inahaneloang
Ho senyehile lipotoloho tsa meputso le taolo e fokotsehileng ea boits'oaro e le li-pathophysiologies tsa bothata ba lipapali tsa inthanete (IGD). Ts'ebetso ea lelapa ho nahanoa hore e bapala karolo ea bohlokoa taolong e amanang le moputso. Re ile ra nahana hore bacha ba nang le IGD ba bonts'a litšitiso tsa likamano tsa malapa, tse amanang le ts'ebetso ea boko ka har'a potoloho ea moputso. Bacha ba 42 ba nang le IGD ntle le comorbidities le taolo e phetseng hantle ea 41 ba ile ba hlahlojoa bakeng sa ts'ebetso ea lelapa le linaha tsa kelello ba sebelisa Korea Wechsler Intelligence Scale for Children (K-WISC), mofuta oa Korea oa DuPaul's attention deficit hyperactivity disorder (ADHD) Scale Scale (K-ARS) , Young Internet Addiction Scale (YIAS), Children's Depression Inventory (CDI), Beck Anxiety Inventory (BAI), le sebaka sa kamano sa Family Environmental Scale (FES-R). Ketsahalo ea boko e ile ea lekoa ka fMRI ea phomolo. Bacha ba nang le IGD ba bonts'itse lintlha tse eketsehileng tsa K-ARS, BAI, le YIAS, empa ba fokotse lintlha tsa FES-R le FES-cohesion subscale; Lintlha tsa YIAS li ne li hokahane hampe le lintlha tsa FES-R. Khokahano ea bokooa ho tloha ho cingulate ho ea ho striatum e fokotsehile, e hokahane hantle le lintlha tsa FES-R, mme e hokahane hampe le ho tiea ha IGD. Bacha ba nang le IGD ba bonts'itse likamano tsa malapa tse senyehileng, tse neng li amahanngoa le boima ba lefu lena, le ho se hokahane ka har'a potoloho ea moputso.
Selelekela
Mathata a Inthanete a Lipapali le Potoloho ea Moputso
Le ha ho na le liphehisano tse tsoelang pele mabapi le hore na ho lemalla joala ke eng, lefu la bokuli, lefu le amanang le ts'oaetso ea taolo ea maikutlo le ho hlahlojoa hofeta1, hona joale ho se ho hlahisitsoe papali e fetelletseng ea inthanete hore e kenyellelitsoe (ho netefatsa ho tsoela pele ho ithuta), joalo ka "bothata ba lipapali tsa inthanete" (IGD), Karolong ea III ea Diagnostic and Statistical Manual of Mental Disorders (DSM-5)2 hape joalo ka "boloetse ba papali" (GD), ho Classification of International Diseases (ICD-11)3.
Boithuto bo 'maloa bo bontšitse hore pathophysiology ea IGD e amahanngoa le potoloho ea moputso e senyehileng le taolo e nyenyefalitsoeng ea boits'oaro4-6. Phuputsong ea meta ea lithuto tse sebetsang tsa ho nka litšoantšo ho bakuli ba nang le IGD, Zheng et al a.4 e khothalelitse hore moputso le taolo ea taolo ea phethahatso li bapala karolo ea bohlokoa ho pathogenesis ea IGD. Monghali Wang et al a.5 e khothalelitse hore ho bakuli ba nang le IGD, ho ba le kutloelo-bohloko potolohong ea moputso ho eketsehile, athe bokhoni ba ho laola ho se ts'oenyehe ka katleho bo fokotsehile. Lee et al a.6 e tlalehile hore lihlooho tsa sehlopha sa IGD li ne li na le li-anterior cingulate (ACC) tse otlolohileng le tse nepahetseng tsa lateral orbitofrontal (OFC) ho feta tse laoloang hantle. Ntle le moo, lehlakore le letle le letona la OFC sehlopheng sa IGD le ne le amahanngoa le khatello e phahameng.
Ts'ebetso ea Lelapa le Potoloho ea Moputso
Ts'ebetso ea moputso e ka fetoloa mafu a fapaneng a kelello, ho kenyeletsoa maloetse a lemalloang le khaello ea tlhokomelo ea khatello ea kelello (ADHD)7,8. Potoloho ea moputso e na le striatum, e entsoeng ka mokokotlo oa lentiform le mokokotlo oa caudate, le li-cortices tse tsoang pele tse kenyellelitsoeng ho kenyelletsa OFC le ACC9,10. Ho se leka-lekane lipakeng tsa striatum le ventromedial preortal cortices ho amahanngoa le li-psychopathologies tse fapaneng11. Mohlala, mokhoa oa ho khetholla mesebetsi kahare ho striatum o kanna oa itšetleha ka karolo ea ts'ebetso ea moputso, joalo ka boikaketsi nakong ea tebello ea moputso le botsitso nakong ea pelehi.12.
