Ts'ebetso ea bokooa ka ho susumetsa batho ba nang le mekhoa e metle ea banna ba phelang boemong bo botle (2006)

inahaneloang

Morero oa thuto ea hajoale e ne e le ho supa litsi tsa boko, tseo liphetoho tsa tsona li amanang le lits'oants'o tsa maikutlo tse tsosang takatso ho banna ba phetseng hantle, ba bong bo fapaneng le ba lilemong tse bohareng. Banna ba leshome ba bong bo fapaneng, ba letsoho le letona ba nang le ts'ebetso e tloaelehileng ea thobalano ba kentsoe thutong ea joale (ho bolela lilemo tse 52, moeli oa 46-55). Litaba tsohle tse ka bang teng li ile tsa hlahlojoa ka lipotso tse fetang 1 h, 'me tsa khothaletsoa ho tlatsa lipotso tse kenyelletsang Lenane la Ts'ebetso ea Botona le Botšehali la Monna. Lihlooho tsohle tse nang le nalane ea bothata ba ho tsosa takatso ea thobalano kapa ho se sebetse ha erectile ha li kenyelelitsoe.

Re ile ra etsa litšoantšo tse sebetsang tsa boko ba motlakase oa motlakase (fMRI) ho baithaopi ba batona ha ho bapaloa filimi e 'ngoe e tsosang takatso le e seng ea' mino bakeng sa metsotso e 14 le 9. TLikarolo tse kholo tsa ts'ebetso e amanang le ho tsosa takatso ea thobalano ho tšusumetso ea pono e ne e le sebaka sa occipitotemporal, anterior cingate gyrus, insula, orbitofrontal cortex, nucleus ea caudate.

Leha ho le joalo, hypothalamus mme thalamus ha ea ka ea buloa. Re fana ka maikutlo a hore ho se sebetse ha hypothalamus le thalamus ho banna ba lilemong tse bohareng ho ka ba le boikarabello ba ho tsosa takatso e nyane ea mmele ho arabela lits'oants'o tse mpe tsa pono.

Selelekela

Ka nts'etsopele ea mekhoa ea ho nka litšoantšo e sebetsang e kang positron emission tomography (PET) kapa imaging e sebetsang ea matla a khoheli (fMRI), tsebo ea karoloana ea boko bakeng sa karabelo ea thobalano ea bokellana.^{1, 2} Park et al a.³ o ne a batlile likamano lipakeng tsa ts'ebetso ea boko le karabelo ea thobalano ho banna ba batona ba 12 (lilemo tse bolelang = lilemo tse 23) ka ts'ebetso e tloaelehileng ea thobalano. Ba tlalehile hore libaka tsa boko tse sebelisitsoeng ka mokhoa o bonts'ang maikutlo a litšila e ne e le lobe e ka tlase e ka pele, cingate gyrus, insula, corpus callosum, khubung ea caudate, globus pallidus, lobe ea nakoana le thalamus. Tseba et al a.² e hlahisitse paradigm ea liteko e kenyelletsang sekhahla sa tumescence le tšusumetso ea pono e tsosang takatso, hammoho le likarolo tsa taolo tse sa nke lehlakore le tse bonang tse sebelisang theknoloji ea fMRI ho lekola ts'ebetso ea bokong nakong ea thobalano. Libaka tse kholo tsa ts'ebetso e amanang le tumescence e ne e le sebaka sa insula / subinsular se nepahetseng, ho kenyeletsoa le claustrum, caudate nucleus, putamen, cingate gyrus, sebaka sa occipito-temporal le hypothalamus. Phuputso e ile ea bapisa liphapang tsa bong litabeng tsa thobalano e bonts'itseng hore ke tsa banna feela ba nang le ts'ebetso e kholo ea hypothalamus.⁴ Le ha kutloisiso ea karolo e bokong ea ho tsosa takatso ea thobalano e eketsehile haholo joalo ka lithuto tsena, lithuto tsohle li ne li lekanyelitsoe ho batho ba baholo. Kaha ho se sebetse hantle litabeng tsa thobalano ho atile haholo ho banna ba baholo ho feta ba banyenyane, ho lokela ho hlakisoa liphetoho tse amanang le botsofali tsa ts'ebetso ea boko ka tšusumetso ea thobalano.⁵ Ho khetholla libaka tsa boko moo litšitiso tse sebetsang li sitisang taolo ea ts'oaetso ea thobalano ho bakuli ba nang le mathata a ho tsosa takatso ea thobalano, ho tla hlokahala phuputso e hlahlobang ts'ebetso ea boko ba banna ba lilemong tse bohareng.

