Ukuvinjelwa kokudla emantwaneni omncane kakhulu kuhlotshaniswa nokunciphisa ivolumu ye-orbitofrontal nokuhluleka kokusebenza okuphezulu (2011)

L Maayan,^{2,4 *} C Hoogendoorn,^1* V Sweat,¹ no-A. Convit^1,3,4

LINKA KUFUNDO ESIFUNDWAYO

Ukukhuluphala (i-Silver Spring). I-2011 Julayi; I-19 (7): 1382-1387.

¹ UMnyango Wezengqondo, eNew York University School of Medicine, i-550 First Avenue, New York, NY 10016, USA.

² UMnyango Wezengqondo Zomntwana, i-New York University School of Medicine, i-550 First Avenue, eNew York, NY 10016, e-USA.

³ UMnyango Wezokwelapha, i-New York University School of Medicine, i-550 First Avenue, eNew York, NY 10016, e-USA.

⁴ UNathan Kline Isikhungo Sokucwaninga Ngezengqondo, i-140 Old Orangeburg Rd. I-Orangeburg NY 10962, e-USA

Kubantu abadala, ukukhuluphala kuhambisane nokudla okuvinjelwe, kunciphise ivolumu ye-cortical greyical grey, kanye nokusebenza okuphansi kuhlolo lokuqonda. Kuncane kakhulu okwaziwayo ngalobu budlelwano ebusheni futhi akukho zifundo ezihlola izindlela zokuziphatha, zokuqonda, ne-neurostructural eqenjini elifanayo lababambe iqhaza ocwaningweni. Lolu cwaningo luhlole ubudlelwano phakathi kokukhuluphala, ukusebenza kwesigungu esiphezulu, ukubulala amagciwane, nobuchopho obuningi ebusheni obunempilo. Abahlanganyeli bafaka i-54 i-feta kanye ne-37 tean tean teens. Ababambe iqhaza bathola ibhethri eliqondayo, imibuzo yemikhakha yokudla, kanye ne-magnetic resonance imaging (MRI). Ukuhlolwa kwe-Neuropsychological kufaka phakathi imisebenzi ekhomba phambili umsebenzi we-lobe. Ukuziphatha kokudla kunqunywe kusetshenziswa i-Three Factor Eating Questionnaire (TFEQ), futhi ama-MRIs ahlelekile enziwa ku-1.5 T Nokia Avanto MRI System (i-Nokia, Erlangen, Germany) ukunquma imiqondo yobuchopho be-grey brain. Intsha eyeqile nenamafutha amakhulu ifaniswe nobudala, iminyaka yemfundo, ubulili kanye nesimo senhlalo yomnotho. Okuhlobene nokwehla kwentsha, ababambiqhaza abakhuluphele babenezilinganiso eziphakeme kakhulu zokukhishwa kwe-disinhibition ku-TFEQ, ukusebenza okuphansi ezivivinyweni zokuqonda, nevolumu ye-cortex ephansi ye-orbitof. I-Disinhibition ihlangana kakhulu ne-Mass Mass Index, isikolo se-Stroop Colour-Word, kanye nevolumu ye-cortex ye-orbitofrontal. Lona ngumbiko wokuqala walezi zinhlangano ebusheni obusha futhi ukhomba ukubaluleka kokuqonda kangcono ukuzihlanganisa phakathi kokushoda kwemizwa nokukhuluphala.

Amagama agqamile: Ukukhuluphala, Intsha, Ukukhipha disinhibition, i-MRI, i-Frontal Lobe, Ingqondo, i-Orbitof Pambal Cortex

Isingeniso

Ukwanda kokukhuluphala kwengane nentsha e-US kuye kwaphindeka kathathu kusukela nge-1970. Yize ubufakazi bamuva nje bubonisa ukuthi kungenzeka ukuthi ukukhuluphala kwengane sekuncishisiwe, amanani aphezulu abikezela inkinga yezempilo yomphakathi ebanga ukugula okubandakanya ukugula kwenhliziyo ne-endocrine (1).

I-disinhibition yokuziphatha kokudla, ebonakala ngokwengxenye njengokudla kokudla ngokunensa ukuphendula izintambo zemvelo, kudala ihlotshaniswa nokukhuluphala kokubili ebusheni nakubantu abadala (2). Ukwehluleka kokulawulwa okuhlobene kokudla kwe-caloric okuholela ekuphepheni ngokweqile kungenzeka emazingeni ambalwa ebuchosheni kufaka phakathi i-hypothalamus (3) futhi, ngokusho komsebenzi wakamuva, ku-cortex ye-cerebral (4). Uchungechunge locwaningo olusebenzayo lwe-neuroimaging lwabantu abanenkani nabakhuluphele kuzo zombili izifunda ezilambile nezondlekile zikhombisile izifunda eziningana zecortical kufaka phakathi i-cterize engaphandle, indondo yangaphambili5), i-insula, i-cingate yangemuva kwasemuva, yesikhashana, kanye ne-cortices yangaphakathi (6) ukusebenza ngokwahlukile ngokuya ngezinga le-satiety ne-BMI, okuphakamisa ukubandakanyeka kwabo kulawulo lokudla kwe-caloric. Ukuqonda kwe-OFC njengendawo ebalulekile ekuvinjelweni kokuziphatha kwehlela emuva esimweni sePhineas Gage, ngeshwa le-19^th isisebenzi sasejantshi esasinda engozini esalimaza i-cortex yaso ejikelezayo, okuholele ekushintsheni kobuntu kanye nokwanda kokucindezelwa (7).

