Ama-Neural Correlates e-Sexual Cue Reactivity kuNobuntu abangenazo ngaphandle kokucindezela ngokocansi (2014)

Isikhombo: I-voon V, i-Mole TB, i-Banca P, i-Porter L, i-Morris L, et al. (2014) I-Neural Correlates ye-Reactivity Cac Reactivity kubantu abathile abangenawo ngaphandle kokuncintisana ngokocansi. PLoS ONE 9 (7): e102419. i-doi: 10.1371 / iphephandaba.pone.0102419

Umhleli: I-Veronique Sgambato-Faure, INSERM / CNRS, eFrance

Utholiwe: March 6, 2014; Kuvunyelwe: Juni 19, 2014; Kushicilelwe: July 11, 2014

I-copyright: © 2014 Voon et al. Lokhu kuyisihloko sokufinyelela okuvulekile esasakazwa ngaphansi kwemigomo ye- Ilayisense ye-Creative Commons Attribution, evumela ukusetshenziswa okungavimbeki, ukusatshalaliswa, nokukhiqiza kunoma yimuphi umthombo, unikeze umlobi nomthombo wangempela abakwa.

Ukutholakala kwedatha: Abalobi baqinisekisa ukuthi yonke idatha esekelwe ekutholeni iyatholakala ngokugcwele ngaphandle kwemingcele. Yonke idatha ifakiwe ngaphakathi kwephepha.

Imali: Imali eyanikezwa yi-Wellcome Trust Intermediate Fellowship grant (093705 / Z / 10 / Z). UDkt. Potenza usekelwa ingxenye yezinsiza ze-P20 DA027844 no-R01 DA018647 ezivela eNational Institutes of Health; uMnyango WezeMpilo WaseConnecticut Wempilo Yengqondo Nezinsizakalo Zomlutha; Isikhungo sezempilo se-Connecticut; kanye neSikhungo Esivelele Esikhathini Sokugembula Sokugembula esivela kuNational Center for Gaming Respponsible. Abaxhasayo babengenalo indima ekuklanyweni kocwaningo, ukuqoqwa kwedatha nokuhlaziywa kwedatha, isinqumo sokushicilela, noma ukulungiselela umbhalo wesandla.

Izithakazelo zokuncintisana: Abalobi baye bathi akukho zintandokazi ezikhona.

Isingeniso

Ukubandakanya ngokweqile noma okunenkinga kwezocansi, okuye kwabizwa ngokuthi ukuziphatha kocansi okuphoqelekile (CSB), ukuphazamiseka kwengqondo ngokobulili noma ukulutha ngokocansi, inhlangano ejwayelekile yokutholwa kwengqondo engase ibe nemiphumela emibi yengqondo nengokwenyama [1]. Nakuba izilinganiso ezicacile aziwa ukuthi izibalo eziningi ze-psychiatric epidemiological azibandakanyi izinyathelo ze-CSB, idatha ekhona ibonisa ukuthi amazinga we-CSB angase avela ku-2 kuya ku-4% emphakathini nasemphakathini asebekhulile abasha abanezinga elifanayo ezigulini zengqondo [2]-[4], nakuba kuye kwabikwa amazinga aphakeme futhi aphansi kuye ngokuthi i-CSB ichazwa kanjani [5]. Isici esiyinkimbinkimbi ekunqumeni ukusakazeka okuqondile kanye nomthelela we-CSB kuhilela ukungabi nencazelo ehlelekile yalesi sifo. Nakuba izixazululo ze-hypersexual disorder zahlongozwa nge-DSM-5 [6], lesi sifo asizange sifakwe ku-DSM-5. Kodwa-ke, njengoba i-CSB ingase ihlotshaniswe nokucindezeleka okuphawulekayo, imizwa yehlazo nokukhubazeka kwengqondo, iqinisekisa ukuhlolwa okuqondile.

Kungcono kakhulu ukucabanga ukuthi i-CSB ixoxiswane, futhi kunengqondo ehlongozwayo yokucubungula isimo njengesiyaluyalu sokulawula umfutho noma ukulutha okungeyona imithi noma "ukuziphatha" [7]. Ngokusekelwe kwedatha ekhona, ukugembula ngokwemvelo (noma ukubheja ukugembula) kwakamuva kufakwe kabusha ku-DSM-5 kanye nokukhathazeka kokusebenzisa izidakamizwa njengokulutha komzimba [8]. Kodwa-ke, ezinye izinkinga (isib. Lezo eziphathelene nokubandakanya ngokweqile ukusetshenziswa kwe-inthanethi, ukudlala kwevidiyo noma ubulili) azange zifakwe engxenyeni eyinhloko ye-DSM-5, ngokwengxenye ngenxa yedatha elinganiselwe ezimweni [9]. Ngakho-ke, ukuqonda okuthuthukisiwe kwe-CSB nokuthi ingabonisa kanjani ukufana noma ukungafani nokuphazamiseka kokusetshenziswa kwezidakamizwa kungasiza ngemizamo yokuhlukanisa kanye nokuthuthukiswa komzamo wokuvimbela nokwelashwa osebenza kahle. Ukulingana okunikezwe phakathi kokusetshenziswa kwezidakamizwa, ukugembula kanye nokuhlukunyezwa ngokobulili (isib. Ukulawulwa okungekho emthethweni phezu kokuziphatha okujabulisayo noma okuvuzayo), uphenyo lwezici lungabhekana nokulutha (isibonelo, ukukhishwa kwemisebenzi) i-warrant yophenyo oluqondile ku-CSB.

I-reactivity ye-Cue ilandisa ngokubalulekile kwizici ezifanele emitholampilo yezidakamizwa zokusebenzisa izidakamizwa. Isibonelo, ukukhishwa kwe-cac reactivity kuhlotshaniswa nokubuyela emuva [10], [11]. Ukuhlaziywa kwe-meta-uphenyo okwakamuva kwamathuluzi ekuqaphelweni kokusetshenziswa kwezidakamizwa kuhlanganise nokuphuza utshwala, i-nicotine ne-cocaine kubonisa umsebenzi oweqa ngokubhekwa kwezidakamizwa ku-ventral striatum, i-dorsal anterior cingulate (dACC) ne-amygdala, ngomsebenzi oqoqwayo ngokuzifiso okubikiwe okuziwayo-ku-DACC, i-pallidum ne-ventral striatum [11]. Kodwa-ke, izinga lezi zindawo ezingabonisa ngazo ukuhlukanisa ukuhlukunyezwa ngokobulili nabantu abangekho ngaphandle kwe-CSB azange zifundwe.

Kunezinhlobo ezahlukene ezihlongozwayo zokuchaza ukuziphatha okuluthayo, ngesibonelo esisodwa sokuthi izidakamizwa, "ukufuna" kuhlukaniswa "ukuthanda" njengoba umuntu eba umlutha [12]. Kodwa-ke, izinga elilingana nokufuna elihlobene nokucutshungulwa ngokocansi kanye ne-coralates yayo ye-neural akuhloliswanga ngokuhlelekile, futhi okutholakele kulolu cwaningo kunganikeza idatha ukusiza ukuqondisa ukuhlukaniswa okufanele kakhulu kwe-CSB nokukhomba izinhloso ze-neural zokwelapha ukuthuthukiswa.

