Izinkambo zocansi zishintsha ukusebenza kwememori yokusebenza nokusebenza kobuchopho emadodeni anokuziphatha okucindezelayo kocansi (2020)

1. Isingeniso

Izithombe zocansi bezilokhu ziphindaphindwa esikhungweni sokunakwa ngumphakathi futhi kuxoxiswane ngazo isikhathi eside. Izimpikiswano zisukela enkulumweni yenkululeko yezocansi njengenqubekela phambili yenhlalo kuya kumbangela yobudlova obuphathelene nobulili nemiphumela emibi. Kodwa-ke, kuncane okwaziwayo mayelana nokuxhumana phakathi kokukhuthazeka kwezithombe zobulili ezingcolile nomuntu ngamunye (ama-neuronal) wokunaka nememori. Ngokutholakala kalula, ukufinyeleleka nokungaziwa i-intanethi inikeza kulezi zinsuku, ukusetshenziswa kwezithombe zocansi kuyanda njalo (Cooper, i-1998, Lewczuk et al., 2019). Kodwa-ke, ukusetshenziswa ngokweqile kwezithombe zobulili ezingcolile kungaba inkomba yokuziphatha okuphoqelekile kwezocansi (CSB). Ukuphazamiseka kwe-CSB kubonakaliswa iphethini eqhubekayo yokwehluleka ukulawula okukhulu, ukuphindaphindeka kokuya ocansini noma ukunxenxa okuholela ekuziphatheni okubi ngokobulili nokuphazamiseka kwengqondo (I-World Health Organization, i-2018). Ngokuya ngocwaningo olumele, kuthathwa ngokuthi ama-3-7% abesifazane kanye no-10.3% - 11% wabesilisa bayathinteka (UDickenson et al., 2018, Grubbs et al., 2019). Kodwa-ke, akubonakaliswa kuphela ukusetshenziswa ngokweqile kwezithombe zocansi oku-inthanethi kodwa futhi kungakhonjiswa ngokuziphatha 'kwangempela', okufana nobudlelwano bezocansi obuyingozi noma ubulili obungaziwa. I-aetiology okwamanje ayicacile futhi i-CSB ivame ukuxoxwa maqondana nokulutha (I-Kraus et al., I-2016), ikakhulukazi njengoba izifundo ze-neuroimaging zikhombise ukubandakanyeka komjikelezo wemivuzo ku-CSB, ikakhulukazi maqondana ne-ventral striatum (I-Brand et al., I-2016, UGola noDraps, ngo-2018, I-Gola et al., 2017, I-Voon et al., I-2014). Ngaphezu kwalokho, umehluko ohlobene nokusetshenziswa kwezithombe zobulili ezingcolile ku-striatum ubuye wabonwa ezifundweni ezinempilo (UKühn noGallinat, i-2014). Umsebenzi ophakeme we-striatal ku-CSB uhambisana kakhulu nomqondo we-incenceenti salience theory (IST) (I-Robinson ne-Berridge, i-1993, I-Robinson ne-Berridge, i-2008, URobinson et al., 2016), ehlukanisa phakathi 'kokufuna' (isib. ukufisa) kanye 'nokuthanda' (isib. imiphumela ejabulisayo) ekuziphatheni okushukumisayo. Kuphakamisa ukuthi uhlelo lwe-dopaminergic lunikeza isisusa esithile esihambisana nokuziphatha okushukumiseleke ukwedlula (i-incentive salience) Ukuzwela kwesisusa kukhulisa ukungasebenzi ngokusebenza kohlelo lomvuzo, okungaholela emuva ekuholeleni umlutha. Ngokucatshangelwa, indima yesisulu ukuqondisa ukunakwa ngendlela eqondile yokuziphatha eqondiswe ngokuziphatha (UParr noFriston, ngo-2017, UParr noFriston, ngo-2019). Ngakho-ke, ukugqugquzela okuqhamile kufanele kudonsele ukunakwaUKerzel noSchönhammer, 2013). Ukuqashelwa ukuthi ukugqugquzela ezocansi kudonsela ukunaka kungakhonjiswa kusetshenziswa umsebenzi wamachaphaza ngethonya lokuya ocansini nomsebenzi we-line (I-Kagerer ne-al., I-2014). Futhi, ngokusebenzisa umsebenzi we-dot-probe, kungakhonjiswa ukuthi izifundo zisebenzisa kakhulu i-inthanethi ebeka ezocansi zinokuphikisana okukhulu ngezinto ezibonakalayo zocansi (I-Mechelmans et al., 2014), okuholela ezikhathini zokuphendula okusheshayo. Noma kunjalo, ngomsebenzi we-dot-probe, idatha exubekile ikhona, njengoba U-Prause et al. (2008) kutholakala ngokushesha (futhi hhayi kancane) izikhathi zokusondelana ekufezeni ugqozi locansi, kepha eminye imisebenzi futhi ikhombisa ukunaka okuqondayo maqondana nezisusa zocansi. Ngokusebenzisa umsebenzi wokuhlolisisa okubonakalayo, ukukhetha okucashile maqondana nokugqugquzela ezocansi kungakhonjiswa ngezihloko ezinempilo (UPekal et al., 2018). Ngaphezu kwalokho, ukuhlangana okucacile okuqondile kokuqukethwe okubeka obala ezocansi kwezihloko ezinempilo kungambulwa kusetshenziswa umsebenzi wokugwema indlela (ISklenarik et al., 2019, I-Stark et al., I-2017). Ngaphezu kwalokho, ukukhetha okubhekiswe emvuzweni wobulili kuboniswe ku-CSB (I-Banca et al., 2016). Ngaphezu kwalokho, ocwaningweni nababambiqhaza besilisa abaphilile, kungakhonjiswa ukuthi ukusebenza kwememori yokusebenza kwezinto eziqukethe ezocansi kwakhubazekile (Laier et al., 2013), kepha noma ngabe izithombe ezingcolile zobulili zidonsela ukunaka kude nenqubo yokusebenza kwememori akuphenywanga kahle. Ezingeni le-neural, kungakhonjiswa ukuthi isikhathi eside sokuphendula emsebenzini wokuhlukaniswa kwezithombe nomsebenzi wokuqondisa umugqa kusisusa sobulili esingcolile kuholela ezikhathini zokuphendula ezinde kanye nokwenza kusebenze okuphezulu ku-caudate nucleus, putamen, thalamus, ACC, ne-OFC, lahunyushwa njengokubandakanyeka kohlelo lomvuzo (Strahler et al., 2018).

