSI LE LINAKO:
Leha lithuto li bontšitse hore batho ba nang le bothata ba lipapali tsa marang-rang (IGD) ba ka ba le mathata a ts'ebetso ea kelello, kamano ea kamano ha e hlake ha ho fanoa ka hore tlhahisoleseling e tsoa lipatlisisong tse mabapi le likarolo.
LITLHAHISO:
Batho ka bomong ba nang le IGD e sebetsang (n = 154) 'me batho bao ha ba sa kopana le litekanyetso (n = 29) kamora selemo sa 1 ba ile ba hlahlojoa ka nako e telele ba sebelisa litšoantšo tse sebetsang tsa matla a khoheli nakong ea ts'ebetso ea mesebetsi ea takatso. Likarabo tse ikhethileng le li-neural correlates li fapane qalong ea thuto le selemong sa 1.
LIKOTSO:
Likarabo tsa litakatso tsa bafo litabeng tsa papali li fokotsehile haholo selemong sa 1 se amanang le ho qala ho ithuta. Ho fokotseha ha likarabo tsa bokooa ka har'a anterior cingulate cortex (ACC) le mokokotlo oa lentiform ho ile ha bonoa selemong sa 1 ha ho bapisoa le ho qala. Ho na le likamano tse ntle tsa bohlokoa lipakeng tsa liphetoho liketsong tsa boko mokokotlong oa lentiform le liphetoho litakatsong tse itlalehang. Tlhatlhobo e matla ea causal modelling e bonts'a khokahano e eketsehileng ea ACC-lentiform selemong sa 1 se amanang le ho qala ho ithuta.
CONCLUSIONS:
Kamora ho hlaphoheloa ho tsoa ho IGD, batho ka bomong ba bonahala ba sa natse litšebeletso tsa papali. Pholoso ena e ka kenyelletsa taolo e nyane e amanang le ACC holim'a sepheo se amanang le lentiform taolong ea litakatso. Boemo ba taolo ea cortical holim'a subcortical susumetsang bo ka lebisoa ho kalafo ea IGD bo lokela ho hlahlojoa ho ea pele.
LITLHAKISO: Bothata ba lipapali tsa inthanete; anterior cingulate cortex; mosebetsi oa ho rata ho tseba; lithuto tse telele
PMID: 31891311
Selelekela
Bothata ba lipapali tsa inthanete (IGD) bo amahantsoe le mathata a tebileng a ts'ebetsong ea sechaba le ea motho, takatso e laoloang hampe (Kim le al., 2018), nako e sebelisitsoeng haholo bakeng sa papali (Dong, Zhou, & Zhao, 2010), katleho e tlase ea thutoHawi, Samaha, & Griffiths, 2018), le mehato e meng e mebe ea bophelo bo botle le ts'ebetso. IGD e nkuoa e le bothata ba ho lemalla lithethefatsi, 'me litekanyetso tsa pele tsa ho hlahloba li se li thehiloe ka karolo e ngoe ho ipapisitsoe le boitsoaro bo bong ba boitšoaro, ke hore, bothata ba papali ea chelete (Dowling, 2014; Petry, Rehbein, Ko, & O'Brien, 2015). Khatiso ea bohlano ea Buka ea ho hlahloba le ea Statistical ea Mathata a kelello (DSM-5) e thathamisitse IGD e le "Boemo ba ho tsoela pele ho ithuta" (Mokhatlo oa Mahlale oa Amerika, 2013). Ka Mots'eanong 2018, boloetse ba lipapali bo ile ba amoheloa bakeng sa ho kenyelletsoa khatisong ea 11 ea International Classization of Diseases (ICD-11; http://www.who.int/features/qa/gaming-disorder/en/), leha ho bile le lipuisano (Aarseth et al., 2017; Karabelo ea Indasteri ea King & Gaming, 2018; Rumpf et al., 2018; Saunders et al., 2017).
Nakong ea mesebetsi e bolotsana ea ho batla litšoantšo, IGD e amanang le lihlooho tsa taolo e bonts'itse tlhokomelo e kholo ho lithahasello tse amanang le papali (Choi et al., 2014), ka libaka tse etelletsoeng peleAhn, Chung, & Kim, 2015). Nakong ea mesebetsi e phahameng, IGD e amanang le lihlooho tsa taolo e bonts'itse taolo e tlase ea taolo (Nuyens et al., 2016), ka dorsolateral prefrontal cortex (DLPFC) le anterior cingulate cortex (ACC) implication (Dong, Wang, Du, & Potenza, 2017, 2018; Dong, Wang, Wang, Du, & Potenza, 2019). Nakong ea liqeto ho IGD (Pawlikowski & Brand, 2011), striatum le ACC li hlahisitsoe (Qi et al., 2016). Lithutong tsena le tse ling, mekhoa e kenyelletsang ea ho bapisa IGD le lihlopha tsa taolo e sebelisitsoe hangata, e fokotsa kutloisiso ea hore na liphetoho tsa tšebetso ea boko li ka fetolang liphetoho tsa IGD joang.
Le ha lithuto tsa likarolo tse bohareng li ka senola likarolo tsa boko tse amanang le IGD, li ke ke tsa khetholla hore na liphetoho tse ka pele ho kholo tsa IGD li ka hlahisoa ke boitšoaro ba papali kapa tsa hlahisoa ke mekhoa e meng. Ha ho le joalo, lithuto tsa nako e telele li ka thusa ho nyenyefatsa bofokoli ba neural ho tsoa litlamorao tsa neural. Ho kenyelletsa moo, mme ho bohlokoa ho tloha ponong ea bongaka, ho utloisisa liphetoho tsa boko tse amanang le ho hlaphoheloa ho bohlokoa, mme sena se ka fihlelleha ka lithuto tse telele.