Ucwaningo oluningi luye lwalugxila emaceleni okuzibandakanya ngokocansi kumavolontiya anempilo ekhomba izifunda ezihlanganisa i-hypothalamus, i-thalamus, i-amygdala, i-cortex yangaphakathi ye-cingulate, i-insula yangaphakathi, i-cortex yangaphambilini, i-fusiform gyrus, i- gyrus yangaphambili, i-parietal cortex kanye ne-cortix ephakathi nendawo [13]-[19]. Lezi zifunda zibandakanyeka ekuvukeleni ngokomzimba nangokomzwelo, ukunakekelwa nokubhekwa ngokukhethekile kwe-visuospatial, nokugqugquzela. Ukusebenzisa izinyathelo ze-penile tumescence, i-striatum, i-anterior cingulate, i-insula, i-amygdala, i-cortex ye-occipital, i-sensorimotor cortex ne-hypothalamus ziye zaboniswa ukuthi zidlala indima ekukhululweni kwe-penile [15], [20]. Ukungezwani okuhlobene ngokobulili kuye kwabikwa nabesilisa abanomsebenzi omkhulu we-amygdala ne-hypothalamic ezenzweni zobulili eziphathelene nabesifazane, futhi lokhu kungezwani kungabonisa izimo ezithintekayo [21]. Ukuhlaziywa kwe-meta kubonisa inethiwekhi evamile ebuchosheni emiphumeleni yemali, yokudoba kanye nokudla okubandakanya i-prefromalal correx ye-ventromedial, i-ventral striatum, i-amygdala, i-insula yangaphakathi kanye ne-talemus ephakathi [22]. Ukudla nokuvuza okubuhlungu kuhlotshaniswa ikakhulukazi nomsebenzi wangaphakathi wangaphakathi futhi ukuvuza okwemvelo kuvuza ikakhulukazi ngomsebenzi we-amygdala. Ucwaningo lwamuva luye lwabonisa ukuthi isikhathi eside sokusetshenziswa kwezinto ezicacile eziku-intanethi kumadoda aphilile ahambisana nomsebenzi we-putaminal ongakwesokunxele nomthamo we-caudate ophansi ongakwesokudla ukuze uthole izithombe ezimfushane zesebe [23].

Izifundo ze-neurophysiological ezigxile kwi-CSB kubantu abaningi kunezisebenzi zokuvolontiya ezinempilo zilinganiselwe kakhulu. Ucwaningo olwenziwe nge-MRI olugxila eqenjini elincane lezihloko ze-CSB ezingekho-paraphilic (N = 8) uma kuqhathaniswa namavolontiya anempilo (N = 8) abonisa ukungafani komqondo ezindaweni ezisezingeni eliphezulu [24]. Izihloko zaqashwa ohlelweni lwezokwelapha nge-7 yezihloko ze-8 ezinomlando wokusetshenziswa kwezidakamizwa, i-4 ye-8 nomlando wezinye izidakamizwa noma ukuxhomeka kanye ne-1 ye-8 enomlando wokugula okucindezelayo okucindezelayo. Esicwaningweni esibhekene nezihloko ze-52 zesilisa nabesifazane ezinkingeni zokulawula ukubukwa kwezithombe zocansi ezitholwa ezikhangisweni ze-intanethi, ukuvezwa kwezithombe zobulili ezibucayi uma kuqhathaniswa nemifanekiso engathathi hlangothi kuhlotshaniswa nama-amplitudes aphezulu wempendulo ye-P300, okubandakanyeke ekulawuleni okungaqondakali [25]. Njengoba lesi silinganiso sihambisana nesifiso sobulili se-dyadic kepha hhayi izinyathelo zokuphoqeleka ngokocansi, ababhali baphakamise isifiso sobulili se-P300 amplitude phakathi kokuziphatha okucindezelayo. Ubungqingili bubikiwe kumongo wokuphazamiseka kwemizwa nemithi yabo ehambisanayo. Ubungqingili obuphoqelekile, obenzeka ku-3-4% weziguli zesifo sikaParkinson futhi ezihlobene nemithi ye-dopaminergic [26], [27], uye wahlolisiswa ngokusebenzisa izindlela zokucabanga. Umbiko wombiko osebenzisa i-technetium-99 m-ethyl cysteinate dimer SPECT ibonise ukukhuphuka kwegazi okwenyuka ezindaweni ezingasesikhathini esifundeni se-CSB [28]. Isifundo esikhudlwana esigxile ezigulini zikaParkinson ezinesifo sobulili obufanayo sikhombisa ukusebenza okukhulu kwe-MRI Blood Oxygen Level Umsebenzi oxhomeke ezithombeni zezocansi ezihambisana nesifiso sobulili esithuthukisiwe [29], okushiwo abalobi bangase babonise imibono yokugqugquzela ukugqugquzela. Ucwaningo olwenziwe nge-voxel-based-morphometry lwe-sexualism oluvame ukubikwa ngokuhlukumezeka kokuziphatha kwangaphambili kwe-frontotemporal, isifo esithinta izizinda zangaphambili nezizinda zangaphambili, zibonisa ukuthi i-atrophy enkulu kakhulu kwi-ventral putamen ne-pallidum ngokubambisana nezikolo ezifuna umvuzo [30]. Okuphawulayo, kulesisampula, ukuxhumene kocansi kwabikwa ku-17% ngeminye imikhuba yokufuna umvuzo kuhlanganise nokudla ngokweqile ku-78% futhi okusha noma ukwandisa utshwala noma ukusetshenziswa kwezidakamizwa ku-26% wabantu kulolu cwaningo. Kulesi sifundo samanje, sigxila kwizihloko ze-CSB kubantu abaningi.

Lapha sibheke ukucubungula kokucatshangelwa kobulili ngokuqhathanisa imibono yezocansi ecacile ngokobulili (okufana namavidiyo wemisebenzi yezemidlalo) nokuhlola izifiso zesondo noma ukufunwa nokuthanda ngezifundo ngaphandle kwe-CSB. Sithemba ukuthi abantu abane-CSB uma kuqhathaniswa nalabo abangaphandle bangabonisa isifiso esikhulu (befuna) kodwa bengathandi (amaqembu ahlukene kuwo wonke amaqembu) ngokuphendula ngokucacile ngokobulili kepha hhayi emibonweni engacabangi ngokobulili. Nakuba kunezifunda ezihlukahlukene eziye zathinteka ekuphenduleni imibono yezocansi kumavolontiya anempilo, njengoba sasihlolisisa iziguli nge-CSB, sithonya ukuthi kuzoba nokuvuselela okukhulu ekuchazeni ngokobulili uma kuqhathaniswa nezinkulumo ezingathandeki ngokobulili ezindaweni ezibandakanya izidakamizwa izifundo ze-reactivity ezihlanganisa i-ventral striatum, i-DACC ne-amygdala. Siphinde sicabange ukuthi lezi zenzo zokusebenza zendawo zizosebenza ngokusebenzisana ngamaqembu kodwa ikakhulukazi kubantu abane-CSB uma kuqhathaniswa nalabo abangenawo, nokuthi leso sifiso socansi (sifuna) sizoxhunyaniswa kakhulu nakumsebenzi kulezi zindawo kubantu abane-CSB uma kuqhathaniswa labo abangaphandle. Izinguquko ezithuthukisiwe zokuthuthukiswa kwezinhlelo zokugqugquzela ezingaphansi kokuziphatha okulimazayo [31], sabuye sahlola ubuhlobo nobudala.

izindlela

Izihloko ze-CSB zaqashwa ngezikhangisi ezisekelwe ku-intanethi nakukudluliselwa kwabagulaphi. Izisebenzi zokuzithandela ezempilo ziqashwe ezikhangisweni zomphakathi endaweni yase-East Anglia. Iqembu le-CSB, ukuhlolwa kwenziwa ngokusebenzisa i- Ukuhlolwa kwe-Sex Screening Test (ISST) [32] kanye nombuzo omkhulu wophikisana nophenyo ngemininingwane kufaka phakathi ukuqala, imvamisa, ubude, imizamo yokulawula ukusetshenziswa, ukuziyeka, izindlela zokusebenzisa, ukwelashwa nemiphumela emibi. Izihloko ze-CSB zithintana ubuso nobuso ingxoxo nomuntu wezifo zengqondo ukuqinisekisa ukuthi zigcwalisekile izindlela zokuhlola ze-CSB [6], [33], [34] (Ithebula le-S1 ku Ifayela le-S1) egxile ekusetshenzisweni okuphoqelekile kwezinto ezibonakalayo zobulili ezitholakala kuyi-intanethi. Bonke abahlanganyeli bahlangabezane nezinqubo ezihlongozwayo zokuxilongwa ze-Hypersexual Disorder [6], [33] kanye nemigomo yokulutha ngokobulili [34] (Ithebula le-S1 ku Ifayela le-S1).

