IZIMVO: Eli linqaku elilula kancinci esekwe kolu phononongo - ISIFUNDO ESIFUNDILEYO - isuka e Ijenali yeziyobisi zengqondo, 44 (2), 134-143, 2012, Ilungelo lokushicilela © Taylor & Francis Group, LLC
J Amachiza oNyango. 2012 Apr-Jun;44(2):134-43.
Blum K1, Chen AL, UGiordano J, Borsten J, UChen TJ, UHause M, Simpatico T, Femino J, I-Braverman ER, Bhara D.
KWI-ABSTRACT
Eli nqaku liza kuchukumisa iithiyori, uphando lwezenzululwazi kunye nentelekelelo malunga nemfuza yendalo yokusebenza kwengqondo kunye nefuthe leenguqu zofuzo ezibizwa ngokuba ziipolymorphisms ekuziphatheni kokufuna iziyobisi. Iza kugubungela isiseko se-neurological sokufuna ulonwabo kunye nokulutha, echaphazela inkitha yabantu kumoya wehlabathi apho abantu bafuna "amazwe olonwabo."
nguGqr. Kenneth Blum
Imagazini yeCollier ka-Epreli ka-2012
Phantse isiqingatha sabemi base-US bazibandakanye kwizenzo zeziyobisi ezingekho mthethweni. Abagqatswa bakaMongameli banyanzelwa ukuba babaleke imibuzo ekhohlisayo yembali yabo yangaphambili ebandakanya ukusetyenziswa kweziyobisi ezingekho mthethweni kwaye phantse wonke umntu waseMelika wehlise iMartini okanye ezimbini ebomini babo. Kufuneka kubekho isizathu, imfuno, okanye impendulo yendalo yokuba abantu bangene kumazinga aphezulu ngolo hlobo. Umbuzo onzima ngakumbi ujikeleze izigidi ezifuna izinto ezintsha ezinobungozi obuphezulu. Kutheni le nto uninzi lwethu lunolu mnqweno wemvelo wokuzibeka engozini? Kutheni izigidi zihlawula ixabiso lokungakhathali kwazo ezintolongweni, ezibhedlele, nakwizitulo ezinamavili okanye zilele zifile emangcwabeni ethu. Liliphi ixabiso esifanele silihlawule ngokufuna uyolo okanye ngokusuka nje “siphakame”? Mhlawumbi impendulo isengqondweni yethu. Mhlawumbi ingaphakathi kwi-genome yethu.
Zonke iindlela zikhokelela kwi-DOPAMINE
Emva kokuba yinyaniso, zonke iindlela zikhokelela eRoma. Le nyaniso ilula ayifani kakhulu kumjikelezo womvuzo wobuchopho beHomo sapiens. Uvavanyo oluninzi luye lwafumanisa ukuba umvuzo omkhulu wengqondo we-neurotransmitter indlela, indlela eya eRoma, ngokwenene yi-dopamine.
Umjikelezo womvuzo, i-cascade ye-neurotransmission kwingqondo ekhokelela ekukhululweni kwe-dopamine, ikhatywa ngawo nawaphi na amava amnandi. Yonke into ukusuka ekutyeni, ukuya ekubeni neentlobano zesini kunye nokuntywila ngebhayibhile kunokuhamba. Inqaku lomvuzo wokujikeleza kukuqinisa ngokuqinisekileyo izenzo ezikhuthaza ukusinda kweentlobo. Ngexesha le nto ingqondo ibona njengezenzo eziluncedo, ukukhutshwa kwe-dopamine kwenza ubuchopho bethu "bonwabe," ngaloo ndlela kusikhuthaza ukuba siyenze kwakhona. Nangona "izenzo ezigqithisileyo" ngokwendalo zingakukhuthazi ukusinda, kwaye enyanisweni zikubeka emngciphekweni, ukungxamela ukugcina ubomi kubangela ukukhutshwa kwe-dopamine kwaye ngenxa yoko uyolo.
Iziyobisi zidlala kule nkqubo kwaye zinokuyitshabalalisa ngokusetyenziswa ngokwaneleyo, ukudala umnqweno osisigxina obangela umlutha. Ulonwabo oluveliswa kusetyenziso gwenxa lweziyobisi lwenzeka kuba uninzi lwala machiza lujolise kwinkqubo yomvuzo wengqondo ngokukhukula isekethe nge-dopamine. Xa ezinye iziyobisi ezifana ne-cocaine zithathwa, zinokukhulula amaxesha angama-2-10 inani le-dopamine njengeempendulo zendalo. Iziphumo zesiphumo kwisekethe yolonwabo yobuchopho zinciphisa ezo ziveliswa yimbuyekezo yendalo efana nokutya kunye nesondo. Le nyaniso iyodwa ikhuthaza kakhulu abantu ukuba bathathe iziyobisi kwakhona kwaye kwakhona, kodwa malunga ne-30% yabemi, i-genetics nayo yinto xa kuziwa kumnqweno wokuthatha iziyobisi.