Litlamong tsa boitšoaro tse joalo ka bothata ba papali ea chelete, batho ba bangata ba fola ka tlhaho (ke hore, ntle le ho kenella ka molao (Slutske, 2006; Slutske, Piasecki, Blaszczynski, le Martin, 2010). Joalo ka ba nang le bothata ba ho becha, batho ba bangata ba IGD ba ka hlaphoheloa ntle le ts'ebetso ea litsebi (Lau, Wu, Gross, Cheng, & Lau, 2017). Likhakanyo tsa phallo e tlohang ho 36.7% ho isa ho 51.4% ho IGD (Chang, Chiu, Lee, Chen, & Miao, 2014; Ko et al., 2014). Leha ho ka hlahisoa mabaka a ka bang teng (a joalo ka ho fokotseha ha takatso ea ho batla pheko ea IGD (Chang et al., 2014; Ko et al., 2014, 2015), ha ho tsejoehale mabapi le mekhoa ea boko e etsoang ka methapo e ntlafatsang ho IGD.
Thutong ea hona joale, re fuputse ka nako e telele sehlopha sa batho ba nang le IGD. Re sebelisitse imagonance imaging imaging (fMRI) e sebetsang ho sekaseka lithuto tsa IGD ho "basement" le hape kamora selemo sa 1, re shebane le batho ba seng ba sa fihle ka mokhoa oa IGD. Ka ho bapisa tlhaiso-leseling ea ho nahana le ho nka litšoantšo ho tsoa ho batho ba nang le ts'ebetso e sebetsanang le IGD, re ne re rerile ho khetholla mabaka a morao-rao le a morao a hlaphoheloang. Mokhoa ona o ka fana ka leseli mabapi le phapang e amanang le boikemisetso le ho hlaphoheloa, mme o ka thusa ho nts'etsopele lipakeng tsa lipuisano tse ikemiselitseng le tse sebetsang.
Ho labalabela mekhoa e amanang le bokhoba ho bontša tšusumetso e matla ea ho etsa boitšoaro bo bobe. Ho lakatsa ho ka khothaletsa tšebeliso ea lithethefatsi (Sayette, 2016; Sinha & Li, 2007), papali ea chelete (Potenza et al., 2003), le lipapali (Dong et al., 2017) bathong ba nang le mathata a amanang. Kahoo, ho lakatsa e bile sepheo sa phekolo ea litlolo (Potenza et al., 2013), joalo ka ha ho lakatsa ho ka lebisa tlhokomelo ho mekhoa e amanang le bokhoba ba tahi (Sayette, 2016; Tiffany, 1990), susumetsa tlhahlobo ea tlhaiso-leseling e nepahetseng (Sayette, Schooler, & Reichle, 2010), le ho sitisa mekhoa ea ho etsa liqeto (Balodis & Potenza, 2015; Berridge le Kringelbach, 2015; Dong & Potenza, 2016). Ntle le moo, ho pepesetsoa mekhoa e amanang le lithethefatsi ho ka lebisa litakatsong tse matla le boits'ebetsong ba lithethefatsi litabeng tsa bokhoba ba lithethefatsi (Gardner, McMillan, Raynor, Woolf, & Knapp, 2011). Bakeng sa mabaka a boletsoeng ka holimo (ho kenyelletsa sehlopha sa IGD e le bothata ba ho lemalla), re tsepamisitse maikutlo litakatsong tsa thuto ea IGD.
Joalo ka lithahasello tsa lithethefatsi bokhobeng ba lithethefatsi, lits'ebetso tsa lipapali tsa papali li ka baka mekhoa e batlang papali ho IGD (Dong & Potenza, 2016). Barupeluoa ba IGD ba bonts'itse likarolo tse phahameng tsa bokong tse kentsoeng ke cue in the ventral le dorsal striatum (Liu et al., 2017), marang-rang a fetotsoeng tšebetso (Ko et al., 2013; Ma et al., 2019)),Kim le al., 2018), ha e bapisoa le lithuto tse laoloang ha e utluoa ho libapali tsa lipapali. Likarabo tsa Neural ho mekhoa ea papali li ka bolela esale pele ho hlaha ha IGD (Dong, Wang, Liu, et al., 2019) hape e sebetsa ka tsela e shebang bong ka mokhoa o hlakileng (Dong, Wang, et al., 2018). Kahoo, re ile ra nahana hore libaka tsa boko tse amehang lithutong tsa pejana tsa takatso (mohlala, striatum) li tla bonts'a ts'ebetso e nyane kamora ho hlaphoheloa ho feta nakong ea IGD e sebetsang ha lihlooho li pepesetsoa lipapaling tsa lipapali.
