Ngaphambili. I-Psychiatry, i-14 November 2018 | https://doi.org/10.3389/fpsyt.2018.00546
Mateusz Gola1,2 * futhi I-Małgorzata Yakha1
1Institute of Psychology, IsiPolish Academy of Sciences, iWarsaw, ePoland
2Isikhungo se-Swartz se-Computational Neuroscience, Institute for Neural Computations, University of California, San Diego, San Diego, CA, United States
Ukunciphisa Ngokweqhaza Ngokwecansi (CSB) kuyisizathu sokufuna ukwelashwa. Njengoba kunikezwe lokhu, inani lezifundo kwi-CSB liye landa kakhulu eminyakeni eyishumi edlule kanti i-World Health Organization (WHO) ihlanganisa i-CSB ekuphakamisweni kwayo kwe-ICD-11 ezayo. Amaphesenti angamashumi ayisithupha ezinkampanini ze-CSB ezanyatheliswa kusukela ngo-2014 zihloswe ukuhlola ukufana nokuhlukana phakathi kwezinqubo zobuchopho ezithinta i-CSB, ukubheja kokugembula, nokuphazamiseka kokusetshenziswa kwezidakamizwa. Esinye sezifunda ezibalulekile zobuchopho ezihilela ukulutha umlutha wuhlelo lokuvuza olubandakanya i-ventral striatum (kubandakanya i-nucleus accumbens). Kukhona imibono emibili ehlukene echaza umsebenzi wokuhlaselwa komuntu ongathandwayo emithini yokulutha: I-Incentive Salience Theory (IST) ne-Reward Deficiency Syndrome (RDS). I-IST ichaza ukukhushulwa kwe-ventral okwenyukayo ngesikhathi sokulindela umvuzo ohlobene nomlutha, kuyilapho i-RDS ichaza ukwehla kokucubungula kwe-ventral kokubili ngesikhathi sokulindela umvuzo kanye nokucubungula umvuzo. Lapha, sihlose ukuphenya ukuthi iziphi izinto ezitholakalayo ekusebenzeni kabusha kwe-CSB ekusekelweni kwe-CSB ngayinye yalezi zinhlaka zombili zokulutha. Ngenxa yalokhu, senze ukubuyekezwa okuhlelekile kwezifundo ze-neuroimaging kwi-CSB etholakalayo ku-Pubmed, EBSCO, naku-Google Scholar phakathi kwe-2005 ne-2018. Sithole amaphepha ayisifundo ayisishiyagalolunye afanele. Izifundo ezine kuphela eziphenywe ngokucubungula ukucubungula izici zemiqondo kanye / noma imivuzo kanye nokuthola okuhlangenwe nakho okuhlobene nokusebenza kwe-ventral striatum. Izintathu zalezi zifundo zibonisa ukukhula okuqhubekayo kwe-ventral yokuhlasela okungahambi kahle, okuhambisana ne-IST futhi ayisekeli ukubikezela okusekelwe ku-RDS. Ngakho-ke, isimo samanje salesi datha sikhombisa ukuthi i-CSB ihlobene nokwenyuka kwe-reactivity ye-ventral ngesikhathi sokulindeleka kwezinto ezithandayo.
Isingeniso
Izithintelo Zokuhlukunyezwa Ngokobulili (CSB) yisizathu sokufuna ukwelashwa kokubili abesilisa (1-3) nabesifazane (4). Izimpawu ezivame ukubikwa kwe-CSB isikhathi esichitha ukubuka izithombe zobulili ezingcolile (ikakhulukazi kwi-inthanethi) nokushaya indlwabu ngokweqile (5-7). Ezinye izinhlobo ezibikiwe zokuziphatha zihlanganisa ubudlelwane obuyingozi bokuzicansi, ubulili obungaziwa, nokusetshenziswa kwezinsizakalo zobulili ezikhokhelwayo (8).
