Lihlopha tsa Anterior Cingulate Cortex Fomu e fapaneng Ho Tšebelisanoa ka Mokhoa o Atlehang Mehlala ea Banna ba Batona ba Inthaneteng Ho Bapala Lipapali le ho Tepella Maikutlong ea Comorbid (2018)

Lihlopha tsa Anterior Cingulate Cortex Fomu e fapaneng Ho Tšebelisanoa ka Mokhoa o Atlehang Mehlala ea Banna ba Batona ba Inthaneteng Ho Bapala Lipapali le ho Tepella Maikutlong ea Comorbid (2018)

Front Psychiatry. 2018 Aug 29; 9: 380. doi: 10.3389 / fpsyt.2018.00380. eCollection 2018.

Lee D^1,2, Lee J², Namkoong K^2,3, Jung YC^2,3.

inahaneloang

Ho sithabela maikutlo ke e 'ngoe ea maemo a tloaelehileng a comorbid ho Internet Gaming Disorder (IGD). Le ha ho bile le lithuto tse ngata mabapi le pathophysiology ea IGD, motheo oa neurobiological o thehileng kamano e haufi lipakeng tsa khatello ea maikutlo le IGD ha o so hlakisoe ka botlalo. Liphuputso tse fetileng tsa neuroimaging li bonts'itse ho se ts'oane ho sebetsang le sebopeho sa anterior cingulate cortex (ACC) ho bakuli ba IGD. Thutong ena, re ile ra lekola ho se sebetse ho hokahaneng ha ts'ebetso (FC) ho amanang le likaroloana tsa ACC lithutong tsa IGD tse nang le khatello ea maikutlo ea comorbid. Re entse tlhahlobo ea FC ea naha ea phomolo ea bacha ba 21 ba nang le IGD ba nang le khatello ea maikutlo ea comorbid (sehlopha sa IGDdep +, lilemo tse 23.6 ± 2.4), banna ba baholo ba banna ba 22 ba se nang IGD ba nang le khatello ea maikutlo ea comorbid (sehlopha sa IGDdep−, lilemo tse 24.0 ± 1.6), le taolo ea banna e 20 e lekanang lilemo tse tšoanang (lilemo tse 24.0 ± 2.2) ACC-seeded FC e ile ea hlahlojoa ho sebelisoa lebokose la lithulusi la CONN-fMRI FC. Dorsal ACC (dACC), pregenual ACC (pgACC), le subgenual ACC (sgACC) li khethiloe e le libaka tsa peo. Lihlopheng ka bobeli tsa IGD li ne li na le pgACC FC e matla ka "precuneus" e nepahetseng, "cortex" ea "posterior" le "gula / insula" e ka tlase ho le letšehali ho feta sehlopha sa taolo. Sehlopha sa IGDdep + se ne se na le dACC FC e matla ka "precuneus" ea leqele le "cerebellar lobule" e nepahetseng ho feta lihlopha tsa taolo le tsa IGDdep-. Sehlopha sa IGDdep + se ne se boetse se na le pgACC FC e fokolang e nang le "cortex" e nepahetseng ea "dorsomedial" le "motor" e tlatselletsang 'me e ne e na le "sgACC FC" e fokolang ka letsohong le letšehali, gyrus e ka letsohong le letšehali le gyrus e ka letsohong le letšehali ho feta lihlopha tse ling. Matla a khokahano lipakeng tsa sgACC le precuneus e ka letsohong le letšehali e hokahane hantle le sekhahla se phahameng sa phoso ea ho tlohella tekong e tsoelang pele ea ts'ebetso sehlopheng sa IGDdep +. Ntle le moo, sehlopha sa IGDdep- se ne se e-na le sgACC FC e matla le bokone ba dorsolateral prefrontal cortex ho feta lihlopha tse ling. Liphuputso tsa rona li fana ka maikutlo a hore banna ba batona ba nang le IGD e nang le khatello ea maikutlo ba na le liphetoho tsa FC tsa marang-rang a mofuta o sa feleng mme ba fokotse FC ka preortal cortex. Mokhoa ona o fetotsoeng oa FC o kanna oa ameha kamanong e haufi ea IGD le khatello ea maikutlo.

Keywords: anterior cingulate cortex, default mode network, khatello ea maikutlo, khokahano e sebetsang, Mathata a ho Bapala Inthaneteng

Eya ho:

Selelekela

Lilemong tse leshome tse fetileng, ho entsoe lipatlisiso tse ngata mabapi le Internet Gaming Disorder (IGD), e khetholloang ka bothata ba ho laola tšebeliso ea papali ea inthanete leha ho na le pherekano ea kelello.1). Sekhahla se phahameng sa comorbidity le kamano ea causal lipakeng tsa IGD le maloetse a mang a kelello li hapile tlhokomelo e kholo (2). Ho tepella maikutlong ke boemo bo tloaelehileng ba comorbid psychiatric ho IGD, mme ho sithabela ha IGD le khatello ea maikutlo ho amana le meroalo e tebileng ea kelello (3). Leano la taolo e mpe ea maikutlo le hatellang ho fapana le ho sebelisa tlhaiso-leseling ea maikutlo le hlahisitsoe e le sesosa se tlatsetsang ho senyeha ha IGD le khatello ea maikutlo (4). Lintlha tse 'maloa tsa methapo ea pelo, joalo ka ho fokotseha ha khokahano ea lipakeng tsa hemispheric ea libaka tse ka pele le liphetoho tsa sebopeho ho dorsolateral prefrontal cortex, ho khothalelitsoe ho buisana ka kamano lipakeng tsa IGD le maikutlo a sithabetsang (5, 6). Le ha lithuto tsena tsa pejana li ntlafalitse kutloisiso ea rona ea mekhatlo e lipakeng tsa IGD le khatello ea maikutlo, lipatlisiso mabapi le kamano lipakeng tsa IGD le khatello ea maikutlo li lula li fokola leha e le tsa bohlokoa haholo kliniking. Hobane tumellano mabapi le lisebelisoa tsa kalafo bakeng sa IGD e ntse e haella (7), Kutloisiso e tsoelang pele ea mekhatlo e lipakeng tsa IGD le khatello ea maikutlo e ka fana ka liphofu tse ncha tsa ho kenella ha IGD. Mohlala, phuputso ea haufinyane e tlalehile hore bupropion e ne e sebetsa hantle ho feta escitalopram e le kalafo bakeng sa bakuli ba IGD ba nang le khatello ea maikutlo ea comorbid (8).