Ha batho ba pepesetsoa litloaelo tse amanang le papali, libaka tsa bokong tsa cortical (mohlala, DLPFC le ACC) li ka fana ka taolo libakeng tse tlase tsa boko (mohlala, striatum) litlamong tse joalo ka ho tsuba koae (Kober et al., 2010) le mefuta ea taolo ea kelello (Bush, Luu, & Posner, 2000). Mesebetsi ea phethahatso e kenyelletsa lethathamo la lits'ebetso tse hlokahalang bakeng sa taolo ea kelello, ho kenyelletsa khetho le ho lekola boits'oaro ho tsamaisa lipheo tsa khetho e khethiloeng (Hall et al., 2017). Likhakanyo li 'nile tsa amahanngoa le taolo ea thibelo e thibelang kelello (Dalley, Everitt, & Robbins, 2011; Ersche et al., 2012), 'me liphetho tsena li eketsa litlatsetso tsa boitšoaro (Leeman & Potenza, 2012; Yip et al., 2018). Taolo e khethiloeng ea kelello ea ho lakatsa ho lakatsa lintho e ka tlatsetsa boits'oarong bo bobebe (Wang, Wu, Wang, et al., 2017; Wang, Wu, Zhou, le al., 2017). Mefuta ea likhopolo, tse kang I-PACE (Brand et al., 2016) le tse ling (Dong & Potenza, 2014), fana ka maikutlo a hore ho hloleha taolong e phahameng ho ka baka mekhoa e mebe ea papali. Boithuto ba IGD bo fumane hypoacaction ea libaka tsa boko tse kenyelletsang taolo e kholo (Nuyens et al., 2016), ho kenyelletsa DLPFC le dorsal ACC (Dong & Potenza, 2014). Taolo e ntle ea taolo e ka thusa ho laola litakatso ka nepo, sepheo sa ho kenella joalo ka kalafo ea boitsoaro e sebelisitsoeng litlamong le boits'ebetsong ba ts'ebeliso ea inthanete joalo ka papali (Bacha le Brand, 2017). Re ile ra nahana hore ts'ebetso ea libaka tse amehang taolong e kholo (DLPFC le ACC) e tla bonts'a ts'ebetso e kholoanyane kamora ho hlaphoheloa ha ho bapisoa le nakong ea IGD e sebetsang.
Ho latela hore lithuto tsa pele li bonts'itse taolo ea DLPFC mabapi le ts'ebetso ea ts'ebetso ea takatso ea takatso ea cue-elicited (Kober et al., 2010), re boetse re khothaletsa hore liphetoho lipakeng tsa ts'ebetso ea cortical li ka amana le taolo holim'a mesebetsi ea boko libakeng tsa boko tse amanang le moputso joaloka striatum. Meetso e matla ea ho kopanya, mokhoa oa ho sekaseka o ka sebelisoang ho etsa lipatlisiso le ho hlakola litšusumetso tse tataisitsoeng tsa bongata ba li-neuronal (O et al., 2019), e loketse hantle ho lekola hore na libaka tse busang li ka fana ka taolo holim'a lits'ebetso tsa subcortical joang. Mabapi le likarabo tse tlatselletsang, re khothalelitse hore ts'ebetso ea neural e ka amana le litlaleho tse mabapi le takatso ea takatso eo re neng re e lebelletse hore e ka ba matla kamora ho hlaphoheloa ho feta nakong ea IGD e sebetsang.
mekhoa
Ho tloha 2016 ho isa 2017, re ile ra thaotha lithuto tsa 154 IGD bakeng sa fMRI nakong ea takatso ea takatso (e hlalositsoeng ka tlase). Re ile ra ikopanya le bankakarolo kamora selemo se le seng mme ra ba lekola botjha bakeng sa IGD. Lithuto tsa IGD tse mashome a mabeli a metso e robong (basali ba bahlano) ba sa kang ba khotsofatsa litekanyetso tsa IGD ba ile ba hlola ba lumela ho nka karolo nakong ea ho lekola ha ba etsa mosebetsi oa ho lakatsa. Ka mor'a moo re bapisa lintlha tsa bona tsa morao-rao (li-reco tsa IGD) le tlhaiso-leseling ea motheo (IGD e sebetsang) ho khetholla liphapang ka nako (Setšoantšo 1A).
Setšoantšo sa 1. Moralo oa boithuto le mosebetsi o sebelisitsoeng thutong ena. (A) Moralo oa thuto ea ho latela selemo ea 1. (B) Lethathamo la nako la teko e le 'ngoe thutong ena
Qalong ea barupeluoa, barupeluoa ba ne ba khethiloe hore ba na le IGD haeba ba ka fumana lintlha tse 50 kapa ho feta ho Young's Internet Addiction Test (lipotso tsa boits'oaro) mme ba fihletse bonyane litekanyetso tse hlano tsa DSM-5 tsa IGD (tlhahlobo ea tliliniki; bona "Tlatsetso ea Litaba" bakeng sa tlatsetso lintlha; Petry et al., 2014; E monyenyane, 2009). Barupeluoa bohle ba bile le lipuisano tse hlophisitsoeng tsa mafu a kelello (MINI) tse tsamaisoang ke ngaka e nang le boiphihlelo ea kelello (Lecrubier et al., 1997), Le batho ka bomong ba nang le mathata a kelello kapa boits'oaro ba ile ba qheleloa ka thoko (bona "Supplemental Material"). Ntle le moo, ha ho na lithuto tse tlalehileng boiphihlelo ba pejana ka papali ea chelete kapa lithethefatsi tse seng molaong (mohlala, hanf le heroine). Lihlooho tsohle li bapalitsoe Selekane sa Legends (Lipapali tsa LOL le tsa Riot) nako e fetang selemo se le seng. Boemo bona bo ne bo thehiloe ts'ebelisong ea rona ea lipapali tsa papali e le tšusumetso thutong ena le LOL e le papali e tummeng ka ho fetisisa nakong ea thuto. Batho ka bomong ba fumaneng pholoso ea IGD ba ne ba hlokoa ho fumana lintlha tse ka tlase ho 1 Thutong ea Tlatsetso ea Inthanete ea Young le ho fihlella maemo a tlase ho a mahlano a DSM-50 bakeng sa IGD ka nako ea selemo sa 5 (Petry et al., 2014; E monyenyane, 2009; sheba Lethathamo 1 bakeng sa lintlha).