Ngokuklanywa futhi unikezwe uhlobo lwama-cues, zonke izihloko ze-CSB kanye nezisebenzi zokuzithandela ezinempilo zazingamaduna futhi zithandana ngokobulili. Izisebenzi zokuvolontiya ezinempilo ezineminyaka emine zazilingana (+/- iminyaka engu-5 ubudala) nezihloko ze-CSB. I-25 eyengeziwe yokulinganisa abantu abesilisa nabesilisa abanamalungu aphilile abanobuchopho babhekana nokulinganisa kwevidiyo ngaphandle kwesithwebuli ukuqinisekisa ukuthi ngokwanele izimpendulo ezizithobayo kumavidiyo njengoba zihlolwe izimpendulo ezizithobayo. Izindlela zokubekelwa eceleni zifaka ukuba ngaphansi kweminyaka eyi-18 ubudala, ukuba nomlando wokuphazamiseka ekusebenziseni izidakamizwa, ukuba ngumsebenzisi ojwayelekile wezinto ezingekho emthethweni (kufaka phakathi i-cannabis), nokuba nesifo sengqondo esibi kakhulu, kufaka phakathi ukucindezeleka okukhulu okuphakathi kwamanje (Beck Depression Inventory > 20) noma ukuphazamiseka okuphoqelela ngokweqile, noma umlando wesifo se-bipolar noma i-schizophrenia (Mini International Neuropsychiatric Inventory) [35]. Ezinye izidakamizwa zokucindezela noma zokuziphatha nazo zazingekho. Izihloko zihlolwe ngumhlengikazi mayelana nokusetshenziswa okunzima kokugembula kwe-intanethi noma ezokuxhumana, ukugembula ngokwemvelo noma ukuthenga ngokweqile, ubuntwana noma umuntu omdala ukukhathazeka kokungaboni kahle kokugula, nokuxilongwa kwesifo sokuzibulala. Izihloko nazo zihlolwe ukuhambisana nemvelo ye-MRI.

Izihloko ziqedile i-UPPS-P Impulsive Behavior Scale [36] ukuhlola ukungabi nesisindo, Beck Ukucindezeleka Inventory [37] kanye ne-State Trait Anxiety Inventory [38] ukuhlola ukucindezeleka nokukhathazeka, ngokulandelana, i-Obsessive-Compulsive Inventory-R ukuhlola izici eziphoqelekile nezivivinyo nokuhlolwa koLwazi lokuThuthukiswa kweziThuthi (UAUDIT) [39]. Ukusetshenziswa okujwayelekile kwe-Intanethi kuhlolwe kusetshenziswa iYoung's Internet Addiction Test (YIAT) [40] kanye ne-Compulsive Internet Use Scale (CIUS) [41]. Isivivinyo Sokufunda Abafundi Kazwelonke [42] yayisetshenziselwa ukuthola inkomba ye-IQ. Inguqulo eguquliwe ye-Arizona Sexual Scale Scale (ASES) [43] isetshenziswe ngenye inguqulo ehlobene nobuhlobo obuseduze kanye nenye inguqulo ehambisana nokuqukethwe okucacile ngokobulili.

Izici zezihloko zibikwa kuThebula le-S1 Ifayela le-S1. Izihloko ze-CSB zinezinkinga eziphezulu nokucindezeleka (Ithebula le-S2 ku Ifayela le-S1) kodwa akukho ukutholakala kwamanje kokucindezeleka okukhulu. Izihloko ezimbili ze-19 CSB zithatha izidakamizwa zokucindezeleka noma zine-disorbid generalized disorder disorder kanye ne-phobia social (N = 2) noma i-phobia yenhlalo (N = 1) noma umlando wobuntwana we-ADHD (N = 1). Esinye isihloko se-CSB kanye nesisebenzi sokuzithandela se-1 esinempilo sisebenzisa i-cannabis ngezikhathi ezithile.

Kwafunyanwa imvume enolwazi, futhi isifundo samukelwa yiKomiti Yezokuziphatha YokuCwaninga ye-University of Cambridge. Izihloko zikhokhwe ngokuhlanganyela kwabo.

Izibalo zokuziphatha

Izici zezihloko kanye nezibalo zemibuzo zaqhathaniswa zisebenzisa izivivinyo ezizimele ezi-T noma izivivinyo ze-Chi-square. Ukuhlaziywa kwe-Multivariate kwasetshenziselwa izikolo ze-ASES. Ukulinganisa kwesifiso sobulili noma ukuthanda, izinyathelo ezixubile ze-ANOVA zisetshenziselwe ukuqhathanisa ukulinganisa okucacile okukwenziwe ngeqembu (CSB, okungewona CSB) njengendlela ephakathi kwezifundo, uhlobo lwevidiyo (izilinganiso ezicacile noma ezithandwayo), nokulinganisa okuzithobayo (isifiso noma ukuthanda) njengezinyathelo ezingaphakathi.

Neuroimaging

Emisebenzini yokucabangela, izihloko zibukwe amavidyo kliphu avezwa ngendlela ehambisana nokulinganisela kusuka kwesinye sezimo ze-5: okucacile ngokocansi, okuthandana, okungezona ngokobulili, okungahambisani nezimali nokungathathi hlangothi. Amavidiyo aboniswe kumasekhondi angu-9, alandelwe umbuzo uma ividiyo ingaphakathi noma ngaphandle. Izihloko zaphendulwe ngokusebenzisa ikhi ye-2-inkinobho ngedijithi yesibili nesithathu yesandla sabo sokunene ukuqinisekisa ukuthi banakekele. Umbuzo uvele ngesikhathi se-interactive trial of 2000 kuya ku-4000 millisecond. Amavidiyo acacile abonise ukusebenzisana ngokocansi phakathi komuntu wesifazane nowesifazane otholakale kumavidiyo alandiwe kusuka ku-Intanethi anelayisense atholakala lapho kudingeka khona. Izibonelo zamavidiyo ahlukumezayo zihlanganisa owesifazane ogqoke ukudansa ukudansa noma isiteleka sowesifazane onyakaza ithanga lakhe. Amavidiyo angathandeki ngokobulili abonayo afaka amavidiyo wezemidlalo afana nemvelo ekuvukeleni izithombe ezivela kwi-International Affective Picture System njengokweqa, ukuhamba ngezinkanyezi, ukukhuphuka kwamadwala, noma ukugibela ngesithuthuthu. Amavidiyo wemali akhombisa izithombe zemali noma imali yamaphepha ekhokhwayo, ewa noma ehlakazekile. Amavidiyo angathathi hlangothi abonise izigcawu zemifino. Lemibandela yayinganiselwe ngezilingo eziyisishiyagalombili ngesimo ngasinye esiboniswe isamba sevidiyo ye-40. Amavidiyo amahlanu ahlukene ngesimo aboniswe inani 25 isiqophi Ukugunda.

Emsebenzini wokulinganisa ividiyo ngaphandle kwesithwebuli, izihloko zibuke amavidiyo afanayo futhi zagcwalisa isilinganiso sokulinganisa okuqhubekayo sesifiso sobulili nokuthanda. Izihloko zabuzwa imibuzo elandelayo kuma-slides ahlukile e-2: 'Lokhu kwande kangakanani isifiso sakho socansi?' futhi 'Uthanda kangakanani le vidiyo?' futhi ubonise impendulo besebenzisa igundane eceleni komugqa okhishwe kusuka 'Okuncane kakhulu' kuya 'Kakhulu kakhulu.' Amavolontiya angamadoda aphilile e-25 ahlolwe umsebenzi wokulinganisa ividiyo. Izihloko zacelwa ukuthi ngabe zibuke ngaphambilini amavidiyo ngaphambi kokucwaninga. Yonke imisebenzi ibhalwe nge-E-Prime 2.0 software.