Ngakho-ke, sihlose ukuphenya ukuphazanyiswa kwezithombe zobulili ezingcolile nezinqubo zememori ezisebenzayo ngokusebenzisa i-functional magnetic resonance imaging (fMRI) ngesikhathi somsebenzi we-n-back onezithombe eziphazamisayo zobulili ezingcolile nezingezona ezocansi ngemuva. Sibona ukuthi okokusebenza kocansi okusobala kakhulu kudonsela ukunaka kude nomsebenzi, kuzokwenzeka amaphutha amaningi kanye / noma isikhathi eside sokusabela, njengoba UFry noJohanson (2008) unikeze ubufakazi bokuphakamisa ukuthi okuqukethwe ngocansi kungaba yisiphazamiso esiphazamisa ukusebenza kolwazi lomkhiqizo. Ngaphezu kwalokho, sifuna ukwazi ukuthi ngabe abantu ababonisa ukuzibandakanya ocansini ngokweqile bathambekele kakhulu emiphumeleni yaso ephazamisayo. Lokhu kungaba yinkomba yokuthi izinto eziqukethe ezocansi ziyisikhuthazo esikhulu kulezi zifundo futhi zizohambisana ne-IST njengoba, ngokusho komqondo, izinto ezihlobene nomlutha kufanele zibe ngokusobala ngokwengeziwe (URobinson et al., 2016). Ngakho-ke, siqhathanisa izifundo zesilisa ne-CSB nezilawuli ezinempilo. Ngenxa yokugxila kwabo kwezocansi (I-Kraus et al., I-2016), izifundo ezinokuziphatha okuthe xaxa kwezocansi kufanele ziphazanyiswe kakhulu yizithombe zobulili ezingcolile futhi ngakho-ke kufanele zenze okubi kakhulu / kancane ngenkathi kwethulwa izifiso zobulili. Ezingeni le-neuronal, umphumela ophazamisayo kufanele umelwe ukwehluka kwinethiwekhi yangaphambili yokunaka yalezi zifundo kuqhathaniswa nezilawuli ezinempilo.

I-2. Izindlela

Tifundvo letifundvwa

Isampula elichaziwe liyisampula yocwaningo lwe-SEX@BRAIN, okufaka zonke izifundo ezibambe iqhaza ekuhlolweni kwe-fMRI. Incazelo enemininingwane yokuqashwa kanye nesampula iyonke ingatholakala ku U-Engel et al. (2019). Ukuqashwa kabusha kwaqala ngokukhishwa kwabezindaba, lapho amadoda angama-539 aphendula. Kulaba bantu abaphendulile, kungafinyeleleka ngo-201 ngocingo ngaphambi kokuhlola kuqala izindlela ezihlongozwayo zeKafka (I-Kafka, i-2010). Uma ukucindezelwa kubangelwe ikakhulu ukungaziphathi kahle kokuziphatha noma ukwephulwa kwezinkambiso eziqinile zenkolo, izihloko azibhekwanga njengezibandakanya. (bheka isibonelo Lewczuk et al., 2020 ngengxoxo). Sekukonke, izihloko ezingama-73 kwezihlolwe kabusha zahlangana okungenani ezintathu zalezi zindlela. Kwenye inqubo, izihloko ezingama-50 ezihlolwe ngamehlo zanquma ukubamba iqhaza ocwaningweni. Izifundo ezintathu azibandakanywanga i-post-hoc, njengoba zingafinyelelanga amaphuzu asikiwe angama-53 kwiHypersexual Behavior Inventory 19 (Reid et al., 2011). Izifundo zokulawula zaqashwa kusetshenziswa izikhangiso eziku-intranet zeHannover Medical School. Isamba samadoda ayi-85 saphendula, ngenkathi amadoda angama-29 engaphendulanga ngeposi noma ngocingo. Kusukela kwabesilisa abangama-56 abasele, amadoda angama-38 afakiwe kulolu cwaningo. Abahlanganyeli abakhishwe inyumbazane ngenxa yokukhubazeka kwengqondo (njengoba kukalwa yi-Wechsler Adult Intelligent Scale-IV) (Wechsler, 2013), ukuphazamiseka kwengqondo noma isiqephu esibuhlungu se-psychotic (sihlolwe nge-Siqu Sokuhlolwa Komtholampilo Kwezinkinga ze-DSM-IV Axis 1 (SCID-I)) (I-Wittchen et al., I-1997), ukulimala kakhulu ekhanda, ukuthambekela kobungqingili esikalini seKinsey (Kinsey et al., 1948), kanye nokuthandwa ngokocansi kwe-paedophilic (kuhlolwe kwinhlolokhono ehlelekile). Idatha yokuziphatha kanye ne-fMRI itholwe ezifundweni zesilisa ezingama-81 zobungqingili. Sibheke kuphela abesilisa abane-CSB, njengoba la madoda efuna usizo ngezikhathi zokubonisana kaningi futhi atholakala kangcono. Izihloko ezinokuthambekela kobungqingili azifakwanga, njengoba imibhalo yezithombe zocansi ecacile ikhombisa ukuxhumana kwabantu besilisa nabesifazane. Kwabangu-50 kubalwa iziguli, abahlanu bebengafanele ukuphenywa nge-MRI ngenxa yenqubo yokukhishwa kwi-MRI kanye nesifundo esisodwa ngenxa yemithi ethinta ukushayela kwakhe ucansi (salvacyl). Ngakho-ke, amadoda we-44 afakiwe njengeziguli ezinokuziphatha kwe-hypersexual ababambe iqhaza esivivinyweni se-MRI. Iqembu lokulawula okunempilo laliqukethe izifundo ze-37, ngenkathi eyodwa ingakwazanga ukubamba iqhaza kwi-MRI ngenxa ye-claustrophobia ebingaziwa ngaphambili. Ekuhlaziyweni kokugcina, izifundo eziyisithupha bekufanele zikhishwe ngenxa yokunyakaza okukhulu kwekhanda (ezintathu ngeqembu elinokunyakaza kwekhanda> 2 mm), isiguli esisodwa ngenxa yokulimala ekhanda, ukulawula okukodwa ngenxa yokuhlukumezeka kwekhanda kwakamuva, umuntu obambe iqhaza elilodwa lokulawula ngenxa i-HBI ephezulu (kepha okungaqondakali) ngokususelwa kwinhlolokhono, isiguli esisodwa ngenxa yamaphuzu aphansi we-Hypersexual Behaeve Inventory (HBI) (≤53) (kepha okuvelayo okugqamile) ngokususelwa kwinhlolokhono, isihloko esisodwa sokulawula ngenxa yesimo sobungqingili nesiguli esisodwa ngenxa yedatha engaphelele. Ngakho-ke, idatha ye-MRI yeziguli ezingama-38 nezilawuli ze-31 zahlaziywa. Ucwaningo lwenziwe ngokuhambisana neSimemezelo saseHelsinki futhi savunywa yikomidi lendawo yokuziphatha. Izihloko zinikeze imvume ebhaliwe yokubamba iqhaza, bekhululekile ukuhoxa esifundweni nganoma yisiphi isikhathi futhi bathola imbuyiselo ngokubamba iqhaza kwabo.

