Uphando oluphambili lweempawu ezingabonakaliyo kunye neentliziyo ze-sexual behavior (2009)

IMIBUZOIimvavanyo zengcamango zibonisa ukufana phakathi kwalabo abanokuziphatha ngokunyanzela ngokwesondo kunye nezinye iingxaki ezinyanzelisayo ezifana nokugembula kunye nekleptomania. Iingqungquthela zeBrazil zityhila ukuba ukuxhatshazwa ngokwesondo kwakuneyona nto ingabonakaliyo ye-cortex. Oku kufunyaniswa kuhambelana nokungazenzisi, into ephawulekayo yobunzima.

Ukuvavanywa kobuchopho kubonisa ukuba abo bane-CSB banciphisile umbutho we-cortex emhlophe engaphambili, efana nokufumana iingxaki zoxinzelelo kunye ne-PTSD. Nantsi indlela yokujonga kwakhona - Isiseko se-Neurobiological of Hysexualality (2016) - uchaze olu phando:

Olunye uphononongo oluye lwaphanda ulungelelwaniso lwe-neural ulungelelwaniso olunxulunyaniswa ne-hypersexuality esetyenziselwa ukusasaza imaging tensor imaging kwaye yaxela ukuphakama kokuthetha okungafaniyo kwitrektara yento emhlophe ephambili kwindawo ephambili engaphambili (uMiner, uRaymond, Mueller, uLloyd, kunye noLim, 2009) kunye nonxibelelwano olubi phakathi kwentsingiselo yokungafani kweli phecana kunye namanqaku kuluhlu lokuziphatha okunyanzelekileyo ngokwesondo. Aba babhali ngokufanayo baxela indlela yokuziphatha engxamisekileyo kwi-Go-NoGo task kwi-hypersexual xa kuthelekiswa nabathathi-nxaxheba kulawulo.

Isifundo esigcwele

Psychiatry Res. 2009 Nov 30;174 (2): 146-51. I-doi: 10.1016 / j.pscychresns.2009.04.008. Epub 2009 Oct 17.

Miner MH1, Raymond N, Mueller BA, ULloyd M, Lim KO.

Inkqubo yoBuchule boBuntu, iSebe lezeMpilo yoLuntu kunye neMpilo yoLuntu, kwiYunivesithi yaseMinnesota, eMinneapolis, eMinnesota, eU.SA.

I-Department of Psychiatry, iYunivesithi yaseMinnesota, iMinneapolis, eMinnesota, eU.SA

ICandelo lezeNgqondo, iYunivesithi yaseMinnesota, eMinneapolis, eMinnesota, eU.SA

UkuPhando, iMfundo, kunye neZiko leZiklinikhi, iZiko lezeMpilo zezilwanyana, iMinneapolis, eMinnesota, eU.SA

Unxibelelwano kunye nobungqina bebala, uMichael H. Miner, u-Ph.D., iNkqubo yoLuntu, iNyuvesi yaseMinnesota, i-1300 So. Isitalato yesibini, i-Suite 180, iMinneapolis, MN. 55454, Ifowuni: 612-625-1500612-625-1500, IFeksi: 612-626-8311, i-imeyile: [imeyile ikhuselwe]

Abstract

Kwiminyaka yakutshanje kukho ukunyuselwa kwinkqubo yesifo sekliniki ebonakaliswe ngcamango engcolileyo ngokwesondo, iinqweno zesondo, kunye / okanye izenzo zokuziphatha ngokwesondo ezinemiba eninzi efana neengxaki zokulawula umgudu. Olu pho nonongo lubonelela ngophando lokuqala lweempawu eziphambili zeli syndrome, ukuziphatha koSondo ngokuCandelelanayo (CSB), njengoko kucatshulwa nguColeman kunye noogxa. Izifundo ezilishumi elinesibhozo, izigulane ze-8 CSB kunye nolawulo lwe-8 olungenagulane, ukulawulwa kweengqondo ze-psychometric zokungahambelani nokuziphatha ngokunyanzela ngokwesondo, umsebenzi wokuziphatha olungiselelwe ukuvavanya ukulawulwa komgudu (go / no-go function), kunye neenkqubo zengqondo ezixhasayo (DTI). .

Iziphumo zibonise ukuba izigulane ze-CSB zibuhlungu kakhulu; ingaba lilinganiswe ngophando lwe-psychometric okanye inkqubo yokuhamba / yokuhamba ngaphandle kolawulo. Iziphumo zibonisa kwakhona ukuba izigulane ze-CSB zibonise umgangatho ophakamileyo ophezulu kummandla ongasentla ukuthetha ukungafani (MD) kunokulawula. Uhlalutyo lwentsebenziswano lubonise imibutho ebalulekileyo phakathi kwamanyathelo okunyaniseka kunye nommandla ongaphantsi wengingqi ye-anisotrophy (FA) kunye ne-MD, kodwa akukho mibutho eneemilinganiselo eziphezulu zommandla. Ukuhlalutya okufanayo kubonakalise umhlobo obunobungozi obukhulu phakathi kwe-MD ephezulu ye-lobe kunye ne-compulsive inventory behavior inventory. Ngaloo ndlela, ngelixa izigulane ze-CSB zikhuphe ngaphezu kokulawula, iziphumo ze-DTI azihambelani neziphazamiso zokulawula.