Izazinzulu ngoku ziyazi ukuba kukho ubuncinci iindlela ezimbini ezahlukeneyo ze-dopamine yomntu D2 receptor gene, (DRD2) elawula inani le-D2 receptors kunye nokuba ingakanani i-dopamine yondliwa ngokwendalo ebuchotsheni bethu. Ngenxa yoko, i-DRD2 yeyona jini ifundwa kakhulu kwimfuzo yengqondo kwaye yintoni ebangela imiba ebalulekileyo yokuziphatha komntu kule mihla. Ifom ye-DRD2 A2, kwihlabathi lanamhlanje ithathwa njengenguqu "eqhelekileyo", ithwalwa yi-2/3 yabemi base-US. Abantu abaphethe le fomu banomvuzo osebenza ngokufanelekileyo wokujikeleza, ngenxa yoko abayi kunqwenela ngokwemvelo okanye iindlela ezizezinye zokukhuthaza ukukhutshwa kwe-dopamine, efana neziyobisi okanye imincili. Abathwali befomu ye-DRD2 A1 bamele malunga nesinye kwisithathu sabemi banamhlanje base-US kwaye banama-30-40% angaphantsi kwe-D2 receptors. La madoda nabasetyhini bathanda ukuba likhoboka, isethi emalunga ne-100 lezigidi zabantu.
Ngenxa yokuba malunga ne-30% yethu sizalwa sinofuzo oluphantsi lwe-dopamine umsebenzi wobuchopho singaloyisa njani le ntlupheko yokusinda yendalo yomntu kwaye sithintele ukuziphatha okunqwenelekayo okugqithisileyo? Ngokuqinisekileyo, ingqondo yomntu lelona lungu lintsonkothileyo emzimbeni—iziko lonxibelelwano eliquka amawaka ezigidi zeeseli zemithambo-luvo. Ngelishwa iziyobisi ziyakwazi ukuguqula iindawo zobuchopho ezifana nesiqu sobuchopho esiyimfuneko ekuzinziseni ubomi ngolawulo lwemoto kunye neemvakalelo, inkqubo yelungu lemilenze elawula ukukwazi kwethu ukuziva ulonwabo, kunye ne-cerebral cortex enika amandla amandla ethu okucinga. Ngokuzimeleyo kwindalo yomntu, ukuba umntu uhlala ethatha iziyobisi, ingqondo ilungelelanisa ukunyuka okukhulu kwe-dopamine kunye nezinye ii-neurotransmitters ezibangela ukuwohloka kwenkqubo yendalo yomvuzo wengqondo ngokuvelisa i-dopamine encinci okanye ukunciphisa inani le-dopamine receptors (D2) receptors. . Oku kubangela umsebenzi ophantsi ngokungaqhelekanga we-dopamine, iminqweno ephezulu, kunye nokuncipha kwamandla okubona ulonwabo, zonke ezinegalelo kumjikelo okhohlakeleyo wokulutha.
I-Evolutionary Genetics kunye neTheory malunga nemvelaphi yeDopamine Driven Society
Cinga ngeempawu zoluntu lwethu lwangoku-ihlabathi eliqhutywayo, elihlala litshintsha, nelikhawuleza ngokugqithisileyo lanamhlanje. Ngoku khawujonge emva, kwiminyaka nje engama-80,000 XNUMX eyadlulayo ookhokho bethu bahamba emhlabeni njengenxalenye elinganayo yexhoba namaxhoba enosukelo olucekethekileyo nokuqonda okulinganiselweyo ngehlabathi elibangqongileyo. Kusenokwenzeka ukuba loo mahluko unokubalelwa kwi-dopamine.
Ngelixa iithiyori ezininzi malunga nokuzivelela kwengqondo zijolise kwindima yobungakanani bobuchopho kunye nohlengahlengiso lwemfuza uFred Previc6 uphonononge umbono oxhokonxayo we "Dopaminergic Society" esekwe kwiinguqu kwi-dopamine. Ukusetyenziswa kwenyama kunye neoli yeentlanzi kwaziwa ngokunyusa i-dopamine receptors. Ngokuka-Previc6 umahluko phakathi kwabantu bale mihla kunye nezalamane zabo ze-hominid zibangelwe kukunyuka kwamanqanaba e-dopamine ebeyinxalenye yolungelelwaniso lomzimba jikelele ngenxa yokonyuka kokusetyenziswa kwenyama, ukuqala malunga nezigidi ezibini zeminyaka eyadlulayo.