Bopaki bo bonts'itse hore lits'ebetso tse sebetsang le tse sebetsang tsa anterior cingulate cortex (ACC) li theha nts'etsopele le tlhokomelo ea IGD (9). Likamano tse fetotsoeng lipakeng tsa ACC le libaka tse ling tsa boko li ka kenya letsoho ntlafatsong ea IGD le litšobotsi tse amanang le eona tsa bongaka. Khokahano lipakeng tsa ACC le libaka tse ling tsa boko li rarahane; karolo e 'ngoe le e' ngoe ea ACC e hokela libakeng tse fapaneng tsa boko ka mesebetsi e fapaneng le e ikhethileng (10). Ho 'nile ha boleloa hore mokokotlo oa ACC (dACC) o kentse letsoho taolong ea tlhokomelo le taolo ka ho hokahana le dorsolateral prefrontal cortex (DLPFC) (11, 12) le hore rostral ACC (rACC) e kentse letsoho ts'ebetsong ea maikutlo ka khokahano le amygdala, hippocampus, le orbitofrontal cortex (OFC) (13). RACC e arotsoe ka pele ho ACC (pgACC) le subgenual ACC (sgACC) (14). PgACC e bonts'itsoe hore e na le khokahano e teteaneng le cortex ea pele mme e bapala karolo ea bohlokoa ho taolo ea holimo-tlase ea maikutlo a maikutlo (15). SgACC e fumanoe e na le khokahano e matla le amygdala le ventral striatum mme e kenya letsoho taolong ea boipuso le boemo ba ho ithuta bakeng sa ts'ebetso ea maikutlo (16).

Phomolo ea khokahano ea ts'ebetso ea mmuso (FC) lipakeng tsa ACC le libaka tse ling tsa boko e ka sebelisoa ho lekola tšebelisano ea ACC le libaka tse ling tsa boko. Boithuto ba nakong e fetileng ba ho phomola ba naha bo sebetsang ka matla a khoheli (fMRI) bo bonts'itse hore batho ba nang le IGD ba fokolitse FC lipakeng tsa DACC le libaka tse ling tsa bokong, ho kenyeletsoa le dorsal striatum, pallidum le thalamus, mme ba eketsa FC lipakeng tsa RACC le insula ea ka pele (17, 18). Liphuputso tsena li tsamaellana le maikutlo a hore ho fokotseha ha taolo ea phethahatso le ntlafatso ea ho batla moputso ho ka theola IGD (19). Ho bakuli ba IGD ba nang le khatello ea maikutlo e bohloko, comorbidity le khatello ea maikutlo e amanang le phokotso ea khatello ea marang-rang ea mode (DMN), e ka tlatsetsang mathateng a tlhokomelo (20). DMN le litšebelisano tsa eona le likhokahano tse ling tsa boko li fumanoe li bapala karolo ea bohlokoa ho tepelleng maikutlo (21). Ho 'nile ha boleloa hore DMN nakong ea boemo ba khatello ea maikutlo e kenyelletsa RACC, haholoholo sgACC (22, 23). Batho ba nang le khatello ea maikutlo ba bontšitsoe ba ekelitse FC lipakeng tsa sgACC le libaka tsa anterior DMN (24) le marang-rang a salience (SN) (25). Kahoo, ka bobeli IGD le khatello ea maikutlo li fetola FC ea likarolo tsa ACC. Liphetoho tsena tsa FC li ka kenya letsoho bothateng ba IGD le khatello ea maikutlo le litšobotsi tse amanang le eona tsa bongaka, empa lipatlisiso tse ling lia hlokahala likamanong lipakeng tsa IGD le khatello ea maikutlo le liphetoho tsa FC.

Mosebetsi oa phethahatso ke lits'ebetso tse phahameng tsa kutloisiso tse bohlokoa bakeng sa taolo e nepahetseng ea boits'oaro, mme lithuto tse fetileng li bonts'itse hore mesebetsi ea phethahatso e holofetse ho IGD (26Mohlala, lithuto tse nang le IGD li bontšitse ho se ts'oenyehe ho hoholo, e leng mohlala oa taolo e fokotsehileng ea bolaoli (27, 28). Likhaello tsa phethahatso li boetse li amahanngoa le khatello ea maikutlo (29Ka mohlala, bakuli ba nang le khatello ea maikutlo ba bontšitse taolo e fapaneng ea tlhokomelo (30), ka hona taolo ea tlhokomelo e bile sepheo sa kalafo sa khatello ea maikutlo (31). Khaello ea phethahatso ke karolo ea bohlokoa ea pathophysiology le lipontšo tsa bongaka tsa IGD le khatello ea maikutlo. Leha ho le joalo, karolo e nepahetseng ea ts'ebetso ea phethahatso kamanong lipakeng tsa IGD le khatello ea maikutlo ha e so hlakisoe ka botlalo.

