Ishicilelwe online Sep 18, 2008. doi: 10.1016 / j.biopsych.2008.07.030
ISIFUNDO ESIPHELELE: I-Medial Orbitofrontal Cortex Grey Matter Iyancishiswa Kuma-Abasendlini Abaphilayo Abaphilayo
Jody Tanabe,1,2 UJason R. Tregellas,2 ULaetitia Thompson,2 Manish Dalwani,2 U-Elizabeth Owens,1 UThomas Crowley,2 futhi UMarie Banich2,3
Uhlobo lokugcina oluhleliwe lomshicileli luyatholakala at I-Biol Psychiatry
Bona ezinye izihloko ku-PMC ukuthi ubalula isihloko esishicilelwe.
abstract
Background
Ukuchayeka okungapheli kwezidakamizwa zokulutha kubangela ukuzivumelanisa kwamaselula ku-cortex ye-orbitofrontal (OFC) kanye nezindlela ezihambisana ne-limbic-prewardal pathways ezingase zibhekane nokuziphatha okuhlobene nokuhlukumeza. Ubungako bokwenza izinqumo ezinobungozi yize kunemiphumela emibi emikhulu kungahle kudluliselwe ekungasebenzi kahle kwe-OFC kubantu abancike entweni ethile (i-SDI). Sivivinye i-hypothesis yokuthi ivolumu ye-medial OFC grey daba (GM) izokwehla ku-SDI ngokuqhathaniswa nezilawuli.
izindlela
Izilawuli eziyi-20 ze-SDI nezingu-2 zibambe iqhaza. I-SDI ibincike ezintweni ezi-4.7 noma ngaphezulu, imvamisa i-cocaine, i-amphetamine, notshwala ngobude besikhathi sokuyeka i-2.4, 3.2, ne-1 iminyaka, ngokulandelana. Izithombe ezinesisindo esiphakeme se-T3 zitholwe kuhlelo lwe-5T MR. Ukucutshungulwa kwesithombe nokuhlaziywa kwenziwa kusetshenziswa i-voxel-based morphometry (VBM) eyenziwe ku-SPM05. Umehluko kumthamo we-GM wesifunda wahlolwa kusetshenziswa ukuhlaziywa kwemodeli ye-covariance, ehlukahluka ngokuhlukahluka kwe-GM yomhlaba kanye nobudala. Amamephu ezibalo asethwe ku-p <.XNUMX, alungiswa ngokuqhathanisa okuningi. Ivolumu ye-medial ye-OFC GM yayihambisana nokusebenza kokuziphatha emsebenzini wokugembula olungisiwe.
Imiphumela
Kwakunokuphansi kwevolumu ye-GM ngokuqondile ku-EMC ye-bilive medial ku-SDI ngokuqhathaniswa nezilawuli. Kube nokuhlangana okuncane kodwa okuphambili phakathi kwendondo ye-OFC GM nokuphikelela kokudlala ama-desk asengozini enkulu emsebenzini olungiselelwe wokugembula.
iziphetho
Leli yiphepha lokuqala ukusebenzisa i-VBM ngokulungiswa kobuchopho ngokuqhathanisa okuningi kwi-SDI ngemuva kokuhlala isikhathi eside. Ukuncipha kwendondo kwe-OFC GM kungakhombisa ukuvumelana kwesikhathi eside ngaphakathi komjikelezo wokufunda wokufunda osisekelo sokwenza izinqumo kokuxhomekeka kwento.
Isingeniso
Ukuxhomekeka ezidakamizweni kubonakaliswa ngokuziphatha okungajwayelekile kwenhloso futhi kuthathwe njengokuthathwa kokuziphatha komvuzo wokujikeleza we-cortico-striatal-limbic.1,2,3,4). Izinguquko zeselula zesikhathi eside ku-cortex yangaphambili ezihambisana nokuchayeka kaningi kwezidakamizwa kucatshangelwa ukuthi zilinganise ukungaziphathi kahle kokuqondisa kokuqondisa komgomo nezinqumo ezingalungile eziholela ekupheliseni umlutha wesigaba.