Ukutholwa kwe-Neurostructural kubuye kwaxhunyaniswa ne-Mass Mass Index (BMI). Ocwaningweni oluncane lwabesifazane abaneminyaka engu-55 yeminyaka nangaphezulu, ababesebenzisa i-voxel-based morphometry (VBM), i-BMI yaxhunyaniswa ngokungemthetho nezinxa zezindaba ezimpunga ezindaweni eziningana zangaphambili kufaka phakathi i-orbitof mbeleal, i-front infal frontal, kanye ne-gyri yangaphambi kwesokudla ngaphezulu kwezinye izifunda kufaka phakathi i-cerebellum yangakwesokudla kanye nesifunda esikhulu sangemuva sangakwesokudla esifaka i-parahippocampal, fusiform, kanye ne-lingy gyri (8). Isifundo esikhudlwana sabadala be1,428 sathola ukuhlangana okungalungile phakathi kwabesilisa phakathi kwe-BMI nendaba eyi-grey ephelele kanye nezindawo ezithile zobuchopho ezinjenge-bilatesal medial temporal lobes, i-occipital lobes, i-lobes engaphambili, i-precuneus, i-midbrain ne-anterior lobe ye-cerebellum (9). Olunye ucwaningo lwe-VBM lubonise ukuthi abantu abadala abakhuluphele banokuxineka okuphansi kwezinto ezindaweni ezinjenge-operculum yangaphambili, gyrus ephakathi nendawo, i-post-central gyrus, kanye ne-putamen (10). Iqembu lethu lichaze ubuciko be-neurostructural phakathi kwentsha eqatha ene-2 isifo sikashukela mellitus (T2DM) (26), kodwa olwazini lwethu akukho kusilela okunjalo okuye kwachazwa phakathi kwentsha yokukhuluphala ngaphandle kwe-T2DM.

Ngokungeziwe kokutholakele kokuhlelekile, ukuhlolwa kwengqondo kukhombisile ukuthi ukusebenza ngokuphatha kanye nokuvinjwa kokuphendula kungathikamezeka kubo bonke abantu abadala nabakhulu abakhuluphele abancane. Olunye ucwaningo olusebenzisa i-positron emission tomography (PET) kanye nokuhlolwa kwengqondo kuthola ukuthi abantu abadala abakhuluphele behlise umgomo wokudla okusasisekelo we-glucose metabolic kanye nokuncipha kokusebenza kwe-Stroop task, ukuhlolwa kokukhetha ukunakwa kanye nomsebenzi wokuphatha (11). Olunye ucwaningo lomsebenzi wokuphatha kanye nokuvinjwa kokuphendula kubantu abadala kukhombisile ukuhlangana okungalungile kwalezo zinto eziguqukayo nge-BMI (12-14). Ngaphezu kwalokho, intsha eyeqile ngokweqile ikhombisa ukusebenza okunciphile emisebenzini ephezulu kuqhathaniswa nedatha ejwayelekile (15).

Sicabange ukuthi kuyahambisana nokutholakele kwangaphambilini kusetshenziswa i-Three Factor Eating Questionnaire (TFEQ), intsha eyeqile ngokweqile ingaba nezilinganiso eziphakeme zokuzithiba ezisebenzayo ekuziphatheni kokuziphatha. Siphinde sagcizelela ukuthi intsha eyeqile izoba nemiphumela ephansi ekuhlolweni kokusebenza okuphezulu futhi inciphise ubuqotho ezilinganisweni zemisipha ye-frontal lobe (i-MRI-based grey volumes kanye namavolumu obuchopho besifunda). Ngaphezu kwalokho, siphakamise ukuthi i-disinhibition ku-TFEQ izohlotshaniswa kabi nezimpawu zokuqonda ezizindeni ezifanele kanye nezilinganiso ezisuselwa ku-MRI zezindawo zobuchopho ezibandakanyekile ekuvinjelweni kokuphendula nokulawula okuphezulu.

izindlela

Abahlanganyeli nezinqubo

Intsha engamashumi ayisishiyagalolunye nanye (14-21y / o), 37 lean (BMI <25 kg / m² noma i-Waist to Height ratio <0.5) kanye no-54 okhuluphele (BMI≥30 kg / m² noma> 95 percentile we-BMI weminyaka nobulili) wabamba iqhaza ocwaningweni. Amashumi ayisishiyagalombili nanye kulaba (ama-36 anciphile, ama-45 abakhuluphele) athola iMRI. Intsha eyishumi ayitholanga i-MRI ngalezi zizathu ezilandelayo: ababili abagcinanga ukuqokwa kwabo, oyedwa ubekhulelwe futhi sakhetha ukwenza iphutha ohlangothini lwezokuphepha, omunye akakwazanga ukubekezelela i-MRI (claustrophobia), kanti abayisithupha babe ne-BMI> 50 kg / m² futhi yeqe usayizi womzimba ongabekwa isithwebuli.