Ukuthola idatha nokucubungula

Imingcele yokuthenga yocwaningo lwe-FMRI ichazwe ku Ifayela le-S1. Isiqeshana sevidiyo semizuzwana engu-9 nezikhawu eziphakathi kokulingwa zenziwe njengemisebenzi yebhokisi-yemoto ehlanganiswe nemisebenzi yokuphendula nge-hemodynamic. Ukuhlaziywa kwenziwa ngokusebenzisa imodeli ejwayelekile yomugqa. Izimo zevidiyo zaqhathaniswa kusetshenziswa i-ANOVA neqembu (CSB, non-CSB) njengesici esiphakathi kwezihloko nesimo (uhlobo lwevidiyo) njengesici esingaphakathi kwezihloko. Imiphumela esemqoka yeqembu kuzo zonke izimo yaqhathaniswa okokuqala. Imiphumela yesimo yaqhathaniswa ngokwahlukile ngokuqhathanisa izimo ezicacile, ezivusa inkanuko nezemali nesimo esithandekayo. Amavidiyo wezemidlalo athokozisayo asetshenziselwe ukulawula izimo ezicacile nezingathandeki njengoba zombili bezibandakanya ukuhambisa abantu kumavidiyo. Ukwenza kusebenze ngenhla kwephutha lokuhlakanipha komndeni eliphelele lobuchopho (i-FWE) elilungiswe i-P <0.05 kuthathwe njengokukhulu ekuqhathaniseni imiphumela. Ukuhlelwa kweqembu ngesimo (isb. I-CSB (okucacile - okuthokozisayo) - Ukusebenzisana kokuzinikela okunempilo (okucacile - okuthokozisayo) ukusebenzisana okugxile a priori izifunda ezithakazelwayo zenzelwa uma ukungafani kwesimo (isb. okucacile - okuthokozisayo) izifunda ezikhonjiwe zibalulekile ezingeni lonke lobuchopho le-FWE P <0.05. Izinga lokudala nokucindezeleka lisetshenziswe njenge-covariates. Izinguquko ezibandakanya izinyathelo ezizithobayo zesifiso socansi nokuthanda izimpendulo ezigciniwe zevidiyo, izibalo ku-Test Internet Yokulutha Umlutha Wezintambo, nezinsuku ezingabonakali zifakwe kumamodeli njenge-covariates ezithakazelisayo. I-covariate yobudala iphinde iphhenywe, ilawulwa ukucindezeleka kanye nesifiso sokuzithoba, emaqenjini kanye nokusebenzisa ukubeka okucacile.

I-striral striatum, i-amygdala kanye ne-dorsal cingulate yizindawo ezithintekayo. Kulezi zifunda ezintathu ezinamandla a priori ama-hypotheses, sihlanganise ama-ROI sisebenzisa ukulungiswa kwevolumu encane (i-SVC) ngokulungiswa kwe-Family-Wise-Error ku-p <0.05 kuthathwa njengokubalulekile. Ukunikezwa okutholakele okuxhumanisa izilinganiso ezizimele zesifiso sokuphamba ukusebenza kwe-anterior cingate activation, ukuhlaziywa kokusebenzisana kwe-psychophysiological kwenziwa nge-dorsal cingate njengesifunda sembewu (ixhumanisa i-xyz = 0 8 38 mm, i-radius = 10 mm) ehluke ngokusobala - amavidiyo athokozisayo. Ngokunikezwa kokubandakanyeka okungenzeka kokujikeleza kwe-mesolimbic ne-mesocortical, umsebenzi we-substantia nigra nawo wahlolwa ezingeni lokuhlola. Isifunda senzalo ye-ventral striatal anatomical (ROI), esetshenziswe phambilini kwezinye izifundo [44], bebanjwe ngesandla e-MRIcro elandela incazelo ye-ventral striatum ngu-Martinez et al. [45]. I-ROIs ye-cingulate ne-amygdala itholakala kuma-aal templates ku-WFUPickAtlas SPM Toolbox [46]. Izifanekiso ezimbili ezihlukene ze-substantia nigra ROI zisetshenziswe kufaka phakathi ithempulethi ye-WFUPickAtlas kanye ne-ROI esetshenziswe ngezandla ku-MRIcro besebenzisa ukuhanjiswa kwe-magnetization kusuka kumavolontiya angu-17 enempilo. Yonke idatha yokucabangela yayisetshenziswe futhi ihlaziywa kusetshenziswa i-SPM 8 (i-Wellcome Trust Center ye-NeuroImaging, i-London, UK).

Imiphumela

Izici

Amadoda ayishumi nesishiyagalolunye abesilisa abesilisa nabesilisa abane-CSB (iminyaka yobudala ye-25.61 (SD 4.77) kanye ne-19 ubudala (iminyaka yobudala ye-23.17 (SD 5.38)) izisebenzi zokuvolontiya zesilisa ezingafani ngaphandle kwe-CSB zafundwa (Ithebula le-S2 ku Ifayela le-S1). I-25 eyengeziwe ubudala ubudala (i-25.33 (SD 5.94) iminyaka) amavolontiya abesilisa abesilisa abesilisa nabesifazane aphilile ahlaziya amavidiyo. Izihloko ze-CSB zibike ukuthi ngenxa yokusebenzisa ngokweqile izinto zokwenza ucansi, zazilahlekelwe yimisebenzi ngenxa yokusebenza emsebenzini (N = 2), ubuhlobo obusondelene noma obuthonya kabi eminye imisebenzi yomphakathi (N = 16), wabhekana nokubhujiswa kwe-libido noma umsebenzi we-erectile ikakhulukazi ebuhlotsheni obungokwenyama nabesifazane (nakuba kungekho ebuhlotsheni obubonakalayo ngokobulili) (N = 11), isetshenziselwa ukuhanjiswa ngokweqile (N = 3), inhloso yokuzibulala (N = 2) nokusebenzisa imali eningi (N = 3; kusuka ku-£ 7000 kuya ku-£ 15000). Izifundo eziyishumi kungenzeka noma ziselulekwa ngokuziphatha kwabo. Zonke izihloko zibike ukushaya indlwabu kanye nokubukwa kwezinto ezibonakalayo zocansi ezitholakala kuyi-intanethi. Izihloko zabika nokusetshenziswa kwezinsizakalo zokuhambisa (N = 4) kanye ne-cybersex (N = 5). Ngenguqulo eguquliwe ye-Arizona Sexual Experiences Scale [43], Izifundo ze-CSB uma kuqhathaniswa namavolontiya anempilo ayebhekene nobunzima obunzima ngokuvuswa kobulili futhi obhekene nobunzima obuningi be-erectile ebuhlotsheni obusondelene nabo obucansi kodwa hhayi ekuziphatheni ngokocansi (Ithebula le-S3 ku Ifayela le-S1).

Uma kuqhathaniswa namavolontiya anempilo, izihloko ze-CSB ziqale zibheke izinto ezicacile zobulili ezisekuqaleni (I-HV: i-17.15 (i-SD 4.74); i-CSB: i-13.89 (i-SD 2.22) ngeminyaka) ngokuphathelene nokuqala kokusetshenziswa kwe-inthanethi ngokujwayelekile (i-HV: 12.94 (i-SD 2.65); i-CSB: i-12.00 (i-SD 2.45) eminyakeni) ukusebenzisana kweqembu ngokuqala: F (1,36) = 4.13, p = 0.048). Izihloko ze-CSB zisebenzise kakhulu i-Inthanethi ngokuphathelene namavolontiya anempilo (Ithebula le-S3 ku Ifayela le-S1). Okubalulekile, izihloko ze-CSB zibikwe kusetshenziswa i-intanethi yokubukela izinto ezicacile zobulili kwi-25.49% yokusetshenziswa okuphelele kwe-intanethi (iminyaka eyi-8.72 (SD 3.56) eyiqhathaniswa) kuqhathaniswa no-4.49% kumavolontiya anempilo (t = 5.311, p <0.0001) (CSB vs. HV: ukusetshenziswa kwezinto ezibeka obala ezocansi: 13.21 (SD 9.85) vs. 1.75 (SD 3.36) amahora ngesonto; ukusetshenziswa okuphelele kwe-inthanethi: 37.03 (SD 17.65) vs. 26.10 (18.40) ) amahora ngesonto).

