Neurosci Biobehav Rev. 2019 Jun 24. pii: S0149-7634 (19) 30370-7. Doi: 10.1016 / j.neubiorev.2019.06.032.
Mochine M1, Wegmann E2, Khohlano R3, Müller A4, Wölfling K5, Robbins TW6, Potenza MN7.
Lintlha-khōlō Tsa
- Boitšoaro bo bobebe bo hokahanngoa le ho etsa lintho tse ncha hape ho lakatsang
- Boitšoaro bo tlatsetsang bo amahanngoa le taolo e fokotsang ea taolo
- Mekhoa ea tloaelo e ntlafalitsoe molemong oa boitšoaro bo bobe
- Ho se leka-lekane pakeng tsa mekoloko ea libapali tsa fronto ho thusa ho etsa boits'oaro bo bobe
inahaneloang
Re fana ka tlhahiso ea mofuta o ntlafalitsoeng oa mofuta oa Interaction of Motho-Afimate-Cognition-Execution (I-PACE), eo re phehang khang ea hore e nepahetse bakeng sa mefuta e 'maloa ea boits'oaro bo bobebe, joalo ka papali ea chelete, papali ea chelete, ho reka le ho reka, le boitšoaro bo qobelloang ba thobalano. mathata. Re ipapisitse le lipatlisiso tsa morao-rao tse fumanoeng le likhopolo tsa kelello, re pheha khang ka hore mekhoa ea ts'ebelisano e teng ka lebaka la tšebelisano lipakeng tsa lintho tse fetotsoeng nako le nako, likarabo tse amanang le ts'usumetso ho lintlha tse ikhethileng le tšebetso ea botsamaisi, tse kang taolo ea thibelo le liqeto. Ts'ebetsong ea boitšoaro bo tlatsetsang, litloaelano lipakeng tsa cue-reac shughuli / takatso le taolo e fokotsang ea taolo li kenya letsoho kholisong ea boits'oaro bo tloaetseng ho phela. Phapang pakeng tsa meralo ea lipotoloho tse potolohileng letsatsi, haholo-holo lipakeng tsa li-ventral striatum, amygdala, le libaka tsa pele tsa dorsolateral, e kanna ea sebetsa haholo mehatong ea pele le dorsal striatum mehato ea kamora nako ea lits'ebetso tse tlatsetsang. Moetso oa I-PACE o ka fana ka motheo oa theoretical bakeng sa lithuto tsa nako e tlang mabapi le boits'oaro bo bobebe le boikoetliso ba bongaka. Lithuto tsa nako e tlang li lokela ho etsa lipatlisiso mekhoa e tloaelehileng le e ikhethileng e kenyellelitsoeng litlamong tse amanang le bokhoba ba taolo, bokhoba ba taolo e matla, tšusumetso ea maikutlo le tšebeliso ea lithethefatsi.
LINKOTSO: Ho lemalla boitšoaro bothata ba ho reka; ho etsa lintho tse ncha; bothata ba ho becha; bothata ba lipapali; taolo ea inhibitory; ts'ebeliso e mpe ea litšoantšo tsa bootsoa
PMID: 31247240
1. Selelekela
Mohlala oa tšebelisano ea Motho-Afimate-Cognition-Execution (I-PACE) oa mathata a itseng a ts'ebeliso ea marang-rang o phatlalalitsoe lilemo tse fetang tse peli tse fetileng (Brand et al., 2016b). Morero o mong e ne e le ho hlalosa ts'ebetso ea kelello le ts'ebetso ea ts'ebetso ea ts'ebetso ea ts'ebetso le ts'ebetso ea ts'ebeliso e mpe ea ts'ebeliso ea lits'ebetso tse ikhethileng tsa inthanete, tse kang tse sebelisoang ha ho bapaloa papali ea chelete, papali ea chelete, ho shebella litšoantšo tse litšila tse tsosang takatso, ho reka mabenkeleng le marang-rang. Ho tloha phatlalatso ea mofuta oa I-PACE, e 'nile ea bontšoa khafetsa ke bafuputsi lefatšeng ka bophara eseng feela bakeng sa bothateng ba lipapali (mohlala, Deleuze et al., 2017; Dieter et al., 2017; Dong et al., 2019; Kaess et al., 2017; Lee et al., 2018a; Lee et al., 2018b; Li et al., 2018; Paulus et al., 2018; Sariyska et al., 2017), empa hape le bothata ba ho becha (mohlala, Ioannidis et al., 2019b; Starcke et al., 2018), tlhekefetso ea boitšoaro bo bobe ba thobalano e kenyeletsa ts'ebeliso e mpe ea ts'ebeliso ea litšoantšo tsa bootsoa (mohlala, Liketso le Lerato, 2017; Strahler et al., 2018; Wéry et al., 2018), bokuli ba ho reka mabenkeleng (mohlala, Lam & Lam, 2017; Vogel et al., 2018), ts'ebeliso e fetelletseng ea likopo tsa puisano (mohlala, Dempsey et al., 2019; Elhai et al., 2018; Kircaburun & Griffiths, 2018; Montag et al., 2018; Rothen et al., 2018), bokuli bo sa sebelisoeng ba tšebeliso ea inthanete (mohlala, Carbonell et al., 2018; Emelin et al., 2017; Ioannidis et al., 2019a; Lachmann et al., 2018; Vargas et al., 2019; Zhou et al., 2018b), le ka mekhoa e meng e lemalloang ho kenyelletsa mathata a ts'ebeliso ea lithethefatsi (Zhou et al., 2018a). Khatiso ea leshome le motso o mong ea Classified ea Mafu a Machaba (ICD-11), ha e sa tsoa lokolloa (Mokhatlo oa Lefatše oa Bophelo, 2019), e shebane le pherekano ka boeona (mohlala, ho beta ha papali ea papali ea chelete) ntle le ho bua ka bothateng, mohlala, papali ea lipapali ho e-na le bothateng ba lipapali tsa inthanete khatisong ea bohlano ea Diagnostic and Statistical Manual (DSM-5) (APA, 2013). Ho ICD-11, tikoloho ea boits'oaro e ka hlalosoa kamora nako e le ngoe, kapa e fumanehang marang-rang bakeng sa mathata a papali ea chelete le lipapali. Ka lebaka leo, mohlala o hlalosang lisosa tsa ts'ebetso ea mathata o tlameha ho ba o sebetsang bakeng sa tikoloho e fumanehang marang-rang le ntle le marang-rang le boits'oaro ba boitšoaro bo kantle ho marang-rang le bo fumanehang marang-rang. Re ntse re tsoelapele ho fana ka maikutlo a hore boits'oaro ka boeona ke karolo ea mantlha eo ho lokelang ho nahanoa ka eona le tikoloho (inthaneteng le mabothobotho ntle le inthanete) e ka ba ea bobeli empa e ka kenya letsoho ka mokhoa o hlakileng ho hlahiseng boitšoaro bo ikhethang ba tlhekefetso le phapang e tloaelehileng ho litloaelo tsena (Baggio et al., 2018). Re fana ka tlhahiso ea mofuta o ntlafalitsoeng oa mofuta oa I-PACE, oo re o qopisisang o tla sebetsa eseng feela bakeng sa mathata a ts'ebeliso ea marang-rang, empa le mefuta e meng ea boits'oaro bo eketsang. Moetso ona oa I-PACE o ntlafalitsoeng o shebana le mekhoa le boits'oaro ba kelello ba motho ka mong. Litaba tse ikhethileng tsa media le lintlha tse ling tsa tikoloho tse amanang le boits'oaro bo ka 'nang ba potlakisa kapa ba theola nts'etsopele ea boitšoaro bo bobebe li ka hlalosoa le ho hlalosoa bakeng sa liphetolelo tse ikhethang tsa mohlala. Feie. 1 e akaretsa karohano e reriloeng lipakeng tsa likarolo tse mahareng / tikoloho, karabelo ea batho ka bomong, le lintlha tsa boits'oaro le neurobiological tse kenyelletsang boits'oarong bo bobe.