Amagama abalulekileyo: Ukuziphatha ngokunyanzelekileyo ngokwesondo, ukusabalalisa ukucamngca, ukunyaniseka, ukuxhatshazwa ngokwesini, i-MRI, isakhiwo sobuchopho

1. INTSHAYELELO

Kwixesha leminyaka emininzi edlulileyo, inani elikhulayo labakliniki nabaphandi baye banomdla kwiinklini zonyango ezibandakanya iingcamango zesondo, ukuxhatshazwa ngokwesini, okanye ukuziphatha okubi ngokwesini. Lo mcimbi uye wabizwa ngokuba yi-Compulsive Sexual Behavior (CSB), (Quadland, 1985; Coleman, 1991), i-paraphilia-related disorder (Kafka, 1994), ukunyaniseka ngokwesondo (Barth and Kinder, 1987), kunye nokuxhatshazwa ngokwesondo (Amakha, 1983; Goodman, 1993). Coleman kunye noogxaColeman, et al., 2000) iikhrayitheriya ezicetywayo ze-CSB ezifuna ubukho bexesha eliphindaphindiweyo nelokhuseleko lokuvusa isondo, izibongo zesondo, okanye iimpawu kwiinyanga ezili-6 ezibangelwa ukukhathazeka okanye ukuphazamiseka. Nangona kukho ukungavumelani malunga nemvelo kunye ne-etiology yokuziphatha ngokunyanzela ngokwesondo, bonke abaphandi abachazwe ngasentla bayavuma ukuba i-syndrome ibandakanya izibongo ezinzulu, ezinqabileyo zesini kunye neengcamango, kunye nokuziphatha okungathandekiyo ngokwesondo. Ngale ndlela, i-CSB ifana neengxaki zokulawula ukuphazamiseka ezifana ne-kleptomania, ukugembula kwentsholongwane, kunye neengxaki zokutya ezifana ne-bulimia nervosa kunye nokutya okuxilisayo.

Nangona akuzange kubekho uphando lwezobuchopho ze-CSB, kuye kwacetyiswa ukuba umonakalo kwi-lobes yangaphambili kungabangela ukukhubaza ukuziphatha ngokwesondo, ngoko ke, ukuxhatshazwa koxhatshazo okanye i-CSB (Coleman, 2005). Ukusasazwa kweengcamango zengqondo (DTI) yindlela yokwenza i-MRI eyenza ulwahlulo lwamanzi kwiisishu zobuchopho. I-DTI isetyenzisiweyo ukubonelela ngolwazi oluninzi malunga nenkonzo emhlophe kunye nenyaniso. Idata ye-DTI inokumelwa ngeendlela eziliqela, kubandakanywa i-anisotropy ye-fraction (FA), umlinganiselo wezinga lokuhambisa amanzi ngamanqwanqwa, kwaye uthetha ukungafani (MD), umlinganiselo wokungafani ngokupheleleyo kwimizimba. Isibonelelo, kunye no-al. (2006) wasebenzisa i-DTI ukuhlola umbandela omhlophe kwikleptomania. Abaphandi bafumene ukuba i-FA yayingaphantsi kakhulu kwimimandla engaphantsi kweendawo zabantu abane-kleptomania, ebonisa ukuguqulwa kwento ebomhlophe kule ndawo yengqondo, echaphazela umsebenzi olawulayo kunye nokulawulwa kwe-inhibitory (Hoptman, et al., 2002).

Injongo yale sifundo kukuphonononga umbandela omhlophe umgangatho kunye ne-DTI kumadoda ane-CSB. Ukubonelelwa ngeziphumo ze-kleptomania kunye nobukho be-CSB, sasixhomekeka ukuba siza kufumana ukungalungiswanga okukhulu kwimiba emhlophe kwi-DTI kwi-lobes yangaphambili yamadoda kunye ne-CSB kwaye ukuba le ngxaki emhlophe ingabandakanywa nokunyaniseka okukhulu kwizigulane ze-CSB ulawulo lwe-CSB.