Morero oa thuto ea hajoale e ne e le ho supa litsi tsa boko, tseo liphetoho tsa tsona li amanang le lits'oants'o tsa pono tse tsosang takatso ho banna ba lilemong tse phetseng hantle, ba bong bo fapaneng. Ha ho bapisoa le liphuputso tse tlalehiloeng liphuputsong tse sebetsang tsa neuroimaging ho banna ba batona, ho ka lebelloa lintlha tse fapaneng tsa ts'ebetso ea boko.^{2, 3, 4}

Ka holimo ho leqephe

mekhoa

Lihlooho

Banna ba leshome ba bong bo fapaneng, ba letsohong le letona ba nang le ts'ebetso e tloaelehileng ea thobalano ba kentsoe thutong ea hona joale (lilemo tse bolelang lilemo tse 52, moeli oa 46-55). Litaba tsohle tse ka bang teng li ile tsa hlahlojoa ka lipotso tsa 1-h, 'me tsa khothaletsoa ho tlatsa lipotso tse kenyelletsang Lenane la Ts'ebetso ea Botona le Botšehali la Monna.Lethathamo 1).⁶

Tafole 1 - Lenane le lekhuts'oane la ts'ebetso ea thobalano.

Tafole e feletseng

Ho ba sieo ha mathata a 'mele le kalafo efe kapa efe ea litlhare ho ile ha hlahlojoa ka tlhahlobo ea bongaka. Moralo oa boithuto o hlalositsoe ka botlalo mme lithuto tse khethiloeng li bala le ho saena tumello e nang le tsebo pele ba kenella thutong. Lihlooho tsohle tse nang le nalane ea bothata ba ho tsosa takatso ea thobalano kapa ho se sebetse ha erectile ha li kenyelelitsoe. Protocol ea thuto e amohetsoe ke boto ea litheko ea setheo Sepetleleng sa St. Mary, The Catholic University of Korea.

Ts'ebetso ea ts'ebetso le ho fumana setšoantšo sa MRI

Re ile ra hlahisa lihlooho tseo filimi, e neng e nka 14 min le 9 s. Sekhechana sena se ne se na le likarolo tse fapakaneng tsa litšoantšo tse khathollang (R), lintlha tsa lipapali (S) kapa litšoantšo tse tsosang takatso ea thobalano (E) ka tatellano e latelang: S, R, E, R, E, R, S, R, S, R le E. Linako tse fapaneng tsa likarolo tsena ka metsotsoana e ne e le: 129, 60, 120, 30, 120, 30, 120, 30, 60, 30 le 120 (li). Ho na le lintlha tse 'maloa tse tsebisitseng moralo le tšusumetso e khethehileng. Ha ho fanoa ka tlhaiso-leseling e fanang ka maikutlo a hore ho ikarola ho tsoa linthong tse bonoang tse susumetsang maikutlo tlasa maemo a fMRI ho nka li-15, likarolo tsa S le E li ne li sa kopane ebile li arotsoe ke bonyane ba 30 s ea R.⁷ Litaba tsa likarolo tsa thobalano li ne li kenyelletsa mefuta e mene ea liketso tsa thobalano: thobalano ka morao, thobalano le mosali boemong bo phahameng, fallatio, le thobalano le monna ea boemong bo phahameng. Har'a lifilimi tse robeli tse bonts'itsoeng tsa thobalano, liketso tsena tse 'ne li ne li amahanngoa le boemo bo phahameng ka ho fetesisa ba thobalano le thobalano ea penile ka mohlala oa banna ba 40 ba phetseng hantle. Qetellong, molemong oa ho laola litlamorao tse ka bang teng tsa tebello, lithuto ha lia ka tsa tsebisoa ka tatellano ea likarolo.

Nakong ea mananeo a fMRI, likoto tsa filimi li ile tsa hlahisoa ho bafo ka seipone se kaholimo ho kela ea hlooho e amohelang litšoantšo tsa video ho tsoa kantle ho phaposi ea makenete. Litšoantšo tsa Echoplanar (EPI) li fumanoe ho 1.5 T MRI system (Magentom Vision Plus, Nokia, Erlangen, Germany). Ho ile ha fumanoa likhae tse mashome a mararo (5mm botenya) ka li-3.106 s tse ling ka sefofaneng se tsamaeang ka axial, se hokahantsoeng le selekane sa AC-PC. Litšoantšo tsena tse sebetsang tse nang le boima ba T2 li fumanoe ho sebelisoa tatellano ea pulse ea EPI (TR = 0.6 ms, TE = 60 ms, Flip 90, FOV = 240 mm, Matrix = 64 64). Kamora ho skena ho sebetsang, tlhaiso-leseling e phahameng e fumanoe ka mokhoa oa T1 o boima ba boleng ba 3D o fumanoeng ka tatellano ea gradient echo pulse (TR = 9.7 ms, TE = 4 ms, Flip = 12, FOV = 240 mm, Matrix = 200 256).