Ntle le moo, re ikemiselitse ho hlalosa ka ho hlaka sebopeho sa moetsi ka ho khetholla mefuta e mmedi e tlase, e le ngoe bakeng sa methati e amehang methating ea pele mme e le e 'ngoe ea mekhoa e amehang mohatong oa morao oa ts'ebetso ea temallo. Ha re phete puisano e qaqileng ea likarolo tsohle tse kenyellelitsoeng mohlaleng oa I-PACE (cf. Brand et al., 2016b). Sebakeng seo, re tsepamisa maikutlo ho lihlooho tsa morao-rao, haholo meta-analysis le tlhahlobo e hlophisitsoeng e bululetseng tlhahiso ea I-PACE.
2. Moetso o ntlafalitsoeng oa I-PACE oa boitšoaro bo lematsang
Ho ntlafatsoa ha mofuta oa I-PACE ho kenyelletsa mehato e meraro e meholo. Pele, re tsepamisa maikutlo menahanong e reriloeng esale pele, e 'nileng ea nkuoa e le karolo ea mefuta e fapaneng ea boits'oaro bo bobe (mathata a papali ea chelete, bothata ba lipapali, le ba bang)' me re ba khetholla ho fapana ka mekhoa e reriloeng esale pele. Taba ea bobeli, re hlalosa hantle mookotaba oa ts'ebetso ea ho lemalla ho mofuta oa I-PACE mabapi le lintho tse fumanoeng haufinyane. Taba ea boraro, re khetholla lipakeng tsa mekhahlelo ea pele le ea morao-rao bakeng sa ho hlakisa likarolo tse fapaneng tsa ho ikamahanya le ho phehisana ho fapana ho latela sethala. Moetso o ntlafalitsoeng oa I-PACE oa boits'oaro bo bobebe o bonts'oa Feie. 2. Feie. 2A e bonts'a tšebelisano lipakeng tsa lintho tse fetohang tse nkoang e le tsa bohlokoa haholo methating ea pele ea boits'oaro bo eketsang. Feie. 2B e bonts'a tšebelisano 'moho ea lintho tse fetohileng maemong a kamora nako ea lits'ebetso tse lematsang.
2.1. Karolo ea P ea mofuta oa I-PACE
Karolo ea P e emetse litšobotsi tsa mantlha tsa motho tse ka amehang tšebetsong ea ho lemalla joalo ka lintho tse ka etsahalang (bona puisano ka Brand et al., 2016b). Mefuta e akaretsang ea lintho tse etsahalang pele (lehlakoreng le letšehali ka lebokoseng le kaholimo la mohlala) e ka kenya letsoho ho bohlokoa mefuteng eohle ea boitšoaro bo lemallang (mohlala, ho becha, ho hloka papali, ho se be le tsebo ea ho reka, boteng ba ho sheba litšoantšo tsa bootsoa / boitšoaro bo feteletseng. Lethathamo la lintho tsena tse ka 'nang tsa baka kotsi esale pele ha le fele. E akaretsa feela lintho tse fapaneng tse fumanehang moo bopaki bo pharaletseng bo leng teng, ho kenyeletsoa ho hlahlobisisa meta, leha bopaki bo ka fapana ka matla bakeng sa mefuta e fapaneng ea boits'oaro bo bobebe. Lintlha li fana ka maikutlo a tlatsetso ea bohlokoa liphatseng tsa lefu la ho becha (Lobo, 2016; Potenza, 2017, 2018; Xuan et al., 2017) le bothata ba tšebeliso ea marang-rang bo sa hlalosoang (Hahn et al., 2017). Ntle le moo, ho tlalehiloe liphihlelo tse mpe tsa bongoana e le lintho tse ka fokolisang bothateng ba ho becha (Roberts le al., 2017) le bokuli ba lipapali (Schneider et al., 2017), liphetho tse lumellanang le maikutlo a morao-rao a karolo ea karolo ea boitlamo ho boits'oaro bo lematsang (Alvarez-Monjaras et al., 2018). Litlatsetso tsa Psychopathological, haholo khatello ea maikutlo le matšoenyeho a sechaba, li tlalehiloe khafetsa bakeng sa papali ea chelete (Dowling et al., 2017), lipapaliMännikkö et al., 2017), ts'ebeliso ea marang-rang e sa hlalosoang (Ho et al., 2014), le ho ea mabenkeleng (Müller et al., 2019) likhathatso, le litlolo tse ling tsa boitšoaroStarcevic & Khazaal, 2017). Lits'oants'o tsa mocheso, joalo ka ho ba le tšusumetso e matla, le tsona li amana le papali ea chelete (Dowling et al., 2017), lipapaliGervasi et al., 2017; Kuss et al., 2018; Ryu et al., 2018), le tšebeliso ea marang-rang e sa hlalosoang (Kayiş et al., 2016) mathata, joalo ka ha a na mokhoa oa ho se sebetse hantle oa ho sebetsana ka katleho le boloetse ba lipapali (Schneider et al., 2018). Mohlaleng oa I-PACE, re sebelisa mantsoe a akaretsang (mohlala, psychopathology, likarolo tsa moea tse kenyelletsang ho kenyelletsa, mohlala, tšusumetso) tse ka hlalosoang ho ea pele mabapi le boits'oaro bo itseng ba boits'oaro. Mefuta e ikhethileng ea boitšoaro (lehlakoreng le letona la lebokose le kaholimo ho mohlala, Feie. 2A le B) li nkuoa e le tšobotsi molemong oa boits'oaro bo fapaneng. Mohlala, batho ba batlang bocha haholo ba ka ba le monyetla oa ho ba le bothata ba ho becha (Del Pino-Gutiérrez et al., 2017). Batho ba nang le mabifi le litšobotsi tse makatsang ba ka ba le tšekamelo ea ho ba le bothateng ba lipapali (Gervasi et al., 2017). Batho ba nang le tšusumetso e matla ea thobalano ba ka ba le menyetla ea ho ba le boitšoaro bo litšila kapa bokhopo ba tšebeliso ea litšoantšo tsa bootsoa (Stark et al., 2017), mme batho ba nang le litekanyetso tse phahameng tsa ho rata lintho tse ngata ba kanna ba ba le tšekamelo ea ho hlekefetsoa ho reka (Claes et al., 2016; Müller et al., 2014).