Morero oa phuputso ena e ne e le ho fuputsa li-FC tsa peo ea ACC ea peo ea IGD ka khatello ea maikutlo. Likarolo tse tharo tsa ACC, DACC, pgACC, le sgACC, li ile tsa hlahlojoa. Re nahanne hore lithuto tsa IGD li tla bonts'a mekhoa e fapaneng ea FC e thehiloeng ho ACC ho latela hore na khatello ea maikutlo e teng kapa che. Ho ipapisitsoe le lithuto tsa pejana, re ne re lebelletse hore lithuto tse nang le IGD li ka be li fokolitse FC lipakeng tsa DACC le libaka tse tlase le ho eketsa FC lipakeng tsa RACC (pgACC kapa sgACC) le lipeo tsa SN ho sa tsotelehe boteng ba khatello ea maikutlo. Re ne re boetse re lebelletse hore FC lipakeng tsa sgACC le libaka tse ling tsa peo tse amanang le DMN- kapa SN e tla ba holimo lithutong tsa IGD tse nang le khatello ea maikutlo ea comorbid e bonts'ang maemo a bona a sa tloaelehang a DMN. Re lekile litebello tsena ka ho phomola ka tlhahlobo ea FC e thehiloeng ho peo, mme re lekole likamano lipakeng tsa liphetoho tsa FC le ts'ebetso ea phethahatso ho bakuli ba IGD ba nang le khatello ea maikutlo e bohloko. Ts'ebetso ea ho se tsotelle le ho ela hloko, e leng mefuta e fapaneng ea bongaka ea mesebetsi ea bolaoli, e ile ea lekoa ka lipotso tsa ho itlaleha bakeng sa ho se ts'oenyehe le tlhahlobo e tsoelang pele ea ts'ebetso (CPT) bakeng sa lits'ebetso tsa tlhokomelo.

Eya ho:

mekhoa

Lihlooho

Phuputso ena e ile ea etsoa ho tloha ka Hlakola 2015 – Mmesa 2017, 'me melaoana ea thuto ena ea ananeloa ke Boto ea Setsi sa Tlhahlobo ea Sepetlele sa Severance, Yunivesithi ea Yonsei. Lihlooho li ile tsa hiroa ka lipapatso tsa inthaneteng, lipampiri le ka molomo. Lithuto tsohle li ile tsa tsebisoa ka ts'ebetso eohle mme tsa saena tumello e nang le tsebo pele li nka karolo phuputsong.

Re hlahlobile batho ba baholo ba banna ba 101 bakeng sa thuto ena. Ho latela liphuputso tse fetileng tsa lefu la seoa, IGD e atile haholo ho banna (32). Hobane ho na le phapang pakeng tsa bong maemong a boits'oaro le sepheo sa papali ea inthanete (33), Phuputso ena e ne e etsoa feela bakeng sa banna ho fokotsa phello e ferekanyang. Lihlooho li ile tsa hlahlojoa ka mekhoa ea tsona ea ts'ebeliso ea Marang-rang 'me tsa qeta Teko ea Young's Internet Addiction Test (IAT) (34). Bafo ba neng ba sebelisa marang-rang haholo bakeng sa ho bapala le bao likolo tsa IAT (34) ba fetang 50 ba ile ba botsoa lipotso ho latela litekanyetso tsa tlhahlobo ea IGD tsa DSM Fifth Edition ho fumana hore na IGD e teng (35). Kamora moo, lithuto tse nang le IGD li ile tsa hlahlojoa bakeng sa khatello ea maikutlo ho sebelisoa Beck Depression Inventory (BDI) (36). Har'a lithuto tse nang le IGD, ba nang le lintlha tsa BDI tsa 20 kapa tse phahameng ba ne ba khetholloa e le lithuto tsa IGD tse nang le khatello ea maikutlo ea comorbid, athe ba nang le lintlha tsa BDI tsa 13 kapa tse tlase ba ne ba nkuoa e le lithuto tsa IGD ntle le khatello ea maikutlo ea comorbid. Lithuto tsohle li ile tsa hlahlojoa bakeng sa bohlale ba tsona ba quotient (IQ) ho sebelisoa Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) (37). Lithuto tsohle li ile tsa hlahlojoa hape bakeng sa boteng ba mathata a maholo a kelello ho sebelisoa Structured Clinical Interview e tsoang ho DSM Fourth Edition (SCID-IV) (38). Lihlooho tsohle tse nang le lintlha tsa BDI tsa 20 kapa tse phahameng li netefalitsoe hore li na le khatello ea maikutlo ea hajoale (ho khotsofatsa litekanyetso tsa ketsahalo e tepelletsang e bonolo kapa ketsahalo e kholo ea khatello ea maikutlo). Bafo ba nang le tse latelang ba ile ba qheleloa ka thoko: lefu la methapo kapa lefu la bongaka, mafu a maholo a kelello ntle le IGD kapa khatello ea maikutlo (ke hore, lefu la ho ferekana kelellong, lefu la kelello, bothata ba ts'ebeliso ea lithethefatsi, khaello ea tlhokomelo / khatello ea kelello) ho skena sa MRI.

Kamora ts'ebetso ea ho lekola, banna ba baholo ba batona ba 63 ba lilemo li 20-27 ba lilemo li (bolela: 23.8 ± lilemo tse 2.0) ba nkile karolo thutong, mme kaofela ha bona ba ne ba le ka letsohong le letona. Bafo ba nang le IGD ba ile ba aroloa ka lihlopha tse peli ho ea ka khatello ea bona ea "comorbid": Litaba tsa IGD tse nang le khatello ea maikutlo ea comorbid (sehlopha sa IGDdep +, n = 21; Lilemo tsa 23.6 ± 2.4) le lithuto tsa IGD ntle le khatello ea maikutlo ea comorbid (IGDdep- group, n = 22; Lilemo tse 24.0 ± 1.6). Bafo ba sebelisitseng nako e ka tlase ho 2 h ka letsatsi papaling mme ba fumana lintlha tse ka tlase ho 50 ho IAT ba ne ba nkuoa e le taolo e nepahetseng (n = 20; Lilemo tse 24.0 ± 2.2). Ntle le IAT le BDI tse sebelisitsoeng ts'ebetsong ea ho lekola, lithuto li phethile Tlhahlobo ea Boitsebiso ba Matšeliso a Joala (AUDIT) (39), Lenane la Beck Anxiety Inventory (BAI) (40), le lipotso tsa lipotso tsa boits'oaro tsa Barratt Impulsiveness Scale-version 11 (BIS-11) (41).