Abahlanganyeli be-Lean babeneminyaka yobudala eyi-17.3 ± iminyaka engu-1.6 kanye neminyaka engu-17.5 yokukhulu ± iminyaka engu-1.6. Womabili la maqembu futhi ayefaniswa ngeminyaka yemfundo, ubulili, kanye nesimo senhlalo yomnotho futhi wonke ayesezingeni elijwayelekile lokuqonda. Ubufakazi be-neurological, medical (ngaphandle kwe-dyslipidemia, ukumelana ne-insulin okufushane kwe-T2DM, isifo se-ovary polycystic, noma umfutho wegazi ophakeme), noma i-psychiatric (kufaka phakathi ukudangala notshwala noma okunye ukusebenzisa izidakamizwa) ukugula okungafakwanga abantu abathile ekubandakanyekeni ocwaningweni. I-T2DM iphinde yahlukanisa abantu abathile ekubambeni iqhaza. Ababambiqhaza nabazali babo banikeze imvume ebhaliwe ebhaliwe futhi banxeshezelwe isikhathi sabo kanye nokuphazamiseka. I-protocol yokufunda ivunyelwe yi-New York University School of Medicine Institutional Review Board.

Bonke ababambiqhaza ocwaningweni babenesampula yegazi ethathwe ngemuva kwehora le-10 ngejubane elikhulu lokuhlola i-glucose, i-insulin, i-lipid, ne-marker yokuvuvukala (amazinga aphezulu we-C-Reactive Protein; hs-CRP) amazinga. IGlucose ilinganiswa kusetshenziswa indlela ye-glucose oxidase (VITROS 950 AT, Amersham, England), i-insulin nge-chemiluminescence (i-Advia Centaur, iBayer Corporation), ne-CRP ikalwa nge-plasma isebenzisa i-enzymatic immunoassay (Vitros CRP slide, Ortho Clinical Diagnostics). Ukuzwela kwe-insulin kwakulinganiselwa kusetshenziswa i-Homeostasis Model Assessment of Insulin Resistance (HOMA-IR).

Ukwahlulela

Ukuhlolwa kwe-Neuropsychological

Senze ukuhlolwa okubanzi kwemisebenzi ye-neurocognitive, kufaka phakathi impumelelo yengqondo, inkumbulo yakamuva, inkumbulo yokusebenza, ukunakekelwa nokusebenza okuphezulu. Sifakazele ukuthi kuzoba nokwehluka emisebenzini ye-lobe engaphambili phakathi kwentsha enciphile futhi ekhuluphele ngakho-ke sikhawulele ekuhlaziyweni kwethu ekuhlolweni kwe-neurocognitive okukhombisa ubuqotho be-lobe bangaphambili nemisebenzi ye-executive engaphelele, okuyi-Controled Oral Word Association Test (COWAT), izingxenye ze-Trail Making Test A & B, iStroop Task, i-Attention / Concentration Index ye-Wide Range Assessment of Learning ne-Memory (WRAML) ne-Working Memory Index ye-WRAML. Ngaphandle kwe-WRAML ne-Stroop, enikezela ngamazinga ajwayelekile alungiswa ngeminyaka, kubikwa izikolo ezingavuthiwe. Zonke izivivinyo ezenziwayo zingamathuluzi ajwayelekile we-neuropsychological achazwe ngokuningiliziwe kwenye indawo (16).

Amaphepha emibuzo amathathu wokudla okudlayo (FF)

Izici zokuziphatha kokudla zahlolwa ngokusebenzisa i-TFEQ. I-TFEQ iyithuluzi le-51-nto, elakhiwa izinhlobo ezintathu zokunciphisa ukulinganiselwa (okusho, ukulawula komqondo kokuziphatha kokudla; ​​izinto ze-21), ukubulala amagciwane (okusho, ukuthambekela kokudla ngokuphendula izici ezingokomzwelo nezimpawu zomzwa; izinto ze-16), kanye indlala (ie, ukuthambekela kokudla ngokuphendula imizwa yendlala; izinto ze-14). I-TFEQ yenziwa cishe ihora elilodwa ngemuva kokuba izifundo zidle isidlo sasemini.