Izifundo ze-Neuroimaging zinikeza ubufakazi bokusebenza (5,6,7,8) nokuhlukunyezwa kwesakhiwo ku-orbitofadal cortex (OFC) yokuncika kwento. Liu et al. kutholwe i-cortex encanyana yokuqala, kepha hhayi yesikhashana, kubahlukumezi be-poly-drug kuqhathaniswa nezilawuli (9). Ucwaningo olusebenzisa i-voxel based morphometry (VBM) lithole ukuthi i-OFC ye-medic encishisiwe, i-anterior cingulate, kanye nendaba engwevu engwebile kumilutha we-cocaine (10) nezindaba ezimpunga zangaphambili nezomzuzwana kumilutha ye-opiate (11). Ocwaningweni lokulutha kwe-methamphetamine kanye nokutheleleka nge-HIV, i-methamphetamine yayihlotshaniswa nokukhuphuka kwevolumu ye-lentiform grey factor, kepha kwaba yinkimbinkimbi ngemiphumela ephikisayo yokutheleleka ngegciwane lesandulela ngculaza ivolumu yobuchopho. Umkhawulo walezi zifundo kube ukwanda kokusetshenziswa kwezidakamizwa ezingekho emthethweni uma kuqhathaniswa nesikhathi sokuthwetshulwa kwe-MR. Lokhu kubalulekile ngoba a) imiphumela ethile yezidakamizwa ku-neural substrate ingahle ibuye kabusha njengoba kukhonjisiwe ngotshwala (12,13,14) kanye b) nezigatshana ze-neural ezibandakanyeka emiphumeleni emibi yezidakamizwa kungenzeka ihluke kulokho okulutha kwesigaba sokuqala (2). Ngakho-ke, ucwaningo olukhona manje lufuna ukuthola iphethini yokulahleka kwe-grey udaba kubantu abancike ezintweni (i-SDI) ngemuva kokuhlala isikhathi eside.
Imininingwane esetshenziselwe lolu cwaningo iqoqwe njengengxenye yocwaningo lapho sibike sanciphisa ukusebenza kwengqondo kwangaphambili kwe-SDI kuqhathaniswa nezilawuli ngesikhathi sokuthatha izinqumo (15). Lo msebenzi bekunguNgqongqoshe Wokugembula we-Iowa (IGT) oguquliwe obonisa ukungaqiniseki kanye nomvuzo wokuthatha izinqumo kwangempela kokuqala okwakhelwe ukuvivinya izinqumo ezingafanelekile ezigulini ezinezilonda zangaphakathi ze-cortex cialex preialal preortal cortex (16). Sandisa leyo miphumela lapha ngokunquma ukuthi umthamo we-medial OFC grey daba uphansi ku-SDI evinjelwayo uma uqhathaniswa nezilawuli
izindlela
Tifundvo letifundvwa
Izifundo ezingamashumi amathathu nesishiyagalolunye, kufaka phakathi izilawuli ze-20 (ama-14 abesifazane / ama-6men, ama-33 SD 11 yrs amadala) kanye nabantu abane-19 abathembele ezintweni (SDI) (abesifazane be-9 / amadoda we-10, ababambe iqhaza kulolu cwaningo. Ama-SDI aqashwa kabusha evela e-University of Colorado School of Medicine Addiction Research and Treatment Service (ARTS), okuyinkonzo yokuhlala isikhathi eside yokwelashwa. Izindlela zokufaka zifaka ukuncika entweni eyodwa noma eziningi ezingekho emthethweni, kusetshenziswa inqubo ye-DSM-IV. Izindlela zokufaka zokulawula zazingekokuhlonza ukuhlukumezeka kwezidakamizwa noma ukuncika. Izindlela zokuxoshwa kubo bonke ababambiqhaza zifaka phakathi ukugula kwe-neurological, i-schizophrenia noma i-bipolar disorder, ukuhlukumezeka kwekhanda okuphambili, isimo se-HIV esihle, isifo sikashukela, i-Hepatitis C, noma okunye ukugula okukhulu kwezokwelapha, kanye ne-IQ engaphansi kwe-35. Bonke ababambiqhaza banikeze imvume ebhaliwe ebhaliwe evunyelwe yiColorado Multiple Institutional ukubuyekeza Board.