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Tafole 1. Likarolo tsa demographic tsa barupeluoa ba IGD ha IGD e ne e le mafolofolo ebile e hlaphoheloa
| Active | E hlakoloe | t | p | |
|---|---|---|---|---|
| Lilemo (lilemo; bolele ± SD) | 21.46 ± 1.83 | 21.73 ± 1.91 | 0.823 | > .050 |
| Lintlha tsa IAT (bolela ± SD) | 65.21 ± 11.56 | 34.45 ± 4.10 | 18.86 | <.001 |
| Palo ea DSM-5 IGD (bolela ± SD) | 5.76 ± 0.91 | 2.83 ± 0.66 | 15.82 | <.001 |
| Takatso e itlalehang (bolela ± SD) | 53.07 ± 15.47 | 30.34 ± 6.44 | 9.19 | <.001 |
Hlokomela. IAT: Teko ea Tlatsetso ea Inthanete; DSM: Buka ea Boholo ba Tlhahlobo le Palo ea Mathata a Kelello; IGD: Bothata ba lipapali tsa inthanete; SD: ho kheloha ho tloaelehileng.
Mosebetsi o amanang le cue-reacaction o amanang le ketsahalo o sebelisitsoe thutong ena, joalo ka ha ho hlalositsoe pele (Dong et al., 2017; Dong, Wang, et al., 2018). Mosebetsi o na le mefuta e 'meli ea litšoantšo tsa cue: litšoantšo tse amanang le papali tse 30 le litšoantšo tse amanang le 30 tsa mofuta o amanang le ona. Ka har'a mofuta o mong le o mong, halofo ea litšoantšo tse 30 li ne li na le sefahleho le matsoho 'me halofo e ne e na le matsoho feela. Litšoantšo tse amanang le papali li bontša motho ea bapalang papali ea inthanete (LOL) ka har'a komporo. Litšoantšong tse amanang le ho thaepa, motho eo o ntse a ngola sengoloa k'homphieutheng ka pel'a khomphutha. Barupeluoa ba ile ba laeloa ho bontša hore na ho na le sefahleho kapa che ho na le sefahleho ka ho tobetsa konopo ea "1" k'honeng ha sefahleho se le teng 'me se tobetsa "2" ha ho ne ho se na sefahleho.
Figure 1B e bonts'a tatellano ea nako ea teko ea mohlala mosebetsing. Taba ea mantlha, ho ile ha hlahisoa sefapano se sa fetoheng sa 500 ms, se lateloa ke setšoantšo sa cue joalo ka ha ho hlalositsoe kaholimo. Litšoantšo li hlahisitsoe ka tatellano ho qoba litlamorao tsa tatellano. Setšoantšo ka seng se hlahisitsoe ho fihla ho 3,000 ms, ka nako eo barupeluoa ba hlokang ho araba. Skrine e ile ea fetoha e ntšo kamora ho tobetsa konopo 'me ea nka 3,000 (nako ea karabelo) ms. Joale, mohatong oa ho lekola litakatso, bankakarolo ba ile ba kopuoa ho lekola boemo ba takatso ea bona ea tšusumetso e tsamaellanang le sekala sa lintlha tse 5, ho tloha 1 (ha ho na litakatso) ho 5 (takatso e phahameng haholo). Sethala sena se bile ho fihlela ho 3,000 ms mme sa emisoa ke konopo ea konopo. Qetellong, skrine e se nang letho ea 1,500-3,500 ms e ile ea hlahisoa lipakeng tsa nyeoe ka 'ngoe. Mosebetsi oohle o ne o na le liteko tsa 60 mme o nkile hoo e ka bang 9 min. Mosebetsi o ile oa hlahisoa mme lintlha tsa boits'oaro tsa bokelloa ka software ea E-prime (Psychology Software Tools, Inc., Sharpsburg, PA, USA). Barupeluoa bohle ba ile ba botsoa ho tlatsa lipotso tsa lipotso tsa papali ea lintho tse 10, ka lintlha tse ngata ho tloha 1 ho isa 10, ho lekola takatso e amanang le papali pele ho fMRI (Cox, Tiffany, le Christen, 2001).
Ho etsa tlhaiso-leseling ea fMRI ho etsoa pele ho sebelisoa SPM12 (http://www.fil.ion.ucl.ac.uk/spm) le Neuroelf (http://neuroelf.net), joalo ka ha ho hlalositsoe pele (Dong et al., 2017; Dong, Wang, et al., 2018). Litšoantšo li ne li lekantsoe nako, li ile tsa hlophisoa bocha, 'me tsa abeloa moqolo oa pele, ka meqolo e ngolisitsoeng ea T1 e sebelisitsoeng ho lokisa motsamao oa hlooho. Litšoantšo li ile tsa hlophisoa hore li be sebakeng sa MNI 'me tsa ntlafatsoa ka sebaka se sebelisa bophara ba 6-mm e nang le halofo e phahameng ea kernel ea Gaussian. Ha ho na lithuto tse ileng tsa tlosoa tlhahlobisong ka lebaka la motsamao oa hlooho (mekhoa ea ho qheleloa ka thoko e ne e le 2 mm ka motsamao o lebisang kapa 2 ° ka motsamao o potolohang). Moetso o akaretsang oa linear (GLM) o sebelisitsoe ho khetholla ts'ebetso ea BOLD mabapi le mesebetsi ea boko. Mefuta e fapaneng ea liteko (tse amanang le papali, tse amanang le ho thaepa, tse fosahetseng, kapa tse hlolohetsoeng) li ile tsa kholisoa ka thoko ka tšebetso ea kananoli ea hemodynamic ho etsa li-regressor tsa mosebetsi. Nako ea teko ka 'ngoe e ne e le 4,000 ms. Li-GLM li kenyellelitse polelo e sa fetoheng bakeng sa ho matha. Ho ile ha kenyelletsoa mekhahlelo e tšeletseng ea motsamao oa hlooho e tsoang sethaleng sa tokiso hape le nalane ea lipapali (lilemo tse itlalehileng tsa papali) li kentsoe ho sebetsana le pherekano ena. Mokhoa oa GLM o sebelisitsoe ho khetholla li-voxel tse kentsoeng haholo ketsahalong ka 'ngoe nakong ea "karabelo".