Inani lezifundo kwi-CSB liye landa kakhulu phakathi neminyaka eyishumi edlule (9, 10) kanye ne-World Health Organization (WHO) ihlanganisa i-CSB njengengcindezi yokulawula isisindo (11) ekuphakamisweni kwayo kwe-ICD-11 ezayo (12). Ngokweziphakamiso ezihlongozwayo (ezifana kakhulu nalabo ngaphambilini ezahlongozwa nguKafka (6), singase siqaphele ukukhubazeka kwe-CSB uma kulandela izimpawu ezilandelayo esikhathini esingenani izinyanga ze-6:
1. Isikhathi esiningi esichithwa emibonweni yezocansi, ukunxusa, noma isimilo siphazamisa kaningi ezinye izinhloso (ezingezona ezocansi), imisebenzi, kanye nezibopho, okusho ukuthi, ukubuka izithombe zocansi sekuyinto ebalulekile empilweni yomuntu, ukuze imisebenzi yomndeni noma izibopho zomsebenzi abanakwa;
I-2. Le ndaba iqhutshwa ngokuphindaphindiwe kulezi zenzo zocansi ngokuphendula emazweni angokomzwelo we-dysphoric, okungukuthi, umsebenzi wezocansi usuyiqhinga eliqinile lokulawulwa kwemizwelo;
I-3. Futhi / noma ekuphenduleni izimo ezicindezelayo; isib, ngezikhathi ezicindezelayo emsebenzini;
I-4. Naphezu kwemizamo ephindaphindiwe, lesi sihloko asikwazi ukulawula noma ukunciphisa kakhulu le misebenzi yezocansi, okungukuthi, isihloko senza imizamo eminingi engaphumelelanga yokunciphisa imisebenzi enenkinga, kodwa njalo ilahlekelwa ukulawula phezu kwazo emva kwezinsuku ezimbalwa;
I-5. Le ndaba iyaqhubeka nalezi zenzo zocansi naphezu kwengozi yokulimala ngokomzimba noma ngokomzwelo kumuntu noma kwabanye, okungukuthi, ukuziphatha ngokuziphatha ngokocansi njalo naphezu kwemiphumela ebuhlungu ebuhlotsheni (isib. Ukuphumula) noma usongo lokulahlekelwa umsebenzi.
Ukuvama kanye nokuqina kwalezi zenzo zocansi kubangela ukucindezeleka komuntu siqu emzimbeni noma ukungasebenzi emisebenzini ebalulekile yokuphila futhi akuveli ekusebenziseni izidakamizwa okungavamile (isib. Ukusetshenziswa kabi kwezidakamizwa noma imithi), ukucindezeleka kwe-bipolar, noma i-paraphilia.
Amaphethini we-Ventral Activation Striatal Ngokusho kwama-Frameworks of Addictions
Esinye sezifunda ezibalulekile zobuchopho ezihilela ukulutha umlutha wuhlelo lokuvuza oluhlanganisa lezi zakhiwo zobuchopho njengendawo ye-ventral (enye yezindawo eziyinhloko zokukhiqiza i-dopamine ebuchosheni) ne-ventral striatum, indlela ye-mesocortical, ne-correx ye-cerebral, ikakhulukazi i-orbitofrontal kanye ne-cortex yeziphambano (13-16). Ngokwemvelo, i-ventral striatum kubantu kanye nezilwane ezingezona abantu zihlanganisa i-nucleus accumbens, isifunda phakathi kwe-nucleus ye-caudate ne-ventral putamen ku-capsule yangaphakathi yama-rostral, i-tubercle enamabala, nesabelo se-rostrolateral isikhala esiphezulu esingaphansi kwesigcawu esilandelayo (17, 18). Kodwa-ke, izifundo zokuxhumana kwabantu zibonisa ukuthi i-ventral striatum ihlanganisa i-nucleus accumbens nesifunda esikhulu se-caudate nucleus ne-rostroventral putamen (19).