I-reactivity ye-Cue

Izilinganiso ezizenzekelayo zesifiso nokuthanda amavidiyo zahlukaniswa lapho kwakukhona ukusebenzisana kweqembu-nge-rating-type-by-video-type (F (1,30) = 4.794, p = 0.037): ukufisa izilinganiso kumavidiyo acacile kwakukhulu ku-CSB uma kuqhathaniswa namavolontiya anempilo (F = 5.088, p = 0.032) kodwa hhayi emaceleni amasha (F = 0.448, p = 0.509), kuyilapho ukulinganisa izilinganiso eziqanjiwe ezikhudlwana kuyi-CSB kuqhathaniswa namavolontiya anempilo (F = 4.351, p = 0.047) kodwa hhayi ezichazweni ezicacile (F = 3.332, p = 0.079). Isifiso nokuthanda izikolo ezichazwe ngokucacile kwakuhlobene kakhulu (I-HV: R² = 0.696, p <0.0001; I-CSB: R² = 0.363, p = 0.017) nakuba ukuhlukunyezwa okulinganayo kwakungavamile kakhulu phakathi kwamaqembu (F = 2.513, p = 0.121). Kwakungenjalo ukungafani ezikoleni zokulinganisa ividiyo ngesifiso nokuthanda isimo ngasinye phakathi kwamavolontiya anempilo asoziwe kanye nezisebenzi zokuvolontiya ezengeziwe ze-25 ezibonisa ukuthi izilinganiso ezizithobayo kumavidiyo zazimele (p> 0.05). Zonke izifundo zibike ukuthi azikaze ziwabone amavidiyo ngaphambi kocwaningo.

Ukucabanga kuhlaziya

Akukho mehluko wokusebenza kobuchopho obuphakathi kweqembu osindile ekulungisweni kobuchopho bonke. Umehluko wamavidiyo acacile - athokozisayo emaqenjini ezihloko akhombe ukwenziwa kwe-ventral striatum, i-DACC ne-amygdala ezingeni eliphelele lobuchopho elilungiswa yi-FWE p <0.05 level (Umfanekiso we-1, Amathebula uS4 no-S5 Ifayela le-S1). Umehluko uphinde wakhomba ukwenziwa kwamazwe amabili kwe-hypothalamus ne-substantia nigra (i-FWE p <0.05 eqondiswe ngokuphelele-ebuchosheni), izifunda ezithintekayo ekusebenzeni kocansi kanye nokusebenza kwe-dopaminergic, ngokulandelana [13], [22]. Ukuqhathanisa kokucacile - okuthokozisayo nokuvusa inkanuko - okuthokozisayo womabili umsebenzi okhonjwe ezifundeni zombili zomhlaba we-occipito-temporal, parietal kanye ne-infortices engaphansi ne-caudate yangakwesokudla (i-FWE p <0.05) elungiswe ngobuchopho bonke (Ithebula le-S4 in Ifayela le-S1). Kodwa-ke, ukungafani kokukhathazeka - okuthakazelisayo akuzange kubone a priori izifunda ezifakiwe. Ngokufanayo, imali - umehluko othokozisayo okhombe amazwe amabili angaphansi kweparietal kanye nama-cortices angaphansi angaphansi (alungiswa ngokuphelele ebuchosheni i-FWE p <0.05) kepha hhayi a priori izizinda ezithandwayo.

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Umfanekiso we-1. Isimo sihluke.

Ubuchopho bengilazi nezithombe ze-coronal zikhombisa imiphumela emaqenjini okuqhathanisa okulandelayo: okucacile - okuthokozisayo (kwesobunxele, irowu ephezulu), i-erotic - ethokozisayo (maphakathi, umugqa ophakathi) nemali - ethokozisayo (kwesokudla, emgqeni ongezansi). Izithombe zikhonjiswa ku-P-0.05 eqondiswe ngokuphelele ebuchosheni. Ukubuka kwe-axial (phezulu kwesokudla) kukhombisa umehluko emaqenjini wamavidiyo acacile - athokozisayo agxile kwi-substantia nigra. Isithombe sikhonjiswa ngesifunda se-substantia nigra senzalo yesembozo esimbozwe ngokulandelana kokudluliswa kukazibuthe.

i-doi: 10.1371 / iphephandaba.pone.0102419.g001

Ngokulandelayo sasihlola ukungafani kweqembu-phakathi kokucacile - okungafani okuthakazelisayo okwakubonise umphumela omkhulu kuwo wonke amaqembu ezindaweni zethu ezixubile. Izihloko ze-CSB zibonise umsebenzi omkhulu ku-ventral striatum efanele (ukuphakama kwe-voxel xyz in mm = 18 2 -2, Z = 3.47, FWE p = 0.032), i-DACC (0 8 38, Z = 3.88, FWE p = 0.020) kanye ne-amygdala efanele (32 -8 -12, Z = 3.38, FWE p = 0.018) (Umfanekiso we-2). Njengoba sinikezwe indima ye-dopaminergic circuitry ku-cue reactivity, sabuye sahlola umsebenzi ku-substantia nigra. Izifundo ze-CSB zinomsebenzi omkhulu ku-substantia nigra (10 -18 -10, Z = 3.01, FWE p = 0.045) ngokucacile - ukuhluka okuthakazelisayo. Ukuhlaziywa okuncane ngaphandle kwezifundo ezimbili ezaziphethwe yizifo ezicindezelayo azizange zishintshe iziphumo ezibalulekile.

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Umfanekiso we-2. Okucacile kunamazwi amnandi.

Imibono ye-coronal imele ukuxhumana kweqembu-byvideo-uhlobo lwezihloko ezinokucindezela kokuziphatha ngokocansi (CSB)> amavolontiya anempilo (HV) ahluke ngokusobala> imikhondo ethokozisayo. Izithombe zikhonjiswa njengezifunda ezithakazelisayo ku-P <0.005. Ukuhlaziywa kwenkambo yesikhathi kumelela ushintsho lwesiginali lwe-% kumavidiyo abeka obala (phezulu) namavidiyo ajabulisayo (ngezansi) anezihloko ze-CSB kumavolontiya abomvu futhi anempilo emnyama. Amabha wephutha amele i-SEM.

i-doi: 10.1371 / iphephandaba.pone.0102419.g002

Ukuze sihlolisise ubuhlobo phakathi kwempendulo ye-neural kanye nezilinganiso zesifiso nokuthanda, senze ukuhlaziywa kwe-covariate okubandakanya izimpendulo zobuchopho ezichazweni ezicacile. Kuzo zombili amaqembu, izilinganiso zesifiso socansi ezizimele zihambisana kahle nomsebenzi we-DACC (-4 18 32, Z = 3.51, p = 0.038), ngaphandle kokungafani phakathi kwamaqembu (Umfanekiso we-3). Kwakungekho ukuhlangana kwe-neural nokuthanda okuthandayo.

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Umfanekiso we-3. Isifiso sobulili.

A. Isifiso esihambisanayo nezikolo zokuthanda izinhlobo zamavidiyo ezifundweni ezinokuziphatha okuphoqelela ngokocansi (CSB) kanye nabahlanganyeli abanempilo (HV). Kube nokuxhumana okubalulekile kweqembu-nge-vidiyo-uhlobo-ngesifiso / ukuthanda ukuthanda. Amabha wephutha amele i-SEM. * p <0.05. B. Isifiso se-covariate samavidiyo acacile kuzo zombili izihloko ze-CSB ne-HV negrafu yokuhlaziya ehambisanayo yokulinganisa kwe-dorsal cingate parameter (PE) nezikolo zesifiso. C. Ukuhlaziywa kokusebenzisana kwe-Psychophysiological nesifiso covariate sokwehlukanisa okucacile-okuthokozisayo nembewu ye-dorsal cingate. Izithombe ze-coronal namagrafu zikhombisa izihloko ze-CSB nge-mask ekhethekile ye-HV kanye nokuhlaziywa okuhambisanayo kokuhlaziya kwe-ventral striatum kanye ne-amygdala parameter yokulinganisa kanye nezibalo zesifiso. Izithombe zikhonjiswa njengezifunda ezithakazelisayo ku-P <0.005.

i-doi: 10.1371 / iphephandaba.pone.0102419.g003

Ezingeni lokuhlola, umsebenzi we-neural uphenywe njengemisebenzi yobudala. Ubudala kuzo zonke izifundo behlukumezwe kabi nomsebenzi okwesokudla kwe-ventral striatum (kwesokudla: 8 20 -8, Z = 3.13, FWE p = 0.022) kanye ne-dACC (2 20 40, Z = 3.88, FWE p = 0.045). Imisebenzi emikhulu njengemisebenzi yobudala ibonwe eqenjini le-CSB uma iqhathaniswa namavolontiya anempilo e-ventral striatum yamazwe (kwesokudla: 4 18 -2, Z = 3.31, FWE p = 0.013; kwesokunxele -8 -18 -2, Z = 3.01 , I-FWE p = i-0.034) (Umfanekiso we-4).