Izingqinamba Zengqondo

Ukuze ufinyelele ekuziphatheni kwe-hypersexual, i-HBI (Reid et al., 2011) kanye nohlobo olubukeziwe lwe-Testing Adding Screening Test (SAST-R) (I-Carnes et al., I-2010) zazisetshenziswa futhi zahlaziywa ngokuya ngencwajana. Kwa-HBI, kusetshenziswe inani elinqunyiwe lama-53, ngenkathi i-SAST-R, kusetshenziswa inani elinqunyelwe le-6 lezinto eziyimfihlo (1 - 20). Futhi, kwenziwa inhlolokhono ehleliwe yokufinyelela kufinyelela izimfanelo zocansi zabahlanganyeli, kanye nemibuzo yemibuzo ye-SIS / SES (UJanssen et al., 2002) Ukuhlola ukubonwa okucashile / ukuthintelwa kobulili. Ngemininingwane, bheka U-Engel et al. (2019).

Ukutholwa Kwemininingwane ye-fMRI

Idatha ye-MRI yatholakala ku-Nokia 3T Skyra esebenzisa i-Syngo VE11 isebenzisa ikhoyili ejwayelekile ekhanda engu-64. Izingcezu zama-axial ezingama-84 (isixazululo 2 x 2 × 2 mm) ngevolumu zitholwe ngokukhuphuka kusetshenziswa i-multiice multislice EPI T2 * ezilandelanayo ezibucayi ngamapharamitha alandelayo: isikhathi sokuphindaphinda (TR) = 1.55 s, isikhathi se-echo (TE ) = 32 ms, i-flip angle = 90 °, inkambu yokubuka = ​​256 × 256 mm kanye nokushesha kokusa = 4. Ngaphambi kokuskena kokusebenza, isithombe somuntu ngamunye esitholakele esitholakele ngamunye obambe iqhaza esebenzisa i-T1 enesisindo semagneti eyenziwe ngokulungiselela ukutholwa okusheshayo ukulandelana kwe-echo (ukulungiswa kwe-0.9 × 0.9 × 0.9 mm, TR = 2.3 s, TE = 3 ms, i-flip angle = 9 ° nenkambu yokubuka = ​​255 × 270 mm).

I-fMRI Task Design

I-Paradigm Yesilingo

Lolu cwaningo beluyingxenye yochungechunge lokuhlolwa okuphenya izihloko ezinokuziphatha kobulili obudlulele (Ucansi@Ukufunda-Ubuchopho). Zonke izifundo zacelwa ukuthi zigweme imisebenzi yocansi amahora angama-24 ngaphambi kokuba zibambe iqhaza. Lapha, besinentshisekelo kumphumela ophazamisayo wezinto zocansi eziyingcaca ezinqubweni zenkumbulo ezisebenzayo. Ngakho-ke, umsebenzi we-n-back letter wasetshenziswa ngokuphazamisa izithombe zocansi nezingezona ezocansi ngemuva. Phakathi nalokhu kuhlolwa izihloko zabhekana nezinto ezingcolile zobulili ezingcolile okokuqala ngqa esifundweni sonke. Ukuhlolwa bekulakhiwe izici ezintathu: okuphakathi kwamaqembu kuhlanganisa UKUZIPHATHA KOCANSI (ukulawula/isiguli) kanye nezici ezingaphakathi kwesihloko UBUNZIMA (1-back/2-back) kanye NOBUCHA (izithombe ezibonisa izithandani zigijima/izithandani ngesikhathi socansi). Ngaphambi komsebenzi, izifundo zazivunyelwe ukuzijwayeza inguqulo ye-1-back kanye ne-2-back yomsebenzi ngaphandle kokuphazamisa izithombe. Ihora elilodwa ngemuva kwesilinganiso se-fMRI, kwenziwa umsebenzi wokuqashelwa okungamenyezelwanga ukuze kuhlolwe ukuthi ukubuyisa inkumbulo yesisusa sangemuva kuyehluka yini phakathi kweziguli nezilawuli.

Isilingo se-fMRI

Ukuhlolwa kwe-fMRI bekubandakanya amabhlokhi angama-24, eziyisithupha zesimo ngasinye (1-emuva ngezithombe zasemuva ezicacile, 2-emuva ngezithombe ezibonakalayo zangemuva, 1-emuva ngezithombe zangemuva ezingathathi hlangothi kanye ne-2-back enezithombe zangemuva ezingathathi hlangothi), eyethulwe ngokungahleliwe ngomkhawulo wokuthi akukho ngaphezu kwamabhlogo amabili wesimo esifanayo alethwe ngokulandelana. Zonke ziqale ngesethulo semiyalo yomsebenzi (1-back or 2-back) for 6 s. Ngemuva kwalokho, ibhulokhi ngalinye lalinesikhathi esingama-20 s, lapho izinhlamvu eziyi-10 (A-Z ngaphandle konkamisa abaphendulisiwe, usayizi wefonti 80, uhlobo lwefonti: Umbala wefonti ne-font: mhlophe) kuboniswe isithombe esingemuva komsebenzi. Unhlamvu ngalunye nesithombe sangemuva sabonakala kuma-1 s, kwalandelwa isiphambano sokwethula se-1 s. Ngaphakathi kwebhulokhi ngalinye, kwafakwa izinhlamvu ezintathu ezihlosiwe ngokulandelana okungahleliwe. Zonke zaphela ngokuvalwa okungu-4- s s (kusho ama-8 s), lapho kuphinde kwethulwa khona isiphambano sombukiso. Izifundo zayalwa ukuba ziphendule kunhlamvu ebhekiswe kuyo ngokucindezela umunwe okhomba ngakwesokudla edivayisini yokuphendula.

Umsebenzi ongaziwa

Ihora elilodwa ngemuva kokuhlolwa kwe-fMRI, izifundo zabamba iqhaza emsebenzini wokuqashelwa ongaziswanga owenziwa ngaphandle kwesithwebuli. Lapha, izithombe ezingama-80 ezisetshenziswe kulingo kanye nezithombe ezingama-80 ezazingaziwa ngaphambili zethulwe, futhi izifundo kufanele zikhombise ukuzethemba kwenkumbulo yazo ngesilinganiso samaphoyinti ayi-6 (waziwa ngempela, cishe waziwa, asiqinisekisiwe, asiqiniseki okusha, mhlawumbe sisha futhi sisha sha ). Isivivinyo ngasinye siqale ngesiphambano sokufakwa ku-1 s. Ngemuva kwalokho, isithombe sethulwa ama-2 s, kwalandelwa isilinganiso sokuzethemba, esivezwa kuze kube yilapho izifundo sezenze isinqumo sabo. Lokhu, kwaholela ekuqulweni kwecala elilandelayo. Ukunemba kokuqashelwa kuthathwe njengokuhlukahluka okuthembekile.