Litlhahlobo tsa boemo ba bobeli li entsoe ka tsela e latelang. Taba ea pele, ho ile ha etsoa tlhahlobo ea voxel e bohlale e pheta-phetoang bokong bohle ho fuputsa tšebetso e amanang le [(pholisoeKhopolo-taba e amanang le lipapali - hlaphoheloaTlhotlheletso e amanang le mofuta- - (mafolofolotšusumetso e amanang le papali - e sebetsangTlhotlheletso e amanang le mofuta)]. Phoso e bohlale ea lelapa e atile (p <.001) li ne li ikemiselitse ho sebelisa 3dClustSim (mofuta o ntlafalitsoeng oa Alphasim), 'me papiso eohle e ile ea lokisoa ho sebelisoa 3dClustSim (https://afni.nimh.nih.gov/pub/dist/doc/program_help/3dClustSim.html), p <.001, e mehatla e 'meli, bonyane ba li-voxel tse 40.
Teko ena e amohetsoe ke Komiti ea Patlisiso ea Botho ea Univesithi e Tloaelehileng ea Zhejiang mme e lumellana le The Code of Ethics of the World Medical Association (Phatlalatso ea Helsinki). Barupeluoa bohle ba ile ba fana ka tumello e ngotsoeng e nang le tsebo pele ba teko
Results
Leano le fumaneng lithuto tsa IGD tse bonts'itsoeng li bonts'itse ts'ebetso ea ts'ebetso ea ts'ebetso ea boko ho linaha tse peli tsa machaba a kopaneng le "AF", "" MFG " 2A; Tafole 2). Mehato ea boima ba Beta e bontšitse hore liphapang tsena li ne li amana le karabelo tse fokotsehileng tsa boko kamora ho hlaphoheloa (Setšoantšo 2B, C).
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Tafole 2. Ho bapisa likarabo tsa boko ba lithuto le IGD e sebetsang le ho hlaphoheloa IGD
| Palo ea sehlopheng | x, y, za | Bophahamo ba matla | Saese ea sehlophengb | sebakengc | Sebaka sa Brodmann |
|---|---|---|---|---|---|
| 1 | 6, 36, le3 | -5.240 | 85 | Leqeleng le ka letsohong le letšehali | 12 |
| 2 | 0, 39, 6 | -4.577 | 54 | Ka lehlakoreng le letona la cingrate | 32 |
| 3 | 18, −21, -18 | -5.183 | 63 | Gyrus ea letsoho le letšehali | 46 |
| 4 | 27, 36, 24 | -5.164 | 41 | Gyrus e bohareng bo ka pele | 46 |
| 5 | 21, 3, 21 | -5.821 | 107 | Lentiform ea leqele | |
| 6 | 30, -12, 27 | -4.740 | 44 | Ho nepahala haese | |
| 7 | 18, 36, 24 | -6.075 | 436 | Cuneus ea leqeleng | 18 |
| 8 | 60, 3, 3 | -6.106 | 83 | Lefts e phahameng ka ho fetesisa ea nakoana | 22 |
Hlokomela. IGD: Bothata ba lipapali tsa inthanete.
aPeak MNI e hokahanya. bPalo ea li-voxels. p <.001, boholo ba sehlopha> li-voxels tse 40 tse ikhethileng. Boholo ba voxel = 3 × 3 × 3. cLikarolo tsa boko li ne li supiloe software Xjview (http://www.alivelearn.net/xjview8) mme e netefatsoe ka ho bapisa le lipapatso tsa bongo.
Setšoantšo sa 2. Ho etsa liphetho ha u bapisa lihlooho tsa IGD ha u hlaphoheloa le ha u bapala ka mathata. (A) Libaka tsa boko li phela kamora ho bapisa lipakeng tsa ha lihlooho li fola le papaling e sebetsang ka bothata. (B, C) Boima ba Beta bo nkiloeng libakeng tsa ACC le lentiform tse khahlisang ha lihlooho li ne li bapala ka mafolofolo ka mathata le ho fola
Re ile ra lekola kamano lipakeng tsa likarabo tsa boko ho ACC ea morao le li-lentiform le ho itlaleha ho litakatso tsa litakatso. Litlhahiso tsa bohlokoa lipakeng tsa litakatso tsa boithati le ts'ebetso ea lentiform li fumanoe, ho sa tsotelloe boemo ba IGD (Setšoantšo. 3). Ha ho lintlha tsa bohlokoa tse hlokometsoeng pakeng tsa ts'ebetso ea ACC le litakatso.