2. IINDLELA

2.1. I zifundo

Amadoda ayisishiyagalombili adibana neempendulo zophando ezicetywayo ze-CSB ezichazwe ngasentla zafunyanwa kwinkqubo yonyango kubantu abafuna unyango lweengxaki zesini. Izigulane ze-CSB zonke ii-CSB ezingekho ngeparaphili. Iintlanu ze-8 (62%) zineembali zokudakumba okukhulu, phantse zonke (i-7 ye-8) inomlando wokusetyenziswa kakubi kotywala okanye ukuxhomekeka, ngelixa i-4 (50%) inembali yezinye iziyobisi okanye ukuxhomekeka. Esinye isihloko sasinomlando wokukhathazeka ngokugqithisileyo kunye nesinye isihloko esichazwe ngokusoloko kwintlalo yoluntu. Kukhethwe ulawulo olulishumi elinesibhozo ebudeni beenkcukacha ezivela kwisiseko sedatha yabantu abaphilileyo abazimisele ukuthatha inxaxheba kwizifundo zophando zophando. Ixesha elide le-CSB kunye namaqela okulawula yayingu-44.5 +/- 10.6 iminyaka kunye ne-43.4 +/- 9.1 iminyaka ngokulandelanayo. Izifundo zazineminyaka yobudala ukusuka kwi-19 ukuya kwi-51 iminyaka kwaye zazingekho ezahlukeneyo. Bonke abathathi-nxaxheba be-CSB babengamaCaucasian kwaye bonke abathathi-nxaxheba be-Caucasian. Abathathi-nxaxheba babekho ubuncinane bekholeji enye (i-100% yeqela le-CSB kunye ne-75% yeqela lolawulo) kwaye babambe imisebenzi yobuchwepheshe okanye yobungcali (86% yeqela le-CSB kunye ne-63% yeqela lolawulo). Akukho nqanaba lezemfundo okanye iinguqu zomsebenzi ezahlukahluka kakhulu.

2.2. Iinkqubo

Bonke abathathi-nxaxheba bahlolwe ukuba bafumane ukuba bafanelekile kwaye banomdla ekuthatheni inxaxheba kwisifundo. Emva koko uvavanyo lokuqala lwaluhlelwe. Ngethuba lokutyunjwa kwabo bonke abathathi-nxaxheba batyathelwa ngodliwano-ndlebe basebenzisa intetho ye-DSM-IV, i-DSID-P: Iyokuqala kunye ne-alXXMUMX) esineqendu eliphuhliswe liqela lethu lophando elongeziweyo ukuvavanya iimpawu zendlela yokuziphatha ngokwesondo (URaymond, et al., 1999). Ezi ngxoxo zazisetyenziselwa ukuba zenze ukuba ngaba uthathe inxaxheba udibana ne-CSB kwaye wayenayo izifo eziphambili zokugula ngengqondo okanye ukukhubazeka kwezidakamizwa njengoko ezi ziyimimiselo eya kuthintela ukuthatha inxaxheba kwisifundo. Kwakhona, iziphumo ze-SCID azibonisi ukuphazamiseka kokulawulwa kokunyanzeliswa kokunyanzeliswa kwezigulane okanye izilawuli ze-CSB.

Ngethuba lokuqala iqela labaqeshwe ukuba baqeshwe baqeshwe amanqanaba amanqaku okuzimela ngokwawo okuquka: 1) UkuVumelana koBucala boTyala (Coleman, et al., 2001; Miner, et al., 2007) Isilinganisi se-22-nto ehlola ubunzima beempawu ze-CSB, i-2) i-Barratt Impulsiveness Scale (BIS 11: Patton, et al., 1995) Isilinganiselo sexabiso le-30 esilinganisa ubunzima beempawu ezingathandabuzekiyo, kunye ne-3) I-Questionnaire ye-Multidimensional Personality Questionnaire (Patrick, et al., 2002) Umlinganiselo wezinto ze-166 ovavanya iimpawu ezahlukahlukeneyo zobuntu kuquka ukunyanzeliswa kwezinto (ukuvavanya impawu echasene nokungafunekiyo ukwenzela ukuba amanqaku aphantsi kweli nqanaba akhombise ukungabikho kompembelelo omkhulu) kunye nomoya ongeyantlukwano (ukuvavanya umxholo obandakanya ubunzima nemimiselo yemoya) . Umsebenzi wekhompyutha ohambayo / ongenawo oqhubekayo wokusebenza (Braver, et al., 2001) yagqitywa ngabo bonke abathathi-nxaxheba. Inkqubo ifuna abathathi-nxaxheba ukuba batyhale okanye bangacofisi iqhosha xa bebona u "X" phantsi kweemeko ezimbini ezahlukeneyo. Ngexesha lomsebenzi 1 ithagethi ibinikezelwa rhoqo, abaphenduli bayalelwe ukuba bacofe iqhosha lasekhohlo le-mouse xa bebona naluphi na unobumba ngaphandle ko “X” (83% frequency) kwaye banqanda ukutyhala iqhosha xa kuvela u “X” (17% Ubuninzi). Le meko ivavanya inqanaba lokunyanzeliswa ziikhomputha zekhomishini, xa umthathi-nxaxheba esilela ukunqanda impendulo ngokutyhala iqhosha phambi kweleta X. Emsebenzini abaphenduli ababini batyhala iqhosha lasekhohlo le mouse kuphela xa bebona u "X" (17% Ukuhamba rhoqo) kwaye into leyo kukuhlala ujonge ukuze ungaphoswa kukucofa iqhosha xa kujolise (ileta X). Lo msebenzi uvavanya ukungakhathaleli ngokubala iimpazamo zokushiya, xa umntu othabatha inxaxheba esilela ukuphendula ngokucinezela iqhosha phambi kweleta X.