IStimuli

Ukwethulwa kwesisusa nokuqoshwa kwedatha yokuziphatha kulawulwa kusetshenziswa isoftware yePresentation® (Presentation 16.3, Neurobehahlangual Systems Inc.,

Berkley, CA, USA; I-neurobs.com) futhi ikhonjiswe kumqaphi wama-32 ”ovela kuNordicNeuroLab (NNL) (Bergen, Norway; www.nordicneurolab.com), obekwe phambi kwesiguli futhi ibonakala ngesibuko. Izimpendulo ziqoqiwe ngezimpendulo ezivela kuNNL.

I-Visual Stimuli

Isisusa esibonakalayo somsebenzi we-n-back sasiqukethe amagama amakhulu we-alfabhethi (A-Z). Kwezithombe zangemuva, izithombe ezingama-20 ezibonisa ukuhlangana kwabantu bobulili obuhlukile, izithombe ezingama-20 ezibonisa ukushukunyiswa ngomlomo, izithombe ezingama-20 ezibonisa izithandani zihamba ngezinyawo nezithombe ezingama-20 ezazibonisa ukugijimela kwezithandani. Izithombe zahanjiswa ngokulingana ngemibandela ehlukene. Ngakho-ke, izithombe eziyi-10 zokuya ocansini nezithombe eziyishumi zokukhuthaza ngomlomo zivezwe esimweni se-10-back, kanti ezinye izithombe ezingama-1 zazisetshenziswa njengesizinda sesimo se-20-back. Okufanayo kwagcinelwa isimo sokungathathi hlangothi. Isikhuthazo ngasinye sivezwe amahlandla ama-2 s ngesikhathi sokuhlolwa konke.

Ukucutshungulwa kwesithombe se-fMRI

Izithombe ze-DICOM ziguqulwe zaba yifomethi ye-NIFTI zisebenzisa i-dcm2nii. Ngemuva kokususa ama-scans amahlanu okuqala ukubuyiselwa kwemiphumela yokugcwaliswa kwe-T1, isikena esisebenzayo sabe sesiphinda sabiwe kabusha. Ngemuva kwalokho, isithombe se-plan eco planar sabhaliswa ngokuhlanganyela ezithombeni ze-T1 ngazinye. Izithombe zesakhiwo nezisebenzayo zahlelwa zaba isikhala se-MNI ngosayizi we-voxel ongu-2 × 2 × 2 mm futhi zibushelelezi nge-4 x 4 × 4 mm FWHM Gaussian kernel zisebenzisa i-SPM12.

Ukuhlaziywa kwesitatimende

Ukuhlaziywa kwedatha yokuziphatha

Idatha yokuziphatha yaqoshwa ngokuzenzakalela yiPresentation® futhi yahlaziywa kusetshenziswa i-SPSS © (IBM Inc.). Ukuhlaziywa kwezibalo kwenziwa kusetshenziswa ukuhlolwa okunemisila emibili, kanye ne-p-value <0.05 yathathwa njengebalulekile ngokwezibalo. Zonke izinombolo, ngaphandle kwezikhathi zokuphendula, zikhonjiswe njengenani elisho ± ukuphambuka okujwayelekile. Ngezikhathi zokuphendula, kwahlukaniswa ukuphambuka okujwayelekile ±. Ukusatshalaliswa okujwayelekile kuhlolwe kusetshenziswa ukuhlolwa kweKolmogorov-Smirnov. Njengoba konke okuguqukayo okuxhomeke kuye kwasatshalaliswa, ukuhlolwa kweparametric kwasetshenziswa kuyo yonke indawo. Ukuhlangana phakathi kwedatha yokusebenza nokuziphatha kuhlolwe kusetshenziswa ukulingana kokulingana kukaPearson. Ukunemba ku-n-back nomsebenzi wokubona kuguqulwe kwaba iphesenti lezimpendulo ezifanele kanye ne-arc-sine eguquliwe ukuze kuqinisekiswe ukusatshalaliswa okujwayelekile.

Ukuhlola kwe-fMRI

Ukuhlaziywa kwedatha kwenziwa kusetshenziswa iGeneral Linear Model (GLM). Ezingeni lesihloko, imodeli ibiqukethe ama-regressor amane wemodeli yenzalo, izimo ezine zokuhlola (i-1-back enezithombe zocansi (okucacile okulula), i-2-back enezithombe zocansi (kunzima okucacile), i-1-back nezithombe ezingathathi hlangothi (kulula ukungathathi hlangothi ) ne-2-back enezithombe ezingathathi hlangothi (kunzima ukungathathi hlangothi)). Ngaphezu kwalokho, ama-regressors ayisithupha angenanzalo aqukethe amapharamitha wokunyakaza afakiwe. Umsebenzi ngamunye we-boxcar stimulus wahlanganiswa nomsebenzi wokuphendula we-canonical hemodynamic. Ngemuva kwalokho, idatha yayiphaswe kakhulu ihlungwe ngesikhathi esinqunyiwe sama-128 s. Ezingeni leqembu, izithombe ezihlukile zesifundo ngasinye ezimele imiphumela emikhulu (enzima> elula futhi ecacile> engathathi hlangothi) kanye nokusebenzisana (UBUNZIMA X UKUXABISWA: okucacile (okulula> okunzima)> kokungathathi hlangothi (okulula> okunzima)) neQOQO X EXICICITNESS: isiguli (okusobala> ukungathathi hlangothi)> ukulawula (okucacile> okungathathi hlangothi)) kusetshenziselwe ukuhlaziywa komphumela okungahleliwe. Okulandelayo, i-t-test emaceleni amabili isetshenziselwe ukuhlola umehluko weqembu. Umkhawulo wakho konke ukuhlaziywa kusethwe ku-p ≤ i-0.05 iphutha lomndeni elihlakaniphile (i-FWE) elilungisiwe ngokuqhathanisa okuningi ezingeni leqoqo. I-voxel ephakeme yamaqoqo abalulekile yenziwa yasendaweni kusetshenziswa ilebula le-anatomical othomathikhi (AAL) (I-Tzourio-Mazoyer et al., 2002).