Setšoantšo sa 3. (A, B) Likamano lipakeng tsa ACC ea boko le ts'ebetso ea lentiform le takatso e ikhethang ha u bapala papaling ea pele. (C, D) Likamano lipakeng tsa ACC ea boko le ts'ebetso ea lentiform le takatso e ikemetseng ha u bapala papaling ea bobeli. (E, F) Likamano lipakeng tsa ACC ea boko le ts'ebetso ea lentiform le takatso e ikhethang ha u bapala papaling ea pele le ea pele
Re boetse ra sekaseka khokahano e sebetsang pakeng tsa ACC ea leqele le lentiform e setseng ka ho sebelisa methapo ea methapo e matla (DCM) maemong a mabeli a nako. Li-node tse sebelisitsoeng li hlalositsoe ka liphetho tsa tšebelisano tse hlahisitsoeng ka holimo. Likarolong tse 'maloa tsa boko tse boletsoeng tlhahlobisong ea boko eohle, ACC e sebakeng sa marang-rang a taolo e phahameng le lentiform netweke ea moputso. Ka lebaka la khopolo ea rona ea hore taolo e phahameng ea ho lakatsa ho tlameha ho fetoloa ho hlaphoheloa ho tsoa ho IGD, re khethile likarolo tsena tse peli tsa boko e le likarolo tsa lithahasello thutong ena bakeng sa tlhahlobo ea khokahano. Ka mantsoe a mang, re khethile libaka tsena tse peli e le likarolo tsa taolo ea botsamaisi le marang-rang a moputso ho etsa lipatlisiso mabapi le tšebelisano lipakeng tsa lits'ebetso tsena tse peli ho hlaphoheloa IGD.
Re nkile khokahanyo ea tlhōrō ea lihlopha, (maxima ea lehae 'mapeng oa lipalo) e le ntlha ea mantlha ea ho theha libaka ka radii ea limilimithara tse 6 (−21, 3, 21); ACC (−3, 39, 6)]. Ho kenyelletsoe li-voxel tse ka bang 33 karolong e 'ngoe le e' ngoe. Libaka tsena tse khethiloeng bakeng sa sehlopha ka seng li kenyellelitsoe marang-rang a matla, 'me DCM e ne e sebelisoa ho khetholla sebopeho sa marang-rang haholo, ha se fuoa data.
Ka khokahanyo e tsitsitseng, likhakanyo tsa DCM li bonts'itse kholo e kholo ea khokahano ea ACC-lentiform ha lithuto tsa IGD li hlaphoheloa (t = 3.167, p = .003). Ka mokhoa o ts'oanang, khokahano ea lentiform-ACC le eona e ile ea eketseha haholo ha lithuto tsa IGD li fola (t = 4.399, p <.001).
Litšobotsi tse tšoanang li ile tsa boela tsa bonoa ha lithuto li ne li pepesoa ke mekhoa ea lipapali. Litlamorao tsa phetoho, likhakanyo tsa DCM li bonts'itse khokahanyo e kholo ea ACC-lentiform ha lithuto tsa IGD li hlaphoheloa (t = 2.769, p = .009). Leha ho le joalo, khokahano ea lentiform-ACC e ile ea eketseha hanyane feela ha lithuto tsa IGD li fola (t = 1.798, p = .09; Setšoantšo 4).
Setšoantšo sa 4. DCM e fella ka lithuto tsa IGD ha li bapala ka mafolofolo ka mathata le nakong ea ho fola. (A) Li-node tse khethiloeng bakeng sa tlhahlobo e ngoe. (B) Liphetoho liphellong tse sa fetoheng lipakeng tsa ACC le libaka tsa lentiform tse khahlisang ka linako tse fapaneng. (C) Liphetoho liphellong tsa modulatory lipakeng tsa ACC le libaka tsa lentiform tse khahlisang ka linako tse fapaneng
Puisano
Phuputso ena e fuputse likarolo tsa neural tsa ho sebetsa hape ha cue lithutong tsa IGD ka nako e telele ho tseba lintlha tsa neural tse amanang le pheko. Likarabo tse fokotsehileng tsa boko ho li-cues tsa papali holima lentiform le ACC li ne li amana le ho hlaphoheloa. Lits'ebetso tse atlehang hamolemo tsa ACC-lentiform li ile tsa boela tsa bonoa lithutong tsa IGD kamora ho hlaphoheloa. Se fumanoeng se fana ka maikutlo a hore litšebelisano lipakeng tsa moputso le litsamaiso tsa taolo e kholo li ka ba bohlokoa ho IGD.
Phokotso ea kutlo litabeng tsa lipapali
E lumellana le hypothesis ea rona, ts'ebetso e amanang le papali e fokotsehileng e amanang le papali libakeng tsa boko tse amanang le moputso [lentiform, ventromedial prefrontal cortex (vmPFC, ho kenyelletsa le orbitofrontal cortex (OFC)] e fumanoe ha lithuto tsa IGD li hlaphoheloa papaling. Boits'oaro bo tsamaisanang le ts'ebetso ea moputso (Ikemoto, Yang, & Tan, 2015; Sayette, 2016), ho kenyelletsa le bokhobeng ba lithethefatsi (Balodis & Potenza, 2015; Cheng et al., 2016; Tobler et al., 2016; Yang et al., 2017). Sistimi ea moputso e ka qalisoa ha batho ba fuoa tšusumetso e nepahetseng ts'ebelisong ea lithethefatsi kapa mathata a papali ea chelete (Balodis et al., 2012; Worhunsky, Malison, Rogers, & Potenza, 2014) hammoho le ho IGD (Ko et al., 2009; Liu et al., 2017; Sun et al., 2012). Batho ba nang le IGD ha ba bapisoa le ba ts'ebeliso e tloaelehileng ea papali ba bonts'itse ts'ebetso e phahameng ea lentiform ho li-cues tsa lipapali, tse lumellanang le ts'ebetso ea cue le ho labalabela liphetho mathateng a ts'ebeliso ea lithethefatsi (Dong et al., 2017; Dong, Wang, et al., 2018).