Momahano ea lelapa le likamano tsa 'm'a le ngoana joalo ka sephuthelwana li ka bapala karolo ea bohlokoa tebellong ea tebello13,14. Mekhoa ea ho hokela bana e amahanngoa haholo le kopano ea lelapa15. Kuznetsova16 momahanyo ea lelapa e ka thibela litlamorao tse mpe tsa kutloisiso ho putsa ka ntle, ha Holz et al a.13 Tlaleho ea hore tlhokomelo ea bakhachane e sa le pele e ka thibela tšusumetso e mpe ea lelapa ho psychopathology e hokahantsoeng le potoloho ea moputso, joalo ka ADHD. Pauli-Pott et al a.14 e khothalelitse hore karabelo e ntle ea bo-mme le kutloisiso li ka noha kholo ea taolo e amanang le moputso ho bana.
Ts'ebetso ea Lelapa e Sebetsang le Bothata ba ho Bapala Inthaneteng
Ts'ebetso ea lelapa e tsejoa e le e 'ngoe ea lintlha tsa bohlokoa tse phethang karolo ho boithuto le ho kenella bakeng sa ts'ebetso ea papali e fetelletseng ea inthanete.17. Boithuto bo bongata bo bontšitse hore ts'ebetso ea lelapa joalo ka momahano e kanna ea ba sesosa sa bohlokoa ho aetiology ea IGD18,19. Ka tlhaiso-leseling e hlophisehileng ea mabaka a lelapa papaling ea bocha ea mathata a lilemong tsa bocha, Schneider et al a.20 e tlalehile hore likamano tse futsanehileng tsa motsoali le ngoana li ne li amahanngoa le ho tiea ha IGD, le hore likamano tse ntle li ka supa sesosa sa ts'ireletseho ho jeleng setsi ha IGD. Chiu et al a.21 e fumane tšebetso e ntle ea lelapa e le tšireletso khahlano le papali e nang le mathata Taiwan. Liu et al a.22 o hirile kalafo ea sehlopha sa malapa a mangata bakeng sa mocha ea lemaletseng inthanete (ho kenyeletsoa le IGD). E HLAHETSE KA MONG: Torres-Rodríguez et al a.23 e kenyelelitse mojule oa ho kenella oa lelapa lenaneong la bona la kalafo bakeng sa IGD, ka liphetho tse ntle tsa mofofisi. Monghali Han et al a.24 o sebelisitse kalafo ea boits'oaro ea boits'oaro (CBT) e nang le likarolo tse ntlafalitsoeng tsa kalafo ea malapa bakeng sa IGD mme a bonts'a sephetho se ts'episang. González-Bueso et al a.25 e tlalehile hore lihlopha tsa IGD tse fumanang CBT ntle le thuto ea kelello ea motsoali li bonts'a litefiso tse phahameng tsa ho tlohela sekolo nakong ea kalafo ho feta tse fumanang CBT ka psychoeducation ea motsoali.
Khopolo-taba
Re nahanne hore bakuli ba nang le IGD ba bonts'itse mekhoa e senyehileng ea likamano tsa malapa, ha e bapisoa le litaba tsa taolo e phetseng hantle. Ntle le moo, re ne re lebelletse hore mekhoa ena ea likamano tsa malapa e tla amahanngoa le ts'ebetso ea boko ka har'a potoloho ea moputso ho bakuli ba nang le IGD.
mekhoa
barupeluoa ba
Bacha ba nang le IGD empa ba se na litlokotsi tse ling tsa kelello ba ile ba hiroa ho tsoa sechabeng sa bacha ba 215 ba ileng ba etela Setsi sa Tleliniki le Lipatlisiso sa Inthanete (OCRC) sepetleleng sa Chung Ang University lipakeng tsa Pherekhong 2015 le Tshitwe 2018. Ho bacha bohle ba 215 ba nang le mathata a ho bapala Inthaneteng, 106 bakuli ba nang le IGD ba fumanoe ba e-na le ADHD le IGD, 15 ba nang le ADHD le khatello e kholo ea khatello ea maikutlo (MDD) le IGD, 42 ba nang le MDD le IGD, le 10 ba nang le IGD le tse ling tse mpe. Palo ea bakuli ba nang le IGD feela (e hloekileng ea IGD) e ne e le 42. Hobane bakuli bohle ba ngolisitsoeng e ne e le banna, re ile ra thaotela bacha ba phetseng hantle ba lilemo tse 41 joalo ka bafo ba taolo, ka lipapatso lefapheng la bakuli ba sepetlele sa Chung Ang University.
Bakuli bohle le bafo ba taolo ea bophelo bo botle ba etileng OCRC ba ile ba hlahlojoa ka Structured Clinical Interview ea DSM-5 Clinician Version26, tataiso e hlophisitsoeng ea lipuisano bakeng sa mathata a maholo a kelello le litekanyetso tsa tlhahlobo ea IGD li ne li thehiloe ho DSM-52. Litlhahlobo tsohle li entsoe ke bangoli (DHH, JH), bao e leng lingaka tsa mafu a kelello le bana ba netefalitsoeng ba nang le boiphihlelo bo fetang ba lilemo tse 10 lipakeng tsa bona. Mekhoa ea ho khetholla e ne e le ka tsela e latelang: 1) nalane ea ts'itiso ea hlooho le mafu a kelello kapa a bongaka, 2) intelligence quotient (IQ) <70, kapa 3) claustrophobia.