Kububulumko ukuqikelela ukuba i-DRD2-A1, uhlobo oludala lwemfuza esabonwa kuma-30% abantu namhlanje, yayibalulekile kubomi bomntu wokuqala. Kwaba khokho bethu, ukunqongophala kwe-dopamine receptors kwaba luncedo kumzabalazo wabo wokuphila, ukukhawuleza kokuhlala bezama ukuphila ngokubonelela ngayo yonke i-dopamine abaya kuyidinga. Nangona kunjalo, malunga neminyaka engama-80,000 eyadlulayo i-dopamine receptors inokuba yongezwa ngakumbi zezinye izinto. Izinto ezifunyaniswe mva nje ezichaza iindawo zokuhlala zaselwandle zabantu bokuqala zibonisa utshintsho olusingqongileyo, lwentlalo, kunye nokutya, njengokufakwa kweoyile yeentlanzi, kubonelela ngobungqina bomsebenzi ophuculweyo we-dopamine ngeli xesha kwimbali yoluntu. Ukusuka kolu phuculo, kwazalwa uluntu olutsha - "uluntu oluphezulu lwe-dopamine" oluthwele uhlobo lwe-DRD2 A2 yale gene ephethwe ngabantu abaninzi ngoku. Ngokwahlukileyo, abo basele benohlobo oludala lwemfuza kufuneka bajongane nesithuba sokukhutshwa kwe-dopamine esishiywe xa ingozi isusiwe kubomi bemihla ngemihla babantu.
Ngokutsho kwethiyori kaPrevic, uluntu "lwe-dopamine ephezulu" luphawulwa ngobukrelekrele obuphezulu, imvakalelo yekamva lomntu, ukuzixakekisa ngenkolo / yecosmic, kunye nokuthanda ukufezekisa iinjongo kunye noloyiso. Le "dopaminergic society" iyakhawuleza okanye i-manic, ayimangalisi, "ngenxa yokuba i-dopamine yaziwa ngokunyusa amanqanaba omsebenzi, ikhawulezisa iiwotshi zethu zangaphakathi kunye nokwenza ukhetho lwenoveli ngaphezu kweemeko ezingaguqukiyo." Amanqanaba aphezulu e-dopamine nawo acetywayo ukuba anyanzelise ukwanda kokuphazamiseka kwengqondo kumazwe ahambele phambili kwezoqoqosho. 6 UDavid Comings, ebhala kwincwadi yakhe edumileyo ethi The Gene Bomb, wachaza ukuba nangona kusenokuba yinyaniso ukuba ulungelelwaniso lwemfuza lucotha kakhulu, kusenokubakho iimeko ezithile ezibonisa ukuba utshintsho olukhawulezayo olufana nolu lunokwenzeka, ngakumbi imfuza yokuphakama kweTibetan kuvunyelwe ukuziqhelanisa nokuphakama okuphezulu.
I-Comings iphinde yaxoxa ngekamva le-DRD2 yofuzo ukusuka kumbono wokuziphendukela kwemvelo, ebonisa indlela ukuguquguquka kwabantu malunga nalo mfuzo kunokutshintsha. Masicinge ukuba umahluko wemfuza obizwa ngokuba ngu-X ubangela umlutha, kwaye abantu abanale X bayeka isikolo kwangethuba, bahlalisane nabanye abaphethe uhlobo olufanayo, (“Iintaka zoMhlambi woSiba kunye”, olunye uphawu lweDRD2 A1 ) kwaye baqalise ukuba nabantwana kwangethuba kunabantu abangenawo loo mfuza. Masiphinde sicinge ukuba umyinge weminyaka ekuzalweni komntwana wokuqala we-X gene carriers yiminyaka engama-20, ngelixa abo bangathwali ukuhluka yiminyaka engama-25. Ngenxa yoko, uhlobo lwe-X lwemfuza luya kuzala ngokukhawuleza kumlinganiselo we-1.25 ukuya ku-1, onokuthi udibanise ngokuhamba kwexesha. Nangona le gene X isenokubonakala ngathi ayinayo nayiphi na inzuzo ekhethiweyo umntu kufuneka athathele ingqalelo into yokuba ukuba ne-D2 receptors ephantsi kuluntu lwethu lwangoku kunokubonelela ngeengenelo ezithile zokukhuphisana ezifana nobundlongondlongo obuphuculweyo, ukufuna into entsha, ukuthatha umngcipheko okukhokelela ekusindeni okukhulu, njengoko kwenzekileyo kuqoqosho. elidlulileyo. Eyona nto ibalulekileyo, ukukhotyokiswa ayisiyongxaki ehambayo.