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Umfanekiso we-4. Ubudala.

Umbono we-coronal ukhombisa iminyaka yobudala yamavidiyo asobala ezifundweni ezinamaCompulsive Sexual Behaviors (CSB) anemaski ekhethekile yokuzithandela (HV). Igrafu ikhombisa ukuhlaziywa okuhambisanayo kokuhlehliswa kwesilinganiso se-ventral striatal parameter (PE) nobudala eminyakeni. Isithombe sikhonjiswa njengesifunda sentshisekelo ku-P <0.005.

i-doi: 10.1371 / iphephandaba.pone.0102419.g004

Njengoba kunikezwe ubudlelwane obuphakathi kokulinganisa kwesifiso socansi esivumelana nomzimba we-DACC, ukuhlaziywa kwengqondo ye-psychophysiological esebenzisa i-DACC njengembewu yenziwa ngokuqhathanisa okucacile - amagama amnandi. Kuzo zonke izinhlangano zombili, kunyuke ukuxhumana komsebenzi we-DACC nge-ventral striatum efanele (8 20 -4, Z = 3.14, FWE p = 0.029) kanye ne-amygdala elungile (12 0 -18, Z = 3.38, FWE p = 0.009) . Kwakungehluko phakathi kweqembu phakathi kokuxhumana okusebenzayo. Lapho izifiso zesifiso esiphezulu zihlolwe njenge-covariate, kube nokuhlanganiswa okuhle phakathi kwezifiso zesifiso nokuhlanganiswa okukhulu komsebenzi kuzihloko ze-CSB phakathi kwe-DACC kanye ne-ventral striatum efanele (12 2 -2, Z = 3.51, FWE p = 0.041) kanye ne-amygdala efanele (30 -2 -12, Z = 3.15, FWE p = 0.048) (Umfanekiso we-3) futhi, ezingeni lokuhlola, kushiya substantia nigra (-14 -20 -8, Z = 3.10, FWE p = 0.048) uma kuqhathaniswa namavolontiya anempilo. Kubekho okutholakele okuphawulekayo okuphathelene nezinyathelo ezifanisayo.

Ingxoxo

Kulolu cwaningo lwezici zobulili, ezibucayi nezingezansi zobulili, abantu abane-CSB nalabo abangaphandle bangaboniswa okufanayo nokungafani ngokuqondene namaphethini wokuphendula kwe-neural kanye nobuhlobo phakathi kwezimpendulo ezizithobayo nezimpendulo. Isifiso sobulili noma ukufuna izici zobulili ezicacile kuhlanganiswe kwinethiwekhi ye-DACC-ventral-amygdala yenethiwekhi ebonakalayo ebonakala kuwo wonke womabili amaqembu futhi asebenza ngokuqinile futhi axhumene nesifiso sobulili eqenjini le-CSB. Isifiso socansi noma izinyathelo zokuzifunela ezibonakalayo zivele zihlukaniswe nokuthanda, ngokuhambisana nezintshisekelo zokukhuthaza umlutha [12] lapho kukhona khona okuthuthukisiwe okufunayo kepha engafuni imivuzo engavamile. Siphinde sibheke indima yesikhathi lapho ubudala obuncane, ikakhulukazi eqenjini le-CSB, lihlotshaniswa nomsebenzi omkhulu emgodleni we-ventral.

Uma kuqhathaniswa namavolontiya anempilo, izihloko ze-CSB zinezifiso ezingathí sina zobulili noma zifuna ukucacisa amagama futhi zinezici ezithandwa kakhulu ezihlokweni ezibucayi, ngaleyo ndlela zibonisa ukuhlukaniswa phakathi kokufuna nokuthanda. CIzifundo ze-SB nazo zaba nokulimala okukhulu kokuhlukunyezwa ngokocansi kanye nobunzima be-erectile ebuhlotsheni obuseduze kodwa hhayi ngezinto ezicacile zocansi eziqokomisa ukuthi izici ezifisayo ezithandwayo zaziqondile ezichazweni ezicacile hhayi ngesifiso sobulili esikhulisiwe ngokugcwele. Ezifundweni ze-CSB uma kuqhathaniswa namavolontiya anempilo, izibalo eziphakeme zesifiso sobulili ezinkomba ezicacile zihlotshaniswa nomsebenzi omkhulu we-DACC nokuxhumeka kokusebenza okuthuthukisiwe phakathi kwe-DACC, i-ventral striatum ne-amgydala (njengoba kuchaziwe ngezansi), okuphakamisa inethiwekhi ebandakanyeka ekusetshenzisweni kokuzithoba ukufuna okuhlobene nezinkomba zocansi. Isifundo sangaphambilini sobulili obucindezelayo obuhlobene nama-agonists e-dopamine esifo sikaParkinson, esingafaka phakathi isimilo njengokuphoqelela ukusetshenziswa kwezinto ezicacile zocansi, sikhombise imisebenzi emikhulu ye-neural ezithombeni zobulili ezihambisana nesifiso sobulili esithuthukisiwe. [29]. Okutholakele kwethu okugxila kwi-CSB kubantu abaningi ngokufanayo kufana nokugqugquzela izintshisekelo zokugqugquzela ukugcizelela ukufisa ukufuna noma ukugqugquzela izidakamizwa noma ucansi, kodwa hhayi 'ukuthanda' noma i-hedonic tone [12].

Ukucutshungulwa kwezidakamizwa-ukucutshungulwa kwezidakamizwa kanye nokufunwa kwe-nicotine, i-cocaine ne-alcohol ezinomthelela omunwe kuhlanganise ne-ventral striatum, i-DACC ne-amygdala [13]. Esikhathini sesifundo samanje, lezi zifunda zenziwe kusebenze ngesikhathi sokubukwa kwezici zobulili ezicacile kuwo onke amaqembu angaphandle futhi ngaphandle kwe-CSB. Ukubheka kokusebenza okunamandla kulezi zifunda ku-CSB ngokuhambisana nabahlanganyeli abavolontiya abanempilo kufana nokuthola okubanjwe izidakamizwa ezidakamizwa ezidakamizwa, okuphakamisa ukufana kwe-neurobiological kuzo zonke izinkinga.

Esifundweni samanje ekuphenduleni imibono ecacile ngokobulili, isifiso sobulili sasihlotshaniswa nomsebenzi omkhulu we-DACC, futhi umsebenzi omkhulu wenethiwekhi we-DACC-ventral-amygdala osebenzayo wawuhlobene nesifiso esithuthukisiwe kakhulu kwizifundo ze-CSB kunezifundo ezivolontiya eziphilile . Izihloko ze-CSB nazo zabonisa umsebenzi omkhulu we-substantia nigra uma uqhathaniswa namavolontiya anempilo, ngaleyo ndlela ehlanganisa ukutholakala komsebenzi we-dopaminergic. Kubantu nasezimpilweni ezingezona zomuntu, i-DACC iyinhloso ebalulekile yokuqapha kwe-dopaminergic kusuka endaweni ebizwa ngokuthi yi-substantia nigra ne-ventral tegmental [47], ama-tracking salience nezibonakaliso zephutha zokubikezela. I-DACC ithumela ukuhlolisisa kwe-anatomical ku-striral ne-dorsomedial striatum, okubandakanyeka ekumelelweni kwezimpawu zokubaluleka nokuvuza kanye nokugqugquzela okuphindaphindiwe kwesikhala se-baseal basal ye-amygdala ukuthola ulwazi ngalezi zenzakalo ezithinta ngokomzwelo [48], [49]. Lesi sifundazwe sinokuxhumana okuningi nezifunda ze-cortical kufaka phakathi ama-premotor, ama-motor eyinhloko kanye ne-fronto-parietal cortices futhi ifakwe kahle ukuze ithonye ukukhetha kwesenzo. I-DACC ibandakanyeka ekucubungulweni kobuhlungu, ukuphazamiseka okungahambi kahle nokulawulwa kwengqondo [48], ngezifundo zamuva eziqokomisa indima ye-DACC ekuboniseni iphutha lokubikezela futhi libuyisele ukulindela [50], [51], ikakhulukazi ukuqondisa ukufunda-umvuzo wokufunda [52], [53]. Iziphumo zethu zokuxhumana ezisebenzayo zihambisana nendima yenethiwekhi eguquguqukayo ku-DACC ekucubunguleni imivuzo yobulili nasekusebenzeni okuhlobene nocansi nokuhlobene nobuhlobo bayo nesifiso njengesignali eshukumisayo.

