Tšebeliso e atlehileng ea ho fetoha ha matla a motlakase ho thata ho phekola boloetse ba hypersexual (2016)

inahaneloang

Hypersexual disc e na le phapang e ts'oanang le mathata a sefahleho a ipatileng. Inhibitory repetitive transcranial magnetic stimulation (rTMS) e fetang sebakeng sa tlatsetso ea makoloi (SMA) e fumanoe e sebetsa hantle ho taolo ea boits'oaro bo sa qobelloang. Inhibitory rTMS e fetang SMA e ka ba molemo ho hypersexual disorder. Mona re hlakisa nyeoe ea hypersexual disc (ho feteletseng ka thipa ea thobalano) e ileng ea sitoa ho araba ka mokhoa o nepahetseng kalafo ea bongaka e tloaelehileng 'me ea arabela ka rTMS augmentation.

MANTSOE A SEHLOOHO: Hypersexual disorder, phetisetso ea transcranial ea matla a khoheli, sebaka sa makoloi se tlatsetsang

SELELEKELA

Hypersexual disorder e hlalosoa haholo-holo e le bohlasoa ba takatso ea thobalano, e nang le karolo e kenelletseng. [] E na le matšoao a hlahang a tšusumetso, a ho qobella, le lithahasello joalo ka menahano e khahlisang le e matla ea likamano tsa botona le botšehali, khothatso, kapa boits'oaro, ho sitoa ho laola kapa ho emisa boits'oaro ba thobalano, mme ka makhetlo a mangata o etsa boits'oaro ba ho khesa likotsi tse amanang le ona. [,] Ho khethiloe li-serotonin reuptake inhibitors, meriana ea antihormonal (medroxyprogesterone acetate [MPA], cyproterone acetate, gonadotropin-releasing analogue), le baemeli ba bang ba meriana (naltrexone, topiramate) ba bontšitsoe ho fokotsa boitšoaro ba thobalano ho bakuli ba bang; leha ho le joalo, bopaki bo bongata ba katleho bo ntse bo fokola. [] Transcranial magnetic stimulation (TMS) e bonts'itse ts'episo ea taolo ea mathata a fapaneng a amanang le ho aha ka mokhoa o sa tsitsang joalo ka ho lemalla lithethefatsi, bothata ba ho qhekella (OCD) le lefu la Tourette. [] Ho nka ho ferekana ha hypersexual ho sebata se sa qobelloang, TMS e ka ba molemo ho tsamaiso.

TLHOKOMELISO TLALI

Re tlaleha taba ea monna ea lilemo li 29 ea hlahisitseng ka litletlebo tsa takatso e matla le e sa laoleheng ea thobalano ea lilemong tsa 15 tse fetileng. Mokuli o tla lula a nahana ka lintho tse ngata tse mpe tse etsahalang nako e telele. O ne a bua ka mokhoa o phollatsi, ka foleteng, a bala lingoliloeng tse tsosang takatso, a ipholla litho ka makhetlo a mangata ka letsatsi, a etela batho ba etsang thobalano, 'me a ikutloa a imolohile ka ho kenella liketsong tsa thobalano. O ile a utloa menahano ena ea likamano tsa botona le botšehali e le ntho e khahlisang, leha ho le joalo, e feta le litlamorao tse bohloko. Ho bile le keketseho ea butle-butle ea matšoao le ho teba ha matšoao, a ileng a baka tsitsipano ea lenyalo le mathata a ts'ebetso ea letsatsi le letsatsi. Ka lebaka la ho nyahama, hang ha a leka ho kuta litho tsa hae tsa botona ka sebetsa se bohale, leha a sa atleha.