Lintlha li ile tsa hlahlojoa ho sebelisoa Statistical Parametric Mapping (SPM99, Wellcome Department of Cognitive Neurology, London, UK). Lisebelisoa li ile tsa hlophisoa bocha 'me tsa hlophisoa ka sebaka sa sebaka sa heno ho sebelisoa template e tloaelehileng ea Montreal Neurological Institute (MNI). Litšoantšo li ile tsa kopanngoa sepakapakeng ka 3D isotopic Gaussian kernel (bophara bo felletseng ka halofo ea bolelele, FWHM, ea 8 mm) ho ntlafatsa sekhahla sa letšoao ho lerata le ho amohela phapang e setseng ea neuroantomy e sebetsang e atisang ho phehella lipakeng tsa litaba kamora ho tloaela sebaka. Liphello ho voxel e ngoe le e ngoe li hakantsoe ho sebelisa mofuta o akaretsang oa linear. Litekanyetso tsa Voxel bakeng sa phapang ka 'ngoe li hlahisitse' mapa oa lipalo tsa parametric oa t statistic (SPMt), 'me hamorao ea fetoloa ho ba karolelano e tloaelehileng ea yuniti, SPM {Z}. Moetso oa 'litlamorao tse sa reroang' o sebelisitsoe ho hlahisa phapang ea E (erotica) tlasa N (ho se nke lehlakore). Moetso ona o kengoa tšebetsong kahare ho SPM99 o sebelisa methati e mengata.

Hypothalamus, thalamus, anterior cingulate gyrus, occipitotemporal cortex, anterior temporal cortex, parietal cortex, amygdala, hippocampal form, orbitofrontal cortex, ventral striatum, the claustrum, nucleus accumbens, li-parietal lobules kaofela li bontšitsoe ho arabela lifilimi tse hlakileng tsa thobalano. lithutong tsa banna.^{2, 3, 4, 8} Bakeng sa sebaka ka seng sa boko se boletsoeng kaholimo, sete sa likhokahano se ne se baloa ka ho nka karolelano ea axis e ngoe le e ngoe ea orthogonal X, Y 'me Z ea likhokahanyo tse tlalehiloeng tsa Talairach.⁹ Libaka tse reriloeng esale pele tsa thahasello (ROI) li ne li lekantsoe ke likarolo tse nang le radius ea 9 mm le bakeng sa setsi, likhakanyo tse lekantsoeng tse tlalehiloeng. Bakeng sa li-ROI tsena tsa bohlokoa, moeli oa bophahamo o ile oa beoa ho P<0.001z= 3.09), e sa nepisoang bakeng sa papiso e mengata. Bakeng sa libaka tse ling tsa boko, bophahamo ba bophahamo bo ile ba beoa ho P<0.05, e lokisitsoe bakeng sa papiso e mengata.

Ka holimo ho leqephe

Results

Ha tšebetso ea boemo ba oksijene ea mali (BOLD) e amanang le ho shebella karolo ea filimi e sa jeleng paate (S) e ile ea tlosoa ho e amanang le ho shebella karolo e tsosang takatso (E), ea bohlokoa (P<0001, e sa nepahala) loci ea ts'ebetso e thathamisitsoe ho Lethathamo 2 le ho bontšoa ka Litšoantšo 1 'me 2. Likarolo tse kholo tsa ts'ebetso e amanang le ho tsosa takatso ea thobalano ho tšusumetso ea pono e ne e le sebaka sa occipitotemporal, anterior cingate gyrus, insula, orbitofrontal cortex, nucleus ea caudate. Leha ho le joalo, hypothalamus le thalamus ha lia ka tsa sebelisoa.

Setšoantšo sa 1.

Libaka tsa boko tseo ts'ebetso ea tsona e neng e amana le litšusumetso tse bonts'ang takatso ea boits'oaro lithutong tsa banna ba lilemong tse mahareng tse phetseng hantle (tlhaiso-leseling ea sehlopha se kopaneng, N= 10).

Sebopeho se felletseng le litšomo (162K)

Setšoantšo sa 2.

Pono ea Axial ea libaka tsa boko tse sebelisitsoeng ka mokhoa o bonts'ang takatso ea maikutlo lithutong tsa banna ba lilemong tse mahareng tse phetseng hantle (tlhaiso-leseling ea sehlopha se kopaneng, N= 10).