Ukutholwa kwe-MRI nokuhlaziywa kwesithombe

Zonke izifundo zifundwe ohlelweni olufanayo lwe-1.5 T Nokia Avanto MRI, enobubanzi be-intshi ye-65 kanye netafula elilungele umuntu ongamaphawundi we-400. Sithole izithombe ezinesisindo se-T1 ezinesisindo se-T1300-zalungisa ngokushesha ukutholwa kwezithombe ze-echoent (MPRAGE; TR 4.38 ms; TE 800 ms; TI 250 ms; FOV 250 × 1.2; slice thickness 1 mm; NEX 15; Flip angle 256 °; size matrix size I-256; i-192 izilwanyana ezi-coronal).

Ukuhlaziywa kwe-WM / GM Volumetric

Ukulungiswa kwendawo nokuhlukaniswa kwezithombe ze-MPRAGE kusetshenziswe izinqubo ezizenzakalelayo njengoba kuchaziwe ku (17) isoftware ye-parametric mephu software (SPM5). Izithombe ze-MPRAGE zaqale zalungiswa ngenxa yokungafani kobuningi futhi zalungiswa endaweni ngokwezifiso zethempulethi ye-T1 Montreal Neurological Institute ejwayelekile. Sisebenzisa i-algorithm yokuhlukaniswa kwezicubu ku-SPM5, sahlukanisa izithombe ezijwayelekile ze-MPRAGE ezindabeni zabo ezimpunga (GM), i-white jambo (WM), kanye ne-cerebro-spinal fluid (CSF), okuyimephu emelela ukuthi i-voxel ngayinye ihlukaniswa ngokuthi GM, WM noma CSF. Lezi zingxenye ezihlukaniselwe zaguqulwa zaba ngokwejwayelekile kwizifanekiso zazo ezijwayelekile. Ngaphezu kokwenza ukuhlolwa kobuchopho ngokuphelele, futhi sinikezwe ukuthi ngesikhathi sokukhula kobuso be-lobe myelination namanje kuyaqhubeka, sisebenzise izifanekiso ezimbili ezahlukahlukene ukuthola izifunda zenzalo (i-ROI) kwi-frontbe lobe. Lawa bekuyi-SPM Automatic Anatomic Labeling (AAL) (18) ithempulethi nendlela yethu yokushicilela yangaphandle ephusile ethembekile (19). Ithempulethi ye-AAL yayisetshenziselwa ukuthola i-lobe ephelele yangaphambili, isifunda esingaphandle kwangaphakathi, kanye nesifunda esingaphambi kwaso. Indlela yethu yokusebenzisa iphasela isetshenziselwe ukuthola isifunda sangaphambili (i-frontbe lobe minus the supplementary motor district). Siphinde salinganisa inani leWW, GM, CSF imiqondo kulo lonke ubuchopho kanye nezindawo ezisebangeni elisezingeni lamacala ngokuqala ngokufaka imephu esifundeni ngasinye sokwahlukaniswa okuhlukanisiwe bese silinganisela amanani kuzo zonke izifundo kulawo maqembu amabili.

Ukuhlaziywa kwesitatimende

Senze amasampula azimele anemisila emibili ukuhlola ukuhlolwa kweqembu kubantu, idatha ye-endocrine, idatha yokuqonda, kanye nenani lobuchopho kanye nokuhlangana kwePearson phakathi kwamaphuzu we-TFEQ we-disinhibition kanye ne-BMI, i-Stroop color word score, ne-orbitofrontal cortex grey volume volume. Idatha ebingaphezu kokuphambuka okujwayelekile okungu-2 okuvela encazelweni yeqembu yalolo guquko ayifakwanga. Njengoba kunikezwe ukwahluka ngakunye kumanani wobuchopho besifunda ahlobene nosayizi wekhanda jikelele, silinganise usayizi womuntu ngamunye we-intra-cranial vault (ICV) sasebenzisa amanani we-ICV ukulungisa amavolumu obuchopho besifunda. Ngakho-ke, ukuvumela ukuqhathaniswa kwezinye izifundo nokunikeza umfundi umqondo wosayizi wezifunda zobuchopho ezifundwe, itafula elichaza amavolumu obuchopho besifunda likhombisa amavolumu aluhlaza (angagciniwe). Kodwa-ke, ukuqhathanisa kwezibalo nokubaluleka nosayizi womphumela wakho konke ukucabanga okwethulwe kusetshenziswe imiqulu yobuchopho eguquliwe (esalile).

Imiphumela

I-Demographics ne-Endocrine Idatha

Amaqembu ezihloko afaniswa iminyaka yobudala, ubulili, ibanga lesikole, kanye ne-Hollingshead yenhlalo yezomnotho nezomnotho (SES). Ababambiqhaza be-Obese babephakeme nge-BMI, futhi njengoba kwakulindelekile futhi babenomfutho wegazi ophakeme we-systolic ne-diastolic, i-insulin esheshayo kanye namazinga kashukela (kepha bonke abasezingeni le-standardoglycemic) kanye nokuhlola imodeli ye-homeostatic yokumelana kwe-insulin (HOMA-IR ), triglycerides, low density lipoprotein (LDL) cholesterol, kanye ne-high-sensitivity C-reactive protein (CRP). Izifundo ze-Obese nazo zazinezinga eliphansi kakhulu le-high density lipoprotein (HDL). Sicela ubheke Ithebula 1.