Mokuli o ne a batlile puisano ho tsoa ho bafani ba bangata ba tlhokomelo ea bophelo bo botle mme o amohetse liteko tsa li-antidepressants tse ngata (fluoxetine, sertraline, clomipramine, a le mong hape le ka mokhoa o kopaneng) bakeng sa litekanyetso tse lekaneng le nako. Boiteko ba ho hlasimolla antipsychotic, ho kena lipakeng maikutlong le phekolo ea motlakase le bona bo lekoa ntle le thuso e kholo. O bonts'itse ntlafatso ho depa MPA empa a e tlohela ka lebaka la litlamorao tse sa mamelleheng. Nalane ea hae ea bongaka e ne e ke ke ea rekisoa. Tlhahlobo ea "compact tomography scan" ea boko le ho hlaseloa ha lihormone (liteko tsa tšebetso ea qoqotho, boemo ba prolactin, boemo ba cortisol, le androgen) li ne li tloaelehile. Ho fumanoe hore ho na le ts'ebetso ea ho ts'oaroa ho feteletseng ka thobalano (ICD-10 F52.7) e entsoeng. O fane ka 109 ho tlhaiso ea takatso ea botona le botšehali ea 14 (XIUMX) le 40 ho 10-ente ea tlhekefetso ea thobalano ka thobalano (SCS); sekala se phahameng haholo se ka fumanoang sekaleng ka bobeli. Mokuli o ne a sa batle kalafo ea lihormone ka lebaka la liphihlelo tse mpe tse fetileng. O ne a fuoe escitalopram (ho fihlela 20 mg / letsatsi). Ho ne ho etsoa lipuisano tsa kelello tse kang ho hlophisa mesebetsi ea letsatsi le letsatsi, ho ikoetlisa ka boikhathollo le ho thuisa ka kelello. Kaha ho ne ho se na ntlafatso ea bohlokoa holim'a kalafo e tsoelang pele, ho pheta-pheta-TMS (rTMS) ho ne ho reriloe bakeng sa ho khothaletsa kalafo. O ile a hlalosetsoa mokhoa oa phekolo, 'me a fumana tumello e ngotsoeng. Sebaka sa ho phomola ha makoloi (RMT) se ne se ikemiselitse, 'me 1 Hz TMS ho 80% ea RMT e ne e tsamaisoa holim'a sebaka se tlatsetsang sa motor motor (SMA) se sebelisa MediStim (MS-30) TMS therapy (Sistimi ea Medicaid). Sebaka sa maiketsetso se ne se le mothating oa karolo ea bobeli ea bohlano le bohlano ba kotara ea bohlano (ho latela International 10 / 20 System of electrode plosition) ea sebaka sa nasion-inion bohareng. Seboka se seng le se seng sa kalafo se ne se e-na le literene tsa 14 tsa li-pulses tse mashome a robeli ka 'ngoe e nang le metsotsoana ea 5 nako e kenngoeng ka nako ea 19, e fana ka kakaretso ea 1120 pulses / session. Kakaretso ea mananeo a 22, a fetang libeke tsa 4 tse latellanang, a ile a tlisoa. Ho ne ho e-na le ntlafatso butle-butle matšoao a hae. O ne a e-na le taolo e ntle menahanong ea hae ea thobalano le khafetsa ea ho ipholla litho e fokotsehile. Ho bile le phokotso ea 90% ho palo ea SDI le SCS nakong ea beke ea 4-beke ho rTMS le pharmacotherapy e tšoanang. Ntlafatso e ile ea phehella ho fihlela ho latela likhoeli tsa 3 tseo khafetsa mehopolo ea thobalano e neng e fokotsehile haholo mme a boela mosebetsing oa hae.

TŠOHLOA

Hypersexual disorder e kanna ea ba le mathata a amanang le methapo e ts'oanang le mathata a mang a pherekano moo ho bonts'itsoeng lits'oaetso tsa "cortical-striatal-thalamic-cortical (CSTC)."] Ho CSTC loop, libaka tse ikhethang tsa cortical (joalo ka dorsolateral preortal cortex, SMA, orbitofrontal cortex, medial prefrontal cortex, and anterior cingulate gyrus) e amanang le libaka tse fapaneng tsa methapo ea kutlo. [,] SMA e bontšitsoe hore e na le khokahano e sebetsanang le likarolo tse ling tsa boko e kentseng tšebetsong ea kelello le taolo ea makoloi. Ho feta moo, khokahano e fetotsoeng ea SMA e bontšitsoe ho bakuli ba nang le OCD. Boithuto bo boetse bo fana ka maikutlo a fokotsehileng a cortico-subcortical regulation le ho eketsa thabo ea cortical ho bapala karolo ea boits'oaro bo pheta-phetang. [,] rTMS e shebileng loop ena (haholo ho SMA) e bontšitsoe ho fokotsa boitšoaro bo hatelletseng ho bakuli ba OCD, 'me mokhoa o ts'oanang oa motheo o ka ikarabella bakeng sa phello e ntle ho mokuli oa rona. []

TMS ke mokhoa o bolokehileng oa kalafo. Hoo e ka bang bakuli ba 5% ba ka belaela ka liketsahalo tse ling tse bobebe tse kang ho opeloa ke hlooho le ho nyekelwa ke pelo, kamora seboka sa TMS. [] Bakuli ba nang le tšepe e kentsoeng (likarolo tsa aneurysmal, implants ea cochlear) le pacemaker ba hloka tlhokomeliso kaha matla a makenete a ka fetola tšebetso ea bona kapa a ka baka ts'abo ea lithane. [] Ho ts'oaroa ke litlamorao tse sa tloaelehang haholo ka TMS, e ka bonoa ho bakuli ba sebelisang meriana e fokotsang mokhoa oa bona oa ho tsietsana. []

Sena ke, ho ea ka tsebo ea rona eohle, tlaleho ea pele e totobatsang ho sebetsa ha li-rTMS bothateng ba takatso ea hypersexual. Khathala ea rona, TMS e ne e sebetsa hantle ho hatella ho thata ho phekola matšoao a amanang le khatello ea maikutlo. Kahoo, TMS e kanna ea nkuoa e le khetho ea kalafo ho bakuli ba nang le lefu la hypersexual.

Ts'ehetso ea lichelete le tšehetso

Nil.

Likhohlano tsa thahasello

Ha ho lintoa tse thahasellisang.

LITLHAHISO

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