Ts'ebetso e tsoelang pele ea ts'ebetso (CPT)

Re sebelisitse Teko ea Tlhokomelo e Akaretsang ea Khomphutha ho lekola bokhoni ba tlhokomelo e sa khaotseng le ho arola tlhokomelo (42). Mosebetsing oa tlhokomelo o tsitsitseng, libopeho tse fapaneng li hlahisoa skrineng sa likhomphutha ka linako tsohle tsa 2 e le tšusumetso ea pono, mme mosebetsi o etsoa bakeng sa 10 min. Bafo ba ile ba laeloa hore ba tobetse bareng kapele kamoo ho ka khonehang neng kapa neng ha ho bonts'oa lits'oants'o tsa pono, empa eseng ha ho hlahisoa sebopeho sa "X". Mosebetsi oa tlhokomelo e tsitsitseng o lekola bokhoni ba ho fana ka likarabo tse lumellanang tsa boits'oaro ha o ntse o boloka tlhokomeliso ho likhothaletso tse tsoelang pele le tse pheta-phetoang. Mosebetsi ona o hakanya ho se ts'oenyehe ka ho lekola hore na sehlooho se ka hatella likarabo tsa boits'oaro ho litšusumetso tse itseng. Mosebetsing o arotsoeng oa ho tsepamisa mohopolo, lits'oants'o tsa pono le kutlo li hlahisoa ka nako e ts'oanang li-2 s tse ling, mme mosebetsi o nka kakaretso ea 3 min le 20 s. Bafo ba ile ba laeloa hore ba tobetse sebaka sa sebaka kapele kamoo ho ka khonehang haeba ketsahalo ea pele e bonoang kapa tšusumetso ea kutlo e hlahisoa hape. Mosebetsi o arotsoeng oa ho lekola o lekola hore na lihlooho li ka sebetsana le tse peli kapa ho feta ka nako e le ngoe ka ho arola tlhokomelo ea tsona hantle. Ho lekantsoe mefuta e 'meli ea boits'oaro bakeng sa ts'ebetso ho CPT. Phoso ea phoso ke ho hloleha ho etsa karabelo e hlokahalang ea boits'oaro mme e bonts'a ho se tsotelle. Phoso ea khomishene ke boteng ba likarabo tsa boits'oaro tse neng li lokela hore ebe li hatelletsoe mme e bonts'a ho se tsotelle.

Ho fumana litšoantšo tsa MRI le ho e lokisa pele

Litšoantšo tsa MRI li fumanoe ho sebelisoa sesebelisoa sa 3T Siemens Magnetom MRI se nang le kela ea hlooho ea likana tse robeli. Lintlha tsa fMRI li ile tsa bokelloa ho sebelisoa tatellano e le 'ngoe ea T2-weighted gradient echo planar pulse sequence (echo time = 30 ms, repetition time = 2,200 ms, flip angle = 90 °, field of view = 240 mm, matrix = 64 × 64, botenya ba selae = 4 mm) bakeng sa 6 min. Bafo ba ile ba laeloa hore ba shebe sefapano se sefubelu se tšoeu bohareng ba semelo se setšo ntle le ts'ebetso ea kutloisiso, lipuo tse ngata kapa makoloi. Setšoantšo sa anatomical sa data ea fMRI se fumanoe ho sebelisoa tatellano ea T1 e boima bo senyehileng (TE = 2.19 ms, TR = 1,780 ms, flip angle = 9 °, lebala la pono = 256 mm, matrix = 256 × 256, botenya ba selae = 1 limilimithara). Tlhahlobo ea pele ea ts'ebetso le lipalo-palo tsa data li entsoe ho sebelisoa SPM8 (Welcome Trust Center bakeng sa Neuroimaging; http://www.fil.ion.ucl.ac.uk/spm). Bakeng sa sehlooho ka seng, lintlha tsa pele tse supileng letotong la linako li ile tsa lahloa ho felisa ho bola ha lets'oao. Ho ikamahanya le maiketsetso a makoloi bakeng sa taba ka 'ngoe, re ile ra sheba hore motsamao o phahameng ka ho fetisisa oa hlooho e' ngoe le e 'ngoe e ne e le <2 mm le hore ho ne ho se na motsamao oa hlooho o sa lebelloang ka ho lekola likhakanyo tsa maemo a ntlafatso. Bakeng sa sehlooho ka seng, litšoantšo tse sebetsang tsa boko li ile tsa hlophisoa hape tsa ngolisoa ka litšoantšo tsa sebopeho. Litšoantšo tse ngolisitsoeng ka kopanelo li ile tsa hlophisoa ka mokhoa oa sebaka ho template ea Montreal Neurological Institute (MNI) (e fanoeng ke SPM8) ho sebelisoa phetoho ea li-parameter tse 12 le liphetoho tse seng molaong. Ho ile ha sebelisoa mekhahlelo ea ho tloaela litšoantšo tse sa phutholohang, tse ileng tsa etsetsoa sampole ho boholo ba voxel ba 2 × 2 × 2 mm. Lintlha li ntlafalitsoe ho sebelisoa bophara ba 8 mm ka bophara ba kernel ea halofo ea boholo.

