Volume 223, 2016, maqephe a 43-62
Neuroscience ea Meriana e Lemalloang: Ho Thibela ho Thibelo ho ea Tlhabollong - Lihahi le Lithethefatsi
inahaneloang
Khaolong ena, re hlahloba ka bokhutšoanyane biology ea mantlha ea khatello ea kelello le karabelo ea khatello ea maikutlo. Re fana ka maikutlo a hore khatello ea kelello le neurobiology ea karabelo ea khatello ea maikutlo li bapala ho ts'ebelisong ea tšebeliso ea lithethefatsi, ho e lokisa le ho e khutlisa. Mekhoa e reriloeng ea sena e kenyelletsa, ka lehlakoreng le leng, likhohlano tse rarahaneng pakeng tsa babuelli ba tlhaho ba karabelo ea khatello ea maikutlo le tsamaiso ea moputso oa dopaminergic, ka lehlakoreng le leng, babuelli ba karabelo ea khatello le lits'ebetso tse ling tsa bohlokoa ho lokiseng boits'oaro bo amanang le ts'ebeliso e matla ea bokhoba ba taolo. joalo ka li-opioids tsa endo native, sistimi ea kutloelo-bohloko ea adrenal-medullary, le endocannabinoids. Mekhoa e mecha ea ho ithuta e kenyelletsa genomics, thobalano e le mookameli oa karabelo ea khatello ea maikutlo, le lithahasello tsa boitšoaro (papali ea chelete, tšebeliso ea maikutlo, ts'ebeliso e mpe ea inthanete, le lijo e le ntho e lemalloang) li hlahisoa ka bokhutšoanyane maemong a khatello ea maikutlo joalo ka mookameli oa ts'ebetso ea ho lematsa.
Keywords Matšoenyeho; Lits'ebetso tsa karabelo ea khatello ea maikutlo; Pheta; Maikutlo; Boitšoaro bo tlatsetsang; Hypothalamic-pituitary-adrenocortical axis; Karabelo ea Sympathetic-adrenal-medullary; Boitšoaro bo tlatsetsang; Cortisol
LITLHAKISO:
Khatello ea kelello ea khatello ea maikutlo maemong a moriana oa lithethefatsi ho tloha lithethefatsing tsa tlhekefetso ho isa litlamong tsa boits'oaro
Le ha likhatello tse fapaneng tsa kantle ho ts'ebetso ea bokhoba li ka tsamaisa teko ea pele, tšebeliso e sa feleng, kapa ho khutlela morao, ho tlosa le ho ama hampe tse tsamaellanang le ho iketla ka bo tsona ke boiphihlelo bo bobe le bo sithabetsang (Kassel et al., 2007) .Sebellana le karabelo ho ama hampe ho tla baka ho ho matlafatsoa ho matla (ho tlosoa hoa tšusumetso) eo, le eona e eketsang monyetla oa tšebeliso e tlang mme, haeba e phetoa hape. Matlafatso a matle a hlaha ho tsoa holimo kapa ho natefeloa ke ho araba ntho e lemalloang
DSM ea hona joale ea 5 (American Psychiatric Association, 2014) e hlalositse moelelo oa tšebeliso ea lithethefatsi ho kenyelletsa ts'ebeliso e mpe ea lithethefatsi le ho ts'epahalla ho etsahalang ka nako e telele ho tloha ho bobebe ho isa ho matla. Ho tšoaneleha bakeng sa tlhahlobo tlasa sistimi ena e ncha mantsoe "bokhoba" le "ho itšetleha" a qobelloa ho latela mathata a ts'ebeliso e mpe ea lithethefatsi
Bongata ba liteko tsena tsa ho sebetsana le khatello ea maikutlo kapa ho li tlosa nakong ea khatello ha li atlehe, kapa maemong a tšebeliso ea lithethefatsi ho batho, li kotsi.