Ukuphonononga iiMystery of Relapse and Recovery
“Ngaba unomfanekiso-ngqondweni wokutsiba kwinqwelo-moya ngaphandle kweparashute?” - UJohn Giordano, umongameli we-G & G Holistic Addiction Treatment Centre, North Miami Beach
Ukuba likhoboka leziyobisi yingxaki yehlabathi lonke yaye ixhaphakile kuluntu lwanamhlanje. Ekuqaleni kwenkulungwane yamashumi amabini ananye, inani labantu baseUnited States bebonke babezizigidi ezingama-281 kunye nezigidi ezingama-249 ngaphezulu kweminyaka eyi-12. ULawulo lweeNkonzo zeMpilo yeNgqondo ngo-12 lufumene ukuba i-2001 yezigidi zabantu baye basebenzisa iziyobisi ezingekho mthethweni ebomini babo, i-104 yezigidi zasebenzisa ichiza elisebenza kwengqondo kunyaka odlulileyo (32-2000) kunye ne-2001 yezigidi zisebenzisa ichiza elisebenza kwengqondo kwiintsuku ezingama-18 ezidlulileyo. Okubangela umdla kukuba, oku akubandakanyi utywala.
Ngaphezulu kwala manani, abantwana abanxilisayo bangama-50-60 ekhulwini amathuba okuba baphuhlise ingxaki yokusetyenziswa kotywala kunabantu ngokubanzi. Ngokufanayo, abantwana babazali abasebenzisa iziyobisi ezingekho mthethweni banokuba ngama-45-79 % amathuba okuba basebenzise kakubi iziyobisi ngokwabo kunabantu ngokubanzi. Ngo-2008, abantu baseMelika abaneminyaka eyi-18 ukuya kwengama-24 babenelona zinga liphezulu lokusetyenziswa kotywala kwi-18.4% kunye nokuphazamiseka kokusetyenziswa kweziyobisi kwi-7%. Amadoda kunokwenzeka ukuba abe neengxaki zotywala, iziyobisi, okanye izinto ezimbini ezidityanisiweyo kunabasetyhini. I-2007 yabona i-182 yezigidi zemimiselo ebhalelwe amayeza eentlungu, ukuqhubela phambili inkxalabo phakathi kweengcali zokulutha malunga nobhubhane olutsha eMelika olubandakanya amayeza eentlungu zentlungu. Kufuneka sibuze ke ngoko, ngoobani abantu abanokuthi “HAYI”?
Inzululwazi idibana noBuyiselo
Nangona ulweyiseko lokuba ukuxhomekeka kwiziyobisi notywala yayisisifo endaweni yokuba luphawu lobuthathaka bokuziphatha lwalukhula ngasekupheleni kwenkulungwane yeshumi elinesithoba nasekuqaleni kwenkulungwane yamashumi amabini, kwakungekho lwazi lwendlela esinokuthi sifumaneke okanye sinyangwe ngayo esi sifo. Iindaba ezimnandi namhlanje kukwamkelwa kwe "Reward Deficiency Syndrome" (RDS) njengegama leambrela le-predisposition to obsessive, isinyanzelo, kunye nokuziphatha okungxamisekileyo okuhambelana nokwahluka kwemfuza okunokukhokelela ekubeni likhoboka, kuvula indlela yokuchaza umlutha njengoko. ukuphazamiseka kwengqondo okubandakanya ukukhubazeka kwinto ebizwa ngokuba "yi-reward circuitry." Le nkcazo yokulutha ngoku yamkelwe yi-American Society of Addiction Medicine kwaye kukuqonda okwakhuthaza utshintsho kunye nokuqhubela phambili kwiinketho zonyango.