2.2. Lesakana le ka hare: Lintho tse amang (A-), cognition (C-), le ho bolaoa (E-) tsa mofuta oa I-PACE
Morero o mong oa potoloho ea mofuta oa I-PACE ke hore nts'etsopele ea bothata bo nang le mathata le tšenyo e etsahala feela ha ho sebetsanoa ka linako tse fapaneng le maemo a itseng ao maemo a itseng a a hlahisang. Litšebelisano li fella ka liphihlelo tsa thabo le puseletso tse amanang le boits'oaro bo itseng. Mehatong ea pele (Feie. 2A), batho ka bomong ba ka lemoha kantle (mohlala, ho tobana le maikutlo a amanang le boits'oaro) kapa lisosa tsa kahare (mohlala, maikutlo a fosahetseng kapa a nepahetseng haholo) maemong a itseng. Maikutlo a ka baka likarabelo tse lumellanang le tse hlokolosi, tse kang ho lebisa tlhokomelo ho li-stimuli tsena le ho khothaletsa ho phela ka mekhoa e ikhethang; Mohlala o khothalletsa ho bapala lipapali tsa marang-rang kapa ho sheba litšoantšo tsa bootsoa (Starcke et al., 2018).
Likarabo tse khahlisang le tse bonts'a maikutlo li lebisa liqetong tsa ho itshwara ka tsela tse ikhethileng. Qeto ea ho etsa boits'oaro bo itseng e kanna ea tataisoa ke litsamaiso tse peli tse sebelisanang: ts'ebetso e sa tsitsang / e sebetsang, e thehiloeng haholo ho thuto e kopaneng (maemo a khale le a ts'ebetso), le sistimi e bonts'ang / e nahanang, e amanang haholo le ho beha mabaka le mesebetsi e metle (Kahneman, 2003; Schiebener & Brand, 2015; Strack & Deutsch, 2004). Bathong ba nang le bokhoba ba ho lemalla, boitšoaro bo nkuoa bo itšetleha haholo ka lits'ebetso tsa maqhubu tse qobelloang / tse sebetsang, ho kenyeletsa le likarolo tsa maoto (Noël et al., 2006). Taolo ea thibelo ea bokhachane e amanang le pele le litakatso e ka fokola nakong ea ts'ebetso ea bokhoba (Bechara, 2005; Volkow & Morales, 2015). Ho kopanya maikutlo ana a khopolo, re fana ka maikutlo a hore likamano lipakeng tsa likarabelo tse amehang le tse nang le kelello ho lisosa tsa kantle kapa tsa kahare le liqeto tsa ho etsa boits'oaro bo itseng li khethoa ke boemo ba taolo e akaretsang ea thibelo (ho fapana le taolo e tobileng ea maikutlo kapa e susumetsang e ikhethang). Boitlhotlhollo / BoitlhotlholloHahn et al., 2017), bonyane methating e qalang ea boits'oaro bo bobebe. Tlhatlhobo ea meta ka Meng, Deng, Wang, Guo, le Li (2015) e bonts'a hore lits'oaetso tsa pele ho nako li amana le bothata ba lipapali, bo bonts'ang khohlano e teng lipakeng tsa tebello ea moputso le lits'ebetso tsa boitaolo, ho kenyeletsa likhohlano tse amanang le ho lieha ho khotsofatsa. (Volkow & Baler, 2015). Mabapi le taolo e akaretsang ea thibelo, Yao et al. (2017) tlaleha liphetoho tse sebetsang tsa sebopeho le sebopeho bothateng ba lipapali tse amanang le phokotso ea tšebetso e phahameng. Boitšoaro bo ikhethileng (mohlala, ho bapala papali ea inthanete, ho becha ka har'a casino, ho reka lintho) ho ka etsa hore u ikutloe u khotsofetse kapa u lokolohile maikutlong a fosahetseng (Laier & Brand, 2017). Liphihlelo tsena hamorao li fetola litebello tsa moputso oa subjential tse amanang le boits'oaro bo itseng. Ba ka boela ba fetola mokhoa oa ho ikopisa o le mong. Mohlala, haeba batho ba ithuta hore ho bapala lipapali tsa marang-rang ho sebetsa hantle ho hlahisa maikutlo a matle kapa ho qoba maemo a mabe a maikutlo, ba kanna ba akaretsa tebello ea hore ho bapala lipapali tsa marang-rang hoa thusa bakeng sa ho sebetsana le maikutlo bophelong ba letsatsi le letsatsi (Kuss et al., 2018; Laier et al., 2018). Liphetoho tsa litebello le mekhoa ea ho sebetsana le maemo li ka eketsa monyetla oa ho araba ka maikutlo kapa maikutlo a takatso maemong a latelang ha ho tobanoa le lisosa tsa ka ntle kapa tsa ka hare. Tšebelisano ena ea liphihlelo tse lakatsang le ho lebella lintho e lebelletsoe ke batho ba nang le matšoao a holimolimo a ts'ebeliso e mpe ea lits'ebeletso tsa puisano tsa inthanete (Wegmann et al., 2018b). Kamora nako, litloaelano tsena lipakeng tsa karabelo tse amohelehang le tse hlokolosi, liqeto tsa ho phela ka mekhoa e fapaneng, liphihlelo tsa khotsofalo le matšeliso le litebello tse ikhethang tsa boits'oaro li ka ba matla le ho feta. Ka lebaka leo, taolo ea boits'oaro ka mekhoa e thibelang lintho ka kakaretso e ka ba thata le ho feta, 'me liqeto tsa ho phela ka litsela tse itseng li ka tataisoa haholo ke likarabo tse potlakisang / tse mafolofolo ho tse tsosang. Mekhoa e khothalletsoang ho nka karolo mekhahlelong e latelang ea boits'oaro bo bobebe e akaretsoa ho Feie. 2B.