I-striral striatum ithola ukungena kwe-cortical kusuka kwe-cortex yangaphambili ye-orbital ne-cortex yangaphakathi ye-cingulate ngaphezu kokufakelwa kwe-dopaminergic kusuka emkhatsini we-midbrain. Imiklamo efanayo yesifunda esivela ku-pallidum ye-ventral nasendaweni ye-ventral tegmental, okuyinto iphrojekthi ebuyisela emuva kwe-correx ye-prefrontal ngokusebenzisa i-nucleus yangaphakathi e-thalamus. Lesi sigaba siyingxenye ebalulekile ye-cortico-basal ganglia system (19). Ama-nodes ahlukene ale nethiwekhi adlala indima ehlukene kulezi zici zokucubungula umvuzo njengezisusa kanye nenjabulo ye-hedonic (20, 21). I-striral striatum (ikakhulukazi i-nucleus accumbens) mhlawumbe isifunda sebuchopho esifundwe kakhulu kunomongo wokucubungula umvuzo (22, 23), kubonisa ukuvuselelwa ngesikhathi sokulindela nokwamukela izinhlobo ezahlukene zemiklomelo (24, 25).
Kule mibono eminingi yokulutha izidakamizwa ezithakazelisayo, lapha, singathanda ukugxila kokubili okuvumela ukubikezela okucacile mayelana nokusebenza kokuqeda kwe-ventral nokuxhumanisa kwayo ekuziphatheni okuluthayo: I-Incentive Salience Theory [IST, (26-28)] kanye noMvuzo Wokunciphisa Syndrome [RDS; (29, 30)].
Umhlahlandlela we-Incentive Salience Theory, ohlongozwa nguRobinson noBerridge (28), uhlukanisa phakathi kwezingxenye ezimbili eziyisisekelo zokuziphatha okukhuthazayo- "ukuthanda" nokuthi "ukufuna." "Ukuthanda" kuxhunywe ngqo wazibonela ukubaluleka komvuzo, okuvame ukuqhutshwa ngokungahambisani nemibandela efana ne-heroine ukusetshenziswa; Ngakolunye uhlangothi, "ukufuna" kuhlobene no kulindelwe ukubaluleka komvuzo, okuvame ukuqhutshwa yisimo somthetho (isibonelo, ukutholakala kwabantu abasebenzisa izidakamizwa). Izifundo ezithinta izinto zokugembula nokugembula zibonisa ukuthi ufunde ama-stimuli anomgomo (okuthiwa cues) okuhlobene nokulutha umlutha kuphakamisa izimpendulo ezengeziwe kwi-ventral striatum kanye nokuziphatha okukhushulwayo okwenyuka (kuboniswe ngezikhathi ezimfushane zokuphendula) phakathi kwabantu abanomlutha, kuyilapho izimpendulo zemivuzo ngokwazo zingaguquki noma zithinteka ngokuhamba kwesikhathi (26, 31). Ngakho-ke, ngokusho kwe-IST, uma izinkinga ze-CSB zihlanganyela ngezinqubo ze-neural nezidakamizwa, kufanele sibone impendulo yokwandiswa kwegazi-Oxygen-Level-Dependent (BOLD) emgodini we-ventral ngokuqondile ukukhomba ukuveza imivuzo engavamile / ngokobulili, kulandela ukugqugquzela okuphezulu ukuthola kubo (kulinganiswa njenge-RTs emfishane) phakathi kwabantu abane-CSB uma kuqhathaniswa nezinye iziqephu zokubikezela ezinye izinhlobo zezinkomba ezivuzayo.