Amaphepha emibuzo amathathu wokudla okudla

Intsha ekhuluphele yathola amaphuzu aphakeme kakhulu kunababambiqhaza abancikile esikhungweni sokubulala amagciwane se-Three Factor Eating Questionnaire (6.85 ± 3.55 vs. 3.91 ± 1.96, p <0.000, cohen's d (d) = 1.07), kanye nendlala (6.60 ± 3.37 vs. 4.68 ± 2.84, p = 0.008, d = 0.81) kanye nesici sokuvimbela ukuqonda (9.19 ± 4.30 vs. 6.78 ± 4.11, p = 0.012, d = 0.57). Uyacelwa ukuthi uqaphele ukuthi siphindaphinde lokhu kuhlaziywa kwe-subset yabahlanganyeli abangama-81 abane-MRI futhi imiphumela ibingashintshiwe (idatha ayikhonjisiwe).

Izinyathelo Zokuqonda

Okuhlobene nokwehla kwentsha, intsha ekhuluphele ibe nokusebenza kwengqondo okukubi kuwo wonke umsebenzi we-lobe, ibizelwa kakhulu i-Stroop (isilinganiso sokuvinjwa), kanye ne-Working Memory Index ye-WRAML, noma ngabe silawula isilinganiso se-IQ. Sicela ubheke Ithebula 2.

Ngenxa yokuthi izifundo ze-10 azange zithole ukuhlolwa kwe-MRI (ngemininingwane sicela ubheke lowo obambe iqhaza nezinqubo zenqubo ngenhla), siphinde sabuyekeza ukucubungula kwethu kweqembu elingaphansi kwentsha ye-81 elaline-MRI nokuqondiswa nokubaluleka kwemiphumela yokuqonda yahlala ingashintshiwe (idatha ayibonisiwe).

Izingqondo zobuchopho

I-Front lobe grey udaba ivolumu (ngamasentimitha angama-cubic) ithambekele incane, yize ingekho ezingeni lokubaluleka kwezibalo, phakathi kwentsha eyeqile (265.3 ± 29.5 vs. 269.6 ± 26.7; 0.00369 residualised 0.018312 ± 0.00609 vs −0.014076 ± 0.139, p = 0.35, p = 32.3, p = 3.68, p = 33.3, p = 3.99, p = 0.00781, p = 0.024944 d = 0.01227). Uyacelwa ukuthi uqaphele ukuthi yize umehluko ophelele phakathi kwale mavolumu wawumncane, ukuhlaziya kwenziwa ngemuva kokubalwa kabusha ku-ICV nokubaluleka kwamanani nosayizi womphumela kukhombisa lokhu kuhlaziya. Ngaphezu kwalokho ukuze silawule imiphumela yokuthuthuka yobudala emthanjeni wangaphambi nangokwezifiso siphinde sasebenza ukuhlaziya kwethu kuyahluka ngobudala. Sithole into ephansi kakhulu engwevu ye-greyex yentsha e-fetabit e-orbitofrontal cortex (0.018947 ± 0.005 vs. 0.66 ± XNUMX; residualised XNUMX ± XNUMX vs. −XNUMX ± XNUMX, p = XNUMX, d = XNUMX). Ukwehluka kweqembu levolumu ye-OFC bekungashintshiwe ngemuva kokulawula umfutho wegazi we-systolic noma i-HOMA-IR. Ezinye izindawo ezihlolwe ngobuchopho, kufaka phakathi i-cortex yokuqala ne-cortex ye-anterior zazingafani kakhulu phakathi kwababambiqhaza abakhuluphele nabangenamandla. Ukuhlukahluka ngokobudala akuzange kushintshe noma ibuphi lobu budlelwano.

izinhlangano

Sithole ubudlelwane obubalulekile phakathi kwe-TFEQ nezindlela zokuqonda ze-BMI, ne-MRI. Ngokuqondile, isibalo se-disinhibition factor ku-TFEQ sikhombise ukuhlangana okubalulekile ne-BMI (r (81) = 0.406, p <0.001), isikolo se-Stroop Colour-Word (r (77) = -0.272, p = 0.017), kanye ne-OFC grey ivolumu yendaba (r (71) = -0.273, p = 0.021). Ukuze siqonde kahle ubudlelwano phakathi kwevolumu ye-OFC nokubulala amagciwane sahlola inhlangano ngokuhlukile kula maqembu womabili. Sithole ukuthi bekungekho ukuhlangana phakathi kwe-disinhibition nevolumu ye-OFC yabantu abakhuluphele (r (40) = -0.028, p = 0.864), kanti kwakukhona inhlangano eqinile yeqembu elincikile (r (31) = -0.460, p = 0.009). Izinhlangano ezihlangene phakathi kwesilinganiso se-disinhibition factor ne-BMI ne-Stroop zihlala zibalulekile kwi-subset yabantu abane-MRI (idatha engakhonjisiwe).