Protocol ea lipatlisiso tsa thuto ena e amohetsoe ke boto ea tlhahlobo ea setheo sa Sepetlele sa Chung Ang University. Mekhoa eohle e ile ea etsoa ho latela Phatlalatso ea Helsinki. Tumello e ngotsoeng e ngotsoeng e ile ea bokelloa ho tsoa ho bacha bohle le ho batsoali ba bona bakeng sa ho nka karolo ha bana ba bona thutong.
Tsamaiso ea ho ithuta le likamano tsa lelapa
Barupeluoa bohle (bacha ba nang le IGD le taolo e phetseng hantle) ba ile ba botsoa hore ba tlatse lipotso tsa lipotso mabapi le tlhaiso-leseling ea sechaba mme ba fuoa sekala se lekolang boemo ba bona ba kelello, ho tiea ha bothata ba bona le likamano tsa bona tsa malapa. Boemo ba kelello, IQ, ADHD, ho tiea ha IGD, MDD, le matšoenyeho li ile tsa lekanyetsoa ho sebelisoa Korea Wechsler Intelligence Scale for Children (K-WISC)27, Mofuta oa Korea oa DuPaul's ADHD Rating Scale (K-ARS)28,29, Tekanyo e nyane ea bokhoba ba inthanete (YIAS)30, Inventory ea Bana ea Ho Tepella Maikutlong (CDI)31, le Beck Anxiety Inventory (BAI)32, ka ho latellana. Likamano tsa lelapa li ile tsa hlahlojoa ho sebelisoa sebaka sa kamano sa Lelapa la Tikoloho (FES-R).33 e nang le lihlapiso tse tharo: momahano ea lelapa, ho hlahisa maikutlo le likhohlano18,33. Momahano ea lelapa e lekanya hore na litho tsa lelapa li fane ka tšehetso e kae (mohlala: “Litho tsa lelapa li thusana le ho tšehetsana”). Ho hlahisa maikutlo ho lekanya hore na litho tsa lelapa li nahana hore ba ka phetlelana maikutlo a bona hakae (mohlala, “Litho tsa lelapa hangata li ipolokela maikutlo a tsona”). Khohlano e lekanya hore na bohale bo hlahisoa pepeneneng ka lelapeng (mohlala, “Re loana haholo ka malapeng a rona”). Setsi sa likamano sa FES se lekanya hore na litho ka bomong tsa lelapa li talima tšebetso ea malapa a tsona joang; lintlha tse phahameng hangata li bolela hore motho o bona malapa a bona a sebetsa hantle, le hore ba na le maemo a tlase a tlhabollo33-35.
Ho fumana le ho sebetsana le litšoantšo tsa Brain
Lintlha tsohle tsa resting-state magnetic resonance imaging (rs-MRI) li ile tsa bokelloa ho skena sa 3.0 T Philips Achieva. Nakong ea skena sa Rs-MRI. Bacha bohle ba ile ba bolelloa hore ba robale fatše 'me ba lule ba falimehile leihlo le koetsoe metsotsoana e 720 ho fihlela ho fumanoa meqolo e 230. Ho sebelisa li-cushion, lihlooho tsa bankakarolo li ile tsa tsitsisoa ho thibela ho sisinyeha ha hlooho. Lintlha tsa fMRI li ile tsa bokelloa ka tatellano ka tatellano ea imaging-planar imaging (EPI) ho sebelisoa mekhahlelo e ka tlase: TR / TE = 3000/40 ms, 40 slices, 64 × 64 matrix, 90 ° flip angle, 230-mm FOV, le 3- mm botenya ntle le lekhalo. Meqolo ea pele ea 10 e ile ea tlosoa bakeng sa botsitso ba tšimo.
Ho lokisa le ho sebetsana le data ho hlophisitsoe ho sebelisoa Mothusi oa Ts'ebetso ea Ts'ebetso ea Rs-fMRI (Lebokose la lithulusi la DPARSFA)36, e sebetsang ho Statistical Parametric Mapping (SPM12; http://www.fil.ion.ucl.ac.uk/spm/software/spm12/) le Rs-fMRI Data Analysis Toolkit (REST)37. Litšoantšo tsa boko li ile tsa bokelloa ka ho fumana selae, ho se tšoane ha nako, ho hlophisoa bocha, ho hlophisoa ka mokhoa o hlophisehileng, ho ntlafatsoa ka sebaka ka kernel ea 6-mm Full-Width Halum Maximum (FWHM), de-trended, le temp-temp band-pass e hloekisitsoeng (0.01-0.08 Hz). Ho ipapisitsoe le liphetho tsa ts'ebetso ea tokiso, bafo ba bonts'itseng ho sisinyeha ha hlooho ka mokhoa o fetelletseng (phetolelo e fetang 3 mm kapa motsamao oa potoloho e fetang li-degree tsa 2 ka tsela efe kapa efe) e lokela ho qheleloa ka thoko tlhahlobisong. Leha ho le joalo, ha rea ka ra fumana lihlooho tse nang le ho sisinyeha ho feteletseng ha hlooho.