I-2.2.1 Imaging Parameters

Kwiminyaka yesibini yokuqokwa kwamagontic i-resonance imaging data yafunyanwa kubo bonke abathathi-nxaxheba kwi-Siemens 3T Trio scanner (Erlangen, eJamani). Iifoto zobuchopho obunzima be-T1 kunye ne-proton yokunyaniseka (PD) kwahlukelelwa ukuba kusetyenziswe ukuhluzwa kwezicubu. T1 imifanekiso yafunyanwa ngokuqhelaniswa kwe-coronal, usebenzisa i-MP-Rage ilandelelwano (TR = 2530ms, TE = 3.65ms, TI = 1100ms, i-flip angle i-7 degrees, izahlulelo ze-240, i-1 mm isotropic voxel). Izithombe ze-PD zithengwe kwi-orientation ye-axial, usebenzisa i-hyper-echo, i-turbo spin echo ngokulandelelana (TR = 8550ms, TE = 14ms, ii-flip angle ze-120, i-80, kunye ne-1 × 1 × 2mm voxel). Imiqulu ye-DTI yafunyanwa nge-axia orientation kwaye ihambelana nomqulu wePD, usebenzisa i-spin echo ephindwe kabini, ukuthengwa kwe-EPI enye kunye ne-12 yokudibanisa i-gradient directions (TR = 11500ms, TE = 98ms, i-64 i-2 mm, i-2 mm i-voxel isotropic, b = I-1000 sec / mm2, I-2). Ukulandelelana kwemephu emibini ye-echo yemephu kunye nemigangatho ye-voxel eqhelekileyo kwi-DTI yafunyanwa kwaye isetyenziselwa ukulungisa idatha ye-DTI yokuphazamiseka kwe-geometric ebangelwa yi-field magnetic inhomogeneity.

2.2.2. Ukucwangciswa kwesantya

Idatha yesithombe iqhutywe kusetyenziswa isofthiwe (i-BET, FLIRT, FAST, FDT, FUGUE) kwi-LibraryRIB Software Library (http://www.fmrib.ox.ac.uk/). Ingqondo yaqala ukukhishwa kwiT1 kunye nemifanekiso yePD usebenzisa i-BET. T1 Ingqondo yadibaniswa ngokobuchopho be-PD usebenzisa i-FLIRT. Ukwahlula kwimizimba yesibini yesikhokelo kwenzelwa kwi-PD kwaye ihambelanisiwe T1 imifanekiso esebenzisa i-FAST, ukuvelisa iiklasi ezine (i-CSF, emhlophe, igrey, negazi).

2.2.3. Ukusetyenziswa kweDTI

Idatha yokusabalalisa ikhusi yaqala ukulungiswa ngokuphazamiseka okwangoku kwangoko kwaye emva koko i-tensor ye-diffusion yayibalwa ngokusebenzisa i-FDT kunye ne-FA kunye ne-MD kunye ne-MD.Basser, 1995). I b = I-0 ivolumu volume kunye ne-FA kunye ne-MD imiqulu yalungiswa ngenxa yokuphazamiseka okubangelwa yintsimi yamagnetic ukungafani nokusebenzisa umfanekiso webalazwe yasemaphandleni.

Imibuzo ethile yemigca emhlophe yayenziwe kwiimiqulu ze-DTI ezidityanisiweyo ngokubhalisa ukulinganisela kwemilinganiselo yevolumu (PVE) imephu yombala omhlophe ukusuka kwicandelo elinesibini le-FAST le-FAST kwicandelo lokuguqulwa elungiswe umfanekiso we-DTI usebenzisa ukutshintshwa kwenguqu eveliswa ngokulungelelanisa i-DTI b = Umfanekiso we-0 kumqulu wePD. Iimvoxels kwimifanekiso ye-DTI zahlanjululwa njengento emhlophe ukuba ukulinganiselwa kombakala omhlophe we-voxel kudlulile kwi-90% njengoko kumiselwe i-DTI imephu yePVE.