Maemong a kamorao ho ts'ebetso ea bokhoba ba tahi, leha phetoho e kanna ea lieha, litloaelano tse boletsoeng esale pele li ka ba matla le ho feta, tsa fella ka boits'oaro bo tloaelo bo ka ikutloang bo iketsahalla maemong a itseng. Ho etsa ntho e ncha hape ho lakatsa takatso ea hau ho ka fetoha ho tsoa likararong tse ntle tsa tšebetso ka nako e telele ka lebaka la lits'ebetso tsa maemo (Starcke et al., 2018). Patlisiso e fetileng e bonts'a karolo ea bohlokoa ea maikutlo a mabapi le tšusumetso e amanang le bokhoba le ts'ebetso lits'ebetsong tsa moputso oa neural tse kenyelletsang hare le dorsal striatum le likarolo tse ling tsa litho tsa boits'oaro bo botle ka boits'oaro bo bobe.Fauth-Bühler le Mann, 2017; Fauth-Bühler et al., 2017; Luijten et al., 2017; Palaus et al., 2017). Ho lebella lintho tse ka 'nang tsa fetoha ho ka fetoha ka ho ba leeme le boteng, tse ka kenyelletsang tlhokomelo e ts'oanelang kapa e shebahalang e le boiketsetso ho li susumetso tse amanang le boits'oaro bo amanang le boitšoaroJeromin et al., 2016). Re fana ka maikutlo a hore litlamorao li tla ba matla ho feta litlamorao nakong ea ts'ebetso ea bokhoba (cf. Brand et al., 2016b). Ntle le litlamorao tsa taolo ea thibelo e akaretsang ea likamano lipakeng tsa cue-reac shughuli / takatso ea litakatso le boits'oaro bo tloaelehileng, re fana ka maikutlo a hore taolo e tobileng ea tšireletso e ka sebetsa joalo ka mokena-lipakeng mehatong e tlang ea lits'ebetso tse tlatsetsang (Everitt le Robbins, 2016). Bafuputsi ba bangata ba totobalitse ho senyeha ha taolo ea thibelo le ts'ebetso ea botsamaisi bothateng ba papali ea chelete (Ioannidis et al., 2019b; van Timmeren et al., 2018), bokuli ba lipapali (Argyriou et al., 2017; Kuss et al., 2018; Yao et al., 2017), le mathata a ts'ebeliso ea marang-rang a sa hlalosoang (Ioannidis et al., 2019a). Re khothaletsa, leha ho le joalo, hore leha taolo e akaretsang ea thibelo e ka boela ea fokotseha nakong ea ts'ebetso ea bokhoba, nts'etsopele ea taolo e fokolisitsoeng e amanang le tšusumetso e amanang le ts'usumetso e nka karolo ka mokhoa o makatsang boitshwarong bo tloahelehileng mekhoeng e latelang ea boits'oaro bo bobe. Re fana ka maikutlo a hore haeba ho etsa lintho tse ncha le ho lakatsa ho hlahisitsoe e le likarabo tsa lisosa tsa kantle kapa tsa kahare, sena se ka lebisa ho fokotseng taolo ea takatso ha ho tobanoa le tšusumetso e mpe, e ka eketsang monyetla oa ho phela ka mokhoa o tloaelehileng.Piazza & Deroche-Gamonet, 2013).
3. Mechine ea neurobiological
3.1. Likhopolo tsa thuto ea methapo ea kutlo li kenyelletsoa selikalikoeng sa kahare sa mofuta oa I-PACE
Likhopolo tse 'maloa tsa li-neurosci science le mehlala e hlalosang mekhoa e lemalloang li kentsoe sebopeho sa mohopolo sa sedikadikwe sa kahare sa mofuta oa I-PACE (Brand et al., 2016b). Lihokela tse tobileng li ka bonoa ho Ho Senya ka Karabelo e Mpehileng le Salience Attribution (I-RISA) mohlala (Goldstein le Volkow, 2011), Kholiseho (Robinson le Berridge, 2008), Moputso Disability Syndrome (Blum et al., 1996) mehlala le likhopolo, le ka mekhoa e habeli ea ts'ebeliso ea tlhekefetso (Bechara, 2005; Everitt le Robbins, 2005, 2016) le mehopolo ea ho se lekane pakeng tsa boits'oaro bo khahlisang sepheo le litloaelo (Robbins et al., 2019). Re boetse re bua ka likarolo tse ling tsa theoretical tse tobileng tse kopanyang likhopolo tsa neurosciological tsa bothateng ba ho becha (Blaszczynski & Nower, 2002; Goudriaan et al., 2004) le bokuli ba lipapali (Dong & Potenza, 2014; Wei et al., 2017). Ha re kopanya likhopolo tsena, re nahana ka tsoelopele ea ho se lekane pakeng tsa litakatso le litakatso tse ntseng li eketseha tse lebisang lehlakoreng le leng le ho fokotsa taolo e ikhethileng ea taolo ea litabatabelo le litakatso ka lehlakoreng le leng ho bohlokoa nts'etsopele le ho boloka boits'oaro bo bobebe. Ho eketsa matla a ho susumetsa, ka lebaka la lits'ebetso tsa maemo (Berridge le al., 2009), e ka amahanya le leeme la ho tsotella le ho etsa lintho hape ka mekhahlelo ea morao ea lits'ebetso tsa ho lemalla. Batho ba nang le bofokoli ba moputso ba kanna ba ba le tšekamelo ea ho hola maikutlo a ho susumetsa (Blum et al., 2012). Ho hloka matla ho khothaletsang ho ka khothaletsa ho etsa lintho tse ncha hape ho lakatsa, tse ka tlatsetsang ho kenya letsoho boits'oarong bo bobe.
Phokotso mesebetsing ea botsamaisi e li nkile e le mabaka a tlokotsi le litlamorao tsa boitšoaro bo lemallang ho kenyelletsa mathata a ts'ebeliso ea lithethefatsi (Volkow et al., 2012). Litabeng tsa bokhoba ba boitshwaro, jwaloka mathata a papali ea papali ea chelete le papali ea chelete, motho a ka pheha khang ea hore ho fokotsa litšebelisano ke lintho tse ka bang kotsi mme ha li hlahise litholoana tsa boitšoaro, hobane ha ho na litlamorao tse tobileng tse amanang le ts'ebeliso ea kelello bokong. Tumellanong le mohopolo ona, re fana ka tlhahiso ea hore tekanyo e fokotsehileng ea taolo ea thibelo e akaretsang ke ntho e ka bang kotsi bakeng sa boitšoaro bo lemallang mme e sebetsa e le phokotso ea kamano pakeng tsa karabelo e lumellanang le sepheo se itseng se susumetsang (mohlala, khatello ea maikutlo kapa maikutlo a mabe) le liqeto ho etsa boits'oaro bo ikhethileng (bona Feie. 2A). Ntle le moo, re pheha khang ea hore ntle le ts'usumetso ena e lekanyelitsoeng ea ts'ebetso ea botsamaisi e le sesosa sa tlokotsi ea litheko, taolo e tobileng ea maemo (ha e shebane le tšusumetso e amanang le bokhoba) e ka fokotseha ha nako e le litlamorao tsa boits'oaro bo bobebe, leha - khahlano le mathata a ts'ebeliso ea lithethefatsi - ha ho litlamorao tse tobileng tsa "neurotoxic" bokong tse kenyellelitsoeng lithahasellong tsa boitšoaro. Phokotso ea taolo e thibelang e kahare ea ts'usumetso e ka hlaha ho ipapisitse le ho labalabela lintho 'me ea tsamaisana le liphetoho tsa tšebetso tsa boko lipotolohong tse amanang le bokhoba ba tahi.Ersche et al., 2012; Koob le Volkow, 2010; Volkow & Morales, 2015; Volkow et al., 2012). Kahoo, mehatong ea morao ea boits'oaro bo lematsang (Feie. 2B), lits'ebetso tse ikhethang tsa taolo ea thibelo ea tšibollo li kanna tsa susumetsoa ke litakatso le litakatso tse amanang le maikutlo a amanang le bokhoba, tseo ka nako eo li ka etsang hore ho be le monyetla oa hore motho a its'oare kapa a iketsahalle ka boeona.Everitt le Robbins, 2005(2013, 2016).