Izindlela zokuziphatha
Ku-SDI, ukuxhomekeka kwezidakamizwa kukalwa kusetshenziswa i-Computer Composite International Diagnostic Interview (CIDI) -Substance Abuse Module (SAM) (CIDI-SAM) (17). I-CIDI-SAM ingxoxo ehlelekile eyenzelwe abaqeqeshiwe abaqeqeshiwe, ababeke izingxoxo, futhi ikhonjiswe ukuthi inokwethenjwa okuhle kokuhlola nokuthembela phakathi kwezimpawu (18). Kwisidakamizwa ngasinye, ukubalwa kwezimpawu nosuku lokusetshenziswa kokugcina kwabhalwa. I-CIDI-SAM ayinikezwanga izilawuli. Idatha yokusebenza emsebenzini wokugembula oguquliwe ibitholakala nge-34 (izilawuli ze-15, i-19 SDI) yezifundo ze-39. Sisebenzise ukuguqulwa kwe-Iowa Ginja Task (IGT) evumelanisiwe nokuhlolwa kwe-fMRI (16). Imininingwane yalomsebenzi ichazwe ngaphambilini (15). Kwakunezilingo ze-80 lapho isihloko sakhetha khona u- "Dlala noma Dlula" futhi lezi zahlukaniswa zaba ngama-time 2 block, mapema and late. Inani lezikhathi umuntu akhethe ukuzidlala ama-deski “amabi” ekuqaleni uma kuqhathaniswa nokulingwa sekwedlule isikhathi lalinganiselwa. Ukuhlaziywa kwezinyathelo okuphindaphindwe kokwehluka (rmANOVA) kusetshenziswa i-IQ, imfundo, kanye nobudala njengama-covariates enziwe ekuhlaziyeni kwe-SPSS ngemiphumela yeqembu ngokusebenzisana kwesikhathi.
I-IQ ilinganiswa ngesisekelo se-Scch of Intelligence enezinhlaka ezimbili lapho iSolabulary and Matrix Ukubonisana kukhishwe.
Ukulingiswa kwe-MR
Izithombe zatholakala kwisithwebuli se-3.0T umzimba wonke we-MR (General Electric, Milwaukee, WI) kusetshenziswa ikhoyili ejwayelekile ye-quadrature ekhanda. Ukulandelaniswa okuphezulu kwe-3D T1-isisindo se-SPGR-IR isebenzise le mikhakha elandelayo: TR = 45, TE = 20, FA = 45, 2562 matrix, 240 mm2 I-FOV (.9 × .9 mm2 endizeni), ubukhulu be-1.7 mm slice, indiza ye-coronal. Isikhathi sokuskena sasiyi-9 ′ 24 ″. Udokotela we-neuroradiologist (JT) uhlaziye izithombe zomzimba we-anatomy kanye nezithombe ze-EPI T2 * zezinto ezimbi kakhulu ezihlelekile, ikakhulukazi i-encephalomalacia. Azikho izifundo ezingafakwanga.