2.2.4. Ummandla wesigqibo somnqweno

Inkqubo ehamba ngokuzenzekelayo efana neleyo esetyenziswe kuyo Wozniak, et al. (2007) yayisetyenziselwa ukuchaza imimandla yomdla (i-ROI). T1 Idatha yayihambelaniswe nobuchopho be-MNI jikelele ngokusebenzisa i-FLIRT nge-degree ye-12 yenkululeko yokulungelelanisa i-affine. Umqhubi oqeqeshwe uzimisele umda we-ROIs kwisifundo ngasinye ngokukhetha ezine iiplani kwi-MNI ehambelanisiweyo T1 umfanekiso. I-plonal coronal plane (ACP) yachazwa njengeyona ndlela ephezulu kakhulu ye-corpus callosum; indiza ye-coronal yangaphambili (i-PCP) ichazwe njengendawo engaphezulu kwesithuba se-splenium ye-corpus callosum; Inqwelo ye-AC-PC (ACPC) ichazwe ukuba iyadlula i-AC-PC; indiza ye-supra-callosal (SCP) ichazwe ukuba yiyona moya ephezulu kuneyona ndlela iphezulu kakhulu ye-corpus callosum kwinqanaba eliphakathi (bona Umfanekiso we1).

Umzobo 1    

Umbono we-Sagittal: Ummandla wangaphambili uchazwe njengendawo yangaphambili kwindawo ye-coronal yangaphandle (ACP) kwaye ihlulwe yi-ACPC indiza ibe yinqanaba eliphezulu (SUP) kunye nemimandla engaphantsi (INF).

Imimandla emibini yomdla ihlolwe kulolu hlalutyo: ummandla ophezulu ophezulu wachazwa njengezicubu zangaphakathi kwe-ACP kunye no-ACPC ophezulu, kwaye ummandla ophantsi ongaphantsi wachazwa njengezicubu zangaphambili kwi-ACP kwaye ungaphantsi kwe-ACPC (jonga Umfanekiso we1). Ii-ROI zaze zaxelwa kwiimifanekiso ze-DTI zisebenzisa iinguqu ezitshintshileyo zemveliso yenguqu eguqulelweyo esuka kwi-MNI ukuya kwi-T1, T1 kwi-PD, kunye ne-PD ukuya kulungelelaniso lwe-DTI. Imilinganiselo ebalulekileyo kumcimbi omhlophe we-FA kunye ne-MD kwingingqi nganye kuyo yonke imfundo ibonelelwe ngokubaluleka kwalawo ma-voxels kwimaski emhlophe ekwayi-ROI ehambelanayo.

2.3. Uhlalutyo lwesatisatisti

Ukungafani phakathi kwezigulane kunye nezilawuli ze-CSB zahlaziywa zisebenzisa i-Student iimvavanyo kubalwa usebenzisa i-SPSS Version 15 ye-Windows. Imibutho yabalwa ngokusetyenziswa kwee-Coefficients ze-Pearson's Product-Moment Coefficients.

3. IINKCUKACHA

Idatha ekhoyo 1 Table bonisa ukuba iqela le-CSB lihluke kwiilawuli kwiimilinganiselo ezininzi zokungafuneki. Ulwahlulo olubanzi lwe-CSB kunye nokuhlukana kolawulo lufunyenwe ukukhangela ngokubanzi, t14= -2.64, P <0.019, kunye nesithintelo, t14= 2.50, P <0.026. Ukongeza, abathathi-nxaxheba be-CSB babonisa iimvakalelo ezimbi eziphezulu, t14= -3.16, P <0.007. Abathathi-nxaxheba be-CSB bakwabonisa amanqaku aphezulu kakhulu kwi-CSBI, t14= 9.57, P <0.001,

1 Table    

Kuthetha ukungafani phakathi kwezigulana zokuziphatha ngokuSigxina kunye noLawulo lweMigangatho yeZengqondo, iindlela zokuziphatha kunye ne-Neuroanatomical

Imiphumo ye-Go-No Hamba inkqubo, okuyimilinganiselo yokuziphatha yokungafuneki, ngaba ababathathi-nxaxheba be-CSB benza iimpazamo ezingakumbi, zombini ukuthunywa,14= 3.09, P <0.008, kunye nokushiya, t14= 2.69, P <0.018, ngexesha lokujolisa rhoqo kwimeko kwaye ikwabonakalise iimpazamo ezizezona zibalulekileyo kuzo zombini iimeko kunolawulo (iimpazamo zeKhomishini: t14= 2.98, P<0.01; Iimpazamo zokungabikho: t14= 2.76, P<0.014).

Iziphumo zeengcamango zengcamango eziqhathanisa abachaphazelekayo be-CSB kunye nabathathi-nxaxheba balawulwayo 1 Table kwaye Umzobo 2. Iqela le-CSB lincinci kakhulu kuMmandla ophezulu. Nangona ukungafani phakathi kwamaqela e-FA kumgangatho ophezulu wawubalulekanga (P= 0.15) ubungakanani bomlinganiselo wokohluko (d= 0.8) liphakathi ukuya kumakhulu (Cohen, 1988). Kwakungekho nantlukwano ebalulekileyo phakathi kweqela le-CSB kunye neqela lolawulo kuwo nawaphi na amanyathelo kummandla ongaphaya komda kwaye ubunzima beempembelelo zabancinci.