3.2. Li-correlates tsa Neural tsa lits'ebetso tsa mantlha kahare ho potoloho e ka hare ea mohlala oa I-PACE
Taba e boletsoeng ka holimo ea ho se lekane lipakeng tsa lipotoloho tsa boko le maoto le taolo ea pele ho litekanyetso tsa boitshwaro e lekantsoe haholo bakeng sa bothata ba papali ea chelete (Clark et al., 2013; Goudriaan et al., 2014; Potenza, 2013; van Holst et al., 2010) le bokuli ba lipapali (Kuss et al., 2018; Weinstein, 2017; Weinstein et al., 2017), ho kenyelletsoa le litlhahlobo tsa meta (Meng et al., 2015). Leha e le tlase haholo, ho boetse ho na le lithuto tse khahlisang tsa boits'oaro bo matla ba thobalano, ho kenyelletsoa le ts'ebeliso e mpe ea litšoantšo tsa bootsoa (mohlala, Brand et al., 2016a; Gola et al., 2017; Klucken et al., 2016; Schmidt et al., 2017; Voon et al., 2014), tse hlahlobiloeng litekong tsa morao-rao (Kraus et al., 2016; Stark et al., 2018). Lithuto tsa mahlale tsa neural correlates tsa theko ea mabenkele a ho reka li haella. Ho na le leha ho le joalo, ho na le lithuto tse tsoang mahlale a kelello a bareki (mohlala, Raab et al., 2011) le lithuto tse sebelisang mehato ea electrophysiological ho fuputsa mekhoa ea methapo ea kutlo ea maloetse a ho reka (Trotzke et al., 2014) tse sa tsoa hlahlojoa haufinyane (Kyrios et al., 2018; Trotzke et al., 2017). Leha e se e amoheloe e le boemo ba bongaka, ho boetse ho na le liphatlalatso tsa morao-rao mabapi le lipatlisiso tsa ts'ebetso le tšebetso tse ntle tsa tšebeliso e mpe ea liwebosaete tsa marang-rang tsa sechaba le lits'ebetso tse ling tsa puisano ea inthanete (mohlala, Dieter et al., 2017; He et al., 2017; Lemenager et al., 2016; Montag et al., 2017; Montag et al., 2018; Turel le Qahri-Saremi, 2016), tse ntlafalitsoeng ke Wegmann le ba bang. (2018a).
Ho na le phapang e kholo ho pholletsa le lithuto tsa maiketsetso tse mabapi le mefuta ea bokhoba ba boits'oaro, mekhoa e sebelisitsoeng (mohlala, sebopeho / tšebetso ea bonohe ba maikutlo a matla a kelello [s / fMRI], positron emission tomography [PET]) , mesebetsi ea liteko e sebelisitsoeng ho lekanya mesebetsi e itseng, disampole li kenyellelitsoe (disampole tse bonolo le batho ba bonts'a matšoao a fapaneng le matšoao a khetholloang ke lingaka kapa bakuli ba batlang kalafo), le lits'ebetso tsa tlhahlobo tse sebelisitsoeng. Leha ho le joalo, ha ho etsoa liqeto ho tsoa lithutong, meta-analysis le litekolo (bona, ka mohlala, litekanyetso tse kaholimo), ho na le bopaki ba pele ba ho kenya letsoho ha moea mabapi le likarolo tsa litho tsa maoto, ho kenyelletsa le amygdala le li-ventral striatum, le li-circaal tsa pele tsa litheko tse amehang. taolong ea kelello holim'a boitšoaro. Ho na le leha ho le joalo, ho na le likheo tse ling, ka mohlala, boitlamo ba ho kenella ha meputso nakong ea karolo e lebelletsoeng ea ts'ebetso ea chelete (Balodis & Potenza, 2015), ha bafuputsi ba bang ba fana ka maikutlo a phapang e amanang le ts'ebetso ea likhakanyo tse lemalloang (karabelo ea moputso o matla) le likeletso tse sa tlatseheng tse tlatsetsang (tse batlang li fana ka moputso o moholo) (Limbrick-Oldfield et al., 2013). Insula e kanna ea ba 'muelli lipakeng tsa lits'ebetso tse peli (limbic le pele-striatal), e emelang linaha tse ikhethileng tse amanang le ho lakatsa le takatso ea ho phela ka ho otloloha (bona puisano ka Namkung et al., 2017; Wei et al., 2017). Likatso tse kholo tse bonts'itsoeng e le li-correlates tsa boko bo ka ntlafatsang tsa boitšoaro bo lemalloang li akaretsoa ho Feie. 3.
Thutong ea morao-rao ea meta mabapi le ts'ebetso e amanang le cue-reacaction e amanang le ts'ebetso ea kelello ho lithuto tsa fMRI-ka lipampiri tsa bakuli ba nang le ts'oaetso ea boitšoaro ha ba bapisoa le lithuto tsa taolo (Starcke et al., 2018), dorsal striatum (caudate nucleus) e ne e le mafolofolo ho batho ba lemalloang ho bapisoa le ba kantle le ho batho ba nang le litlolo ha ba bapisa boemo bo amanang le bokhoba le boemo ba ho se nke lehlakore mesebetsing ea cue-reacction. Liphumano li ka bonts'a liphetoho tse tlisoang ke ho kenella hoa tšebetso ea "ventral striatum" mekhatlong ea pele ea litekanyetso tsa boits'oaro ha ho tobanoa le tšusumetso e amanang le bokhoba ba ho kenya letsoho moqoqong oa dorsal maemong a latelang a pherekano, ha boitšoaro bo tloaela ho feta (Everitt le Robbins, 2013, 2016; Zhou et al., 2019). Likarolo tsa boko le lipotoloho tse ka bang le boits'oaro bo bobebe le ho tloha mehatong ea pele ho isa ho ea morao li bontšoa ka mokhoa o hlophisitsoeng ho Feie. 3.
Khokahano e pharalletseng har'a meaho ea kereke e hlahlobiloe ho sebelisoa lipatlisiso tsa 'muso tsa fMRI ka litaba tse phetseng hantle' me ho bontšitsoe hore ba nka karolo ho phetoho ea boitšoaro (Morris et al., 2016). Li-circuits tsena li boetse li tsamaisana hantle le marang-rang a sebetsang a amehang molatong oa maikutlo (Monghali, 2018). Liphetoho tsa khokahano pakeng tsa meaho e meng e kentsoeng lihlopheng tse potelletseng tsa mokoloto (mohlala, khokahano lipakeng tsa amygdala le medial PFC) li bonahala li le bohlokoa ha ho hlalosoa tšebeliso ea maikutlo liphatlalatsong tsa tšebeliso ea lithethefatsi (Koob, 2015; Wilcox et al., 2016). Khokahano ea marang-rang a amehang taolong ea kelello (li-circuits tsa fronto-parietal le libaka tsa pele tsa kalafo) le ts'ebetsong ea moputso (ho kenyelletsa le likarolo tsa subcortical le limbic) le tsona li bonts'itsoe ho bolela esale pele ka ho hloka ts'ebeliso ea ts'ebeliso ea koae ka mor'a ho phekola koae (ka tšebeliso ea koae).Ee le ba bang, 2019). Ho arotsoe ka matla khokahano ea likhokahano tse peli tse amehang taolong e kholo le kutloisisong ea moputso ho khothalelitsoe ho ba bonolo boitshwarong le ho fokotsa khatello, tse ka hlalosang liphetho tse ntle tsa kalafo (Ee le ba bang, 2019).