Ukusebenza kwesithombe nezibalo
Ukucutshungulwa kwezithombe kwenziwa ngebhokisi lamathuluzi le-Voxel-based morphometry (VBM5.1) (http://dbm.neuro.uni-jena.de/vbm/) isetshenziswa ku-SPM5 egijima kwi-Matlab 7.5. I-VBM ku-SPM5 ihlanganisa ukuhlukaniswa kwezicubu, ukulungiswa kokukhetha, kanye nokuhlelwa kwendawo kube yimodeli ebumbene (19). Izinkambu ezifihliwe zeMarkov Random Fields zazisetshenziselwa ukuphucula ukunemba kokuhlukaniswa kwezicubu (i-HMRF 0.3) ephakathi. Ngaphandle kwalokho, kusetshenziswe amapharamitha azenzakalelayo. Ubuchopho obufana nobunye bezihlelwe zenziwa kumamephu wamandla we-izicubu ezinikezwe yi-International Consortium for Brain Mapping (ICBM). I-12 mm FWHM i-Gaussian kernel yaphumela ekunciphiseni kokugcina kwe-14 × 15 × 14 mm3. Ezingeni lesibili, yonke imininingwane yobuchopho yalingiswa kuwo wonke amaqembu kusetshenziswa ukuhlaziywa kwe-covariance (ANCOVA) ngevolumu ephelele ye-GM kanye nobudala njengama-covariate. Imiphumela yevolumu ephelele ye-GM isusiwe ukuvumela ukucatshangelwa mayelana nokwehluka kwesifunda kumthamo we-GM. Kusetshenziswe imaski yomkhawulo ngokuphelele .1. Amamephu wezibalo asethwe emkhawulweni wezinga leqoqo le- p <.05, elilungisiwe ngokuqhathanisa okuningi kusetshenziswa iphutha elihlakaniphile lomndeni (FWE), kanye nomkhawulo wezinga le-voxel we-p <.005. Ukuqinisekisa ubuqiniso bezibalo zezinga leqoqo, kusetshenziswe ukulungiswa okubushelelezi okungeyona isotropic (20).
Isifunda senzalo ye-medial OFC (ROI)
Ukuqinisekisa ukucubungula kobuchopho bonke, ukuhlaziywa kwe-ROI kwengqondo ye-ROC kwesokudla nakwesobunxele kwaqalwa kusetshenziswa umtapo wezincwadi we-automated anatomic labeling (AAL) ROI ngaphakathi kwebhokisi lamathuluzi le-Marsbar SPM (21,22).
Ukuhlangana phakathi kwevolumu ye-GM nokuziphatha kokuthatha izinqumo
IVoliyumu ye-GM itholwe ku-voxel ehambelana ne-maxima yomhlaba wonke yemodeli yokuhluka kweqembu okwenziwe kuyo medial OFC (-5, 53, -5, MNI) (Umfanekiso we-1). Ukuhlanganiswa okuyingxenye phakathi kwevolumu ye-GM nedatha yokuziphatha ehlelelwe i-IQ, imfundo, kanye nenani eliphelele le-GM kuthathwe njengokubalulekile ku- p <.05, 1-tailed. Ukuhlolwa kwe-1-tailed kusetshenzisiwe ngoba i-hypothesis yayiwukuthi i-GM ephakeme izohambisana nokugwema okukhulu kwamakhadi "amabi".
Ukuhlangana phakathi kwevolumu ye-GM nokubalwa kwesibonakaliso se-CIDI
Kwisidakamizwa ngasinye, i-CIDI-SAM ikhiqize ukubalwa kwezimpawu (inani le-11, kusuka ekuncikeni kwe-7 kanye nezimpawu zokuhlukunyezwa kwe-4). Ukuxhunyaniswa okuyingxenye phakathi kokubalwa kwezimpawu nethamo le-OFCGM ye-medial kwenziwa, kwalungiswa ngokuphelele i-GM, IQ, kanye nobudala.
Imiphumela yobulili ivolumu ye-GM nokuziphatha kwezinqumo
I-2 × 2 (ubulili, iqembu) ANOVA ene-covariates yobudala nenani eliphelele le-GM nokulungiswa kokuqhathanisa okuningi kwenziwa ukuhlolisiswa komphumela oyinhloko wobulili nobulili ngokusebenzisana kweqembu ngevolumu ye-GM nokuziphatha kokuthatha izinqumo.