Tlhahlobo ea FC

Limmapa tsa Seed-to-voxel FC tsa sehlooho ka seng li hahiloe ka lebokose la lithulusi la CONN-fMRI FC (http://www.nitrc.org/projects/conn). Libaka tsa peo bakeng sa likaroloana tsa ACC li ne li hlalosoa e le likhokahano tse shebaneng le radius tse 5 mm tse tsoang liphuputsong tsa FC tsa nakong e fetileng (dACC: 4 14 36; pgACC: 2 44 20; sgACC: 2 20-10) (43, 44). Mofuta oa wavex e 'ngoe le e' ngoe ea boko o ne o tlhotliloeng ka nakoana ka sefahleho sa bandpass (0.008 Hz <f <0.09 Hz) ho ikamahanya le litlamorao tsa maqhubu a tlase le lerata le phahameng. Tlhatlhobo e ts'oanang ea khatello e entsoe ho tlosa matšoao ho tsoa sebakeng sa ventricular le taba e tšoeu (45). Ho fokotsa litlamorao tsa motsamao oa hlooho, mekhahlelo ea motsamao e kentsoe tlhahlobisong ea tatellano ea tatellano. Ho hakanya matla a FC, li-coefficients tsa khokahano li ile tsa sebetsoa 'me tsa fetoleloa ho z-boleng ho sebelisoa phetoho ea F-r-to-z ea Fisher. Joale, likhakanyo tsa matla a FC li ile tsa bapisoa lipakeng tsa lihlopha tse sebelisang tlhahlobo ea phapang (ANOVA) ho voxel ka ngoe. Joalo ka lipalo-palo tsa tlhahlobo ea bokong bo felletseng, sehlopha se theha monyako o sebelisang bophahamo ba se sa nepahalang p-value <0.001 mme ho sebelisitsoe moeli o lekanyelitsoeng oa li-voxels tse 100 tse kopaneng. Kamora hore lihlopha tse nang le liphapang tse kholo tsa sehlopha li hlahlojoe, Bonferroni post hoc liteko li ile tsa etsoa ho hlahloba hore na ke lihlopha life tse fapaneng le tse ling.

Tlhahlobo ea statistical

Liteko tsa ANOVA tsa tsela e le 'ngoe li sebelisitsoe ho bapisa lipalo tsa palo ea batho le tsa bongaka, ho kenyeletsoa lilemo, IQ, IAT, AUDIT, BDI, BAI, le lintlha tsa BIS, har'a lihlopha tse tharo. Hobane likhopolo tsa tloaelo li ne li sa fihlelloe, papiso ea ts'ebetso ea boits'oaro ho CPT lipakeng tsa lihlopha e ile ea hlahlojoa ka tlhahlobo ea Kruskal Wallis. Ho sebelisitsoe tokiso ea Bonferroni post hoc tlhatlhobo. Tlhatlhobo e ikhethileng ea khokahano ea matla a khokahanyo, liphallelo tsa BIS, le ts'ebetso ea boits'oaro ba CPT li entsoe kamora ho laola BDI le BAI. Liphuputso tsa lipalo-palo li entsoe ka SPSS (Chicago, IL) ka bohlokoa bo behiloeng ho p <0.05 (mehatla e 'meli).

Eya ho:

Results

Palo ea batho le likliniki tsa lithuto

Litaolo le lithuto tsa IGD ha lia ka tsa fapana haholo ka lilemo, IQ, le lintlha tsa AUDIT (Lethathamo (Tafole1) .1). Litekanyo tsa psychometric tsa ho itlaleha li bontšitse liphapang ho IAT [F_{(2, 60)} = 111.949, p <0.001], BDI [F_{(2, 60)} = 185.146, p <0.001], le BAI [F_{(2, 60)} = 30.498, p <0.001] lintlha. Litlhahiso tsa BIS li fapane lipakeng tsa lihlopha [e seng moralo: F_{(2, 60)} = 11.229, p <0.001; enjene: F_{(2, 60)} = 11.246, p <0.001; kutloisiso: F_{(2, 60)} = 11.019, p <0.001]. Post hoc liteko li bontšitse hore lihlopha ka bobeli tsa IGD li na le lintlha tse phahameng haholo tsa IAT le BIS ho feta sehlopha sa taolo. Sehlopha sa IGDdep + se bontšitse lintlha tse phahameng tsa BDI le BAI ho feta lihlopha tse ling. Papiso ea ts'ebetso ea boits'oaro ho CPT e bonts'itse liphapang feela ka sekhahla sa phoso ea ho se phethise mosebetsi o arotsoeng (χ ² = 6.130, p = 0.047). Post hoc liteko li bonts'itse hore sehlopha sa IGDdep + se na le sekhahla se phahameng sa liphoso ho feta lihlopha tse ling.

Lethathamo 1

Palo ea baahi le litleliniki tsa lithuto.

Bula ka fensetere e fapaneng

Papiso ea sehlopha e ne e etsoa ke tlhahlobo ea tsela e le 'ngoe ea liteko tsa variance (ANOVA). Hobane likhopolo tsa tloaelo li ne li sa fihlelloe bakeng sa mekhoa ea boits'oaro bakeng sa mesebetsi ea tlhokomelo, teko ea Kruskal Wallis e sebelisitsoe ho bapisa.

IGD_dep−, Litaba tsa Bothata ba ho Bapala Inthaneteng ntle le khatello ea maikutlo; IGD_{dep +}, Litaba tsa Bothata ba ho Bapala Inthaneteng ka khatello ea maikutlo; IQ, bohlale ba quotient; IAT, Teko ea Tlatsetso ea Marang-rang; BAI, Beck Matšoenyeho Inventory; BDI, Beck Depression Inventory; AUDIT, Teko ea Boitsebiso ba Mathata a Ts'ebeliso ea Joala; BIS, Barratt Impulsiveness Scale.