Okutholakele kwethu kusikisela ukuthi umsebenzi we-DACC ubonisa indima yesifiso sobulili, okungenzeka kube nokufana nesifundo ku-P300 kwizifundo ze-CSB ezihambisana nesifiso [25]. Sikhombisa ukungafani phakathi kweqembu le-CSB namavolontiya anempilo kanti lesi sifundo sangaphambilini asinaso iqembu lokulawula. Ukuqhathaniswa kwalolu cwaningo lwamanje kanye nezincwadi zangaphambilini kwi-CSB ezibhekene nokusabalalisa i-MRI kanye ne-P300 kunzima kunikezwa ukuhlukahluka kohlelo. Izifundo ze-P300, ikhono elihlobene nomcimbi elisetshenziselwa ukutadisha ukunakekelwa kokukhathazeka kokusetshenziswa kwezidakamizwa, bonisa izinyathelo eziphakeme mayelana nokusetshenziswa kwe-nicotine [54], utshwala [55], nama-opiates [56], ngezinyathelo ezivame ukuhambisana nama-indices okufunayo. I-P300 nayo ijwayele ukutadisha ngezidakamizwa zokusebenzisa izidakamizwa besebenzisa imisebenzi engavumelekile lapho okuhloswe khona okungenani okungase kube khona okuhlangene namazinga aphezulu angenayo imigomo. Ukuhlaziywa kwe-meta kubonise ukuthi izihloko zokusetshenziswa kwezidakamizwa-izidakamizwa kanye namalungu omndeni angathintekile wehlile ukuphakama kwe-P300 uma kuqhathaniswa namavolontiya anempilo [57]. Lokhu okutholakele kuphakamisa ukuthi ukuphazamiseka kokusetshenziswa kwezidakamizwa kungabonakala ngokungabi khona kahle kwezinsizakusebenza zokunaka imininingwane efanelekile yokusebenza kwengqondo (imigomo engeyona eyezidakamizwa) ngokuthambekela kokunakwa kokunakwa kwezidakamizwa. Ukwehla kwe-P300 amplitude nakho kungaba uphawu lwe-endophenotypic lokuphazamiseka kokusebenzisa izidakamizwa. Izifundo zamakhono ahlobene nomcimbi agxile ekuhambisaneni nogqozi kwe-cocaine ne-heroin cues kuqhubeka nokubika okungajwayelekile ezingxenyeni zamuva ze-ERP (> 300 milliseconds; [58]-[60]. I-LPP ikholelwa ukuthi iboniswa kokubili ukuthunjwa kokuqala (400 kuya ku-1000 msec) futhi okuqhubekayo kusetshenziselwa ukugqugquzelwa okubalulekile. Izihloko ezinokusetshenziswa kwezidakamizwa ze-cocaine zaphakamisa izinyathelo zokuqala ze-LPP uma kuqhathaniswa namavolontiya anempilo acacisa indima yokubheka kuqala ukuthunjwa kokugqugquzela kanye nezimpendulo ezithintekayo ezimangalisweni ezingokomzwelo ezimnandi. Kodwa-ke, izinyathelo zeLPP zekwephuzile azifani kakhulu nalabo abasezivolontiya ezinempilo [61]. Ama-generator we-P300 okuhlobene nomcimbi okuhlobene nomcimbi wezimpendulo ezihlobene nokubhekiswe kukholakala ukuthi yi-cortex ye-parietal futhi i-cingulate [62]. Ngakho-ke, kokubili umsebenzi we-DACC ocwaningweni lwamanje we-CSB nomsebenzi we-P300 obikiwe ocwaningweni lwe-CSB wangaphambilini ungabonisa izinqubo ezifanayo zokuqala zokubamba. Ngokufanayo, kokubili izifundo zibonisa ukuhlangana phakathi kwalezi zinyathelo ngesifiso esithuthukisiwe. Lapha siphakamisa ukuthi umsebenzi we-DACC uhambelana nesifiso, okungase kubonise inkomba yokulangazelela, kodwa akuhambisani nokuthanda okusikisela ekutheni umthamo wokulutha umfutho we-incentive-salience.

Okutholakele kwamanje kusikisela amathonya ahlobene neminyaka ekusetshenzisweni kwezici zocansi. Ukuqhathaniswa kwe-fronto-cortical indaba ebomvu ehilelekile ekulawulweni okuphezulu kuqhubeka ekukhuleni phakathi no-20 s [63]. Ingozi ekhulisiwe ebantwaneni abasha ingabonakalisa ukuthuthukiswa kwangaphambili kwesisusa somgqugquzeli kanye nomvuzo wesifunda esihlobene nokuthuthukiswa okubambezelekile kwezinhlelo zokulawula eziphezulu ezithintekayo ekuqapha noma ekuvimbeleni ukuziphatha [31], [64], [65]. Ngokwesibonelo, intsha iye yabonisa umsebenzi omkhulu wokuzibulala ohambisana ne-prefrontal cortical umsebenzi ngesikhathi sokucubungula umvuzo uma kuqhathaniswa nabantu abadala [65]. Lapha sibona ukuthi izifundo ezihlukahlukene, ukukhula kwentsha kuhlotshaniswa nomsebenzi omkhulu we-ventral wokuhlaselwa emibonweni ecacile ngokobulili. Lokhu kusebenza emisebenzini yokuqothulwa kwemvelo kubonakala ngokuqinile kwizihloko ze-CSB, okuphakamisa indima engaba khona yesikhulumi sokudala ekuphenduleni imibono yezocansi ngokujwayelekile nakwi-CSB ngokuqondile.

Ngokuhambisana nezincwadi zokusebenza kobuchopho ezivolontiya ezinempilo ukuchaza izindawo ezicatshangelwe zobulili ezicacile, sibonisa inethiwekhi efanayo kufaka phakathi ama-cortices e-occipito-temporal kanye ne-parietal, i-insula, i-culaulate kanye ne-orbitofrontal ne-inferior cortices yangaphambili, i-gyrus yangaphambili, i-caudate, i-ventral i-striatum, i-pallidum, i-amygdala, i-substantia nigra ne-hypothalamus [13]-[19]. Ukuhlala isikhathi eside kokusetshenziswa kwezinto ezicacile ku-intanethi kumadoda aphilile kuye kwaboniswa ukuthi ihambisana nomsebenzi we-putaminal ophansi ongakwesokunxele ukuze kufushane imifanekiso ecacile esho ukuthi indima engase ibe khona yezinkinga ezimbi [23]. Ngokuphambene nalokho, lolu cwaningo lwamanje lugxile eqenjini lezinkinga ze-CSB elibhekene nobunzima bokusebenzisa ukusetshenziswa okuhambisana nemiphumela emibi. Ngaphezu kwalokho, lolu cwaningo lwamanje lusebenzisa amavidyo kliphu uma kuqhathaniswa nemifanekiso emfushane. Kuzivolontiya ezinempilo, ukubukwa kwezithombe ezithinta izithombe ezincane uma kuqhathaniswa neziqeshana zevidyo kunamaphethini wokusebenza okulinganiselwe okuhlanganisa i-hippocampus, i-amygdala nama-cortices yangemva kwesimo se-temporal nama-parietal [20] ukuphakamisa ukungalingani kwe-neural okungenzeka phakathi kwemifanekiso emfushane namanje namavidiyo asele asetshenziswe kulesi sifundo samanje. Ngaphezu kwalokho, ukuphazamiseka kwezidakamizwa ezifana nokukhathazeka kokusebenzisa i-cocaine kuye kwaboniswa ukuthi kuhlotshaniswa nokuxhaswa okuthuthukisiwe okwamanje lapho abasebenzisi be-cocaine bezokuzijabulisa bengakabonakali ukuthi baye bathuthukiswa [66] sukuphazamisa ukuhlukahluka okukhona phakathi kwabasebenzisi bokuzilibazisa nabazondayo. Ngakho-ke, umehluko phakathi kwezifundo kungabonisa ukungafani kwabantu noma umsebenzi. Ukutadisha kwethu kusikisela ukuthi ubuchopho buphendula emabalazweni avela ku-intanethi kungahlukahluka phakathi kwezihloko nge-CSB uma kuqhathaniswa nabantu abanempilo abangase babe abasebenzisi abakhulu bezinto ezibonakalayo eziku-intanethi kodwa ngaphandle kokulahlekelwa kokulawula noma ukuhlangana nemiphumela emibi.