Ho fumana tšebetso ea boko libakeng tse khahlisang (ROIS), bophahamo ba karolo e nyane ea ho feto-fetoha ha maqhubu a tlase (fALFF) e ntšitsoe ho sebelisoa REST software. Nakong ea tlhahiso ea pele ea data e sebetsang, li-coefficients tse kopantsoeng tsa Fisher lipakeng tsa li-ROI hammoho le phapang ea FALFF lipakeng tsa li-ROI e baliloe ho sebelisoa lebokose la lisebelisoa la khokahano la CONN-fMRI (mofuta oa 15)38. Coefficient ea Kendall ea concordance e fetotsoe ho z-lintlha tsa ho hlophisa tlhahlobo ea sehlopha. Khokahano lipakeng tsa lintlha tsa FES le FALFF e ile ea sebelisoa ho fumana libaka tsa peo tse neng li sebelisoa e le tlhahlobo ea ts'ebetso ea khokahano ea peo (FC).
Tlhahlobo ea FC e thehiloeng ho peo e entsoe ho sebelisoa peo ea ROI e nkiloeng mohatong o fetileng oa papiso ea khokahano lipakeng tsa FES le FALFF. Li-coefficients tsa pearson li kopantsoe ho tsoa tekanyetsong ea nako ea peo ea mali-oxygenation level (BOLD) ho voxel e ngoe le e ngoe. Li-coefficients tsa khokahano li ile tsa fetoleloa ho li-z tsa sekolo tse atisang ho ajoa li sebelisa Fisher's z-transform.
Lipalo-palo li
Lintlha tsa palo ea batho le tsa kelello li ile tsa bapisoa lipakeng tsa bacha ba nang le IGD le taolo e nepahetseng ba sebelisa liteko tse ikemetseng tsa t. Likamano lipakeng tsa limmapa tsa FALFF le lintlha tsa FES li baliloe ho sebelisoa sephutheloana sa software sa SPM12. Litekanyetso tsa FALFF li ile tsa bapisoa lipakeng tsa bacha ba nang le IGD le taolo e phetseng hantle ba sebelisa liteko tse ikemetseng tsa t. FC lipakeng tsa peo le libaka tse ling e ile ea bapisoa le bacha ba nang le IGD le taolo e phetseng hantle ba sebelisa liteko tse ikemetseng tsa t. Limmapa tse hlahisitsoeng li ne li thibetsoe ho p-boleng ba <0.05, le litokiso tsa bohata tsa ho sibolla (FDR) li sebelisitsoe bakeng sa lipapiso tse ngata tse nang le li-voxels tse fetang 40 tse ikhethileng.
Results
Lintlha tsa palo ea batho le tsa bongaka
Ho ne ho se na phapang e kholo ho lilemo, thuto ea sekolo, IQ le lintlha tsa CDI lipakeng tsa bacha ba nang le IGD le lithuto tse laoloang hantle (Tafole 1). Leha ho le joalo, bacha ba nang le IGD ba bontšitse lintlha tse eketsehileng ho K-ARS (t = 6.27, p <0.01), BAI (t = 2.39, p = 0.02), le YIAS (t = 18.58, p <0.01) mme ba fokotsa lintlha ho FES-R (t = -3.73, p <0.01). Liteko tsa Post-hoc ho lintlha tsa FES-R li bonts'itse hore li-cohesion subscale scores tsa FES-R li ne li le tlase bakeng sa bacha ba nang le IGD ho feta bakeng sa taolo e nepahetseng (t = -8.76, p <0.01).
Lethathamo 1
Papiso ea tlhaiso-leseling ea sechaba le litšoaneleho tsa bongaka lipakeng tsa bacha ba nang le IGD le lithuto tse laoloang hantle.
| Bacha ba nang le IGD | Mocha ea phetseng hantle | Lipalo-palo li | |
|---|---|---|---|
| Lilemo (lilemo) | 14.6 ± 1.1 | 14.8 ± 2.0 | t = -0.67, p = 0.51 |
| Thuto ea sekolo (lilemo) | 7.5 ± 1.0 | 7.8 ± 1.9 | t = -0.92, p = 0.36 |
| IQ | 96.4 ± 10.3 | 96.3 ± 14.0 | T = 0.01, p = 0.99 |
| K-ARS | 13.6 ± 6.9 | 5.7 ± 4.3 | t = 6.27, le <0.01 * |
| CDI | 7.2 ± 5.2 | 5.8 ± 3.8 | T = 1.40, p = 0.16 |
| bai | 8.1 ± 8.3 | 4.7 ± 3.4 | t = 2.39, p = 0.02 * |
| YIAS | 60.6 ± 8.2 | 30.1 ± 6.6 | t = 18.58, le <0.01 * |
| FES-R | 10.5 ± 4.4 | 14.6 ± 5.4 | T = -3.73, le <0.01 * |
| Sesebelisoa sa likhohlano | 3.5 ± 1.6 | 4.0 ± 2.7 | t = -1.09, p = 0.28 |
| Tlhaloso e nyane | 3.5 ± 1.8 | 4.2 ± 2.1 | t = -1.68, p = 0.10 |
| Bonngoe bo kopaneng | 3.4 ± 1.5 | 6.4 ± 1.6 | T = -8.76, le <0.01 * |
K-ARS: Phetolelo ea Korea ea DuPaul's ADHD Scale Scale, CDI: Inventory ea Bana ea Ho Tepella Maikutlong, BAI: Beck Matšoenyeho Inventory, YIAS: Tekanyo e nyane ea bokhoba ba inthanete, FES-R: Sebaka sa kamano ea tikoloho ea lelapa
Bacha bohle ba kopantsoe (bacha ba nang le IGD le lithuto tse laoloang hantle) ba bonts'a kamano e mpe lipakeng tsa YIAS le lintlha tsa FES-R (r = -0.50, p <0.01); Ka har'a lihlotšoana, lintlha tsa YIAS li ne li hokahane hampe le lintlha tsa FES-R ho bacha ba nang le IGD (r = -0.67, p <0.01) empa eseng taolong e phetseng hantle (r = -0.11, p = 0.46).