Umzobo 2    

I-FA (x 1000) kunye ne-MD kunye neqela le-Inferior Frontal ne-Superior Frontal Regions

Imibutho yokunyaniseka kunye nemilinganiselo yokuvakalelwa kunye nemilinganiselo yokucinga iyaboniswa kuyo 2 Table kwaye Umzobo 3. Iziphumo zibonisa ubudlelwane obubalulekileyo, obubi bokungabi nomoya kunye nomoya ongeyantlukwano kunye nommandla ongaphantsi kwe-FA. Inkxalabo ibonise indlela eyahlukileyo yemibutho ne-FA, kwakunye nokuhamba ngokubambisana kakubi kunye nommandla ongaphantsi kwe-MD. Le miqathango ibonisa ukuba akukho mibutho kwimimandla ephambili. I-CSBI, nangona kunjalo, ayikho imibutho ebalulekileyo kwimimandla engaphaya komda, nangona kunjalo, ubudlelwane obunobungozi obuninzi bufunyenwe phakathi kwamanqaku e-CSBI kunye ne-MD.

Umzobo 3    

I-Scatterplot ye-Inferior Frontal Region FA (× 1000) kunye ne-Barratt Impulsivity kunye ne-Negative Feelings kunye ne-Superior Frontal Region (MD) kunye noKhuseleko lwezesondo oluPhezulu.
2 Table    

Ulungelelaniso phakathi koMngcipheko kunye neMilinganiselo yoBuntu kunye neMilinganiselo yokuCamngca.

4. UKUQALA

Idatha ekhoyo kweli phepha ihambelana nokucinga ukuba i-CSB ifana kakhulu kunye neengxaki zokulawula umgudu, ezifana ne-kleptomania, ukugembula okunyanzelisayo kunye nokukhathazeka kokutya. Ngokukodwa, sifumene ukuba abantu abahlangabezana neendlela zokuxilonga ngokunyanzela ukuziphatha kwezesondo ziphakamileyo kwiingxelo zokuziphendulela ngokwabo, kubandakanywa amanyathelo okuphelelwa komntu kunye nomntu wobunzima. Nangona kunjalo, nangona kwakukho umahluko omkhulu phakathi kwamanqaku kwi-Barratt Impulsivity Scale phakathi kwezigulane ze-CSB kunye nokulawula, kwaye lo bunzima besiphumo salolu daba lwalukhulu, amanqaku ethu kwizigulane ze-CSB aphakathi kwinqanaba eliphakathi lwesampula yoluntu lwakutshanje (Spinella, 2005).

Ukongezelela kumanyathelo angaphezulu okunika ingxelo, izigulane ze-CSB zibonise umtsalane obaluleke kakhulu emsebenzini wokuziphatha, i-Go-No Hamba inkqubo. Ukuhambelana nophando malunga nokulahleka kwengxaki yokuxhatshazwa komzimba (Dickstein, et al., 2006: Ifama kunye neRucklidge, i-2006) kunye neencwadi eziqhelekileyo zolawulo (Asahi, et al., 2004; Cheung, et al., 2004; Spinella, 2004) izigulane nge-CSB zineephosiso ezininzi zekhomishini kwi-Go-No Hamba inkqubo. Nangona kunjalo, babonisa ezininzi iimpazamo zokungabikho kokulawula. Kwimpendulo engapheliyo, iimpazamo zokushiya zingumlinganiselo wokunganaki. Amaqela ethu awazange ahluke kwiiphene kwiimpendulo ezingapheliyo. Ukungafani kweziphoso zokungaphumeleli ngexesha lompendulo kwimeko yeziganeko zifana neziphumo ezifunyenweyo kwizigulane eziphosakeleyo, apho kukho iziphene ezingapheliyo zokungaphumeleli ezifunyenweyo kwi-Go-No No inkqubo yokuhamba xa kuthelekiswa nezigulane kunye nezilawuli (trichotillomania)Chamberlain, et al., 2007). Oku kuya kubonisa ukuba ngaphezu kokubonakalisa ukungafuneki, iimpazamo ezongeziweyo zekhomishini kwizigulane ze-CSB, kukho nenye inkcazelo yenkalo ethile, eboniswa ukungaphumeleli ukuphendula xa kukho iimpendulo. Kungenzeka ukuba le ngenye indlela yokunyamezela, enokuthi ihambelane ne-compulsive, ngaphezu kokungachukumisi, umlinganiselo we-CSB.