Ucwaningo lwamanje lunamkhawulo amaningi. Okokuqala, lolu cwaningo luhilelekile kuphela izifundo zesilisa, futhi izifundo zesikhathi esizayo kufanele zihlolisise abantu abathintekayo kwezocansi kanye nabesifazane, ikakhulukazi njengoba amantombazane abanezinkinga zempilo yengqondo angabonisa izinga eliphezulu le-CSB [67]. Okwesibili, nakuba izifundo ze-CSB kulesi sifundo zihlangabezane nezinqubo zokuhlonza okwesikhashana futhi zibonakele ukukhubazeka okusebenzayo okuphathelene nobulili besebenzisa izikali eziningi eziqinisekisiwe, okwamanje azikho izimo zokuhlonza ezihlelekile ze-CSB ngakho-ke lokhu kubonisa umkhawulo wokuqonda okufundwayo nokuwabeka ngaphakathi kokukhulu izincwadi. Okwesithathu, unikezwe uhlobo lwesigaba esiphambene nesifundo, okukhulunywa ngakho mayelana nesimo asikwazi ukwenza. Ucwaningo lwesikhathi esizayo lufanele luhlolisise izinga lokusebenza kwe-neural ekubhekaneni nezocansi kungase kubonise ukuthi kungase kubonakale ukuthi kukhona engozini yokubeka engcupheni noma ngabe ukuchayeka okuphindaphindiwe, okungenzeka kuthonywe intsha futhi kufinyeleleke kakhulu ezintweni ezicacile ngokobulili, kungaholela emaphethini we-neural egcinwe ku-CSB. Ucwaningo oluqhubekayo lwezinto ezizokwenzeka noma labo ababhekene namalungu omndeni abangathinteki kufanelekile. Ibanga elilinganiselwe yobudala esifundweni singase futhi limise ukutholakala okungenzeka. Okwesine, ukutadisha kwethu kwakugxile kakhulu ekusetshenzisweni okuphoqelelwe kwezinto eziku-inthanethi ngokushaya indlwabu ehambisanayo nokusetshenziswa kangako kwe-inthanethi ye-inthanethi noma ukusetshenziswa kwezinsizakalo zokuhambisa. Njengoba lezi zihloko zibhalwa ezikhangisweni zombili zakwa-intanethi nasezilungiselelweni zokwelapha, ngabe zimelela ngokugcwele izihloko ezilungiselelweni zokwelashwa azicaci kahle. Ucwaningo lwezihloko ze-207 ezifuna ukwelashwa kwe-CSB ezisetshenziselwa ukuhlolwa kwesimo se-DSM-5 ukuze kutholakale ukukhubazeka kocansi ocansini kufana nokuziphatha okuvame kakhulu ukusetshenziswa kocansi (81.1%), ukushaya indlwabu (78.3%), ucansi lwe-inthanethi (i-18.1%) nobulili nabantu abadala (44.9%) [33] siphakamisa ukufanana phakathi kwabantu bethu futhi lokhu kubika abantu besifundo. Kodwa-ke, izifundo ezigxile ekufuneni ukwelashwa kwabantu zingabonisa ukuqina okukhulu kwezimpawu. Sisebenzise isifunda sokuhlaziywa kwesithakazelo kunokuba senze konke okuphathelene nobuchopho. Ngakho-ke, isampula encane nokuntuleka kobuchopho obuphelele ukulungiswa indlela kuyimingcele. Nokho, kunikezwe amandla ethu a priori ukucabanga okusekelwe kulwazi olutholakalayo lwe-meta-analytic kusuka ekucwaningweni kwe-reactivity izifundo, sazizwa isifunda sokuhlaziywa kwesithakazelo umndeni wephutha elihlakaniphile elungiselelwe ukufaniswa okuningi, indlela esetshenziselwa ukucwaninga nge-imaging [68], kwakuyindlela enengqondo.

Ukuthola okukhona kwamanje futhi okukhona kuphakamisa ukuthi inethiwekhi evamile ikhona ekusebenzeni ngokocansi nokuqaphela izidakamizwa ngamaqembu nge-CSB nezidakamizwa zezidakamizwa, ngokulandelana. Lokhu okutholakele kuphakamisa ukudluliselwa kwamanethiwekhi aphethwe izifo zokusetshenziswa kwezidakamizwa zezidakamizwa kanye nemivuzo yemvelo. Ngenkathi lolu cwaningo lungase luphakamise ukugqashuka ngezidakamizwa zokusebenzisa izidakamizwa, kudingeka kwenziwe izifundo eziqhubekayo zokwelashwa ukuze kunqunywe ukuthi ngabe i-CSB kufanele ihlelwe yini njengengxabano yokulawula umfutho, ngaphakathi kwe-spectrum okucindezelayo noma njengokweqile ukuziphatha. Izifundo ezinkulu ze-epidemiological ezinamazinga amaningi okulandelwa kwesikhathi eside zidingeka ukuba zihlole imvamisa ye-CSB nemiphumela yayo yesikhathi eside. Ucwaningo lwe-epidemiological ebuhlotsheni obuphakathi kwe-CSB kanye nokukhathazeka kokungafisi, ukuphoqeleka nokulutha okudingekayo. Ngokufanayo, ukuqhathaniswa okubanzi ngokwengeziwe kumaphrofayli engqondo kanye neurophysiological kuzo zonke izinkinga kuzoba usizo ekuthuthukiseni phambili imizimba ye-physiological kanye ne-neural amanethiwekhi abangela lezi zinkinga. Sigcizelela futhi ukuthi lokhu okutholakele kubalulekile ikakhulukazi eqenjini labantu abakha ubunzima ngokusetshenziswa okuphoqelekile kwezinto ezibonakalayo zobulili ezingenasici futhi cishe akubonakali kubantu abanzi abasebenzisa izinto ezinjalo emikhuba engeyona eyingozi. Okutholakele kubonisa ithonya lobudala ekusebenziseni ukuphindaphindiwe kwesibindi kumvuzo wokulala ngocansi, ikakhulukazi eqenjini le-CSB. Njengoba kunikezwe ukunyuswa kwamuva kokusetshenziswa kwe-Inthanethi, kubandakanya phakathi kwabantu abasha, nokufinyelela okulungele ekuthengeni izinto ezicacile zobulili, izifundo ezizayo ezigxile ekuboneni izinkinga eziqondene nabantu (ikakhulukazi kwentsha) engozini yokuthuthukisa i-CSB zifanelekile.

Ukusekela Ulwazi

Ifayela le-S1.

Ukusekela ulwazi.

i-doi: 10.1371 / iphephandaba.pone.0102419.s001

(I-DOCX)

Ukuvuma

Sithanda ukubonga bonke abahlanganyeli abahlanganyele ekutadisheni kanye nabasebenzi e-Wolfson Brain Imaging Centre. UDkt. Voon ungumuntu ophakathi we-Wellcome Trust. Isiteshi se-4 sasihilelekile ekusizeni ngokuqasha ngokubeka izikhangisi ezisekelwe ku-intanethi zesifundo.

Iminikelo Yomlobi

Yakhelwe futhi yenzelwa ukuhlolwa: VV. Yenza ukuhlolwa: VV TBM PB LP SM TRL JK MI. Uhlaziye idatha: VV TBM PB LP LM SM TRL JK NAH MNP MI. Wabhala leli phepha: VV TBM PB LP LM SM TRL JK NAH MNP MI.