Phuputsong ena, ts'ebetso e fokotsehileng e fumanoe ka mokokotlong oa lentiform le libakeng tse ling tse amanang le moputso ka mor'a ho hlaphoheloa. Se fumanoeng se fana ka maikutlo a hore karabelo ea neural ho mekhoa ea lipapali e fokotseha kamora ho hlaphoheloa, e lumellanang le lithuto tse fetileng ho bapisa IGD le li-control (Kim le al., 2018; Ko et al., 2013; Ma et al., 2019). Lits'ebetso lipakeng tsa fokotseha ts'ebetsong ea lentiform le takatso e ikemetseng ea cue-elicited e fana ka ts'ehetso ho maikutlo a fokotsehileng a reaction ea neural ho lentiform e ka tlase e fokolitse likarabo tsa takatso ea takatso ea ho tseba ho hlaphoheloa ho IGD mme e ka amana le bohlokoa ba ho fokotsa ts'usumetso ea ho kenya letsoho haholo ho boits'oaro ba lipapali. Phuputso ea rona e fetileng e bonts'itse hore mekhoa ea papali e ka eketsa litakatso tsa lithuto tsa IGD (Dong, Wang, et al., 2018). Ho feta moo, re ne re tlaleha hore ts'ebetso e kholo ea lentiform ho mekhoa ea lipapali e ne e hokahane le ho hlaha ha IGD ho batho ba sebelisang lipapali tsa kamehla (Dong, Wang, Liu, et al., 2019). Phuputso ena e fana ka maikutlo a hore nakong ea pholiso phokotso ea papali e nang le mathata e hokahane le litakatso tse fokotsehileng tsa IGD, ka mokokotlo oa lentiform o amehang kamanong ena. Ha ho kopantsoe hammoho, liphuputso li fana ka maikutlo a karolo ea bohlokoa bakeng sa mokokotlo oa lentiform le takatso e matla ea takatso ea ho fetoha lipakeng tsa IGD le ts'ebeliso ea papali e tloaelehileng le ka tsela e fapaneng. Likamano tse nepahetseng (mohlala, hore na papali e fokotsehileng e lebisa ho fokotseheng ha boikarabello ba lentiform le ho fokotsa takatso, kapa hore na boikarabello bo fokotsehileng ba lentiform bo lebisa ho fokotseheng takatso le ho fokotsa papali) li hloka lipatlisiso tse ling.
Taolo ea ho lakatsa kamora ho hlaphoheloa
Sebaka se seng sa boko se bonts'ang liphapang tsa sehlopha e ne e le ACC, e kentsoeng ts'ebetsong ea taolo e phahameng le lits'ebetso tse ling. Ho fapana le mohopolo oa rona, ts'ebetso e ile ea fokotseha ho ACC (hammoho le MFG) kamora ho hlaphoheloa. Sehlopha se anngoeng se kenyelletsa ACC le MFG le ho atoloha ka ntle ho kenyelletsa vmPFC le OFC. Haholo-holo, "cortex" ea mori e tlang pele ho nako e entsoe ka mokhoa o matla oa takatso e matla ea litakatso tsa lithethefatsi joalo ka ts'ebeliso ea ts'ebeliso ea koae (cocaine-ts'ebeliso)Kober et al., 2016; Wexler et al., 2001), ho sebetsana le meputso, haholo nakong ea linako tsa tsebiso kapa sephetho (Knutson, Fong, Adams, Varner, & Hommer, 2001; Knutson & Greer, 2008), ho etsa liqeto (Tanabe et al., 2007), ts'ebetso ea kamehla-mode (Harrison et al., 2017), le lits'ebetso tse ling (Li, Mai, & Liu, 2014). Ka lebaka la hore mosebetsi o sebelisitsoeng thupelong ena o tsepamisitse maikutlo litakatsong tsa takatso e matla, o batla ho nahana hore ts'ebetso e fokotsehileng haholo e fumanoeng sehlopheng se amang OFC / vmPFC / ACC / MFG e ka amana le ho fokotsa mosebetsi oa cue hape, leha tlhaloso ena e le nyane e ts'ehetsoeng ke data ho feta liphetho tsa lentiform tse fanoeng ka ho se be teng ha kamano le litakatso tse ipolelang.
Kahobane ACC le libaka tse ling tsa boko tsa cortical li kentsoe taolong kapa maemong a kelello (Rolls, 2000), ho kenyelletsa le batho ba nang le mathata a ho lemalla (Filbey et al., 2008; Franklin et al., 2007; Kosten et al., 2005; Myrick et al., 2004; Wrase et al., 2002), ho ka etsahala hore batho ba nang le IGD ba fola ba bonts'a ts'ebetso e sebetsang haholoanyane ea libaka tsa taolo tse amanang le ha ba ne ba bapala ka mathata. Ho hlahloba likamano lipakeng tsa ACC le mesebetsi ea lentiform, re kentse DCM mme ra fumana hore li-connectivities li eketsehile kamora ho hlaphoheloa. Ho ea ka litlhaloso tsa kelello tsa kelello tsa li-connectivities tse sebetsang har'a libaka tsena tsa boko (Havlicek et al., 2015; Stephan et al., 2010), boleng bo holimo ho li-connectivities tsa ACC-lentiform le lenstiform-ACC nakong ea ho hlaphoheloa ho latela linako ha papali e fana ka maikutlo a hore ts'ebelisano pakeng tsa likarolo tsena tse peli tsa boko e sebetsa hantle lithutong tse latelang. Kahoo, lipatlisiso tsa nako e tlang li lokela ho hlahloba hore na sena se bonahatsa mokhoa oa ho laola litakatso ka mokhoa o atlehileng joang, ho kopanya likarolo ka kotloloho tsa libaka tse amehang ts'ebetsong ea meputso, kapa litabatabelo tse amanang le tsona kapa menyetla e meng.