Tlhahlobo ea FC

Tshekatshekong e felletseng ea boko, lihlopha tse ngata tse nang le phapang e kholo ho FC li fumanoe lipakeng tsa lihlopha (Tafole (Tafole2) .2). Tlhatlhobo ea FC e thehiloeng ho DACC e bonts'itse hore sehlopha sa IGDdep + se ne se na le matla ho feta DACC FC ka precuneus ea leqele le cerebellar lobule IX e nepahetseng ho feta lihlopha tse ling (Setšoantšo (Figure1) .1). Tlhatlhobo ea FC pgACC e bonts'itseng hore sehlopha sa IGDdep + se na le pgACC FC e fokolang e nang le dorsomedial prefrontal cortex (dmPFC) le sebaka se nepahetseng sa tlatsetso ea makoloi (SMA) ho feta lihlopha tse ling (Setšoantšo (Figure2) .2). Lihlopha ka bobeli tsa IGD li ne li na le pgACC FC e matla ka "precuneus" e nepahetseng, "postcing" cortex (PCC) e ka letsohong le letšehali, le "infra / anterior insula" e ka pele ka letsohong le letšehali ho feta taolo. Tlhatlhobo ea FC e thehiloeng ho sgACC e bonts'itse hore sehlopha sa IGDdep + se na le sgACC FC e fokolang ka letsohong le letšehali, gyrus ea leleme le letšehali le gyrus ea leqele ea postcentral ho feta lihlopha tse ling (Setšoantšo (Figure3) .3). Sehlopha sa IGDdep se ne se e-na le sgACC FC e matla ho feta le dorsolateral prefrontal cortex (dlPFC) ho feta lihlopha tse ling.

Lethathamo 2

Tlhahlobo ea khokahanyo e sebetsanang le peo e sebetsang ka bongata ea peo (FC).

Libaka tsa boko moo FC e bonts'itseng phapang e kholo lipakeng tsa lihlopha [bophahamo ba bophahamo ba p-value <0.001, tekanyo ea k_e > Li-voxels tse 100 (18)].

IGD_botebo, Litaba tsa bothata ba ho bapala ka Inthanete ntle le khatello ea maikutlo; IGD_{dep +}, Litaba tsa Bothata ba ho Bapala Inthaneteng ka khatello ea maikutlo; ACC, cortex e kantle ea anterior.

Setšoantšo sa 1

Libaka tsa boko tse bontšang phapang e kholo ho FC e thehiloeng ho DACC lipakeng tsa lihlopha. (A) Left precuneus le (B) cerebellar lobule IX e nepahetseng. Bophahamo ba monyako oa tse sa nepang p-value <0.001 le boholo ba moeli oa li-voxels tse 100 tse kopaneng. Litlhophiso tsa tlhoro ea sehlopha ka seng li bontšoa ke sistimi ea Montreal Neurological Institute (MNI). Post hoc liteko li ile tsa etsoa ho fumana liphapang lipakeng tsa lihlopha tse sebelisang tokiso ea Bonferroni. *p <0.05.

Setšoantšo sa 2

Libaka tsa boko li bonts'a phapang e kholo ho FC pgACC e lipakeng tsa lihlopha. (A) Sebaka sa likoloi tse tlatsetsang ka ho le letona, (B) cortex e ka pele e nepahetseng ea dorsomedial, (C) nepahetseng precuneus, (D) ka morao ho cingulate cortex ea morao-rao, le (E) siile tlaase tlase gyrus / anterior insula. Bophahamo ba monyako oa tse sa nepang p-value <0.001 le boholo ba moeli oa li-voxels tse 100 tse kopaneng. Litlhophiso tsa tlhoro ea sehlopha ka seng li bontšoa ke sistimi ea Montreal Neurological Institute (MNI). Post hoc liteko li ile tsa etsoa ho fumana liphapang lipakeng tsa lihlopha tse sebelisang tokiso ea Bonferroni. *p <0.05.

Setšoantšo sa 3

Libaka tsa boko tse bonts'ang liphapang tse kholo ho FC sgACC e lipakeng tsa lihlopha. (A) Leqhoa le khethiloeng ka ho le letšehali le letšehali (B) setseng sa lipuo tse ling, (C) o ile a tloha precuneus, 'me (D) gyrus ea morao-rao ea morao-rao. Bophahamo ba monyako oa tse sa nepang p-value <0.001 le boholo ba moeli oa li-voxels tse 100 tse kopaneng. Litlhophiso tsa tlhoro ea sehlopha ka seng li bontšoa ke sistimi ea Montreal Neurological Institute (MNI). Post hoc liteko li ile tsa etsoa ho fumana liphapang lipakeng tsa lihlopha tse sebelisang tokiso ea Bonferroni. *p <0.05.

Tlhatlhobo ea khokahano e bonts'itse khokahano lipakeng tsa matla a khokahano ea pgACC-IFG / AI le boits'oaro ba kelello sehlopheng sa IGDdep- (r = 0.482, p = 0.031; Setšoantšo Figure4A) 4A) le khokahano lipakeng tsa sgACC-precuneus khokahano ea matla le phoso ea ho se phethise mosebetsing oa tlhokomelo o tsitsitseng sehlopheng sa IGDdep + (r = -0.499, p = 0.030; Setšoantšo Figure4B) .4B). Liteko tse ling tsa khokahano ha li bontše bohlokoa ba lipalo.

Setšoantšo sa 4

Tlhatlhobo ea karolo e itseng kamora ho laola BDI le BAI. Masala a sa sebetsoeng a ile a sebelisoa ho etsa libaka tsa ho hasanya. (A) Litaba tsa IGD tse se nang khatello ea maikutlo li bonts'a kamano e ntle lipakeng tsa khokahano ea pgACC-IFG / AI le lintlha tsa BIS-cognitive impulsivity subscale score (r = 0.482, p = 0.031). (B) Litaba tsa IGD tse nang le khatello ea maikutlo tse matlafatsang li bonts'a khokahano e mpe lipakeng tsa khokahano ea sgACC-precuneus le sekhahla sa phoso mosebetsing o arotsoeng oa tlhokomelo (r = -0.499, p = 0.030).