Ingxoxo

Njengoba bekulindelekile, intsha eyeqile ngokweqile yayinezilinganiso eziphakeme kakhulu zokukhipha izidumbu, indlala, nokuvinjwa kokuqonda kwe-TFEQ. Yize amazinga aphakeme wokuvinjelwa kwengqondo phakathi kwentsha yokukhuluphala kungahle kubonakale kungafaneleki, kufana nemodeli echaziwe "yokuzibamba ngokuqinile" lapho umuntu onokudla okuvinjelwe kanye nokuvinjelwa kwengqondo okuvamisile kungavimbela khona ukudla kwezinye izimo kepha kudliwe ngokweqile kwabanye (20).

Imiphumela yethu yanoveli yemvelo phakathi kwentsha yokukhuluphala iyahambisana nokutholakele ezincwadini zabantu abadala (8, 9) okukhombisa ukuncishiswa kwevolumu ndaba grey. Esibonelweni sethu sobusha lokhu kwehla kwakumakelwe kakhulu i-orbitofrontal cortex, isifunda sobuchopho ekubalulekeni kokulawuleka, kodwa futhi sakhombisa ukuthambekela okubuthaka kuyo yonke i-lobe yangaphambili. Sicabanga ukuthi ukuncishiswa okuvulekile kokwethuka okukhona kwezinye izazi zobuchopho phakathi kwentsha eqolo ngokweqile kungafinyelela ukubaluleka kwesampula enwetshiwe.

Ngokubalulekile kulo mbiko, sathola iqembu linesisindo esengeziwe ukuze lingabi nezikolo eziphakeme zokusabalalisa ku-TFEQ, kepha ukusebenza okuphansi ekuhlolweni kokuqonda okubonisa imisebenzi yobuchopho okucatshangwa ukuthi kungumgogodla wokuvinjwa kokuziphatha, noma ngabe ilawula i-IQ. Ngaphandle kwezifunda zangaphambili ze-lobe nemisebenzi esiyilingile, besinesifiso esikhulu sokuthola ubudlelwane phakathi kwe-disinhibition factor ye-TFEQ ne-OFC, isifunda sobuchopho esibaluleke kakhulu ekuvinjelweni kokuziphatha (ukulawulwa kokufaka amandla). Sikhethe i-Stroop ngoba yiwona kuphela wemisebenzi yethu yangaphambili ye-lobe (kufaka phakathi leyo ethinta imisebenzi ephezulu) evivinya ngokukhethekile amandla okuvimba izimpendulo ezenzakalelayo. Lokhu kufana kokuqonda okuqondile kwesimo sokuziphatha (i-disinhibition factor ye-TFEQ) nesifunda sobuchopho (OFC) nakho okubandakanyekile ekuvinjelweni kwezimpendulo ezizenzakalelayo. Intshisekelo yethu bekuwukuthola ulwazi olusebenzayo (lwe-Stroop vs. eminye imisebenzi yangaphambili engalinganiseli impendulo yokuvinjwa) nokucaciswa kwe-anatomic (OFC) kokutholakele nokuhlangana kwabo nesici sokukhishwa kwe-TFEQ.

Siphinde sathola ubudlelwane obalulekile phakathi kwe-disinhibition factor izikolo kanye ne-BMI ne-OFC yevolumu. Lapho ubudlelwano obuphakathi kwe-disinhibition nevolumu ye-OFC buhlolwa ngokuhlukile kwabahlanganyeli abangenanhliziyo nabakhulu, sathola ukuzihlanganisa okuqinile kuphela kweqembu elivumayo. Kungenzeka ukuthi abantu abakhuluphele sebevele bathola isilinganiso esibucayi sokususa- (esibonisile ukuthi kuhlotshaniswa ne-BMI), lapho ukucekelwa okwengeziwe kungakhonjiswa ngokucacile kwezinye izinguquko ezise-OFC, kepha mhlawumbe ezifundeni ezahlukahlukene zobuchopho noma kumanethiwekhi angahloliwe njengengxenye yalolu cwaningo. Okunye okungenzeka kulokhu kutholwa okuhlukile kweqembu ngalinye lesisindo ukuthi amaqembu anamafutha anokuphakeme kokuvumelanisa into, angahle athinteke kakhulu ezindabeni zokufiswa komphakathi ngakho-ke angaba mancane amathuba okubika ngokuphelele ubukhulu ukungaziphathi kwabo kokudla, kunciphisa ukuhlangana kuleli qembu. Okokugcina, kungenzeka futhi ukuthi ukukhawulelwa kwebanga, okuwukuthi ukwanda kokufana kunciphe lapho umehluko unciphile njengoba kwenzeka lapho sihlukanisa isampula yethu kabili kungathinta imiphumela yethu.