Bohlokoa le litlamorao tsa bongaka
Mefuta ea thupelo e hlahisitse likarolo tsa bohlokoa bakeng sa likarolo tsa boko le khatello ea tšebeliso ea tšebeliso ea marang-rang. Nchafatso ea morao-rao ea mofuta oa I-PACE (Brand et al., 2019) e buelletse mekhoa e amanang le boits'oaro e amanang le phetoho liphatlalatsong tsa tšebeliso ea marang-rang joaloka IGD. Mohlaleng ona, ho kopana hape ha cue le liphetoho lipotolohong tsa cortical-to-basal-ganglia e ne e le likarolo tsa bohlokoa, li lumellana le se fumanoeng thutong ena. Taba ke hore mofuta oa I-PACE o ntlafalitsoeng o fana ka karolo ea karolo bakeng sa polokeloBrand et al., 2019), e lumellanang le liphetoho mesebetsing ea litakatso tsa cue-reacuction le takatso ea lipatlisiso le ts'ebetso e kenelletseng le khokahano ho batho ba IGD ba amohelang ho kenella ka boits'oaro.Zhang et al., 2016b). Ntle le moo, tlhaiso-leseling ea mmuso oa sehlopha se le seng e khothalelitse phokotso ea khokahano (mohlala, lipakeng tsa OFC le hippocampus le lipakeng tsa libaka tse ka morao tsa cingate le tse amanang le makoloi; Zhang et al., 2016a). Kahoo, phuputso ena le tse ling tsa morao-rao li fana ka maikutlo a hore ho ka ba le lipheo tsa methapo ea kutlo bakeng sa ho kena lipakeng (mohlala, ho sebelisa mekhoa ea ho feto-fetoha ha kelello joalo ka ts'ebetso e potlakileng ea matla a khoheli kapa tšusumetso ea hona joale ea maqhubu) ho fokotsa litakatso le ho khothaletsa ho hlaphoheloa ho IGD. Mekhoa ea boits'oaro e shebileng takatso ebile e kanna ea sebetsa ka mekhoa e arolelanoang kapa e arohaneng ea methapo (mohlala, kalafo ea boits'oaro le boits'oaro bo theiloeng kelellong) le eona e lokela ho tsotelloa ho latela liphetho tsa hajoale, haholoholo e fuoe karolo ea bohlokoa bakeng sa kalafo ea boits'oaro kalafong ea lithethefatsi. le boleng ba ho utloisisa hore na liphekolo tse ikhethang li ka sebetsa joang maemong a methapo ea kutlo.
Ho lokela ho boleloa meeli e 'maloa. Taba ea mantlha, ha re kenyeletsa lithuto tsa bophelo bo botle thutong ena. Leha re fumane hore nalane ea papali e ne e sa amane le ho teba ha IGD (r = .088, p = .494) hape e kenyelelitse nalane ea papali e le karolo ea GLM, sehlopha sa taolo se kanna sa ba le thuso ho utloisisa lintlha (mohlala, mabapi le litlamorao tse ka bang teng tsa tlhahlobo-ea liteko). Taba ea bobeli, lithuto tse ngata e ne e le tsa banna (basali ba bahlano feela). Kahoo, lithuto tsa nako e tlang li lokela ho lekola hore na sephetho se ka sebetsa ho batho ba basali hakae, haholo hobane liphapang tse amanang le bong li bonoe ho li-neural correlates ho batho ba IGD (Dong, Wang, et al., 2018; Dong, Wang, Wang, et al., 2019; Dong, Zheng, et al., 2018). Taba ea boraro, leha re entse tlhahlobo ea DCM e bonts'ang hore taolo e phahameng ea ts'ebetso ea lentiform e ka ntlafala ka ho hlaphoheloa, re ke ke ra khetholla litlhaloso tse ling tse lokelang ho fuputsoa ka kotloloho lithutong tse tlang.
Nahanisisa
Lithuto tsa IGD ponong ea ho hlaphoheloa li bontsitse likarabo tse lakatsang ho tseba ho bapala papali ea maemong a subjective le neural. Patlisiso ea nako e tlang e lokela ho lekola ka kotloloho hore na liphumano li emela taolo ea cortical ho ts'ebetsong ea takatso e tlase le menyetla e meng, 'me li lokela ho hlahloba hore na ho kenella ho lebisanang le tšebelisano ea cortical-subcortical ho ka sebetsa hantle hakae kalafong ea IGD.
GD e ralile mosebetsi mme ea ngola moralo oa pele oa buka e ngotsoeng ka letsoho. MW le JZ ba ile ba bokella le ho lekola lintlha mme ba lokisa lipalo le litafole. XD e kentse letsoho ho bokella le ho hlophisa lintlha. MNP e kentse letsoho ho hlophisetsweng, ho toloka le ho ntlafatsa lits'ebetso. Bangoli bohle ba kentse letsoho ho fana ka tumello ea mofuta oa ho qetela oa buka e ngotsoeng ka letsoho.
Khohlano ea thahasello
Bangoli ba tlaleha hore ha ho likhohlano tsa lichelete tse amanang le litaba tsa buka ena e ngotsoeng ka letsoho. Ngaka MNP e amohetse matšeliso a lichelete bakeng sa ho buisana le ho eletsa ho RiverMend Health, Opiant / Lightlake Therapeutics, le Jazz Pharmaceuticals; o amohetse tšehetso e sa lekanyetsoang ea lipatlisiso (ho Yale) ho tsoa Mohegan Sun Casino le ho fana ka tšehetso (ho Yale) ho Setsi sa Naha sa Lipapali se Ikarabellang; mme o buisane le ho eletsa mekhatlo ea molao le ea papali ea chelete litabeng tse amanang le bokhoba ba taolo le tšusumetso ea taolo ea tšusumetso.
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