METSOALLE E ETSA METSOALLE E ETSA STRESS LE HO FIHLELA
Ho na le bopaki ba hore, ka litsela tse ngata, matla a ho feto-fetoha ha maikutlo a khatello ea methapo ea maikutlo a khatello ea kelello a bonoang ho batho le liphoofolo a pepesetsoeng lithethefatsi tsa tlhekefetso. Mohlala, khatello ea maikutlo le bokhoba ba tsona bo arolelana liphetoho tse tšoanang boits'oarong, liphetoho tse tšoanang tsa methapo ea kutlo ho HPA, LC-NE, tsamaiso ea tsamaiso ea lintho le tsamaiso ea eCB, le lintlha tse tšoanang tsa kotsi (thobalano, psychopathology, jj.). Matšoenyeho a sa feleng a sechaba ho liphoofolo le batho a lebisa ho eketseha ha ho tšoenyeha, ho ama hampe, le ho fetoha ha ho robala le ho ja (Adam le Epel, 2007; Akerstedt, 2006; Chida le Hamer, 2008), tseo kaofela li tloaelehileng tlhahisong e mpe ea lithethefatsi. Hoa tšoana le bakeng sa ho sitisoa ha maikutlo, tlhokomelo, ho hopola le ho etsa liqeto (Het et al., 2005). Ho tloha ponong ea methapo ea kutlo, ho boetse ho na le litsela tse ngata tse tloaelehileng. Joalokaha ho bontšitsoe kaholimo, khatello ea maikutlo e sa feleng ea sechaba le ho pepeseha ho sa feleng ha lithethefatsi tsa tlhekefetso joalo ka morphine ho lebisa ho liphetoho ho ts'ebetsong ea LC-NE e shebahalang e its'etleha mesebetsing ea opioid endeo (Chaijale et al., 2013; Curtis et al., 2012) . Ka kakaretso, leha ho na le phapang e itseng e ipapisitseng le k'hemistri ea ntho e hlekefelitsoeng, ts'ebeliso ea lithethefatsi tse mpe e boetse e lebisa ho HPA e matla le SNS e sebetsa ka tsela e ts'oanang le khatello ea maikutlo (al'Absi et al., 2008; Fox et al., 2006; Hamidovic et al., 2010; Mick et al., 2013).
Tsela e 'ngoe e tloaelehileng e fumaneng tlhokomelo e matla haholo ea patlisiso ke karolo ea meputso ea dopaminergic pathways bokong. Joalokaha ho boletsoe kaholimo, lithethefatsi tsa tlhekefetso li holisa tšebetso ea HPA, SNS, le lits'oants'o tsa opioid ka mokhoa o ts'oanang le khatello ea maikutlo e sa foleng. Litlamorao tsa boits'oaro, li fetoloa ka methapo e mengata ea methapo ea kutlo e kenyeletsang catecholamines: dopamine, NE, le serotonin (Salamone le Correa, 2013). Litsamaiso tsa HPA le dopaminergic li lumellane (Boyson et al., 2014). Dopamine ka ho khetheha e hokahane le thepa ea moputso ea ts'ebeliso ea lithethefatsi. Mohlala, lithuto tsa pharmacological li bontšitse hore khatello ea maikutlo e eketsa tlhahiso ea dopamine ka ts'ebetso ea glucocorticoid receptor activation (Boyson et al., 2014). Haholo-holo, ho eketseha ha tšebetso ea CRF e bohareng e le mosebetsi oa N-methyl-D-aspartate receptor, eo, e hlahisang phetisetso e eketsehileng ea dopaminergic (Marinelli, 2007). Ts'ehetso bakeng sa karolo ea ts'ebetso ea HPA ho eketsa ts'ebetso ea dopaminergic e bonahetse lithutong tse sebelisang mekhoa e fapaneng (Barrot et al., 2000; Graf et al., 2013). Ka lipatlisiso tsena, litsela tsa moputso oa CNS tsa bohlokoa le meaho li bonts'itse ho kenyelletsa sebaka sa tefo ea mokokotlo, li-nucleus accumbens, le preortal cortex (Baik, 2013; Kringelbach et al., 2012; Lawrence le Brooks, 2014).