Ukusebenzelana Kwezengqondo

Ukuhlola futhi izindlela zokwenza isifunda se-gyrus siguqulelwe ngenkathi kusenziwa izithombe ezithombeni zobulili, ukuhlaziya kwe-psychophysiological (PPI) (UFriston et al., 1997) kwenziwa. Ukuhlaziywa kwe-PPI kwembula umehluko ekuxhumaneni okusebenzayo phakathi kwesifunda esithile senzalo nawo wonke amanye ama-voxels kulo lonke ubuchopho njengomsebenzi wento engokwengqondo. Lapha, siqhube ukuhlaziywa kwe-PPI ukukhomba izifunda zobuchopho ezikhombise ukuxhumana okuhlukile phakathi kwala maqembu womabili ngesikhathi kusetshenzwa izithombe ezingemuva zocansi. Sisebenzise izingxenye ze-gyrus yolimi lwesobunxele ngesikhathi sokuvuselelwa kocansi njengembewu, ngoba ikhombise ukuxhumana kwe-SEXUAL BEHAVIOR X EXPLICITNESS komsebenzi we-neuronal (isifunda sembewu (x, y, z) (-2, 82, 2)), njengoba kukhonjwe ngu umehluko wokusebenzisana (iziguli (izithombe zocansi> ezingathathi hlangothi)> izilawuli (izithombe zocansi> ukungathathi hlangothi)) (bona Ithebula 3). Uchungechunge lwesikhathi sokuncika kwe-oxygen oxygenation lukhishwe endaweni engaphansi kwe-lingual gyrus (ububanzi obuyi-5 mm futhi bugxunyekwe ku-voxel ephezulu) kuzo zonke izihloko ngazinye kusetshenziswa uchungechunge lokuqala lwe-eigen-time (ukuhlaziywa kwengxenye eyinhloko). I-regressor ye-PPI ibalwa isifundo ngasinye njengomkhiqizo we-element-by-element of activation-repaated of district seed (kukhishwe isikhathi chungechunge) kanye ne-vector coding yokuhlukahluka kwengqondo (1 kuma regressor angcolile kanye -1 ku-regressor ye isimo sokulawula ukufakwa kwezindawo ezithintelwe ukucutshungulwa kwezithombe zocansi). Ngakho-ke, i-PPI yethu yahlola ukumodelwa okucacile kobulili okuxhunyiwe kokuxhumana okusebenzayo phakathi kwegyrus yolimi lwesobunxele nanoma yisiphi esinye isifunda sobuchopho. Ekugcineni, umehluko ngamunye obonisa ukusebenzisana phakathi kokuguquguquka kwengqondo nangokomzimba (i-PPI regressor) wangena ekuhlolweni kwe-t-sampuli emibili.

I-3. Imiphumela

Ukubalwa kwabantu

Ukuziphatha

Ukuhlola imiphumela yezinto ezibonakalayo zocansi kwimemori yokusebenza, idatha yokusebenza yacutshungulwa ngesilinganiso esiphindaphindwe esingu-2 × 2 × 2 i-ANOVA ehlanganisa izici ISEXUAL BEHAVIOR (iziguli / ukulawulwa), ISIFUNDO (izithombe zobulili ezingcolile / ezingathathi hlangothi) ne-DIFFICULTY (1-back / 2- emuva).

Ukuhlaziywa kokunemba kuveze umphumela oyinhloko WOBUNZIMA (F (1,67) = 140.758, p <0.001, η² = 0.678) ne-SEXUAL BEHAVIOR (F (1,67) = 5.213, p = 0.026, Stud² = 0.072) kepha akunamphumela we-EXPLICITNESS (F (1,67) = 0.305, p = ns) noma ukusebenzisana phakathi kwezinto (bona Umdwebo 1a).

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Umfanekiso we-1. Imiphumela yokuziphatha: a) Umphumela oyinhloko wobunzima nokuziphatha kocansi ngokunemba emsebenzini we-n-back. Izifundo zenza kubi kakhulu esimweni esinzima kakhulu se-2-back futhi zilawula iziguli ezingaphandle kobunzima ngaphandle kobunzima. Imigoqo yamaphutha isho iphutha elijwayelekile le-kusho (SEM). b) Okukhonjiwe kungukuziphatha okubandakanya ukuya ocansini X ngokubonakaliswa kwezikhathi zokuphendula okubonisa ukuthi iziguli zisabela kancane ngezinto eziphazamisayo ezithinta izithombe zocansi ngenkathi kungatholakali umehluko ngezithombe ezingathathi hlangothi. Imigoqo yamaphutha isho iphutha elijwayelekile le-kusho (SEM). c) Ukuziphatha kocansi X ukuhlangana okubonakalayo komsebenzi wokuqashelwa okumangazayo. Iziguli zikhombisa ukusebenza okungcono kwememori kwezithombe ezingemthetho zocansi ezingekho emthethweni ngenkathi kungatholakali umehluko wezithombe ezingathathi hlangothi. Imigoqo yamaphutha isho iphutha elijwayelekile le-kusho (SEM).

Ngokuphathelene nezikhathi zokuphendula okuphakathi, i-rm-ANOVA ikhombise ukusebenzisana phakathi kwe-SEXUAL BEHAVIOR ne-EXPLICITNESS (F (1,67) = 11.73, p = 0.001, η² = 0.149) kanye nemiphumela emikhulu ye-DIFFICULTY (F (1,67) = 45.106, p <0.001, η² = 0.402) ne-EXPLICITNESS (F (1,67) = 4.142, p = 0.046, Stud² = 0.058), kepha awukho umphumela omkhulu we-SEXUAL BEHAVIOR (F (1,67) = 0.868, p = ns) noma yikuphi okunye ukusebenzisana okubalulekile okungatholakali. Ukuhlolwa kwe-post-hoc t-kubonise ukuthi iziguli zisabela kancane ngezithombe ezihlukumezayo ngokobulili uma kuqhathaniswa nezilawuli ezinempilo (T (67) = 2.271, p = 0.027), kepha womabili la maqembu enza okufanayo ngesikhuthazo sokungathathi hlangothi ngemuva (T (67) = 0.563, p = ns). Ngaphezu kwalokho, iziguli ziphendule kancane ngokucace ngokuqhathaniswa nokukhuthaza ukungathathi hlangothi ngemuva (T (37) = 3.195, p = 0.003), ngenkathi kulawulwa okunempilo, kuthambekela kokubalulekile kuphela (T (30) = 1.956, p. = 0.060), ekhomba izikhathi zokuphendula okusheshayo ezimeni ezicacile (bheka futhi Umdwebo 1b).