Eya ho:

Puisano

Thutong ena, FC-based FC lithutong tsa IGD e nang le khatello ea maikutlo le ntle le eona e ile ea hlahlojoa. Lihlopha ka bobeli tsa IGD li ne li na le pgACC FC e matla ka "precuneus" e nepahetseng, PCC, le IFG / AI le letšehali ho feta lithuto tsa taolo, empa ho ne ho na le phapang lipakeng tsa FC pakeng tsa lithuto tsa IGD tse nang le khatello ea maikutlo le ntle le eona. Litaba tsa IGD tse nang le khatello ea maikutlo li na le dACC FC e matla le precuneus le cerebellar lobule IX e fetang lithuto tse ling. Litaba tsa IGD tse nang le khatello ea maikutlo li bile le pgACC FC e fokolang e nang le dmPFC e nepahetseng le SMA e nepahetseng le sgACC FC e fokolang e nang le precuneus ea leqele, gyrus ea leleme le letšehali le gyrus e ka letsohong le letšehali ho feta lithuto tse ling. Liphetoho tsena tsa FC, tse fapaneng hanyane ka lebaka la boteng kapa ho ba sieo ha khatello ea maikutlo, li lumellana le khopolo-taba ea rona ea hore bakuli ba IGD ba nang le khatello ea maikutlo ba ka ba le semelo sa neurobiological se tlatsetsang ho likarolo tsa bona tse ikhethang tsa bongaka.

Ha e bapisoa le lihlopha tse ling, lithuto tsa IGD tse nang le comorbid depress li bontšitse matla ho feta DACC FC le precuneus le cerebellar lobule IX, e amanang le DMN (46, 47). Liphuputso tsena li tsamaellana le bopaki ba pejana ba hore lithuto tsa IGD tse nang le khatello ea maikutlo li ka ba le kamano e tlase pakeng tsa ACC le libaka tse amanang le boko tsa DMN, tse bonts'ang bothata ba bona ba ho hatella DMN (20). Leha ho le joalo, tlhahlobo ea FC e thehiloeng ho sgACC e bonts'itse hore FC lipakeng tsa sgACC le precuneus ea leqeleng e ne e fokola haholo lithutong tsa IGD tse nang le khatello ea maikutlo ea comorbid ho feta lihlopheng tse ling. Boithuto ba pejana bo bontšitse hore DMN e kantle le e kamorao e na le mekhoa e metle ea ts'ebetso maemong a tepelletseng (48). Phumano ea rona ea sgACC-precuneus FC e fokolang e tšehetsa thuto e fetileng e bonts'itseng liphetoho ho FC lipakeng tsa DMN e ka pele le e kamorao ho khatello ea maikutlo (49). Ntle le moo, khokahano e fokolang ea sgACC-precuneus e hokahane le sekhahla se phahameng sa phoso molemong oa tlhokomelo e sa fetoheng lithutong tsa IGD tse nang le khatello ea maikutlo ea comorbid. Makhetlo a mangata a liphoso tse tlohelang lithutong tsa IGD tse nang le khatello ea maikutlo a comorbid a fana ka maikutlo a hore mathata a tlhokomelo a bonahala haholo lithutong tsa IGD ha khatello ea maikutlo e ameha. Khokahano ea bohlokoa lipakeng tsa khokahano ea sgACC-precuneus le sekhahla sa phoso e tšehetsa khopolo-taba ea hore liphetoho tsa FC tsa DMN li kenya letsoho ho senyeheng lits'ebetsong tsa tlhokomelo.

Ha li bapisoa le lihlopha tse ling, lithuto tsa IGD tse nang le comorbid depress li bontšitse bofokoli pgACC FC e nang le dmPFC e nepahetseng le SMA e nepahetseng. Ho bonts'itsoe hore dmPFC ha e na tšusumetso ea dopamine mme e amahanngoa le ho feto-fetoha ha litekanyetso tsa bohlokoa le tse susumetsang tsa tšusumetso (50). DmPFC e amahanngoa le ho lekola bocha litšusumetso tsa maikutlo (51), Le phetoho ea FC ea dmPFC le libaka tse ling tsa boko e tlalehiloe ho bakuli ba nang le khatello ea maikutlo (52, 53). DmPFC le eona e khothalelitsoe ho bapala karolo ea bohlokoa ho neurocircuitry ea tahi (54). Ha li kopantsoe hammoho, e fetotsoeng FC ea dmPFC e kanna ea ba sehokelo sa bohlokoa lipakeng tsa ts'ebeliso e mpe ea papali ea Inthanete le khatello ea maikutlo. Ntle le moo, lithuto tsa pejana li bontšitse hore FC lipakeng tsa pgACC le dmPFC e hokahana haufi le likarabo kalafong ea kalafo ea transcranial magnetic stimulation (TMS) (55) mme bupropion e eketsa boemo ba phomolo FC ho dmPFC (56). FC e fetotsoeng ea dmPFC e na le monyetla oa bohlokoa e le sepheo sa ho kenella kalafo bakeng sa bakuli ba IGD ba nang le khatello ea maikutlo ea comorbid. Ntle le moo, SMA e hokahantsoe le taolo ea boits'oaro ea boits'oaro (57), Le phetoho ea sebopeho kapa ts'ebetso ea SMA ho IGD e tlalehiloe (58, 59). Ho fumana ha rona FC e fetotsoeng ho SMA ho kanna ha amana le taolo e fokotsehileng ea boits'oaro lipapaling tse feteletseng.