Ngelixa unalo naluphi na ukusilela kwemfuza kwindawo yomvuzo wengqondo kunokubeka umntu emngciphekweni omkhulu we-RDS, ihlala iyindibaniselwano yemfuza yethu kunye nokusebenzisana kwabo nezinto zokusingqongileyo (ikhaya, usapho, ukufumaneka kweziyobisi, uxinzelelo, uxinzelelo loontanga. esikolweni, ukusetyenziswa kwangethuba, kunye nendlela yokulawula) exela kwangaphambili indlela yokuziphatha ekhobokisayo ngokubanzi, kodwa uhlobo oluthile lwechiza okanye indlela yokuziphatha ekhethwayo. Uqulunqo lwezibalo lwaseBayesi lwalusetyenziselwa ukuqikelela umngcipheko wobomi kuyo nayiphi na indlela yokuziphatha ye-RDS ukuba uphethe inguqulelo ye-A1 ye-DRD2 gene ekuzalweni. Umngcipheko uwonke kuyo nayiphi na indlela yokuziphatha kwaqikelelwa ukuba uphezulu ukuya kuma-74%. Nangona kunjalo, njengoko uSteve Sussman weYunivesithi yaseSouthern California ebonisa, kunokuba sibe lixhoba lezinto zethu zofuzo ezisekelwe kwi-DNA yethu, i-RDS ichatshazelwa kakhulu yimeko yendalo (epigenetic) echaphazela i-RNA yethu. Izazinzulu ziqikelela ukuba imiba yemfuza iphakathi kwe-40-60 yeepesenti yomntu ukuba semngciphekweni wokukhotyokiswa, kanti ezinye zizizinto ezisingqongileyo ezinokuchaphazela indlela ezivezwa ngayo ezo mfuza. Umyalezo wokuthatha ekhaya awukagwetywa ngenxa yemfuza yabo ukuba babe likhoboka, kodwa ngokuqinisekileyo basemngciphekweni omkhulu. Ulwazi lwemfuza kwangethuba kunasemva kwexesha ebomini luba luncedo kakhulu kwiimeko ezinjalo.
Nangona le nyaniso, uMark Gold, usihlalo weSebe leNgqondo kwiYunivesithi yaseFlorida, kwiKholeji yezoNyango eGainesville, wathi ngokuchanekileyo, "Nangona yonke imizamo kunye nenkqubela phambili eyenziwa luluntu oluluthayo, ngokubanzi, aluphumelelanga. ukuqonda nokubandakanya ngokuzithandela iindlela zonyango ezisekelwe kubungqina kunyango, ngakumbi ngokunxulumene nothintelo lokubuyela emva. ”
Kuyandikhuthaza ukuba okokuqala kule nkulungwane yeminyaka, uluntu olukhobokisayo lulungele ukwamkela iindlela ezintsha zenzululwazi kunye nezingqiniweyo ngokweklinikhi. Ngokubhekiselele koku, le mimandla ilandelayo kufuneka iqwalaselwe ngokufanelekileyo ngababoneleli bonyango ukuya phambili:
- Uvavanyo lwemfuzo ukumisela ingozi ye-RDS
- I-agonist ekhuselekileyo nesebenzayo ye-D2 engasebenziyo eyaziwa ngokuba yi-KB220 ukuze isebenze iindlela ze-dopaminergic engqondweni.
- Iindlela ezipheleleyo ezikhuthaza ukuhlala kakuhle
- Uvavanyo lweziyobisi ukunceda ukubambelela kunyango kunye nokusetyenziswa njengemilinganiselo yesiphumo
- Uvavanyo olunxulumene nokuguqulwa kokubonakaliswa kofuzo njengomlinganiselo wesiphumo semolekyuli
- Ukuqhubekeka kokusetyenziswa kwemibutho yokuzinceda
- Psychological, ukuziphatha, kunye nonyango lomoya
Ngelixa olu luluhlu lweminqweno enzulu, inkqubela phambili ebonakalayo iyenziwa kwinjongo yehlabathi ukuphawula, ukucalula, nokuphuhlisa, ngophando olungqongqo oluyimfuneko, ezo zinto zifunekayo ukuguqulela uphando ukusuka kwibhentshi ukuya ecaleni kwebhedi.
Ukuqonda uxilongo, uThintelo, kunye nezicwangciso zoNyango
Ngokubanzi, abantu baqala ukusebenzisa iziyobisi ngenxa yezizathu ezahlukeneyo: ukuziva belungile, benze ngcono, kwaye bangene. ziyakwazi ukulawula ukusetyenziswa kwazo. Noko ke, xa ukusetyenziswa kakubi kweziyobisi kuthabath’ unyawo, amandla omntu okuqhelisela ukuzeyisa anokuba buthathaka ngokunzulu. Izifundo zokucinga ngengqondo ezivela kwizifundo ezikhotyokiswe ziziyobisi zibonisa utshintsho lomzimba kwiindawo zengqondo ezibaluleke kakhulu ekugwebeni, ekwenzeni izigqibo, ekufundeni, ekukhumbuleni nasekulawuleni ukuziphatha. Umzekelo yi-cocaine ethintela ukuphinda kuthathwe i-dopamine ngokubophelela kwiiproteni ezihlala zithutha i-dopamine. Ayisiyiyo kuphela i-cocaine bully dopamine ngaphandle kwendlela, ixhomekeke kwiiproteni zothutho ixesha elide kune-dopamine. Ngenxa yoko, i-dopamine eninzi ihlala ivuselela ii-neurons, ezibangela iimvakalelo ezinde zolonwabo kunye nemincili. I-Amphetamine ikwanyusa amanqanaba e-dopamine. Kwakhona, isiphumo kukuvuselelwa ngokugqithisileyo kwezi mithambo-luvo zisendleleni yolonwabo ebuchotsheni.