Imiphumela
Kwakungekho mehluko yobudala noma ubulili phakathi kwamaqembu. Kwakunokungafani emfundweni nase-IQ phakathi kwamaqembu. I-IQ kanye nemfundo zazihlangene (p = .03). Ithebula 1 ikhombisa inani lemibandela yokuhlangana kwe-SDI yokwethembela noma yokuhlukunyezwa. Kube nokuhlukahluka okukhulu ngesikhathi sokulahlwa ngaphakathi nangaphakathi kwezidakamizwa ezahlukahlukene. Ukuvama okumaphakathi kwe-cocaine, utshwala, ne-amphetamine kwakungu-4.7, 3.2, kanye neminyaka ye-2.4, ngokulandelana.
Ukuhlaziywa kobuchopho ngokuphelele
Izilawuli> SDI
Umfanekiso we-1 imbondela yombala nengqondo yengilazi kusuka ekuhlaziyweni kobuchopho okuphelele kusetshenziswa i-ANCOVA, kulungiswa izingxabano ezaziwayo zeminyaka kanye ne-GM yomhlaba. Kwakukhona i-GM ebaluleke kakhulu ikakhulukazi kumaphakathi we-OFC medial kwizilawuli ngokuqhathaniswa ne-SDI. Umehluko ophawuleka kakhulu bekungumbhali we-OFC olungile ([-5, 53, -3], p <.004, ulungisiwe). Ukungeza i-IQ njenge-covariate akuzange kuyiguqule imiphumela. Njengoba i-IQ nemfundo bezihambisana kakhulu, asiphindanga ngokuhlaziywa ngawo womabili ama-covariate.
I-SDI> Izilawuli
Azikho izifunda ezibalulekile zokwanda kwe-GM ku-SDI ngokuqhathaniswa nezilawuli ezisebenzisa ukulungiswa kwezinga leqoqo lobuchopho elifanayo ngokuqhathanisa okuningi.
Ukuhlaziywa kwe-ROI
Izifunda ezisezingeni eliphakathi nendawo kwesokunxele nangakwesokudla ze-orbitofrontal ziqinisekisile imiphumela evela kukho konke ukuhlaziywa kwengqondo (control> SDI, Frontal_Med_Orb_Left, t = 3.59, p = .001, Frontal_Med_Orb_Right, t = 2.9, p = .006).
Ukuziphatha
Awukho umphumela oyinhloko wesikhathi noma iqembu ekukhetheni kwezitebhisi ezimbi. Izilawuli zithambekele ekugwemeni ama-decks amabi ngezinga elikhulu kune-SDI ngokuhamba kwesikhathi, kepha lokhu kusebenzisana bekungabalulekile (Umfanekiso we-2) (F = .88, p = .3).
Ukuhlangana phakathi kokuthatha izinqumo kokusebenza kanye nokuzindla kwe-OFC grey taba yevolumu
Ukuxhumana okuncane, okuphikisayo okungatheni phakathi kwevolumu ye-medC OF GM kanye nokugwema kwezikhundla ezimbi kubonwe kuwo wonke amaqembu (r = -. 39, p = .01,1-umsila). Ngemuva kokulungiswa kobudala, imfundo, ne-IQ, ukuxhumeka kuhlala kubalulekile (r = -. 35, p = .03, 1-umsila). Ukuxhumeka bekuphakeme kuzilawuli (r = -. 37) kune-SDI (r = -. 22) kodwa ngenxa yezinombolo ezincane bekungabalulekile eqenjini (Umfanekiso we-3).
Ukuhlangana phakathi kwevolumu ye-GM nokubalwa kwesibonakaliso se-CIDI
Phakathi kwe-SDI kwakungekho ukuhlangana phakathi kwethamo le-OFC ye-medial ye-GM nokuhlukumeza kanye nokubalwa kwezimpawu zokubonisa (inani le-11, kusuka ekuthembekeni kwe-7 kanye nezimpawu zokuhlukunyezwa kwe-4).