Khokahano lipakeng tsa lintlha tsa FES le boleng ba FALFF
Ho bacha bohle ba kopaneng, FALFF kahare ho cortex ea ka ho le letšehali (x, y, z: -3, -18, 30, ke = 105, T = 6.30, FDRq = 0.002) e ne e hokahane le lintlha tsa FES-R (r = 0.66, p <0.01) (sa feiga. 1A). Tlhatlhobo ea post-hoc e bonts'a kamano e ntle lipakeng tsa boleng ba FALFF kahare ho cortex e ka letsohong le letšehali le lintlha tsa FES-R bakeng sa IGD (r = 0.61, p <0.01) le lihlopha tsa taolo e phetseng hantle (r = 0.60, p <0.01) .
Khokahano lipakeng tsa tšebetso ea boko le likamano tsa lelapa le papiso ea khokahano e sebetsang lipakeng tsa bacha le IGD le lithuto tsa taolo e phetseng hantle. (AKhokahano lipakeng tsa sebaka sa likamano tsa lelapa la tikoloho (FES-R) le litekanyetso tsa FALFF (FALFF vs FES). Mebala e bonts'a khokahano lipakeng tsa boleng ba FALFF kahare ho cortex e ka letsohong le letšehali (x, y, z: -3, -18, 30, ke = 105, T = 6.30, FDRq = 0.002) le lintlha tsa FES-R ho bacha bohle (r = 0.66 , p <0.01). (BPapiso ea khokahano e sebetsang (FC) ho tloha ka peo e ka letsohong le letšehali ho ea libakeng tse ling lipakeng tsa bacha ba nang le bothata ba lipapali tsa inthanete (IGD) le lithuto tse laoloang hantle (Tlhatlhobo ea peo). FC ho tloha peo ea cingate ea letsohong le letšehali ho isa ho li-nuclei tsa lentiform (x, y, z: -21, -18, -3, ke = 446, T = 3.96, Pe sa lokang <0.001 le ke = 394, T = 3.49, Pe sa lokang <0.001, 21, -15, 12) e fokotsehile, ha e bapisoa le taolo e nepahetseng.
Papiso ea FC ho tloha peo ea cingate ea leqele ho ea libakeng tse ling lipakeng tsa bacha ba nang le IGD le taolo e phetseng hantle
FC ho tloha peo ea cingate ea letsohong le letšehali ho isa ho li-nuclei tsa lentiform (x, y, z: -21, -18, -3, ke = 446, T = 3.96, Pe sa lokang <0.001 le ke = 394, T = 3.49, Pe sa lokang <0.001, 21, −15, 12) e ile ea fokotseha ho bacha ba nang le IGD ha e bapisoa le taolo e nepahetseng (Fig. 1B). Ho ne ho se na libaka tse bonts'itseng keketseho e kholo ea FC ho bacha ba nang le IGD ha e bapisoa le taolo e nepahetseng.
Likamano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea ho nuclei ea lentiform
Ho bacha bohle ba kopaneng, boleng ba FC ho tloha ka letsohong le letšehali ho ea mokokotlong oa lentiform (r = 0.31, p <0.01) bo ne bo hokahane hantle le lintlha tsa FES-R. Boleng ba FC ho tloha ka letsohong le letšehali ho ea mokokotlong oa lentiform o ne o boetse o hokahane hantle le lintlha tsa FES-R, empa khokahano e ne e se ea bohlokoa lipalo (r = 0.27, p = 0.02) (Fig. 2A, B). Ho bacha bohle ba kopaneng, litekanyetso tsa FC ho tloha ka letsohong le letšehali ho ea ka ho le letšehali (r = -0.35, p <0.01) le mokokotlo o nepahetseng oa lentiform (r = -0.37, p <0.01) li ne li hokahane hampe le lintlha tsa YIAS (sa feiga. 2C, D). Ho bacha bohle ba kopaneng, litekanyetso tsa FC ho tloha ka letsohong le letšehali ho ea ho le letšehali (r = -0.41, p <0.01) le mokokotlo o nepahetseng oa lentiform (r = -0.31, p <0.01) li ne li hokahane hampe le lintlha tsa K-ARS ( Feie. 2E, F).