Ntle le tsela ea moputso oa dopaminergic, khatello ea maikutlo le lithethefatsi hampe li ka ama tsela eo serotonergic e tsamaeang ka eona ke "raphe kinus" striatum, nucleus accumbens, le neocortex kaofela. Litlamorao tsa ts'ebetso e fetotsoeng ea serotonergic e hlahisoa e le liphetoho mokhoeng oa ho hopola, ho hopola, ho robala le ho ba le kelello. tsena tsohle li bonahala metseng ea khatello ea maikutlo le tšebeliso e mpe ea lithethefatsi (Kirby et al., 2011; Meerlo et al., 2008; Meneses, 2013)
Matšoao a fapaneng a 'mele a khatello ea maikutlo a bolela esale pele hore motho o tla khutlela teng. Mohlala, batho ba tsubang ba bonts'ang karabelo ea kutloelo-bohloko le khatello ea maikutlo ea HPA nakong ea pele ea 24 h ea ho khutlela morao e na le kotsi e eketsehileng ea ho boelloa ke boemo nakong ea libeke tse 4 tsa postquit (al'Absi, 2006; al'Absi et al., 2004, 2005; Ceballos le al'Absi, 2006) joalo ka ha ho eketseha ho hobe ho ama
Ka mokhoa o ts'oanang, ho ts'oara kapa ho ts'oaroa ke khatello ea maikutlo hape ke ts'usumetso e mpe e matla bakeng sa ho tsuba ho sa khaotseng (Ahmed le Koob, 2005). Leha boiphihlelo bona bo sithabetsa maikutlong le kelellong, karabelo e bonahala e le khahlanong le maikutlo a ba khutlelang morao e bonahala e amana le CRF (Erb, 2007).
Ntle le axis ea HPA, li-catecholamine le glutamate kahare ho bokellane ba nucleus le cortex ea pele li ts'oaroa ke litokelo tsa lithethefatsi, ts'ebeliso ea lithethefatsi, le / kapa khatello ea maikutlo.
Leha re qalile karolo ena re sebelisa temallo ea nicotine joalo ka mohlala, ho bohlokoa ho supa hore khatello ea maikutlo le likarabo tse sa tloaelehang tsa cortisol li boetse li hokahane le ho khutla le liteko tse ling tsa ho khaotsa ho sebelisa cocaine, opiates, joala, amphetamines le matekoane. ., 2013; Hamidovic et al., 2010; Higley et al., 2011; Sinha, 2011). Ka lintho tse ling tse sebelisang tlhekefetso tse joalo ka heroin, leha ho le joalo, karabelo ea cortisol e phahame ho e-na le ho tsebahala, haholo-holo ho arabela litabeng tsa lithethefatsi tsa paraphernalia (Fatseas et al., 2011). Ho sa tsotelehe tataiso ea liphetoho tsa HPA, ho na le bopaki bo bongata ba hore tšebeliso ea lithethefatsi e amana le taolo ea selekane sa HPA, mohlomong khokahanong le taolo ho taolo ea maikutlo, moputso o bohareng, le lits'ebetso tsa ts'ebetso ea botsamaisi.