Imiphumela yobulili ivolumu ye-GM nokuziphatha kwezinqumo
Ayikho imiphumela ebalulekile ebalulekile yobulili noma ubulili ngokusebenzisana kweqembu ngevolumu ye-GM e-OFC. Akukho mehluko wobulili ekusebenzeni.
Ingxoxo
Ukutholwa kwe-medial orbital frontal cortex (OFC) grey udaba (i-GM) ye-grey entweni encike kumuntu ngamunye (i-SDI) kuqhathaniswa nokulawulwa kuyahambelana nezifundo zangaphambilini. UFranklin et al. bebengabokuqala ukubika i-GM ephansi kwizifundo ezixhomekeke ku-cocaine ngokuqhathaniswa nezilawuli ezisebenzisa izindlela ze-voxel-based morphometry (VBM) (10). Babona ukuqina okuphansi kwe-GM ku-ventral medial OFC, i-anterior cingulate, kanye ne-anterior insula. Lyoo et al. kutholwe i-GM ephansi ku-EMC yamazwe amabili medial ku-opiate kuncike kwizifundo ngokuqhathaniswa nezilawuli (11). I-GM engaphansi nayo yatholakala ezindaweni eziphakeme futhi eziphakathi nezinduna zesikhashana. Kuzo zombili lezi zifundo izifundo zazisebenzisa izidakamizwa eduze noma ngesikhathi sokuskena kwe-MR. KuFranklin et al., Inani eliphakathi lezinsuku i-cocaine lagcina ukusetshenziswa ngaphambi kokucabanga yi-15. Ephepheni lesibili, abantu ababethembele ku-opiate babelungiswa imethadone. Ngakho-ke, umehluko obalulekile obonakalayo ocwaningweni lwamanje ukuzincisha isikhathi eside. Kulesi sigcawu seminyaka engu-XIUMX yokuvinjwa kwe-SDI i-amphetamine futhi ende neminye izidakamizwa. Imiphumela eguqukayo yezidakamizwa ekwakhiweni kobuchopho ibhalwe kahle ngotshwala. Ukubuyiselwa komthamo wobuchopho njengoba kuhlolwe nezindlela ze-MRI kuma-alcohol angalinganiswa emavikini ambalwa futhi kungahlala izinyanga ngemuva kokuqina (13,23,12). Ukululama okunjalo kubonakala kungavinjelwa ukubuyela emuva (13,14,23). Ngenkathi izifundo ezifanayo zokulahleka kwezicubu okuguqukayo zangezenzelwa izidakamizwa ezingekho emthethweni, izifundo ze-PET neuroimaging zabahlukumezi be-methamphetamine zikhombisa ukwehliswa kokutholakala kwe-dopamine transporter ebuyela emuva ngokuyeka isikhathi eside (24). Lezi zinguquko zesikhashana ezihambisana nokuyeka nokubuyela emuva zibonisa ukubaluleka kokufunda isikhathi eside kanye nezinguquko zesikhashana. Ngakho-ke, ukungagcini isikhathi eside kwabantu bethu kungabangela ushintsho oluthile ekutholakaleni kwe-OFC futhi kuphakamisa ukuthi kungenzeka ukuthi umehluko ku-MEDC we-medC ubonise ukuphikelela okuqhubekayo, okubekezelela izinguquko zobuchopho.