Uvavanyo lweGenetic ukumisela uMngcipheko we-RDS
Iqhinga elibaluleke kakhulu lokuthintela kukuphuhlisa uvavanyo olusekwe kwimfuza ukumisela umngcipheko kunye nokuba sesichengeni sokusetyenziswa gwenxa kweziyobisi kunye nokuziphatha okuyingozi ngexesha lokufikisa. Enye yeendawo zobuchopho zisakhula ngexesha lokufikisa (ukususela kwi-5-20 yobudala) yi-prefrontal-cortex-inxalenye yengqondo esenza sikwazi ukuvavanya iimeko, senze izigwebo ezivakalayo, kwaye sigcine iimvakalelo zethu i-prefrontal cortex kunye. Ngaloo ndlela ukusetyenziswa kwamachiza ngelixa ingqondo isakhula kunokuba neziphumo ezinzulu kunye nexesha elide kwezi zakhono zibalulekileyo. Ukusetyenziswa kakubi kweziyobisi kudla ngokuqala kwangethuba kwiminyaka eyi-12 kwaye kufikelela incopho kwiminyaka yeshumi elivisayo, oko kongeza umfutho wokwenyani kuphuhliso lovavanyo lokumisela iGenetic Addiction Risk Score (GARS) njengesixhobo sokuthintela kwangethuba. Uvavanyo lwe-GARS luya kuba nokubaluleka kunyango lwezigulane ezikhobokileyo ukunciphisa ubutyala kunye nokwala ukumisela amanqanaba enkxaso afunekayo kulondolozo kunye nothintelo lokubuyela umva. Kunye nomyalezo wokuba iziyobisi ziyingozi engqondweni, olu vavanyo lufanele lukhokelele ekunciphiseni ukusetyenziswa kweziyobisi nolutsha olusebenzisa kakubi.
Izinyango Zonyango
Unyango lwe-Dopamine Agonist olukhuselekileyo nolusebenzayo
Nokuba umntu ebesele enxilile okanye ecocekile iminyaka emi-5, eyi-10, okanye engama-20 kusekho ukuthambekela kokusetyenziswa gwenxa kweziyobisi mhlawumbi kuvela kwimizila yabo okanye umonakalo owenziwe kwi-dopamine receptors ngeminyaka yokuxhatshazwa. "I-White knuckle sobriety" kukuyeka ukusebenzisa amandla apheleleyo-ukuzimisela kuyeyona nto iphambili yokugcina umntu owayesakuba ngumsebenzisi kude nesirinji okanye ukuvula ibhotile.
Unyango lwe-agonist ye-Dopamine luye lwavela njengolona nyango lusebenzayo lokunciphisa "i-knuckle emhlophe" imiba yokuyeka. Eyona nto inomdla kakhulu yolu hlobo lonyango kukuba ngokwenene ibuyisela i-neurotransmitters ebomini-ukukhaba ukuqala umvuzo wengqondo kunye nokubonelela nge-dopamine kwingqondo kwakhona. Izazinzulu kwihlabathi liphela, kubandakanywa noGqr. Nora Volkow, umlawuli weZiko leSizwe lokuSetyenziswa kweZiyobisi (NIDA), bacebise ukuba unyango lwe-dopamine agonist luya kunciphisa iminqweno, luthintele ukuphinda lubuyele, kunye nokuziphatha kokufuna iziyobisi.