Ngenkathi ucwaningo lwethu luthola ukuthi i-disinhibition in feed feed ihlotshaniswa nokuncipha kokusebenza okuphezulu kanye nodaba lwangaphambili lwempunga, ubungako besigaba sesakhiwo sethu akusivumeli ukuthi sibhekane nodaba lokuqondiswa noma kokukhishwa. Njengoba sekushiwo, kunezinkolelo-mbono ezithile eziqondakalayo ngokuqondiswa kwalezi zinhlangano.

Okunye okungenzeka ukuthi ukushiyeka kwengqondo okuyisisekelo noma okusebenzayo kuholela ekudleni okuvinjelwe nokuncipha komsebenzi we-neurocognitive. Lo mugqa wokubonisana usekelwa ngokwengxenye umsebenzi obonisa ukubulala amagciwane ekuziphatheni kokudla ngaphambi kokudla okwandisiwe kwe-caloric (21kanye nokukhuluphala (22). Kubuye kuhambisane nomsebenzi osetshenziswayo wokuqagela obonisa ukuthi abantu abathile, abathi ngenxa yokudla okubonakalayo kokudla okuthandekayo bakhombise ukusebenza okubuthakathaka kokujikeleza komvuzo wobuchopho, basengozini ephezulu yokuthola isisindo esizayo (23); mhlawumbe badinga isikhuthazo esikhudlwana (ukudla okwengeziwe) ukuthola impendulo yomvuzo ofanayo.

Enye incazelo engenzeka ukuthi ukushoda kwengqondo okufana nokwakhonjiswa kulolu cwaningo kubangelwa ukukhuluphala kanye nokungahambisani ne-insulin. Lokhu kungenzeka kusekelwa esifundweni seminyaka emide se-24 esibonisa ukwanda kwe-BMI okuqala kubudala obuphakathi kuhambisane nethamo le-lobe lesikhashana elinciphile empilweni yamuva (24). Okunye futhi okusekela le-oda lomphumela kungumsebenzi wethu kubantu abadala lapho sithola khona ukuthi amavolumu e-hippocampal ahambisana nokulimazeka ekubekezelelekeni kwe-glucose (25) kanye naleyo eyeve eshumini nambili ene-T2DM, lapho sithola khona ukungalawuleki kwengqondo kanye nokwehliswa kumanani we-lobe yangaphambili kanye nasekuthembekeni kobuhle bemibono emhlophe (26). Siphikisa ukuthi ukungahambisani ne-insulin okuhambisana nokukhuluphala okuboniswa yiqembu lethu lentsha enesisindo eseqile kungaba nomthelela ekwehleni kokusebenza okuphezulu kanye nokushoda kwesakhiwo. Sichaze imodeli engaba khona yale miphumela (27) lapho sibonisa khona ukuthi ukumelana ne-insulin kuhlotshaniswa nokuncipha kwengqondo kwe-vascular reacaction ehlobene nokungasebenzi kahle kwe-endothelial. Siyazi ukuthi ngesikhathi sokusebenza kobuchopho, okufana nokwenzeka lapho kwenziwa umsebenzi wokuqonda, kukhona ukwanda komsebenzi we-synaptic esifundeni sobuchopho esihilelekile. Engqondweni evamile lokhu kuphumela ku-vasodilation yesifunda futhi ngenxa yalokho ukwanda kokutholakala kwe-glucose kuleso sifunda ukuxhasa ukwanda kwesidingo sokuqonda (28). Ngakho-ke, i-vasacacacacacion, ehlanganiswe nokugeleza kwegazi lokubeletha elilawulwa kahle, isihluthulelo sokugcina indawo efanelekile ye-neuronal ngesikhathi sokusebenza kobuchopho (29). Ucwaningo olukhombisa ukungasebenzi kahle kwe-endothelial ezinganeni ezikhuluphele, noma ngaphambi kokukhula kwesifo sikashukela (30), iyaqhubeka nokuxhasa lesi sakhiwo. Ngaphezu kwalokho, iphrotheni eyi-C-reactive protein (CRP) yokuvuvukala iphakanyisiwe ebusheni bethu abakhulu. Ezifundweni ezihlola ama-cohorts amakhulu abantu abadala, abaphenyi bathole amazinga akhulayo we-cytokines yokuvuvukala njengabavikeli be-psychology abonakalayo phakathi kwabantu abane-metabolic syndrome (31-34). Indlela engaba khona yale miphumela yokuqonda inikezwa yidatha yezilwane ebonisa ukuthi ama-cytokines angavuvukali ngokweqile anganciphisa amandla okubekezela (i-LTP), inqubo eqondwe njengebalulekile ekuhlanganiseni inkumbulo ku-hippocampus. Ama-cytokines okuvuvukelayo nawo angadala ukukhubazeka ku-neurogeneis ne-neuroplasticity, izinqubo ezibalulekile ekwakhekeni kwezinkumbulo kanye nokugcinwa kobuqotho be-neural.