I-cortex ye-orbitofrontal ivele njengengxenye engaba khona ye-neural yekhono elingasebenzi kahle lokuhlola imiphumela elindelekile eholela ekwenzeni izinqumo ezingezinhle phakathi kwe-SDI (8,2,4) .Ukuqinisekisa ukuxhumana kwayo nohlelo lwe-limbic, i-OFC ihlanganisa imininingwane ehlobene ukukhiqiza isethulo semiphumela elindelekile. Ukusetshenziswa kwezidakamizwa okungamahlalakhona kuphumela ekuvumelaniseni ku-neural morphology kanye nokusayina kweseli okucatshangwa ukuthi kuphazamisa izinqubo zokuqonda ezinjengokwenza izinqumo (8). Amagundane aphathwa nge-cocaine axega emisebenzini exhomeke ku-OFC njengokufunda emuva (4). Kubasebenzisi abasebenzisa i-cocaine abangahlali isikhathi eside, ukuhlukunyezwa kwe-metabolic kucacisiwe kuma-lobes angaphambili (7). Njengoba kuphawuliwe ngenhla, ezinye izinguquko zivela kwesikhashana, kepha ezinye zingaqhubeka isikhathi eside ngemuva kokuvezwa kwezidakamizwa (2,25,26)
Ukuthola kwethu kuhambelana nezifundo zokuziphatha ezibonisa ukushiyeka kokuthatha izinqumo ku-Iowa Gossip Task (IGT) ezigulini ezinezilonda ze-ventral medial OFC (16). Njengeziguli ezinezilonda zangaphakathi zangaphambi kwezindondo, ama-SDI akhubazekile ku-IGT (27,28,29,30), yize kungalungile kakhulu (30,28,31). Lokhu kuyahambisana nedatha yethu ephakamisa ukuthi izilawuli zigweme ama-deski “amabi” ngaphezulu kwesikhathi ngaphezu kwe-SDI, kepha umehluko awubalulekile. Ukuhlobana okungalungile phakathi kwevolumu ye-medic OFC GM kanye nesinqumo sokugwema amakhadi amabi kuyahambisana nendima ye-OFC ekuhloleni imiphumela elindelekile. Ukuxhumeka kubonakale kudonswa ikakhulukazi yizilawuli, hhayi i-SDI. Sibe sesicubungula ngemuva kwalokho ukuthi ngabe i-OFC GM ihlobana nokuzithiba, ngoba ubudlelwano obunjalo bungaphakamisa ukuthi ukudalulwa kwezidakamizwa okungapheli kunomthelela ekutholakaleni kwe-OFC GM. Kodwa-ke, kwakungekho buhlobo phakathi kokukhipha isisu kanye ne-morphology. Ngakolunye uhlangothi, ukuntuleka kobudlelwano akusho ukuthi kungasasebenzi kahle njengoba ezinye izinto zifaka ukuqina kokuncika kwezidakamizwa, inani noma uhlobo lwezinto, kanye nezici zezemvelo ezingaba nomthelela ekutholakaleni. Amathuba wesimo sangaphambi kokungasebenzi kahle, umphumela wamuva kwezidakamizwa, noma inhlanganisela uhlala unokwenzeka ngokufanayo.
Asitholanga izifunda ezanda kakhulu i-GM ku-SDI ngokuqhathaniswa nezilawuli. Ucwaningo olulodwa olusebenzisa izindlela ze-ROI luthola ukwanda kwe-GM kuma-striatum, accumbens kanye ne-parietal cortex (32). Abanye baye babika ukwenyuka kwevolumu kwestriatal abahlukumeza i-cocaine (33) naku-thalamus kanye naphambi kwephakathi kwabasebenzisi bensangu (34) kuqhathaniswa nezilawuli.
Umehluko omkhulu wendlela phakathi kokufunda kwethu nokwedlule usebenzisa i-VBM ukusetshenziswa kwemodeli ehlangene ehlanganisa ukuhlukaniswa, ukulungiswa kokukhetha, kanye nokubhaliswa (19). Umehluko wezobuchwepheshe ukuthi izithombe ze-MR zitholwe ku-3T kulolu cwaningo kuqhathaniswa nezifundo ezedlule e-1.5T (10,11,35,14). Yize lokhu kungalindelwe ukuthi kube nomthelela omkhulu emiphumeleni, kubalulekile ukuqaphela ukuthi izifundo ezihlole inani le-grey-white-udaba lokuqhathanisa nokuhluka komsindo (CNR) lithole i-CNR ephakeme kwi-3T uma iqhathaniswa ne-1.5 T lapho amazinga we-optimised (36,37). Indaba ephakeme ye-grey-white-CNG ingalindeleka ukuthi iholele ekuhlukaniseni izicubu okungcono nemiphumela enembe kakhudlwana ye-VBM yesinqumo esinikeziwe sendawo kanye nesiginali sokwanda komsindo.