Ukubheka okuningiliziwe ngomthelela ophazamisayo, sahlaziya izikhathi zokusabela okuphakathi kweqembu ngalinye ngalinye. Ngakho-ke, ukuhlaziywa okuphindwe kabili kwe-2 × 2 kwenziwa kwenziwa kufaka phakathi izinto i-EXPLICITNESS and DIFFICULTY. Eqenjini leziguli, sithole imiphumela ephambili ye-EXPLICITNESS (F (1,37) = 10.209, p = 0.002, η² = 0.216) nobunzima (F (1,37) = 23.021, p <0.001, η² = 0.384) nezikhathi zokusabela okusheshayo esimweni esilula nezikhathi zokuphendula ezinde nezithombe eziphazamisayo zobulili, kepha akukho ukuxhumana phakathi kwalokhu bobabili (bona futhi Umdwebo 2a). Ngeqembu elilawulayo, ngakolunye uhlangothi, umphumela omkhulu we-DIFFICULTY (F (1,30) = 21.736, p <0.001, η² = 0.42) nokusebenzisana kwe-DIFFICULTY × EXPLICITNESS (F (1,30) = 4.606, p = 0.04, Stud² = 0.133) kutholakele, kepha awukho umphumela omkhulu we-EXPLICITNESS (F (1,30) = 3.826, p = ns) ongatholakala (bona futhi Umdwebo 2b). Ukuhlolwa kwe-post hoc t-kukhombisa ukuthi izifundo ezinempilo zazishesha kakhulu esimweni esinzima kakhulu se-2-back lapho kwethulwa izithombe zobulili ezingcolile (T (30) = 2.666, p = 0.012), ngenkathi zisesimweni esilula kakhulu se-1-back, isivinini sokuphendula sasiqhathaniswa phakathi kwezithombe zangemuva ezingathathi hlangothi nezocansi (T (30) = 0.583, p = ns).

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Umfanekiso we-2. Imiphumela yokuziphatha ngenxa yamaqembu ahlukene: a) Umphumela ophambili wokuvela: Iziguli ziphenduka kancane ngezithombe ezingemuva zocansi ngokuzimela kobunzima bomsebenzi. b) Ukusebenzelana kobunzima be-Explicitness X. Izilawuli ezinempilo ziphenduka ngokushesha ngezithombe zangemuva zocansi kuphela esimweni esinzima.

Emsebenzini wokuqashelwa, i-2 × 2 × 2 rm-ANOVA iveze umphumela omkhulu we-EXPLICITNESS (F (1,66) = 31.574, p <0.001, η² = 0.324) nobunzima (F (1,66) = 85.492, p <0.001, η² = 0.564) kanye nokuxhumana kwe-EXPLICITNESS × SEXUAL BEAVIOR (F (1,66) = 16.651, p <0.001, η² = 0.201) ngokunemba komsebenzi. Ukuhlolwa kwe-hoc t kukhombise ukusebenza kwememori efanayo phakathi kwamaqembu ezithombeni ezingathathi hlangothi (T (66) = 1.51, p = ns), kepha ukusebenza okungcono kwezinto zobulili ezingcolile eqenjini lesiguli (T (66) = 3.097, p = 0 .003). Ngaphezu kwalokho, iqembu elilawulayo lenze ngokufanayo ezimweni ezingathathi hlangothi nezicacisa ngokocansi (T (29) = 1.012, p = ns), ngenkathi iziguli zikhombisa inkumbulo engcono yezithombe zocansi (T (37) = 7.398, p <0.001) ( bheka Umdwebo 1c).

4. I-fMRI

Izithombe ezingcolile zobulili ezingcolile ngemuva zasebenza ngamaqoqo amakhulu ku-occipital cortex futhi i-cingrate cortex (anterior, middle and posterior) kabili. Ngaphezu kwalokho, kusebenze ukusebenza okuphezulu kwe-hippocampus ne-caudate nucleus. Ngokuphambene, izithombe zangemuva ezingathathi hlangothi zaholela emsebenzini ophakeme ku-parahippocampal kanye ne-angular gyrus. Umsebenzi we-2-back uphumele ku-activation ephezulu ezindaweni eziphansi zepharietali nezindawo eziphansi zangaphambili kuqhathaniswa nesimo se-1-back (bona futhi Umfanekiso we-3 futhi Ithebula 3).

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Umfanekiso we-3. imiphumela eyinhloko ye-fMRI: Ukudilizwa yimiphumela eyinhloko yobunzima, okukhombisa ukusebenza okuphezulu kwinethiwekhi ye-fronto-parietal ukunakwa kwesimo esinzima se-2back kanye nomphumela oyinhloko wokuvezwa okubonisa ukusebenza okuphezulu ezindaweni ze-occipital kanye ne-cortex ye-anterior ngenkathi kubhekwa izithombe zobulili ezingcolile. .

Ukusebenzisana kwe-SEXUAL BEHAVIOR × EXPLICITNESS kukhombise ukusebenza okuphezulu ku-gyrus yangakwesokunxele yeziguli lapho kucutshungulwa izinto ezingcolile kuqhathaniswa nokukhuthaza ukungathathi hlangothi (bona Ithebula 3 ngemininingwane). Ngokuthabisisayo, ukulinganisa kwepharamitha kwalesi sigcawu kwakuhlotshaniswe kahle nomehluko wesikhathi sokuphendula phakathi kwezithombe zangemuva ezicacile nezingathathi hlangothi (r = 0.393, p = 0.001), isikhathi esichazayo sokusetshenziswa kwezithombe zocansi ngesonto eledlule (r = 0.315, p = 0.009) , inani lama-orgasms ngokushaya indlwabu kusetshenziswa izinto eziqukethe ezocansi (r = 0.323, p = 0.007) kanye nenqaku lokubonisa ucansi (SES) (r = 0.41, p = 0.0004). Ngaphezu kwalokho, ukuhlangana phakathi kokungafani kwesikhathi sokuphendula (okucacile nokungathathi hlangothi) nesikhathi sokubuka izithombe zocansi ngesonto eledlule (r = 0.254, p = 0.038) kungatholakala, okusho ukuthi inani eliphakeme lesikhathi esichitha izithombe zocansi lihlotshaniswa nokuphazamiseka okuphezulu ngenxa ezintweni zobulili ezingcolile (bheka futhi Umfanekiso we-4 futhi Ithebula 3).

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Umfanekiso we-4. Umphumela wokusebenzelana kwe-fMRI: A) Kukhonjisiwe ukuvulwa okuphezulu kwe-gyrus yolimi lweziguli ngenkathi kwethulwa izithombe zocansi uma kuqhathaniswa nezithombe ezingathathi hlangothi. B) Ukulinganiswa kwepharamitha komphumela wokusebenzisana. C) Ukuhlangana phakathi kokulinganiswa kwepharamitha nomehluko wesikhathi sokuphendula (okucacile - kokungathathi hlangothi).