Likamano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea ho li-nuclei tsa lentiform lithutong tsohle (AKhokahano lipakeng tsa boleng ba khokahanyo ea tšebetso (FC) ho tloha ka letsohong le letšehali ho ea lenaneng la le letšehali le lenaneng la kamano ea tikoloho ea lelapa (FES-R) lithutong tsohle (r = 0.31, p <0.01). (BKhokahano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea ho mokokotlo o nepahetseng oa lentiform le domain ea Family Environmental Scale-kamano (FES-R) lithutong tsohle (r = 0.27, p = 0.02). (CKhokahano lipakeng tsa litekanyetso tsa FC ho tloha ka letsohong le letšehali ho ea ho mokokotlo oa lentiform le sekhahla sa Young Internet Addiction (YIAS) lithutong tsohle (r = -0.35, p <0.01). (DKhokahano lipakeng tsa litekanyetso tsa FC ho tloha ka letsohong le letšehali ho ea ho mokokotlo oa lentiform le sekhahla sa Young Internet Addiction (YIAS) lithutong tsohle (r = -0.37, p <0.01). (EKhokahano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea mokokotlong oa lentiform le mofuta oa Korea oa lintlha tsa DuPaul tsa ADHD Rating Scale (K-ARS) lithutong tsohle (r = -0.41, p <0.01). (FKhokahano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea ho mokokotlo oa lentiform le sekoa sa Korea sa DuPaul's ADHD Rating Scale (K-ARS) lithutong tsohle (r = -0.31, p <0.01).
Ho bacha ba nang le IGD, litekanyetso tsa FC ho tloha ka letsohong le letšehali ho ea ho le letšehali (r = 0.56, p <0.01) le mokokotlo o nepahetseng oa lentiform (r = 0.32, p = 0.04) li ne li hokahane hantle le lintlha tsa FES-R (Fig. 3A, B), ha boleng ba FC ho tloha ka letsohong le letšehali ho ea ka ho le letšehali (r = -0.67, p <0.01) le mokokotlo o nepahetseng oa lentiform (r = -0.41, p <0.01) li ne li hokahane hampe le lintlha tsa YIAS (Fig. 3C, D). Ho bacha ba nang le IGD, litekanyetso tsa FC ho tloha ka letsohong le letšehali ho ea ka ho le letšehali (r = -0.55, p <0.01) le mokokotlo o nepahetseng oa lentiform (r = -0.31, p <0.01) li ne li hokahane hampe le lintlha tsa K-ARS ( Feie. 3E, F).
Likamano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea ho li-nuclei tsa lentiform ho bacha ba nang le IGD (AKhokahano lipakeng tsa boleng ba khokahanyo ea tšebetso (FC) ho tloha ka letsohong le letšehali ho ea mokokotlong oa lentiform le sebaka sa Family Environmental Scale-kamano (FES-R) lihloohong tse nang le bothata ba lipapali tsa inthanete (IGD) (r = 0.56, p <0.01 ). (BKhokahano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea ho mokokotlo o nepahetseng oa lentiform le domain ea Family Environmental Scale-kamano (FES-R) ho bacha ba nang le IGD (r = 0.32, p = 0.04). (CKhokahano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea ho mokokotlo oa lentiform le sekhahla sa Young Internet Addiction (YIAS) ho bacha ba nang le IGD (r = -0.67, p <0.01). (DKamano lipakeng tsa litekanyetso tsa FC ho tloha ka letsohong le letšehali ho ea ho mokokotlo oa lentiform le sekhahla sa Young Internet Addiction (YIAS) ho bacha ba nang le IGD (r = -0.41, p <0.01). (EKhokahano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea mokokotlong oa lentiform le mofuta oa Korea oa DuPaul's ADHD Rating Scale (K-ARS) cores ho bacha ba nang le IGD (r = -0.55, p <0.01). (FKhokahano lipakeng tsa boleng ba FC ho tloha ka letsohong le letšehali ho ea ho mokokotlo oa lentiform le seoa sa Korea sa DuPaul's ADHD Rating Scale (K-ARS) ho bacha ba nang le IGD (r = -0.31, p <0.01).
Ho ne ho se na likamano tse bohlokoa lipakeng tsa lintlha tsa FES-R, lintlha tsa YIAS, le litekanyetso tsa FC ho tloha ho cingate ho isa ho li-nuclei tsa lentiform lithutong tse laoloang hantle.
Puisano
Liphetho tsa rona li bonts'itse lintlha tse eketsehileng tsa YIAS empa li fokotse lipalo tsa FES-R le FES-cohesion ho bacha ba nang le IGD ha ho bapisoa le taolo e phetseng hantle. Lintlha tsa YIAS li ne li hokahane hampe le lintlha tsa FES-R ho bacha ba nang le IGD, mme khokahano ea boko ho tloha ho cingulate ho ea ho striatum e ile ea fokotseha. Ntle le moo, khokahano ea boko ho tloha ho cingulate ho ea ho striatum e ne e hokahane hantle le lintlha tsa FES-R mme e hokahane hampe le ho tiea ha IGD sehlopheng sa IGD.