Ka kakaretso, re fana ka maikutlo a hore ho se lekane ho lipotoloho tse tsamaisang boitšoaro le maikutlo / khothatso li amana le likarolo tsa bohlokoa tsa boits'oaro bo eketsang. Litsela li kenyelletsa likhakanyo tsa dopaminergic tse tsoang sebakeng sa karolelano ea mokokotlo le sebaka se pharaletseng ho ea libakeng tse ka pele, mochini o kenang ka mpeng, le "anterior cingulate gyrus" le lipalo tsa serotonergic ho tloha sebakeng sa raphé nuclei ho ea libakeng tse tlang pele.Everitt le Robbins, 2005; Volkow et al., 2012; Volkow et al., 2013). Khokahano pakeng tsa meaho ea lithaelese, thalamus, le libaka tse etellang pele pele li itšetleha haholo ka glutamate le gamma-aminobutyric acid (GABA) (Naaijen et al., 2015), le lits'ebetso tsa methapo e kenyelletsang ho li-loops tsa fronto-striatal li sebetsa ho lifeshene tse kopanetsoeng le tse tsamaisoang ke melao (Gleich et al., 2015). Litekanyetso tsa Neurochemical tsa lithethefatsi li builoe ka mokhoa o matla libakeng tse ling, 'me lithuto tse ngata li hatisa karolo ea bohlokoa ea dopamine mathateng a ts'ebeliso ea lithethefatsi (Herman le Roberto, 2015; Pascoli et al., 2018; Volkow et al., 2016). Se fumanoeng mabapi le dopamine litlamong tsa boitšoaro, leha ho le joalo, ha se matla (Potenza, 2018).
Leha palo e nang le morero ea lipatlisiso mabapi le litekanyetso tsa neural tsa litlatsetso tsa boitšoaro e phatlalalitsoe lilemong tsa morao tjena, ho sa na le mefokolo e lokelang ho boleloa. Taba ea pele, lithuto tse ngata li phatlalalitsoe mabapi le bothateng ba papali ea chelete le papali ea lipapali (bona maikutlo ka holimo). Ho na le bopaki bo fokolang ba litlatsetso tse ling tsa boitšoaro tse kenyelletsang boitšoaro bo tlamang ba ho kopanela likobo bo kenyelletsang ts'ebeliso e mpe ea ts'ebeliso ea litšoantšo tse manyala tse hlephisang boitšoaro, bothata ba ho reka le lintho tse ling tse seng li sa amoheloe e le maemo a kliniki, joalo ka ts'ebeliso e mpe ea libaka tsa marang-rang tsa marang-rang. Haholo-holo, lithuto tse etsang lipatlisiso tsa neural ka nepo tsa mesebetsi e itseng ea kelello (mohlala, ho lakatsa, taolo ea inhibitory) mefuteng e meng ea litekanyetso tsa boits'oaro ha e eo. Boithuto bo batlisisang mehato ea lits'ebetso tsa bokhoba ba tahi kapa bosholu ba matšoao joalo ka bobuelli kapa ho lekola lintho tse fapaneng tsa ts'ebetso ea neural le likotsi tsa sebopeho sa boko li bohlokoa ho utloisisa mehato e tlatselletsang pele boitshwarong bo fetelletseng ba boitšoaro. Tumellanong le sena, lithuto tsa nako e telele tse amanang le boko tse amanang le boits'oaro bo tlatselletsang ha li fumanehe. Ho etsa lipatlisiso mabapi le phetoho e ka bang teng tšebetsong ea litho tse kenang tšebetsong, le ho arabela liketsong tse amanang le tšebeliso ea litheko le methati e fapaneng ea tšebeliso ea lithethefatsi, ho sebelisoa ka likarolo tse bohareng le tse telele, ho ka thusa ho utloisisa sebopeho sa ho lemalla. boits'oaro. Lithuto tse joalo li hlokahala ho hlakola liphetoho tse ka 'nang tsa fetoha ho lakatsa ho qobelloa le ho lebella ho khotsofalla ho lebella ho imoloha ho tsoa liphatlalatsong tse mpe ha li kopana le tšusumetso e amanang le bokhoba ba litekanyetso tse fapaneng tsa boitšoaro, tseo ka tsona li lokelang ho thusa ho ntlafatseng kalafo. Boithuto bo bapisa mefuta e fapaneng ea boits'oaro bo bobebe le mehato e fapaneng ea mekhoa ea ho lemalla ho kenyelletsa lithuto tse tla nka nako e telele li ka boela tsa etsa lipatlisiso tsa ho kenya letsoho ha lithibelo taolong ea thibelo e le sesosa sa ho ba kotsing le / kapa ka lebaka la boitšoaro bo lemallang, le bo ka hokahanyang likhokahanyo lipakeng tsa mofani oa tšebeliso e mpe. likarabo le boits'oaro bo tloaetseng / bo hatelletsang (bona puisano ho Everitt le Robbins, 2016).
4. Qeto le lintlha tsa nako e tlang
Moetso oa I-PACE o ntlafalitsoeng ke mokhoa oa mohopolo bakeng sa ho hlalosa mohato oa boitšoaro bo lemalloang ka ho kopanya likhopolo tsa kelello le neurosci science tsa mathata a ts'ebeliso ea lithethefatsi le bokhoba ba boitšoaro. Re nka mathata ka lebaka la boits'oaro bo tlatsetsang ho ba tšusumetso ea tšebelisano lipakeng tsa likarolo tsa mantlha tsa motho le lintho tse 'maloa tse fapaneng tsa potolohang le tse arohaneng, tse ka bang matla le ho hola ha nako e ntse e le sephetho sa ho kenya letsoho boits'oarong bo itseng. Re fana ka maikutlo a hore mohlala oa I-PACE oa boits'oaro bo bobebe o ka ba oa bohlokoa bakeng sa lipatlisiso tsa kelello le tsa methapo hobane e lumella ho etsoa le ho hlahlojoa ha litlhaloso tse hlakileng mabapi le litlamorao tsa tšebelisano ea mefuta e fapaneng ea ho hlalosa phapang ea matšoao a bokhoba ba boits'oaro. Moetso o ka boela oa khothaletsa tloaelo ea bongaka (cf. King et al., 2017; Potenza, 2017) ka ho hlalosa le ho etsa lipatlisiso ka lintho tse ka fetolehang tse ka emelang lipheo tsa kalafo (mohlala, litebello, karabelo tse amohelehang le tse hlokoang ke lisosa). Moetso oa I-PACE o ntlafalitsoeng o boetse o fana ka monyetla oa ho fumana likhopolo tsa maikutlo mehatong ea litlatsetso (ka bobeli nakong ea ho phahama le ho hlaphoheloa), mohlala ka ho pheha khang ea hore phokotso ea taolo e khethehileng ea inhibitory e potlakisa mohato oa kamora ho tsoelapele ha lits'ebetso tsa bokhoba. Ho bohlokoa ho hlokomela, leha ho le joalo, hore re nka mefuta ea lithuto e le e matla. Ho nepahala ha li-hypotheses tse ikhethang, tse kopantsoeng moralong oa theoretical, li lokela ho hlahlojoa ka mokhoa o hlakileng, 'me mehlala ea li-theoretical e lokela ho ntlafatsoa ka ho hlahloba lipatlisiso tsa morao-rao tsa saense ho tsoa mehopolong e fapaneng.