Ingxaki ukuza kuthi ga ngoku kukuba ii-arhente zoxubo mayeza ezineempawu zokuvula zinamandla kakhulu kwaye zineziphumo ebezingalindelekanga ezinzulu. Iindaba ezilungileyo kukuba inkqubo ye-dopaminergic inokuvuselelwa nge-patent yendalo, engeyiyo i-addictive D2 agonist eyaziwa ngokuba yi-KB220. Izixhobo ze-Neuroimaging (qEEG, PET, kunye ne-fMRI) zisetyenziselwa ukubonisa impembelelo ye-KB220IV kunye ne-KB220Z yomlomo (I-SynaptaGenX™) njenge-activator ekhuselekileyo yomvuzo wobuchopho i-dopamine. Iyure enye kuphela emva kokulawulwa kwe-KB220Z "ilungelelanisa" umsebenzi ongaqhelekanga we-electro-physiological kwizifundo ezihlala ixesha elide zokuyeka utywala, i-heroin, kunye ne-cocaine kwindawo yengqondo ukuze iphinde ibuyele, ngokunyusa amaza e-alpha kunye ne-beta ephantsi efana neeseshoni ze-10-20 ze-neuro. -unyango lwempendulo. Ngapha koko, idatha yokuqala evela eTshayina ibonisa ukuba i-KB220Z yenza ukuba kusebenze iindlela ze-dopamine kwindawo yomvuzo yengqondo.
Kwabo bane-D2 receptors ephantsi yemfuza, sikholelwa ukuba ukusebenza kwexesha elide kwee-receptors ze-dopaminergic ngale nto yendalo kuya kukhokelela ekudalweni kwe-D2 receptors ezikhokelela ekuphuculweni kobuntununtunu be-dopamine kwaye ke, ukwanda kokonwaba.
Ukulandela unyango-indawo yokuhlala okanye engeyiyo yokuhlala-apho kungekho nzame yenziwayo yokuphucula umsebenzi wengqondo ye-dopamine, isigulana, ekusenokwenzeka ukuba siphethe uhlobo oluphantsi lwe-dopamine, sikhululwa sibuyele eluntwini, sigwetyelwe ukuphinda sibuyele. Kwiimeko ezinjalo i-KB220Z inokuba luncedo kakhulu. Ngaba sisondela kwixesha apho, kunye, "uthando lufuna ukunakekelwa" (oluqulunqwe nguDavid Smith), ababoneleli banokubonelela ngeparashute efunekayo kakhulu.
Ngaphaya Kweyeza: Ukwamkela Iindlela Ezipheleleyo
Ukuphumelela xa kufikwa kumayeza okukhobokisa ngokuqinisekileyo kuyavuyisa. Nangona kunjalo, umzabalazo wokuziphatha kakuhle awuyonto intsha kwaye abanye, ngakumbi abo bangenayo imfuza, baye baphumelela. Kwiimeko ezininzi, inxalenye enkulu yaloo mpumelelo yayikukusetyenziswa kweendlela ezipheleleyo. I-Dopamine ikhutshwa ngeendlela ezininzi kwaye kukho eminye imisebenzi umntu ochachayo anokuthi ayenze ukubanceda ukuba bayeke ukuphinda babuyele. Ukucamngca, i-yoga, umthambo, ukutya, unyango lomculo, ukuphumla kusetyenziswa i-Audio Therapy, i-acupuncture, kunye nonyango olunokubakho lwe-hyperbaric oxygen (HBOT) zizenzo ezaziwayo ezinokubangela ukukhululwa kwe-dopamine. Ngokuhamba kwexesha, banokuphinda bavelise ii-receptors ezitshatyalaliswe kukusetyenziswa kweziyobisi. Unyango lokuthetha, unyango lwengqondo yokuziphatha, inkuthazo yenkuthazo, udliwano-ndlebe olukhuthazayo okanye unyango lweqela oludityaniswa namayeza onyango kunye novavanyo lomzimba wonke kwiimpawu zeperipheral (okt ukusebenza kweadrenal, ukusebenza kwedlala lengqula, amanqanaba ezicubu zesinyithi esinzima, ihomoni, kunye nemephu yobuchopho) inika ugqirha isicwangciso sonyango oluyimpumelelo.
Enye yezona zinto zinamandla kwabaninzi ekubuyiseni kukuqonda inkqubo ye-12-step. Nangona kunjalo, abanye abantu bayaphikisana malunga nokwamkelwa kokomoya kunye neengcamango "zamandla aphezulu" eziyinxalenye enkulu yeprogram. Asiyonjongo yeli nqaku ukujongana nobukho okanye ukungabikho kukaThixo, kodwa kubalulekile ukuqonda iingenelo zenkolelo enjalo. Uqhagamshelwano oluqondayo olusemgangathweni kunye nokuxhomekeka kwinkqubo yenkolelo enjalo kunokuba nempembelelo enkulu kumandla omntu okufumana imeko yoxolo nolonwabo.