5. Ukusebenzelana Kwezengqondo

Kuyathakazelisa ukuthi amanani we-PPI akhishwe eqoqweni lase-insula (i-MNI: 40 12 6) ehambisana nomehluko wezikhathi zokuphendula kwezithombe ezicacile nezingathathi hlangothi (r = 0.289, p = 0.016), okukhombisa ukuthi izifundo eziningi zancishiswa ngenxa ye izinto zobulili ezingcolile, kokuqina kokuxhumana okusebenzayo phakathi kwe-lingual gyrus ne-insula. Bona Ithebula 4 ukuze uthole imininingwane.

I-6. Ingxoxo

Lolu cwaningo luphenye ngomthelela ophazamisayo wezinto ezibonakalayo zocansi ekusebenzeni kwenkumbulo yokusebenza kusampula yezihloko ezibonisa i-CSB. Ezingeni lokuziphatha, iziguli zehliswe yisetshenziswa yizithombe zocansi ngokuya ngokusetshenziswa kwezithombe zocansi ngesonto eledlule. Lokhu bekuhambisana nokwenziwa okuphezulu kwe-gyrus yolimi. Ngaphezu kwalokho, i-girus ye-lingual ikhombisa ukuxhumana okuphezulu kokusebenza kwe-insula ngesikhathi sokulungiswa kogqozi lwezocansi eqenjini lesiguli. Ngokuphambene, izifundo ezinempilo ziveze izimpendulo ezisheshayo lapho zibhekene nezithombe zobulili ezingcolile kuphela ngomthwalo ophezulu wokuqonda.

Ezingeni lokuziphatha, sithole ukuthi ubunzima bomsebenzi nezithombe zocansi kunciphisa isikhathi sokuphendula. Kodwa-ke, ukuxhumana kweqembu le-x kubonise ukuthi iziguli (kodwa hhayi izilawuli) zibonisa izikhathi zokuphendula ezinde lapho zibhekene nezithombe eziphazamisayo zobulili ezingcolile futhi ngenxa yalokho imiphumela yezithombe zobulili ezingcolile ibonakala iqhutshwa yiqembu leziguli. Lokhu kwasekelwa ukuhlaziya kwamaqembu ngamanye akhombisa ukuthi, ngokulawulwa okunempilo, izikhathi zokuphendula zazenziwa ngisho nangezithombe zocansi, kodwa kuphela esimeni esinzima, ngenkathi eqenjini lesiguli, izithombe ezingcolile zobulili ezingaphandle kobunzima zaholela ezikhathini zokuphendula kancane . Ngakho-ke, imininingwane yethu iphakamisa ukuthi izithombe zobulili ezingcolile zithinte ngokwehlukile iziguli nokulawula. Ngaphezu kwalokho, izilawuli ezinempilo azibonakali zikukhumbula kangcono izithombe ezingcolile kunezithombe ezingathathi hlangothi, kanti iziguli zinekhanda elingcono lezinto ezingcolile. Ngokusekelwa kulokhu okutholakele, siphethe ngokuthi izinto ezibonakalayo zobulili ezingcolile azikwazi ukudonsela ukunaka ezifundweni ezinempilo. Njengasezifundweni eziphilile, sibona umphumela kuphela esimweni esinzima. Ngophenyo olwengeziwe, ubunzima bomsebenzi kufanele bonyuswe. Kodwa-ke, izifundo ezinokuziphatha okuthe xaxa kwezocansi okuholela ekutheni kube nezinga eliphakeme lesimo sokuphazamiseka kwengqondo ziphazamiseka ngezinto ezibonakalayo, njengoba zincipha ekuphenduleni kwazo lapho zibhekene nezithombe zocansi ezingafanelekile ezingasebenzi ebunzimeni bomsebenzi. Ukuhlobana kokuziphatha phakathi kokusetshenziswa kwezithombe zobulili ezingcolile kanye nokwehluka kwesikhathi sokuphendula kuhambisana nemiphumela ye UPekal et al. (2018), okubonisa ukuthi ukuthambekela ekubhekeni kwezithombe zocansi kwe-inthanethi kuhlobene nokukhetha okuphezulu kokubhekisisa ezintweni ezingcolile zobulili, futhi USklenarik et al. (2019), okubonisa ukuthambekela kwendlela ezintweni ezingcolile kuhlobene nokusetshenziswa kwezithombe zocansi. Ngokuphathelene neqembu lezifundo ezinokuziphatha okuthe xaxa kwezocansi, isikhathi esingu-∼50 ms isikhathi eside sokuphendula sisesimweni esicacile nesilinganiso sokuqashelwa esingcono se-∼25% ngesikhathi somsebenzi wokuqashelwa okungavunyelwe kusikisela ukuthi izifundo zifunde izithombe eziphazamisayo ngemininingwane eminingi, okuholele ekuthini khumbula kangcono ngemuva kwalokho, noma ngabe isithombe ngasinye sivezelwe 1 s ngaphandle kwesikhathi sokuphendula. Ngakho-ke, isikhathi sokuvezwa nje sasingafani phakathi kwamaqembu. Kuyathakazelisa ukuthi iziguli zazinomfanekiso ongemuhle wobulili ngenxa yesipiliyoni sazo, okuholela ekuxineni okukhulu kwengqondo. Njengoba kungakhonjiswa ukuthi umphumela ophazamisayo wobuhlungu uhlukaniswa ngokwengxenye ngokulindelwe kwezifundo (USinke et al., 2016, 2017), kungenzeka ukuthi ukwehlisa ijubane ekusetshenzisweni kobumnandi nakho kungaqondiswa yizimo zezifundo ngokubuka ezocansi. Njengoba singafinyelelanga okulindelwe yilezi zifundo mayelana nezithombe zocansi, asikwazanga ukukuhlaziya, kepha uphenyo olwengeziwe kufanele luqoqe imininingwane mayelana nezimo zezifundo eziphathelene nezocansi / ezocansi.