Ho bohlokoa ho hopola hore mohlala oa mohopolo o hlahisitsoeng o thehiloe maemong a fapaneng a bopaki ba mahlale mabapi le boits'oaro bo bobebe. Joalokaha ho boletsoe likarolong tse fetileng, ho kenya letsoho mekhoeng e ikhethileng ea kelello le ts'ebetso ea methapo ea kutlo ho ithutoa hantle lithutong tsa papali ea chelete le papali ea chelete 'me ha ho etsoe lipatlisiso tse tebileng ka mefuta e meng ea boits'oaro e ka bang bokhoba ba mohlala, ts'ebeliso ea litšoantšo tsa bootsoa, ho reka le ho reka sechabeng. Ho sebetsa. Ntle le moo, bakeng sa likarolo le mekhoa e khothalelitsoeng ho mofuta oa I-PACE o ntlafalitsoeng, maemo a fapaneng a bopaki a teng. Bakeng sa mesebetsi e phahameng le taolo ea thibelo, palo e kholo ea lithuto e sebelisitse liteko tsa tlhahlobo mme e hlahlobile likarolo tse itseng tsa ts'ebetso ea botsamaisi ka mefuta e fapaneng ea boits'oaro bo eketsang. Ka lehlakoreng le leng, bakeng sa ho kopanya lintho tse ncha le ho lakatsa ho ba le boits'oaro bo itseng ba boits'oaro, lithuto tse ling li sebelisitse moralo o lumellanang, o etsang hore ho hlalosoe ka mokhoa o hlakileng le nako ea nts'etsopele ea ntho e ncha hape ho lakatsa ts'ebetsong ea bokhoba ba ho lematsa ho leng thata.Zilberman et al., 2019). Ha ho nahanoa ka meeli ena ho bohlokoa ho totobatsa hore mohlala o hlahisitsoeng ke mohlala oa kakaretso o akaretsang boemo ba morao-rao ba boithuto ba boits'oaro ba boits'oaro bo nang le sepheo sa ho khothaletsa lithuto tsa nako e tlang tse thehiloeng ho tsona.
Taba e 'ngoe eo ho bohlokoa ho e ela hloko ke hore litšobotsi tsa botho le maemo a hlakileng a boloi li bonahala li le bobebe bakeng sa boits'oaro bo itseng ba tlatsetso, kaha lintlha tsena li kenelletse li-psychopathologies tse ngata mme hangata li hlalosa karolo e fokolang feela ea matšoao mathateng a fapaneng (Zilberman et al., 2018).
Hape re ka rata ho fana ka maikutlo ho ngangisano ea hona joale mabapi le ho khetholla bothata ba ho reka le ho se shebelle litšoantšo tse litšila tse tsosang takatso ea ho sheba litšoantšo tse manyala tse hlephisang boitšoaro e le mathata a laoloang ke boitšoaro kapa bokhoba ba boitšoaro. ICD-11 e kenyelletsa tšebeliso ea mathata a litšoantšo tsa bootsoa e le karolo e le 'ngoe ea tlhekefetso ea boitšoaro bo bobe ba thobalano kahare ho sehlopha sa mathata a laoloang ke tšusumetso. Bothata ba ho reka bo rekisoa e le mohlala bakeng sa mathata a mang a boletsoeng a ho laola tšusumetso ho sesebelisoa sa ho boloka likhakanyo (ICD-11 coding) (Mokhatlo oa Lefatše oa Bophelo, 2019). Leha ho le joalo, bafuputsi ba bangata ba pheha khang ea hore mefuta ee ka bobeli ea mafu a ka hlalosoang hantle e le boits'oaro bo lematsang (Potenza et al., 2018).
Phephetso e 'ngoe bakeng sa lipatlisiso tsa nako e tlang le mohopolo oa khopolo e kenyelletsa ho khetholla le ho khetholla liphapang tse bang teng lipakeng tsa litšitiso ka lebaka la boitšoaro bo bobe le mathata a mang a kelello, joalo ka mathata a laolehang a amanang le khatello le tšusumetso, a ka amanang le tšebeliso ea boitšoaro litabeng tsa kelello le neurobiological. maemo (Chamberlain et al., 2016; Fineberg et al., 2013; Fineberg et al., 2018; Robbins et al., 2019). Mohlala, taolo ea thibelo le ts'ebetso ea moputso le tsona li hlahisitsoe hore li bohlokoa ho mathata a amanang le tšusumetso e amanang le tšusumetso e matla, joalo ka ha ho buisanoa ka bothata ba ho khetholla letlalo le trichotillomania, le bona bo amanang le ts'ebetso ea ts'ebetso ea boko ba lefatše lipotoloho (Chamberlain et al., 2008). Mathata a loops a fronto-striatal, leha ho le joalo, a ka ameha le mathata a mang a mangata a bophelo bo botle ba kelello le (Mitelman, 2019). Le ha ho le joalo, taba ea hore li-loanta tsa fronto-striatal li kenella mathateng a fapaneng a kelello ha ho bolele hore lits'ebetso tsa kelello tse amanang le phenotypes ea bongaka tsa mafu li tšoana. Taba ea mantlha, li-loops tsa feshene li hlalosoa ka mokhoa o fapaneng le ho hlahlojoa lithuto tsohle. Boithuto ba nako e tlang bo lokela ho lekola litefiso tse ikhethileng tsa meaho e seng e hlalosoa ka mokhoa o pharalletseng kahare ho loops-frriatal loops ho mekhoa e itseng ea kelello e mabapi le boits'oaro bo itseng bo nang le mathata. Ntlha ea bobeli, ho nka karolo ka kakaretso taolong ea thibelo le ts'ebetso ea moputso ha ho bolele hore ts'ebetso ea kelello e bapisoa le mathata ohle, leha ho ka ba le ho ba le ho pharalla ho fetang tekano / ho qobelloa le boits'oaro bo tlatsetsang (mohlala, Chamberlain et al., 2018). Ho bohlokoa ho hlalosa ka nepo mabaka a bakang tšusumetso ea nakoana ea ts'usumetso ea batho hore ba kopanele ho feteletseng boitsong bo itseng. Mohlala, litloaelong tse lemalloang, e kanna ea ba lisosa tsa mantlha tsa ho etsa papali ea papali ea chelete kapa papali ea chelete, bonyane lithutong tsa pele, ho kenyelletsa tebello ea moputso. Maemong a morao, ho qoba maikutlo a fosahetseng ho ka ameha ho feta. Mathateng a amanang le ho qhekella, ho ka etsahala hore sepheo sa mantlha mantlha a kenyelletsa ho qoba maikutlo a fosahetseng kapa ho tšoenyeha. Hamorao, boitsoaro ka bo bona bo ka ba le melemo hobane bo ka thusa ho imolla khatello ea maikutlo. Ka mantsoe a mang, ho nka karolo ka kakaretso hoa ts'ebetso e itseng ea ts'ebetso ea methapo ho ka se hlalose bothata bo felletseng. Mohopolo o tšoanang o ka sebetsa hantle ho li-mechine tsa neural. E kanna ea ba maemong a ho hloka taolo ka lebaka la boits'oaro bo bobebe, boemo ba tšebetso bo kenella ka botlalo mathateng a pele a lefu lena, mabapi le ho pheta-pheta le ho lakatsa. Kamora nako, dorsal striatum e ka ameha haholo mme e amana le likarolo tsa tloaelo le tse qobelloang tsa mathata a lemalloang. Ka lehlakoreng le leng, dorsal striatum e kanna ea ameha lits'ebetsong tse amanang le mathata a amanang le khatello le taolo ea tšusumetso, joalo ka trichotillomania, ho tloha matsatsing a pele (Isobe et al., 2018; van den Heuvel et al., 2016).