Ngokuchasene nokulindela, kwakungekho nantlukwano phakathi kwezigulane ze-CSB kunye nokulawulwa kwimiqathango ye-DTI, i-FA kunye ne-MD, kwingingqi ephantsi. Nangona kunjalo, izigulane ze-CSB zibonise ngokuthe ngqo kwi-MD kwingingqi ephezulu kunye ne-FA ephezulu, nangona umahluko kwi-FA awuzange ifikeleleke kubaluleka. Ezi ntlukwano zazibukhulu obukhulu (d = 0.8 ye-FA kunye ne-1.4 ye-MD). Ngoko ke, ngelixa zethu iziphumo ngokubhekiselele kwimpembelelo zihambelana nophando malunga nezinye iziphazamiso zokulawulwa kwempembelelo, iData ye-DTI ingcaciso egciniweyo yongqinelana nelo cwaningo, olufumene iingxaki zokulawula ukuxhatshazwa ukuba zidibaniswe nomngcipheko wokungcola kwamhlophe omgangatho ophantsi. I-FA ephantsi kunye ne-MD (Hoptman, et al., 2002; Isibonelelo, kunye ne-al, 2006; Rüsch et al., 2007).

I-MD ne-FA yimiqathango ye-scalar eyenza isishwankathelo seempawu ze-disseversion diffuser, oluhlobo lwe-matrix kwaye luqulethe ulwazi oluchaza ubukhulu kunye nesikhokelo sohlobo lwe-self-diffusion kwi-tissue. Imodeli yokwahlukana iyakubonwa njenge-ellipsoid enee-axxes ezintathu ze-orthogonal ngobude be-axis emele isantya sokusasazeka kwi-axis. Imele indawo epheleleyo yamahhala efumanekayo ukuze amanzi adibanise, ngoko ke ubude bomyinge yazo zonke iimpawu ezintathu. I-FA ibonisa ukulinganisa phakathi kobude be-axis oyintloko kunye nezinye i-anxes-axagonal-anisotropy eziphezulu ziza kubonisa ukusabalalisa okuxhomekeka kakhulu kwicala elinye (IWozniak kunye neLim, ngo-2006). Amanyathelo e-DTI ayilona amanyathelo ngokupheleleyo kwaye kufuneka aguqulelwe kumxholo. Ukuchonga i-pathology esebenzisa i-DTI ngokubanzi kufuna ukuba kuthelekiswe kunye nesampula esingeyona pathological population endaweni efanayo. Umzekelo, ukuwela iziphumo zefayili ekunciphiseni i-FA. Ukulahlekelwa kwesinye iifom ze-fibers ekugqibeleni, njengoko kuboniswe kwisithintelo (Pierpaoli, et al., 2001), kunokubangela ukwanda kwe-FA kwizigulane ezihlaselwa. Idatha yethu, yabonisa ukwanda kwe-FA kunye nokuncipha kwi-MD kumbandela omhlophe ophambili kumacandelo e-CSB xa kuthelekiswa nezifundo ezingafaniyo zokuthelekiswa. Oku kungabonakalisa intlangano yefayibha eguqulelwe, mhlawumbi ngenxa yezinto ezincinci zokuwela kwiindawo eziphambili zegulane ze-CSB kunye nendawo engaphantsi kwesikolo, mhlawumbi ngenxa yokupakisha okufutshane.

Ngenxa yokungafani okufunyenweyo, sihlolisise idatha ye-DTI ngokuqhubekayo ngokuphanda ubudlelwane bayo kunye nemilinganiselo yethu yokungafuneki nokuziphatha ngokunyanzela ngokwesondo. Ngokuhambelana nophando oludlulileyo, sithole ubudlelwane obukhulu phakathi kwamanyathelo okungahambisani nokunyaniseka kunye ne-DTI yamanyathelo okunciphisa umbandela wombakala omhlophe kwi-cortex ephantsi. Nangona kunjalo, ngokuhambelana nokuhlukana kweqela phakathi kwezilwanyana ze-CSB kunye noLawulo kunye nokungahambelani nemiphumo yokulawula imiphumo, sithole ubudlelwane obubi phakathi kwe-CSBI kunye ne-MD. I-CSBI yayingabonisi ubudlelwane kunye namanyathelo angaphantsi, kwaye amanyathelo angabonakaliyo angabonisi ubudlelwane kunye nemilinganiselo ephezulu. Ukubambisana kwe-CSB kunye nokunciphisa i-MD, ngelixa ihambelana nokungafuneki, ihambelana nolwazi olukhulayo oluvela kwiintlungu zokuxhalabisa. Ukwanda kwe-FA kunye nokwehla kwe-MD kuye kwafunyaniswa kwizigulane ezineengxaki zokuphazamiseka kunye nesifo sengxaki yokuxinwa kwengxaki (post disorder stress disorder)Abe, et al, 2006; Han, et al., Kwi-press). Ukongezelela, ukuqina kweempawu ezixhasayo kuye kwafunyaniswa ngokufanelekileyo kunye ne-FA kwaye ihambelana kakubi ne MD (Han, et al., Kwi-press). Kwakhona, iziphumo zethu malunga ne-FA kunye nee-MD ziyamkeleka kwizifundo ze-DTI ezikhulayo ze-distilsive disorder (OCD). Izifundo eziliqela ze-DTI zifumene ukuba izigulane ze-OCD zibonisa i-FA eyandisiweyo xa kuthelekiswa nokulawulwa kwimiba yengqondo efana nommandla ophezulu ongaphaya kwesi sifundo (Cannistraro, et al., 2007; Yoo, et al., 2007; Menzies, et al., 2008; Nakamae, et al., 2008). Ukongezelela, Nakamae, et al. (I-2008) ifumene i-coefficient ephezulu ebonakalayo (ADC) kwi-cortex yangasese ekhohlo ye-OCD izigulane xa kuthelekiswa nokulawula. I-ADC imilinganiselo efana ne-MD.