Kunemikhawulo eminingana kulolu cwaningo. Okokuqala, usayizi wesampula wawunesizotha (n = 39) yize wawusezingeni lwezifundo ezifanayo. Okwesibili, izifundo zazincike ezintweni eziningi, zivimbela okuphathelene nemiphumela ethize yezidakamizwa esakhiweni sobuchopho. Okwesithathu, ukungazinikeli kwakususelwa ekuzibikeni ngokwakho. Ama-SDI abuyiselwe ekuphathweni okuhlala khona ngohlelo lwezobulungiswa bobugebengu, kungaba ekuphambukeni (esikhundleni sejele) noma kulandela isigwebo sasejele, nangaphambi kokukhululwa ekuqulweni komphakathi. Ukulandela ukwelashwa okungezansi kwezinyanga ze-2 kwakudingeka ngaphambi kokuthi bahlanganyele kulolu cwaningo. Ngakho-ke, isikhathi sokuphambuka noma sasejele kanye nezinyanga ze-2 ku-ARTS kuholele ekuvinjelweni isikhathi eside. I-SDI ibigadwe kakhulu futhi ihlolwe kaningi, ihlolwe ukuhlolwa kwezidakamizwa zomchamo. Yize ukuzibika kungenzeka kungathembeki, kungenzeka ukuthi kube nemiphumela emibi yezidakamizwa. Okwesine, okutholwe umehluko weqembu nobudlelwano phakathi kokuziphatha ne-morphology akuvezi obala mayelana nokubusa noma ukubekeka phambili. Okokugcina, yize bekuxilongwa ngokuxilongwa kokuphazamiseka kwengqondo okuguquguqukayo, asizange sizihlole ngokusobala ukucindezelwa okukhulu okukhonjiswe kuhlotshaniswa nevolumu ye-OFC encishisiwe (38).
Ekuphetheni, sithole ukuncipha okuqinile kumthamo we-GM kukhawulelwe ku-OFC yamazwe amabili e-medC kubantu abathembele ezintweni ezibandakanyekayo ngokuqhathaniswa nezilawuli. Leli yiphepha lokuqala elibika umthamo ophansi we-GM kulesi sizwe ethize kwi-medC ye-medical isebenzisa ukulungiswa kobuchopho obugcwele bokuqhathanisa okuningi. Njengoba ukungasebenzi kwakuqhubeka isikhathi eside, i-OFC GM yokwehliswa kungakhombisa ukuzivumelanisa nesikhathi eside ngaphakathi komjikelezo wokufunda izinqumo osuselwa ekuthatheni izinqumo zokuziphatha ekuthembekeni kwezidakamizwa.
Ukuvuma
Lokhu kushicilelwa kwakusekelwa yiGrant Nombolo K08DA1505 kusuka ku-NIH / NIDA kanye ne-Institute for Research on Pathological Ukugembula kanye Nezinkinga Ezihlobene, i-Harvard Medical School Division of Addictions (JT) ne-DA 009842 (MD, TC). Okuqukethwe yikho kungumsebenzi wababhali kuphela futhi akumelwe kuveze imibono esemthethweni ye-NIH. Sibonga kakhulu uKen Gaipa noJulie Miller bakwa-Addiction Treatment and Research Service ngokuxhaswa kwabo.
Imibhalo yaphansi
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Uhlu Lokubhekisela
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