Ha ho bapisoa le taolo, lithuto tsa IGD li bontšitse FC e matla lipakeng tsa pgACC le IFG / AI e letšehali. Ntle le moo, lithuto tsa IGD ntle le khatello ea maikutlo e matla li bonts'a khokahano e matla ea pgACC-IFG / AI, e hokahaneng haholo le boits'oaro bo phahameng ba kutloisiso bo bonts'ang mekhoa ea ho etsa liqeto e ipapisitse le khotsofalo ea nakoana (60). Hobane IFG / AI ea leqele ke sebaka sa peo ea SN (61), liphuputso tsena li tsamaellana le tebello ea rona ea hore lithuto tse nang le IGD li ka be li ekelitse FC ea RACC ka lipeo tsa SN. Tšebelisano e fetotsoeng lipakeng tsa SN le marang-rang a mang a boko e khothalelitsoe ho kenya letsoho litšobotsing tse susumetsang, tse matlafatsang le tse nang le kelello tse bonoang bokhobeng (62). Liphetho tsa rona tsa hajoale le bopaki bo fetileng (63) bonts'a hore liphetoho tsa FC ho SN, haholoholo ho hokahanya pakeng tsa DMN le SN, li bapala karolo ea bohlokoa ho pathophysiology ea IGD. Lithuto tsa IGD tse se nang khatello ea maikutlo li boetse li bonts'a sgACC FC e matla le dlPFC ea leqele ho feta lihlopha tse ling. Likamano tse sebetsang tsa Aberrant lipakeng tsa marang-rang a boko li hlahisitsoe e le karolo ea pathophysiology ea IGD (64, 65). Khokahano pakeng tsa DMN le netweke e bohareng ea phethahatso e kanna ea ba sesosa sa neurobiological se thehileng IGD.

Ho bile le meeli e mengata thutong ena. Taba ea mantlha, phuputso ena e ne e arohane, mme leha patlisiso ena e batlisitse ho sithabela hoa khatello ea maikutlo le IGD, hajoale ha ho na leseli mabapi le kamano e bakoang ke mafu ana a mabeli. Ho hlokahala lithuto tse ling tsa bolelele ba nako ho hlalosa hantle se fumanoeng ke litšoantšo tsa hajoale. Taba ea bobeli, thuto ena e ne e kenyelletsa palo e fokolang ea lithuto mme e shebile feela libakeng tse ling tsa boko leha kamano pakeng tsa IGD le khatello ea maikutlo e kanna ea kenyelletsa mekhoa e rarahaneng ea methapo ea kutlo. Ho ka ba molemo ho lekola khokahano ea boko palo e kholo ea lithuto ntle le ho shebana le libaka tse ikhethang tsa peo. Taba ea boraro, thuto e entsoe ka lithuto tsa banna feela. Boithuto ba pejana bo bontšitse hore IGD e se e atile haholo ho basali (66). Hore liphetho tsa thuto ena li atolohe haholoanyane, lithuto tse ling li lokela ho kenyelletsa batho ba lemaletseng ho bapala ka basali le banna. Kamora nako, thuto ha ea ka ea laola ka mokhoa o lekaneng bakeng sa mefuta-futa e ka amang kamano lipakeng tsa khatello ea maikutlo le IGD, mme thuto ena ha ea ka ea hlakisa ka botlalo kamano ea boits'oaro ba kelello ho IGD. Lithuto tse ling li tla hloka hore ho nahanoe ka botlalo ka litšoaneleho tsa bongaka tsa lithuto, tse ka amanang le papali ea bona e sa laoloeng ea inthanete.

Ha re phethela, bakuli ba IGD ba tepelletseng maikutlo le ba sa tepelletseng maikutlo ba fapane ka mekhoa ea bona ea FC-based ea ACC. Litaba tsa IGD tse nang le khatello ea maikutlo e matla li bontšitse liphetoho tse khethehileng tsa FC ho DMN. FC e fetotsoeng lipakeng tsa DMN e ka pele le e ka morao e kanna ea amahanngoa le lits'ebetso tse sa sebetseng tsa tlhokomelo lithutong tsa IGD tse nang le khatello ea maikutlo ea comorbid. Litaba tsa IGD tse nang le khatello ea maikutlo li bile le FC e fokolang lipakeng tsa ACC le dmPFC e bonts'ang taolo e sa sebetseng ea tšusumetso ea maikutlo. Liphetho tsa rona tsa phomolo tsa fMRI li fana ka maikutlo a hore ho na le motheo oa methapo ea kutlo bakeng sa kamano e matla lipakeng tsa IGD le khatello ea maikutlo, e ka bang sepheo sa bohlokoa sa kalafo nakong e tlang.

Eya ho:

Melao ea boits'oaro

Mekhoa eohle e kenyelletsang bankakarolo ba batho e entsoe ho latela maemo a boits'oaro a likomiti tsa lipatlisiso tsa setheo le tsa naha le ka phatlalatso ea 1964 Helsinki le liphetoho tsa eona hamorao. Protocol ea liteko e amohetsoe ke Boto ea Setsi sa Tlhahlobo ea Sepetlele Sepetleleng sa Severance, Yunivesithi ea Yonsei, Seoul, Korea.

Eya ho:

Menehelo ea Mongoli

DL le Y-CJ ba emoletse mme ba thehile thuto. JL o ile a hira barupeluoa mme a fumana leseli la litšoantšo. DL e ngotse buka e ngotsoeng ka letsoho. KN le Y-CJ ba ile ba hlahlobisisa buka eo e ngotsoeng ka letsoho mme ba fana ka litaba tsa bohlokoa tsa mahlale. Bangoli bohle ba ile ba lekola le ho amohela mofuta oa ho qetela oa sengolo sena hore o phatlalatsoe.

Khohlano ea polelo ea thahasello

Bangoli ba bolela hore lipatlisiso li ne li etsoa ka ho se be le likamano leha e le life tsa khoebo kapa tsa lichelete tse ka nkoang e le khohlano e ka 'nang ea e-ba le thahasello.

Eya ho:

Mongolo o botlaaseng ba leqephe

Lithuso. Phuputso ena e ne e tšehelitsoe ke thuso e tsoang ho Morero oa R&D oa Korea Mental Health Technology, Lekala la Bophelo le Boiketlo, Rephabliki ea Korea (HM14C2578).

Eya ho:

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