LITLHAKISO TSA BOPHELO LE LITLHAKISO TSA BOPHELO
Ka lekhetlo la pele, bothata ba papali ea chelete ea ho becha bo ile ba eketsoa ho DSM 5 ka 2013 ka lebaka la mekhoa ea eona e hlakileng ea boitšoaro bo bobe (Hasin et al., 2013). Haeba, joalo ka ha re se re ngangisitse kaholimo, khatello ea kelello ke ntlha ea bohlokoa ho qaleng, ho lokisa le ho khutlisetsa litlolo tsohle, ho tla ba le lebaka la hore ho be le bopaki ba kamano e joalo ea khatello ea maikutlo le bokhoba har'a boitšoaro bohle, maikutlong, likarolo tsa kelello, le tsa 'mele tsa khatello ea maikutlo e mabapi le papali ea chelete. Sena ke, ehlile, ke boemo ba litekanyetso tsena tse ngata. Mohlala, ho tlalehiloe likhatello tsa kelello le kelello tse kang tlhalo, lintoa tsa lenyalo le nalane ea tlhekefetso ea bana e atile haholo mehlaleng ea batho ba betang ka tšohanyetso (PGs) (Black et al., 2012). Khatello ea bophelo bo phahameng ka nako ea kalafo ke e 'ngoe ea matla a matla a ho khutla ha PG nakong ea phekolo ea likhoeli tse 4 (Gomes and Pascual- Leone, 2014). Le hoja basort cortisol e ka 'na ea se ke ea phahamisoa ka ho becha
pherekano, ho na le lihokelo tse mpe ka bolelele ba papali ea chelete ea ho becha le cortisol, ho se lekane ha papali ea chelete, le khatello ea maikutlo mabapi le boitšoaro ba papali ea chelete (Geisel et al., 2015). Ho feta moo, boits'oaro bo amanang le papali ea chelete bo eketseha ka ho etsa liteko tsa boemo ba khatello, leha e se ka mefuta eohle ea khatello (Steinberg et al., 2011). Patlisiso ea pejana e bonts'a hore khatello ea 'mele ea khatello ea kelello, joalo ka ha e lekantsoe ke HPA, kutloelo-bohloko, serotonergic, dopaminergic, le endo native opioid, li hokahantsoe le boitšoaro ba papali ea chelete, tlhokomelo le ho khutla hape (Blanchard et al., 2000; Campbell-Meiklejohn et al., 2011; van den Bos et al., 2009). Bakeng sa li-PG, basal potoloho ea NE, EPI, le dopamine li phahamisitsoe 'me ketso ea papali ea papali ea chelete ke naha e tsosang takatso (Meyer et al., 2004). Ho fapana le maemo a basal kapa boitšoaro ba papali ea chelete, karabelo ea cortisol litloaelong tsa papali ea chelete ea ho becha e ka ba sieo bakeng sa li-PG empa e se mekete ea boithabiso
(Paris et al., 2010a, b). Kamora nako, lithuto tsa neuroimaging li bonts'a hore, joalo ka bokhoba ba joala, ts'ebetso ea papali ea methapo e amahanngoa le ho hlekefetsoa ka mokokotlong oa kantle ea cingate, ventral striatum, le li-cortices tsa pele (Koehler et al., 2013). Boitšoaro bo bong bo nang le litsobotsi tse sebelisang (ho phehella le ho se sebetse hantle kapa boits'oaro bo lebisang ho senyeng kapa khatello ea maikutlo) bo kenyelletsa ho ba le moea o mongata, ts'ebeliso ea ts'ebeliso ea marang-rang, le ho ja ka mokhoa o feteletseng (AKA "temallo ea lijo"). Ha e ngoe le e 'ngoe ea tsena e e-so nyolohele boemong ba ho kenyelletsoa ho DSM e le bothata ba tšebeliso ea lithethefatsi, ho na le tlhokomeliso ea hore e' ngoe le e 'ngoe ea tsena e na le mokhoa o tšoanang oa tšebeliso o lebisang ho se sebetseng. Ho feta moo, bopaki ba pele bo teng ba khokahano lipakeng tsa litheko tsena tsa boitšoaro bo botle (tlhekefetso ea thobalano le ts'ebeliso ea ts'ebeliso ea marang-rang) le dopamine, khatello ea boits'oaro, kapa HPA axis dysregulation (Farre et al., 5; Hou et al., 2015) . Qetellong, hajoale ho na le ngangisano e kholo ea hore na ho na le "ts'oaetso ea lijo" kapa "tšebeliso ea ho ja" e fapaneng le mathata a ho ja a anorexia kapa bulimia a teng (Roger and Smit, 2012). Le ha e ntse e le likhang haholo, ba ts'ehetsang khopolo ea ts'oaetso ea lijo e beha kotsing ea eona ea ho sithabela ha khatello ea maikutlo le mokhoa oa moputso oa dopaminergic e le bopaki bo tšehetsang phapang ea mathata a ho ja (Adam le Epel, 2000; Volkow et al., 2007).
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