Iqela lophando likaComings laba lelokuqala ukuchonga indima yemfuza ethile ngokomoya. Ngokukodwa, yi-dopamine D4 receptor gene (DRD4), eyafunyanwa idlala indima ekufuneni izinto ezintsha. Abanye bafumene ubungqina bento eyayibizwa ngokuba yi "God Gene" okanye i-dopamine vesicular transporter gene (VMAT2), ekuye kwaxelwa ukuba inyanyaniswe nobumoya. Ngapha koko, abo bantu bafumene amanqaku aphezulu ekuzicingeleni ngokugqithiselayo abanakufane basebenzise kakubi utywala okanye iziyobisi. I-Dopamine's characterization njenge "ziva kamnandi" neuro-chemicals inokunceda ukucacisa ukuba kutheni ubumoya budlala indima enkulu kwimeko yomntu kwaye uninzi lwabantu lufumana intuthuzelo enkulu kunye nolonwabo ekukholelweni kuThixo.
Ukuncedisa ekuBuyiseni nasekuqinisekiseni iMpumelelo
Uvavanyo lweziyobisi kunye nomchamo lubalulekile ukumisela iziphumo zonyango kunye nokuthotyelwa. Iindidi ezahlukahlukeneyo zamayeza zisenokuba luncedo kumanqanaba ahlukeneyo onyango ukunceda isigulana ukuba siyeke ukusebenzisa kakubi iziyobisi, sihlale kunyango, size siphephe ukuphinda sibuyele. Amazinga okuphinda ayafana kulo lonke uhlobo lwesi-2 seswekile, uxinzelelo lwegazi, umbefu kunye nokuba likhoboka leziyobisi. Ukuphepha ukuphinda ubuyele kwimeko nganye kuxhomekeke ngokuyinxenye ekubambeleleni kunyango lonyango. Ukusetyenziswa ngokungalindelekanga kweziyobisi ngexesha lonyango sesinye isiqalisi sokubuyela umva. Kutshanje, kusetyenziswa uHlahlelo oluBanzi lwaMachiza aXolwayo (i-CARD™) olunikezelwa ngokukodwa yi-Dominion Diagnostics, kwafunyaniswa ukuba kukho ukuthotyelwa okubalulekileyo kunyango, kodwa kunye nokusetyenziswa kweziyobisi okungalindelekanga kuwo onke amazwe amathandathu onxweme lwasempuma avavanyiweyo.
Ukwamkelwa kunye nokuqhubela phambili
Uluntu lwethu luqhutywa yi-dopamine. I-scotch oyinqwenelayo emva komsebenzi, imvakalelo oyifumanayo xa indoda okanye ibhinqa liwela ibar lijonge indlela yakho, ukungxama okufike ngexesha lokuwa kwe-roller coaster yokuqala yonke ibuyele kuyo. Kwabaninzi, ulonwabo olulula olungentla kufuneka luze ngobuninzi ukuze iingqondo zabo zaneliseke kwaye ixabiso lolo kusilela likhoboka.
Ukuqonda ukonakala okungokwemvelo kumvuzo wokujikeleza izigidi ezizalwa nawo kunoxanduva lokukhobokisa kwinani elikhulu labantu ibe linyathelo lokuqala elibalulekileyo. I-Dopamine agonists, njenge-KB220Z™, esetyenziswa kwiindawo zonyango ukuncedisa ukuthobela ukwamkelwa kweprogram ye-12-step yesibini. Ngokudibeneyo, oku kufuneka kuphucule impilo-ntle, kuphucule ukuqonda kunye nokugweba, kodwa okona kubaluleke kakhulu ukuququzelela ukunciphisa uxinzelelo kufuneka kube sisiphumo, esiya kuba nefuthe kwimeko yolonwabo kunye nokomoya. Ekugqibeleni kufanele ukuba ibenezibonelelo ngendlela yokunciphisa umnqweno, uthintelo lokubuyela umva, kunye nothintelo lokuziphatha kwe-RDS, ngakumbi kwabakwishumi elivisayo.
Okokugqibela, ukuqonda kwesayensi malunga nokulutha kunye nayo yonke imilinganiselo yayo kunye nokufakwa kwezi ndlela zintsha kunye neengqikelelo ekuxilongweni, kunyango, kwaye okona kubaluleke kakhulu izicwangciso zokuthintela kunokukhokelela ekunciphiseni ukuphinda kubuyele kwakhona kodwa, okona kubaluleke kakhulu, ukuphucula umgangatho wobomi ukuze siphinde siphile. amaqhawe.
UJohn Giordano, uJoan Borsten, uMary Hauser, uB. William Downs, uMargaret A. Madigan, no-Eric R. Braverman bancedise ekubhaleni eli nqaku kwaye livunywa ngombulelo.
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