I-theory ye-Reward Deficiency Syndrome (29, 30) kubeka ukuthi abantu abanokuziphatha okuluthayo banokushoda okujwayelekile ekutholeni izindlela zomvuzo wobuchopho, okuholela ekuqedeni amandla okungapheli kwalezi masekhethi futhi okuthiwa kunciphise ulwazi olujabulisayo oluvela emivuzweni. Ukuziphatha okuluthayo, njengokusebenzisa izidakamizwa noma ukugembula, ngenxa yalokho kuqalwa ukukhokhela lokhu kusweleka komvuzo nokukhuthaza ukujikeleza komvuzo wobuchopho32). Ngokusho kwe-RDS, uma iqembu labantu abane-CSB lifana nezihloko ezinezidakamizwa zokugembula nokugembula, kunalokho kufanele sibone ukunciphisa ukuqhuma kwe-ventral eqenjini le-CSB ngokuphendula futhi ngesikhathi sokucubungula umvuzo uma kuqhathaniswa nokulawula okunempilo.
Ngaphambi kokuxoxa ngemiphumela yezifundo ezishicilelwe, kufanelekile ukuphawula ukuthi ngokusho kokuqonda kwethu, i-IST ne-RDS aziphikisana, kodwa kunalokho okuhambisanayo, izindlela. Kungase kubonakale kungenakuphikisa ngoba i-IST ibikezela ukuthi inyuvesi ye-ventre yenzelwe ukukhushulwa kwezingxoxo ezihlobene nomphumela wokuziphendulela / ngokocansi, kuyilapho i-RDS ibikezela ukuthi kuncishiswe izinyathelo zokuqeda izinyathelo ezinjalo uma kuqhathaniswa nabantu abakwa-CSB uma kuqhathaniswa nokulawula okunempilo. Kodwa ngenxa yokuqonda kangcono, sidinga ukuthatha umsuka wazo zombili izinhlaka zibe yi-akhawunti. I-RDS ichaza ukuthambekela okuzalwa, okwenziwe ngokwezakhi zofuzo zokungasebenzi kahle kwezijikelezi zomvuzo. Uhlaka lwe-RDS luhlobanisa lo mkhuba ongenasici ekuguqulweni kwezakhi ezithile, ngaphandle ngoba esimweni sokulutha, lapho ukuthambekela okuhlobene khona nokuguquguquka okungaqondile (20, 30, 33). Ngakolunye uhlangothi, i-IST ibheka ukuthi ukukhuthazwa komthelela wezinhlobo ezithile zamagama kungatholakala ngokusebenzisa izinqubo ezijwayelekile zokufunda nokufunda; Nokho, esimweni sabantu abanesimo esithile (isibonelo, abathinteli uphawu: izilwane ezithandwa kakhulu ekufundeni okusheshayo kwezingcaphuno zokubikezela imivuzo (34, 35)], le nqubo yokufunda ingaba ngokushesha kakhulu.
Ngakho-ke, singacabanga ukuthi abanye abantu abane-phenotype echazwe yi-RDS bakhiqize ukukhohlisa okwenziwe nganoma yiluphi uhlobo lwemivuzo kanye nezinkomba zabo ezihambisanayo, futhi bethula ngokusebenza okuphansi kwe-ventral striatum uma kuqhathaniswa nabantu abaningi. Kodwa-ke, ngasikhathi sinye, laba bantu abafanayo bafundile ukuthi ezinye izinhlobo zezinto ezishukumisayo noma izinto zibanikeza injabulo enkulu — ngakho-ke, zonke izinkomba ezihambisana nalezi zinto ezenza ubumnandi zithole ukukhuthazeka okukhulu, ngombandela ngamunye (njengoba kuchaziwe ku-IST) . Kulezi zinkomba ezithile, leli qembu le-ventral striatum lingenziwa lisebenze kakhulu kunalapho liqhathaniswa nabantu abaningi futhi uma liqhathaniswa nezinhlobo ezahlukahlukene zezinkomba. Ngalesi sibikezelo, sihlose ukubuyekeza idatha etholakalayo ye-neuroimaging ekusebenzeni kwe-ventral striatal ku-CSB.