Ezingeni le-neural, izithombe zobulili ezingcolile zacutshungulwa njengoba bekulindelwe, njengoba izindawo ezijwayelekile zokucutshungulwa kwesisusa sobulili zenziwa zasebenza, njenge-occipital ephansi, i-parietal ephansi, i-orbitof Pambal, i-medial prefrontal, i-cortex, i-infula, ne-cortex ye-anterior.Stoléru et al., 2012). Ngaphezu kwalokho, umsebenzi onzima ngokwengeziwe uholele ekuqalisweni okuphezulu ezindaweni zephariyali nezangaphambi kokuzibandakanya ezibandakanyeni izinqubo zememori yokusebenza (Owens et al., 2018, U-Takeuchi et al., 2018, UWager noSmith, 2003). Ukusebenzelana kweqembu ngokubonakalayo okubonakalayo kokuzibonakalisa okuhambisana nokuziphatha kubonakaliswa kusebenze okuhlukile ku-gualus ye-lingual, ehlangene nomphumela ophazamisayo wesisusa sangemuva. Kususelwa endimeni ye-gyrus ye-lingual yokufaka ikhodi ebonakalayo (UMachielsen et al., 2000), umuntu angaqagela ukuthi lokhu kusebenze okuphezulu kukhombisa ukukhunjulwa okungcono okubonakalayo kwezithombe ezicacile eqenjini lesiguli. Noma kunjalo, asitholanga ukuhlangana phakathi kokukhumbula ngokunemba nokukhumbula okuphathelene ne-girus ye-lingual. Njengoba i-lingual gyrus nayo ibandakanyeka ekucutshungweni kwezinhlamvu (UMechelli et al., 2000), kungenzeka futhi ukuthi ukusebenza okuphezulu kubangelwe ngumzamo omkhulu weziguli ukugxila ezinhlamvwini. Lo mbono wesekelwa ngokuxhunyaniswa kwesilinganiso sepharamitha nokuhluka kwesikhathi sokuphendula phakathi kwezithombe ezicacile nezingathathi hlangothi, okubonisa ukuthi izifundo ezinde ezidinga ukuphendula esimweni esicacisiwe, kukhuphuka kokuqalisa ku-girus ye-lingual.

Ngaphezu kwalokho, sithole ukuthi isikhathi esichithwa ngezinto eziqukethe ezocansi kanye nama-orgasms afinyelelwa ukusetshenziswa kwezithombe zobulili ezingcolile axhumene nomsebenzi kule ndawo, okusho ukuthi izifundo eziningi zesikhathi esichithwa zibuka izithombe zocansi futhi zisebenzisa lokhu kufinyelela i-orgasm, okuphezulu lapho kusebenze le ndawo. Lokhu kungahunyushwa kusetshenziswe i-hypothesis yokufunda ngendlela yokuthi, uma umuntu evame ukusebenzisa izithombe zobulili ezingcolile (futhi ethola i-orgasm evuzayo), kufundwa ukuthi lezi zinhlobo zezikhuthazo zihambisana kakhulu bese umuntu ephazamiseka lapho ebhekene nezinto ezihlobene , efana nethiythi yokukhuthaza ukuzizwela kumlutha wezidakamizwa (I-Robinson ne-Berridge, i-1993, I-Robinson ne-Berridge, i-2008). Lo mbono wesekelwa ukuhlangana phakathi kokungafani kokuphendula nesikhathi sokubuka izithombe zocansi phakathi nesonto eledlule, okubonisa ukuthi isikhathi esichithwa ukubuka izithombe zobulili ezingcolile, siyashesha ukusabela okuhlobene nomsebenzi lapho kwethulwa inkanuko yezocansi. Kuyathakazelisa ukuthi UGola et al. (2017) ithole ukuhlangana okuhle kwe-CSB phakathi kokusetshenziswa kwezithombe zobulili ezingcolile kanye nokusebenza kwe-ventral phakathi kokulungiswa kwengqondo okusho ukuthi kunomvuzo wezocansi obuye uhambisane nombono wokuqinisa ukuzwela. Ngaphezu kwalokho uKühn et al. (2014) ibike ukuhlangana okungalungile phakathi kweningi lempunga ye-hand caudate nucleus kanye nokusetshenziswa kwezithombe zocansi ngesonto kwizifundo ezinempilo.

Ngesikhathi sokulungiswa kwezifiso ezingcolile, ukuxhumana okusebenzayo phakathi kwe-lingual gyrus kanye nenethiwekhi yangaphakathi ephambili, ephakeme nephansi ye-parietal, ephansi nephakathi nendawo ye-occipital cortex kanye ne-insula iyanda. I-insula ingahle ibe yindawo ekhangayo, ngoba iyisikhiye senethiwekhi yokuswela (UMenon no-Uddin, 2010). Lokhu kungahunyushwa ngendlela yokuthi izinto ezibonakalayo zobulili ezingcolile zinayo (mhlawumbe ngenxa yezinqubo zokufunda) ukubukeka okuphezulu kweziguli futhi ngaleyo ndlela kusebenze i-salience (insula) kanye nenethiwekhi yokunaka (i-parietal ephansi), okuzoholela esikhathini sokuphendula okuhamba kancane njengesihambu imininingwane ayisebenzi kulowo msebenzi. Ngokusekelwe kulokhu okutholakele, umuntu angaphetha ngokuthi, ngezihloko ezibonisa i-CSB, izinto ezibonakalayo zobulili ezingcolile zinomphumela ophazamisayo ophakeme ngakho-ke ukuzwela okuphakeme. Kamuva, imininingwane isekela i-IST yokulutha kwe-CSB.

Kodwa-ke kufanele siphawule ukuthi lolu cwaningo luphenya kuphela izifundo zobudoda zabesilisa nokuthi inqubo yokufakwa yachazwa ngokuya ngezinqubo zikaKafka ezingazihumushi ngokuqondile kumigomo ye-ICD-11.

Konke kukho konke, kufanele siphethe ngokuthi, ezifundweni ezinempilo, izinqubo zememori yokusebenza aziphazanyiswa yizinto ezibonakalayo futhi zingabonakala njengezinzuzisayo emisebenzini efuna. Ngakolunye uhlangothi, izifundo ezinokuziphatha okuthe xaxa kwezocansi ziyaphazamiseka, eziqondiswa yi-gyrus ye-lingual futhi zingadalwa ngokubekwa kwazo phambili kokukhuthazeka kwezocansi (okungenzeka kufundwe ngokuhlanganisa ngokweqile kwe-orgasm nokusebenzisa kabi izithombe zocansi) kanye nezimo zazo ezingezinhle maqondana nokuma kwazo yokuziphatha kwezocansi.

7. Isitatimende nokutholakala kwekhodi

Imininingwane eluhlaza iyatholakala ngesicelo esivela kumbhali ohambelana.

Izingxabano Zesithakazelo

Le projekthi yokucwaninga ixhaswe yingxenye ye-European Society for Medical Medicine Research Grant (TK; isibonelelo nr .: 15-20). Ngaphandle kwalokho abalobi (CS, JE, MV, JK, TK) bathi akukho zintshisakalo zezezimali noma ukungqubuzana kwezintshisekelo okungaba khona.