Okwesithathu okungenzeka ukuthi le miphumela ingukudonswa kokuziphatha kokudalwa kwengqondo ngaphambi kokukhuluphala, okungahle kube nomthelela omubi ezindaweni zobuchopho obhekene nomsebenzi ophethe kanye nokuvinjwa kokudla kwe-caloric, ngaleyo ndlela kubangele umjikelezo omubi wokungasebenzi. Lokhu kungenzeka kwesithathu kungasiza ukuchaza ukuthi kungani kunzima kangaka ngabantu ukwehlisa isisindo uma sebetholakele.

Siyakhuthazeka ukuthi phakathi kwezifunda ezimbalwa zobuchopho esizihlolisisile, i-OFC, isifunda sobuchopho esibonakaliswe njengebaluleke kakhulu ekuvinjelweni kokuziphatha kuzo zombili izifundo zezilwane nezabantu, kwaba nokuncishiswa okukhulu kwevolumu phakathi kwentsha eqatha. Ukuthola kwethu, kufaka phakathi ukusebenza okuncane kokuhlolwa kwengqondo okucatshangelwe ukuthi kudinga i-OFC eqondile, kuhlanganiswe nokuncishiswa kwevolumu kule ndawo okuhlobene nokuziphatha kokubonisa indlela okubaluleke ngayo ekubalulekeni kwesisindo.

Lolu cwaningo lunemikhawulo ethile ecacile. Okokuqala, kungumbono ohlukanisa izingxenye ezingasivumeli ukuthi siphawule ngobungozi obucacile. Okwesibili, ngenxa yesayizi yethu eyisampula esilinganiselwe sikhawulele ukukalwa kwethu ezifundeni zobuchopho okuthi ezifundweni ezedlule kutholakale ukuthi zihlotshaniswa nokukhuluphala noma ukuvimbela ukubulala amagciwane, noma lezo esinezizathu ezinhle zokukholelwa ukuthi zingabandakanyeka. Ngakho-ke, kungenzeka ukuthi kunezinye izindawo zobuchopho, esingazange sizihlole, nazo ezingabandakanyeka. Umkhawulo wesithathu wesifundo sethu ukuthi sinesisindo samanje sabahlanganyeli kuphela futhi asikwazi ukuphawula ngobude besikhathi sokukhuluphala; isampula ebesilifunda kungenzeka libe nokuhlukahluka okukhulu esikhathini sokukhuluphala kanye nokumelana naso kwe-insulin. Noma kunjalo, isifundo sethu sinamandla amakhulu, kufaka phakathi ukufaniswa ngokucophelela phakathi kwamaqembu, ukuhlolwa kwe-multidimensional kwenziwa, nezindlela ze-MRI ezingakhethi ezisetshenziswe ekuhlaziyweni kwedatha ye-MRI.

Ukuqonda kangcono izingqinamba ezichazwe lapha, umsebenzi wesikhathi esizayo kufanele uhlaziye izifundo ngokuzikhandla, ulandelela ukuthuthukiswa kokukhuluphala ngesikhathi sonke ngenkathi kulinganiswa ushintsho lokuqonda, lokuziphatha, nolokusebenza kwengqondo. Ngenye indlela, ukuqonda kwethu kungahle kwenziwe ngcono ngocwaningo olwenzelwe ukuhlola imiphumela yokwelashwa okukhuluphala ngokweqile (isib. Ukuhlinzwa kwe-bariatric), futhi ngaleyo ndlela qiniseka ukuthi okunye kwalokhu kusilela kubuyela emuva yini. Ngaphezu kwalokho, umsebenzi wesikhathi esizayo kufanele uhlole ezinye izinto ezihlotshaniswa ezifana nama-cytokines pro- and anti-inflammatory futhi usebenzise amasu abucayi kakhulu we-MRI anjenge-infusion tensor imaging (DTI).

Ukubonga

Lolu cwaningo lwalwesekwa izibonelelo ezivela ku-National Institutes of Health R21 DK070985 kanye ne-RO1 DK083537 futhi, zasesekwa ngokwengxenye ngu -ibonelelo1UL1RR029893 kusuka esikhungweni sikazwelonke Sezinsiza Zocwaningo. Ababhali bafisa ukwazisa izingane nemindeni ebambe iqhaza kulolu cwaningo kanye noPo Lai Yau noValentin Polyakov ekuqoqweni nasekucutshungweni kwemininingwane nokusizwa kuka-Allison Larr lapho kulungiswa lo mbhalo wesandla.

Imibhalo yaphansi

Ukudalulwa Kwezezimali:

Akekho omunye wababhali onazo noma iziphi izintshisekelo zezimali / eziphikisanayo ezingadalulwa

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