Bacha ba nang le IGD ba ne ba e-na le lintlha tse phahameng ho K-ARS le BAI ho feta taolo e phetseng hantle, leha ba khethile bacha ba nang le IGD le mafu a mang a kelello, ho bolelang hore bacha ba nang le IGD ba ka ba le mathata a phahameng a tlhokomelo le matšoenyeho. Ntle le moo, litekanyetso tsa FC ho tloha ka letsohong le letšehali ho ea ho li-nuclei tsa lentiform li ne li amana hampe le boima ba lintlha tsa ADHD ho bacha bohle, ho kenyeletsoa le ba nang le IGD. Lintlha tsena li tsamaellana le lithuto tsa rona tsa nakong e fetileng re sebelisa fMRI ho bapisa bakuli ba nang le ADHD le ba nang le IGD; Phuputso eo e bonts'itse phokotseho ea FC lipakeng tsa gyrus e ka pele-bohareng le bokong ba caudate le lipakeng tsa cingate ea ka ho le letšehali le mokokotlo oa caudate ho bakuli ba nang le IGD le ba nang le ADHD, ho bolelang hore lihlopha tsena tse peli li ka arolelana patophysiology e tloaelehileng39. Phuputso ea rona ea pejana ea EEG e bapisang bakuli ba nang le ADHD le comorbid IGD mme ba nang le ADHD e hloekileng ba bontšitse beta e phahameng ea sehlopha se comorbid, e fana ka maikutlo a hore bakuli ba nang le ADHD, ba thatafalloang ho tsepamisa mohopolo, ba ka sebelisa lipapali e le mokhoa oa ho tsepamisa maikutlo a bona40. Likamano tse tšoanang li fumanoe ke bafuputsi ba bang mabapi le mathata a tlhokomelo ho bakuli ba nang le IGD41,42. Mabapi le mathata a ho tšoenyeha ho bakuli ba nang le IGD, Wang et al a.43 o fumane hore bakuli bana ba na le monyetla oa ho ba le lefu la ho tšoenyeha ho akaretsang ho feta taolo e nepahetseng. Yen et al a.44 e bontšitse hore bakuli ba nang le IGD ba sebelisitse tlhahlobo e nyane ea tlhaiso-leseling le khatello e kholo, e leng se ileng sa baka matšoao a mangata a ho tšoenyeha, ha a bapisoa le bankakarolo ba taolo e phetseng hantle.
Re fumane lintlha tse fokotsehileng tsa FES-R le FES-cohesion ho bacha ba nang le IGD. Ntle le moo, lintlha tsa FES-R li ne li hokahane hampe le lintlha tsa YIAS ho bacha bohle ba kopaneng, athe ke bacha feela ba nang le IGD ba bonts'itseng khokahano e ts'oanang ea FES-R-YIAS. Boemo ba kamano ea FES bo lekola hore na motho a ka bona boleng ba likamano tsa malapa a bona joang45. Sena se bolela hore bacha ba nang le IGD ba bona likamano tsa malapa a bona li le mpe, le hore mekhoa e metle ea lipapali le likamano tse futsanehileng tsa malapa li hokahane. Le ha moralo oa thuto ea rona ea hajoale o sa lumelle hore ho ithute hore na ho bakoa ke eng, bafuputsi ba bang ba nahanne hore maikutlo ana a fosahetseng a ts'ebetso ea likamano tsa lelapa e kanna ea ba lebaka le leng la hore bacha ba chesehele papali haholo.46. Boithuto bo hakantsoe hore libapali tse nang le mathata li ka sebelisa lipapali e le mokhoa oa ho baleha mathata a tsona, 'me likamano tse mpe tsa malapa e kanna ea ba lebaka leo bacha ba nang le IGD ba nahanang hore ha ba na boikhethelo bo bong ntle le ho bapala lipapali46,47. Ntle le moo, tlhaiso-leseling ea rona e bonts'a likhahla tse tlase haholo tsa khokahano ho bacha ba nang le IGD ho feta taolo e nepahetseng. Tšebelisano-mmoho e kahara kamano ea FES e lekanya palo ea thuso le ts'ehetso eo setho se seng le se seng sa lelapa se e fang33. Ka kopano e nyane kahare ho lelapa, motho eo a ka ikutloa a qheleloa ka thoko ho lelapa mme a thatafalloa ho fumana tšehetso ho litho tsa lelapa nakong ea tlokotsi, ka hona a fetohela papaling.
Ho bacha bohle ba kopaneng, lintlha tsa FES-R li ne li tsamaellana le FALFF kahare ho cortex e ka letsohong le letšehali. Ha ho hlahlojoa peo, FC ho tloha ka letsohong le letšehali ho ea mokokotlong oa lentiform e ne e hokahane hantle le lintlha tsa FES-R. Ntle le moo, FC ho tloha ka letsohong le letšehali ho ea ho li-nuclei tsa lentiform e ne e hokahane hantle le lintlha tsa YIAS. Sehlopha sa IGD, ho bonoe liphetho tse tšoanang, tse bontšang hore FC e tlase lipakeng tsa cingulate gyrus le nuclei ea lentiform e ne e amahanngoa le likamano tse mpe tsa malapa le IGD e matla le ho feta. Ho khahlisang ke hore cingulate cortex le lentiform nuclei li tsejoa e le karolo ea potoloho ea moputso9,10. Ho feta moo, potoloho ea moputso e nahanoa hore e hokahane le bonngoe ba lelapa le kamano13,14,16. Lintlha tsa rona li bonts'a likamano tse sa sebetseng tsa malapa li amana le lipotoloho tse sa sebetseng tsa moputso ho motho ka mong, tse ka amanang le matšoao a phahameng a IGD. Boithuto ba pejana bo bontšitse hore kalafo ea malapa e ka ba le phello e ntle ho IGD24.