Sebopeho se felletseng le litšomo (355K)

Letlapa la 2 - Libaka tsa boko tse nang le mesebetsi e fapaneng ho arabela lits'oants'o tse hlakileng tsa thobalano le maikutlo a sa nke lehlakore lithutong tsa banna ba lilemong tse mahareng tse phetseng hantle (tlhaiso-leseling ea sehlopha, N= 10).

Tafole e feletseng

Puisano

Ho 'nile ha etsoa tlhahiso ea hore ho tsosoa ha batho ka thobalano, hangata ho bakoang ke tšusumetso e kantle kapa mabaka a sa feleng, ke boiphihlelo bo bongata bo nang le likarolo tse' ne tse amanang haufi-ufi le khokahano: kutloisiso, maikutlo, ts'usumetso le mmele.^{8, 10}

Thutong ea hajoale, libaka tse ka sehloohong tsa ts'ebetso e amanang le ho tsosa takatso ea thobalano ho susumetsa pono e ne e le sebaka sa occipitotemporal, anterior cingate gyrus, insula, orbitofrontal cortex, nucleus ea caudate. Leha ho le joalo, hypothalamus le thalamus ha lia ka tsa sebelisoa. Ts'ebetso ea sebaka sa occipitotemporal e lumellana le litholoana tsa boithuto ba morao-rao bo sebetsang, moo maikutlo a maikutlo a imetsoeng kelellong a ileng a eketsa ts'ebetso ea ts'ebetso sebakeng sena sa cortical.^{11, 12} Reiman et al a.¹³ e fane ka bopaki ba hore anterior cingulate gyrus e kentse letsoho boiphihlelong ba maikutlo. Phuputsong e sebetsang ea neuroimaging, ts'ebetso ea anterior cingulate gyrus e ne e amana haholo le maemo a ts'oaetso ea thobalano, a neng a amana le takatso e nahanoang ea ho etsa liketso tsa thobalano.⁸ Liphetho tsena li 'nile tsa phetoa ha ho latela lithuto tse sebelisang fMRI.^{2, 3, 4} Orbitofrontal cortex e bonts'itsoe hore e na le seabo ho hlahiseng meputso.¹⁴ Redoute et al a.⁸ e khothalelitse hore ts'ebetso ea orbitofrontal e boletsoeng thutong ea bona ea PET e kanna ea amana le setšoantšo sa maikutlo a monate a 'mele a bakoang ke penile tumescence.

Thutong ea hajoale, thalamus le hypothalamus ha lia ka tsa ts'oaroa. Litšusumetso tse amanang li fetisetsoa ho cortex ka thalamus e laolang phallo ea tlhaiso-leseling e utloahalang. Ho khahlisang ke hore thalamus e emela setsi seo sebaka sefe kapa sefe se ka har'a cortex se ka buisanang le libaka tse ling tsa boko. Khokahano ena e pharalletseng ea thalamocortical inter-khokahano e se e thehiloe hore e be motheo oa methapo ea kutlo ea tlhokomeliso.¹⁵ Haeba khopolo-taba ena e ne e nepahetse, thalamus e ne e tla ameha ntlheng ea kutloisiso ea ho tsosa takatso ea thobalano. E 'ngoe ea likhokahano tse kholo tsa thalamocortical ke cortico-striato-thalamo-cortical curcuit. Lits'oants'o tse tsoang ho orbitofrontal cortex ka khubu ea caudate, tseo ka bobeli li nkoang e le lits'ebetso tsa thibelo, ho nahanoa hore e tla sebetsana le ts'ebetso e amanang le moelelo le thibelo ea likarabo.¹⁶ Ka lebaka la pono e joalo, ho se sebelisoe ha thalamus, le ts'ebetso ea orbitofrontal cortex le khubu ea caudate thutong ena ho ka fana ka maikutlo a hore banna ba lilemong tse bohareng ba ka sitisoa haholo ke khokahano ea thalamocortical mme ba se ke ba tsosa takatso e matla ea thobalano ho feta bacha. Palo e kholo ea lithuto e hokahantse hypothalamus le karabelo ea thobalano. Neuroanatomically, liso tse sebakeng sa medial preoptic tsa hypothalamus li sitisa boits'oaro ba banna ho mefuta eohle e lekiloeng,¹⁷ le tšusumetso ea motlakase ea karolo e kahare ea hypothalamus e amahanngoa le ho ts'oaroa ha likhoto.¹⁸ Ntle le moo, methapo ea methapo ea kutlo, ente e tobileng ea apomorphine, dopamine agonist, e kenang khubung ea paraventricular e hlohlelletsa likhahla likhopong.¹⁹ Redoute et al a.⁸ e bonts'itse kamano pakeng tsa ts'ebetso ea hypothalamus le litekanyo tsa penile tumescence thutong ea PET. Tseba et al a.² hape e tlaleha liphetho tse tšoanang thutong ea fMRI. Ho khahlisang ke Karama et al a.⁴ e tlalehile hore hypothalamus e ne e sa sebetsoa ka mokhoa o fokolang ho basali ho feta banna ho arabela litšitiso tsa thobalano, mme ba etsa tlhahiso ea hore lithuto tsa basali li ne li sa tsohe haholo ho feta tsa banna. Yang²⁰ e ile ea hlahloba ts'ebetso ea bokooa ho batho ba nang le khatello ea maikutlo ba ho kopanela liphate, 'me ba tlaleha hore hypothalamus le thalamus li ne li sa sebetse ho feta sehlopha se tloaelehileng sa taolo. Ho ipapisitsoe le liphetho tse boletsoeng kaholimo, hypothalamic nonactivation thutong ena bakeng sa banna ba lilemong tse bohareng e fana ka maikutlo a hore lithuto tsena li ne li sa tsohe haholo moeeng ka lebaka la tšusumetso e mpe ea pono. Le ha ho na le bopaki ba mekhoa e joalo ea thibelo ho feta hypothalamus ebile bo sa tobang ebile bo amohetse tlhokomelo e nyane haholo ho feta mekhoa ea thabo, teko ea haufinyane ea ho fumana litlamorao tsa thibelo ea thobalano ea serotonin e na le karolo ea thibelo sebakeng sa lateral hypothalamic.²¹ Sena se tsamaellana le litlamorao tse thibetsoeng tsa "serotonin re-uptake inhibitors" (SSRIs) mabapi le karabelo ea thobalano.²²