Lithutong tsa nako e tlang, ho bonahala ho le bohlokoa ho etsa lipatlisiso le ho sebetsana le lits'ebetso tse fapaneng tsa methapo ea kutlo ka mefuta e fapaneng ea boits'oaro ba maiketsetso ho fihlela kutloisiso e ntle ea semelo sa lisosa tsa boits'oaro. Moetso oa I-PACE o ka sebelisoa bakeng sa ho hlalosa le ho hlakisa li-hypotheses tse ikhethang ha ho etsoa lipatlisiso tsa liketsahalo tsena. Ho bohlokoa ho hlahloba lits'ebetso tsa hypothesised ka boits'oaro bo bobebe le ho li bapisa le mathata a mang a kelello, a kang mathata a amanang le tšusumetso le khatello ea maikutlo ho utloisisa hore na mabaka a ts'ebetsong a amehang a fapane kapa a tšoana. Ts'ebetsong ena, datha e hlahisitsoeng e lokela ho thusa ho hlakisa hore na mantsoe a fapaneng a ka sebelisoa joang hajoale ho hlalosa mekhoa e tšoanang ho rarolla mathata. Ka mokhoa ona, mofuta o ntlafalitsoeng oa mofuta oa I-PACE o fana ka sebopeho sa theoretical se lokelang ho thusa ho araba lipotso tse kholo tse mabapi le ts'ebeliso e mpe ea khatello, tšusumetso, taolo ea tšusumetso le mathata a mang, ho kenyelletsa le tse amanang le ts'ebeliso ea marang-rang, tse ka bang tsa bohlokoa haholoanyane. ha nako e ntse e feta liphetoho tse fanoeng tikolohong ea mahlale a dijithale.
Phatlalatso ea phaello
Bangoli ba phatlalatsa hore ha ba na likhohlano tsa phaello. Ngaka Brand o amohetse lithuso (ho ea Univesithing ea Duisburg-Essen) ho tsoa ho Motheo oa Patlisiso ea Jeremane (DFG), e Lekala la Federal la Jeremane bakeng sa Patlisiso le Thuto, e Lekala la Federal la Jeremane la Bophelo, Le mokhatlo oa linaha tsa Iropa. Dr. Brand o entse tlhahlobo ea thuso bakeng sa mekhatlo e mengata; e hlophisitse likarolo tsa likoranta le lingoloa; e fane ka lipuo tsa thuto lithutong tsa bongaka kapa tsa saense; mme e hlahisitse libuka kapa likhaolo tsa buka bakeng sa baphatlalatsi ba mangolo a bophelo bo botle ba kelello. Dr. Potenza o fumana tšehetso ho NIH (R01 DA039136, R01 DA042911, R01 DA026437, R03 DA045289, R21 DA042911, 'me P50 DA09241), ea Connecticut Lefapha la Bophelo bo Botle ba kelello le lits'ebeletso tsa tlhekefetso, e Lekhotla la Connecticut ka Bothata ba Papali ea Chelete le Setsi sa Naha sa Papali e Ikarabellang. Ngaka Potenza o ikopantseng le ho eletsa Rivermend Health, Opiant / Lakelight Therapeutics le Jazz Pharmaceuticals; o fumane tšehetso ea lipatlisiso (ho Yale) ho tsoa Mohegan Sun Casino le Setsi sa Naha sa Lipapali tse Ikarabellang; ho botsoa kapa ho eletsoa mekhatlo ea molao le ea papali ea chelete litabeng tse amanang le taolo ea tšusumetso le boits'oaro bo bobebe; fana ka tlhokomelo ea bongaka e amanang le taolo ea tšusumetso le boits'oaro bo bobebe; litlhahlobo tse fanoeng mabapi le lithuso; limakasine tse hlophisitsoeng / likarolo tsa koranta; fuoa lipuo tsa thuto litikolohong tse hlollang, liketsahalo tsa CME le libakeng tse ling tsa bongaka / tsa saense; le ho hlahisa libuka kapa likhaolo tsa baphatlalatsi ba mangolo a bophelo bo botle ba kelello.
Liteboho
Re leboha ka thabo liphallelo tsa bohlale tsa Dr. Kimberly S. Young ho mofuta oa pejana oa mofuta oa I-PACE, o neng o khothaletsa mofuta o ntlafalitsoeng. Dr. Young o hlokahetse ka Pherekhong 2019. Ha re hopola Dr Kimberly S. Young, re mo fa sengoloa sena.
References
- Alvarez-Monjaras et al., 2018
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- APA, 2013
- APABuka ea ho hlahloba le ea Statistical ea Mathata a kelello(Khatiso ea 5th), APA, Washington DC (2013)
- Argyriou et al., 2017
- E. Argyriou, CB Davison, TTC LeeThibelo ea karabelo le Phokotso ea Lipapali tsa Inthanete: Tlhahlobo-leselingLi-Behaviors tse tlatsetsang, 71 (2017), maq. 54-60, 10.1016 / j.addbeh.2017.02.026
Del Pino-Gutiérrez et al., 2017
Limbrick-Oldfield et al., 2013
Piazza le Deroche-Gamonet, 2013
Mokhatlo oa Lefatše oa Bophelo, 2019