Uma ngabe i-CSB ihlobene kakhulu ne-IST, kufanele sithole izifundo eziningi ezibonisa ukwanda kwemisebenzi eyenziwa yi-ventral ngesikhathi sokulindela ukukhushulwa komuntu phakathi kwabantu abane-CSB uma kuqhathaniswa nokulawula okunempilo. Uma i-CSB ihlobene kakhulu ne-RDS, kufanele sibone izifundo ezengeziwe ezibonisa ukunciphisa ama-reactivity we-ventral okuhlaselwa kunoma yiluphi uhlobo lwezinzuzo phakathi kwezihloko ze-CSB uma kuqhathaniswa nokulawulwa okunempilo, futhi kungenzeka ukuthi kunciphise ukusebenza kwe-ventral striatum ngesikhathi kulindeleke umvuzo, kanjalo.
izindlela
Ngenhloso yalokhu kubuyekezwa, siseshe imininingwane ye-Google Scholar, Pubmed, ne-EBSCO yamaphepha wesayensi ashicilelwe ezincwadini zokubuyekezwa kontanga (ngaphandle kwezikhalazo zenkomfa) phakathi kukaJanuwari 1, i-2005 no-February 22, i-2018. Sifaka kuphela izincwadi ezisetshenziselwa ukufaneka kwemifanekiso ye-magnetic resonance (fMRI), njengoba sinesithakazelo ekuphenduleni kwe-BOLD ye-striral striatum futhi kufaka phakathi amagama angukhiye njengokuziphatha okucindezelayo ngokobulili, izithombe zobulili ezingcolile, ukubheja ngokobulili, ukuxhaswa ngokobulili, ukuxilongwa ngokobulili, ukuhlukunyezwa kobulili obucayi, nokusebenzisa izithombe zobulili ezingcolile. ukuxilongwa kwe-pornography ye-intanethi. Usesho lwenziwe ngoFebhuwari 22 noFebhuwari 25, i-2018. Sifake kuphela izihloko ezishicilelwe ngesiNgisi. Sithole izincwadi eziyisishiyagalolunye ezihlangabezane ne-search criteria (ithebula 1), eziyisithupha zazo ezihlolisise ngokucacile ukusebenza kwe-ventral striater ngesikhathi sokucubungula noma ukucubungula umvuzo (36-42). Ukufakwa kanye / noma ukungabikho kuzo zonke izincwadi ezibhalwe phansi kwaxoxwa ngabahluleli ababili. Njengoba inani lezincwadi eziyisikhombisa (futhi eziyisikhombisa libika noma yimiphi imiphumela ehlobene ne-ventral striatum), asikhethanga izifundo ngokusekelwe ngezindlela ze-CSB ukuxilongwa; Ngakho-ke, sichaza izindlela ezithile ezisetshenziselwa izigaba zezifundo kuThebula 1.
Ithebula 1. Izincwadi zokucwaninga nge-CSB noma ukusetshenziswa kwezithombe zobulili ezingcolile kusetshenziswa i-imaging resonance esebenzayo.
Ukubuyekezwa Kwemininingwane Ekhona Kusebenze Kwe-Ventral Striatal ku-CSB
Okokuqala, sizoxoxa ngezifundo ngokuqondile ekubhekiseni ukucubungula nokubuyiswa komvuzo. Phakathi kwalezi zifundo eziyisikhombisa ezibika izinyathelo zokuhlukumezeka ezingenasisindo ngenxa yezinkomba noma imivuzo engezansi, ezimbili zaqhutshwa emphakathini osemtholampilo [abasebenzisi bezithombe zobulili ezingcolile abavamile; (38, 39) akukona ukugcwalisa imigomo ye-CSB] kanti ezinhlanu ezisele zenziwa emiphakathini yemitholampilo egcwalisa imigomo ye-CSB [noma yiziphi izifundo ezazethula nge-CSB ehlukahlukene (37, 40-42) noma abantu abafuna ukwelashwa ikakhulukazi ekusetshenzisweni kobulili obuyinkimbinkimbi (36)]. Izifundo ezimbili zenziwa kubantu abafanayo (37, 42). Zonke izifundo zasebenzisa izithombe ezithandwayo, kodwa enye yevidiyo esetshenziswa ngokucacile (37). E-Kühn naseGallinat (38), USeok noSohn (40), neBanca et al. (42), abalobi baqhathanisa ukuphindaphindiwe kwe-ventral phakathi kwama-erotic ne-neutral, ku-Voon et al. (37), phakathi kwamavidiyo acacile nokuthakazelisayo, kuBrand et al. (39), phakathi kwezithombe ezikhethwayo nezingezona ezithandwayo, nakuGola et al. (36) emkhatsini wezithombe ezithinta izithombe kanye nemivuzo yemali kanye naphakathi kwama-cues ukubikezela izithombe ezithinta izithombe kanye nokuzuza kwezimali.