Liphetho tsa rona, tse bonts'ang bacha ba IGD ba sentse likamano tsa malapa le hore tšitiso e tsamaellana le potoloho ea moputso, e tsamaellana le lithuto tsa pele tse bontšang likamano tsa bana le motsoali ke karolo ea bohlokoa ho IGD17-21. Ho hlalosa kamano lipakeng tsa likamano tsa lelapa le IGD, Throuvala et al a. o hlahisitse hore likamano tse futsanehileng tsa malapa li ka lebisa boikutlong bo bobe bo ka lebisang papaling e feteletseng48. Boithuto ba nako e telele bo bontšitse hore likamano tse sa sebetseng tsa lelapa li ekelitse monyetla oa hore ngoana a be le mathata a amanang le papali49. Phuputso e 'ngoe ea nako e telele e hlokometse sephetho se ts'oanang ho bapalami ba tšoenyehileng, leha maemo a phahameng a momahano ea lelapa kamora ntlha e itseng a sa ka a fokotsa kotsi ea IGD, e ka supang hore ho ka ba le lintlha tse ling tse lokelang ho nahanoa ho IGD ho fapana feela le kutloano ea lelapa50. Boithuto ba rona bo eketsa leseli le lecha ho taba ena, eseng ka lebaka la maemo, empa ka hore re bonts'a khokahano ea kamano ea IGD le ea lelapa ka pono ea neurobiological. Sena se ka kengoa tšebetsong joalo ka bopaki ba lits'ebetso tsa malapa tse thehiloeng ho IGD. Mefuta e mengata ea kalafo ea malapa e se e bontšitse matla a ho phekola IGD22,24,25. Phekolo e khutšoane ea beke ea 3 ea lelapa e bonts'itse ho fetola lintlha tse amanang le papali kahare ho boko ho bakuli ba IGD51 le kalafo e susumetsang ea mofuta o mong, mofuta oa nalane ea sistimi ea lelapa e sebelisetsoang kalafo ea ts'ebeliso ea lithethefatsi, le eona e hlahisitsoe hore e ka thusa ha e fetoloa bakeng sa IGD52.
Boithuto ba hajoale bo na le meeli e mengata. Pele, boholo ba sampole bo ne bo le nyane; ka hona, liphetho li ke ke tsa akaretsoa. Taba ea bobeli, ha rea ka ra sebelisa FES kaofela, ho boloka nako, joalo ka ha bacha ba na le tloaelo ea ho tela kapa ho arabela ka mokhoa o sa nepahalang hape ba tloaetse ho ba le khethollo ea sechaba ha sekala se nka nako e telele18. Khetho ena, leha e ntlafalitse boleng ba kakaretso ea data ea sekala, e re sitisitse ho kenyelletsa litekanyo tse ling tse amanang le malapa, joalo ka kholo ea motho kapa tlhokomelo ea sistimi. Taba ea boraro, leha YIAS, e neng e sebelisoa e le sekala sa tlhahlobo ea psychometric thutong ea rona, e sebelisoa haholo lipatlisisong tse tšoanang, e ile ea ntlafatsoa e le mohato oa ho lemalla inthanete ka kakaretso eseng haholo-holo bakeng sa IGD. Joalo ka ha ho bile le lintlafatso tsa moraorao tsa moralo oa IGD, o qalileng ke American Psychiatric Association le World Health Organisation, lithuto tsa nako e tlang li ka ntlafatsoa ka ho sebelisa sekala se kenyelletsang lintlafatso tsena, joalo ka Internet Gaming Disorder-20 Test53Foromo e Khuts'oane ea ho Bapala Inthaneteng54, Tekanyo ea Matšoenyeho a Inthanete55, le Teko ea Boloetse ba Gaming56. Kamora nako, kaha ena e ne e le thuto e arohaneng, re ne re sa khone ho fihlela liqeto tse hlakileng mabapi le likamano tse nepahetseng lipakeng tsa matšoao a IGD, lipotoloho tse sa sebetseng tsa moputso, le likamano tsa lelapa tse sa sebetseng. Babali ba lokela ho ba hlokolosi ha ba toloka litholoana tsa thuto ena ea hajoale.
Ha re phethela, bacha ba nang le IGD ba ne ba sentse likamano tsa malapa, tse neng li amahanngoa le boima ba lefu lena. Ntle le moo, likamano tse senyehileng tsa malapa ho bacha ba nang le IGD li ne li amahanngoa le ho se hokahane ka har'a potoloho ea moputso.
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