Coleman (1991) ixubusha i-CSB njengoko iqhutywe yinto echaphazelayo, ngakumbi ukukhathazeka kunye nokuxinezeleka. Idatha apha ibonakala ihambelanayo ne-CSB ibe ngumodareyitha weempembelelo ezingathintekiyo kwizigulane ze-CSB eziye zaphakama phezulu kwiimvakalelo ezimbi, isixa esibonisa ubunzima ngemimiselo yemoya (Patrick, et al., 2002), kwaye ibonisa iDTI kunye ne-Hayi-Hayi Hamba ukungafani kwempazamo ehambelana nezifo zokuxhalabisa. Enyanisweni, idatha evela kulolu cwaningo ibonisa ukuba, ubuncinci ngokwemilinganiselo ye-neuroantomical, i-CSB inokufakela ngakumbi kwi-OCD ngaphezu kwebala lolawulo.

Umlinganiselo ophezulu walolu cwaningo lukhulu lwesampula. Ukunikezelwa kweesampuli ezincinci, kunye nenyaniso yokuba sikhetha ukuhlalutya ezininzi ngaphandle kokulawula ukuphulwa kwesilumkiso, kusenokwenzeka ukuba ezinye zeziphumo zethu zikhohlakele. Nangona kunjalo, ezininzi iinkokhelo zethu zokulungelelanisa zibaninzi kwaye izikhulu zentlukwano yethu yeqela liyabaluleke kakhulu. Ngaloo ndlela, olu hlalutyo luyathembisa kwaye lubonelela ukuba kukho iimeko ze-neuroanatomical kunye / okanye ze-neurophysiological ezinxulumene nokuziphatha okunyanzelekileyo ngokwesondo. Ezi nkcukacha nazo zibonisa ukuba i-CSB ibonakala ibonisa ukungabi nentswelo, kodwa iquka nezinye iindawo, ezinokuthi zihambelane nokuxhaswa kwemvakalelo kunye nokuxhalaba kwe-OCD. Izifundo ezongezelelweyo eziphinda ziphendule le nkqubo kumasampula amakhulu, abamele abantu abahlangabezana neenkqubo zokuxilonga kwi-CSB kunye nokulawula okungabikho klinikhi kubonisiwe. Ukongezwa kweqela lesilinganisela isigulane kunye nengxaki engeyiyo yezesondo kunokunyanzelisa ukuxhamla imimiselo eqhelekileyo yokunyanzelisa iimeko zesigxina. Oku kuya kuqhubela phambili ukuqonda kwethu le nto ibonakaliswe ngu-hypersexual. Kwixesha leminyaka ezininzi iingcamango zicetywayo zihambelana ne-etiology ye-CSB. Amatshini amasha okusebenzisa i-neuroimaging ngoku asinika izixhobo zokuhlola i-neurobiological underpinnings (i-brain substrates, njl. Njl) njalonjalo kwezi ngcamango.

AMAKHODI

Le projekthi yayixhaswa yinxalenye yenkxaso-mali yoPhando, i-Artistry kunye neScholarship evela kwiYunivesithi yaseMinnesota ukuya kuMichael H. Miner, kunye ne-P41 RR008079, i-P30 NS057091 kunye ne-M01-RR00400 iZiko leSizwe loNcedo lweeNkxaso, amaZiko kaZwelonke Impilo kuCelvin O. Lim. Ababhali bangathanda ukubonga uDkt. Charles Schulz onike inkxaso ngemali kunye nenkxaso kulolu cwaningo. Sinqwenela ukubonga uDkt. Eli Coleman ngesiluleko sakhe kunye nenkxaso yolu cwaningo.

Imihlathi

Iphepha elichazayo ukuba awusenanto oyifunayo: Le fayili yeFayile yombhalo wesandla ongabhalwanga owamkelwe ukushicilelwa. Njengenkonzo kumakhasimende ethu sinika le ngcaciso yokuqala kwincwadi yesandla. Umbhalo wesandla uza kufumana ukukopishwa, ukufakela, nokuphonononga ubungqina obunokubakho ngaphambi kokuba kukhutshwe kwifomu yayo yokugqibela. Nceda uqaphele ukuba ngexesha lokuveliswa kweeprogram ezinokuthi zifumaneke ezinokuthi ziphazamise umxholo, kunye nazo zonke izisemthethweni ezichasayo ezisetyenziswa kwiphephancwadi.

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