Ha re nahana ka khokahano e pharalletseng ea boko, le 'taolo e habeli' ea karabelo ea thobalano, e 'ngoe ea mekhoa ea ho se sebetse thalamus le hypothalamus, e tsejoang e le setsi sa khale sa ho tsosa takatso ea thobalano e ka ba pheteletso e fetelletseng ea sistimi e thibelang thobalano.

Mabapi le meeli ea thuto, ho lokela hore pele ho hlokomeloe hore re ne re ithutile feela banna ba lilemong tse mahareng le sehlopha sa taolo ea bacha ba neng ba sa kenyelletsoa. Ho tloha ha moralo oa rona oa ho ithuta, (mohlala, nako e tšoarellang ea likarolo tsa lifilimi tse tsosang takatso le tse sa jeleng paate) e ne e ts'oana haholo le mesebetsi e fetileng bakeng sa bacha, ho ka ba bonolo ho bapisa e mong le e mong ka tsela e sa tobang.^{2, 4} Leha ho le joalo, ho laola phapang ea lipatlisiso tse sebetsang tsa ho nka litšoantšo, thuto ea papiso bakeng sa batho ba lilemong tse bohareng le ba baholo ka nako e le ngoe e lokela ho hlokahala. Taba ea bobeli, re ne re sitoa ho bonts'a khokahano e tobileng ea libaka tse ikhethileng tsa boko tse kenyelletsang sistimi e nyarosang le e thibelang. Kahoo, litlhaloso tsa rona li lokela ho nkuoa e le khopolo-taba e lokelang ho lekoa nakong e tlang ha thuto e tobileng e tsepamisitse maikutlo ho potoloho ena ea boko. Thibelo e 'ngoe e amana le khaello ea mehato ea sepheo sa ho tsosa takatso ea thobalano joalo ka penile tumescence.

Ka holimo ho leqephe

Nahanisisa

Re supile ka ho sebelisa fMRI, ka lekhetlo la pele, neuroanatomy e sebetsang ea boko e amanang le ho tsosa takatso ea thobalano ho banna ba lilemong tse bohareng. Phello e bile ts'ebetsong ea gyrus ea occipitotemporal, anterior cingate gyrus, orbitofrontal cortex, le ho se sebetse ha hypothalamus le thalamus. Re fana ka maikutlo a hore ho se sebetse ha hypothalamus le thalamus ho banna ba lilemong tse bohareng ho ka ba le boikarabello ba ho tsosa takatso e nyane ea mmele ho arabela lits'oants'o tse mpe tsa pono.

Ka holimo ho leqephe

References

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Ka holimo ho leqephe

Liteboho

Mosebetsi ona o ne o tšehelitsoe ke Grant No. R01-2003-000-10432-0 ho tsoa Lenaneong la Motheo la Lipatlisiso la Korea Science & Engineering Foundation.