Ingxoxo
Ukucabangela umzimba olinganiselwe wezincwadi zokuhlola (eziyisikhombisa) ukubika ukusebenza kwe-ventral striatum ngenkathi kusetshenziselwa ukususa okungahambi kahle nokungazenzisi kubantu abahlangabezana nemigomo ye-CSB noma emiphakathini engaphansi kwemitholampilo, ezithola iziphetho ezinamandla ngalesi sikhathi ngaphambi kwesikhathi. Ngakho-ke, singathanda kuqala ukuxoxa ngemiphumela etholakalayo, bese uphakamisa ukuhumusha kwabo kumongo we-IST nama-RDS.
Phakathi kwabasebenzisi abangcolile bezingcolile abangenayo inkinga, ukuhlobana okuphambene phakathi kwe-striatum eqondile (ivolumu ngokucophelela kakhulu) kanye nokuvama kokusetshenziswa kwezithombe zobulili ezingcolile kubhekwe (38). Ucwaningo olufanayo lwabika ukungahambisani okungalungile phakathi kwenani lokusebenzisa izithombe zobulili ezingcolile kanye nokusebenza okusebenzayo kwe-putamen kwesokunxele ngenkathi ukubukeka kobulili kubukele. Ngaphandle kwalokho, i-Voon et al. (37) wabonisa ukuthi amadoda ahlangana ne-CSB criteria (6) uma kuqhathaniswa nalabo abangenawo i-CSB, kubonise ukukhishwa kwemiphumela yokuhlaselwa kwamavidiyo okucansi. Ngokuthakazelisayo, iziguli ze-CSB zibuka amavidiyo athakazelisayo (okungukuthi, izethulo zezemidlalo ezidlulele kakhulu) zenze izinyathelo ezingezansi ku-striatum ye-ventral uma kuqhathaniswa nezilawuli (37). Seok noSohn (40) wabonisa ukusebenza okuphezulu kwe-nucleus kwesokunxele se-caudate ekuphenduleni izithombe ezingenakuqhathaniswa eqenjini le-CSB uma kuqhathaniswa nezilawuli nokuvuselela okuphansi kwezithombe ezingathathi hlangothi ku-nucleus kwesokunxele se-caudate. I-Brand et al. (39), ngokufanayo nakuVoon et al. (37), ibonise izimpendulo ezengeziwe ze-BOLD emgodini we-ventral ekuphenduleni izithombe ezithandwayo zobulili uma kuqhathaniswa nabangewona abathandekayo, nokuthi lo msebenzi uhambelaniswe kahle nezilinganiso ekuhlolweni kwe-Inthanethi Ye-Addiction Ukuguqulwa kwe-CyberSpanx emphakathini ongaphansi komtholampilo (39). Ucwaningo lwesihlanu (36) wasebenzisa i-paradigm ehlukile kunezingxoxo ezine ngaphambilini. Esikhundleni sokumane unikeze izinhlobo ezahlukene zokwenza izinto (isib. Izinto ezithandekayo, ezithakazelisayo, noma ezingathathi hlangothi), lolu cwaningo lusetshenziswe ukuguqulwa komsebenzi wokubambezeleka, umsebenzi owawusetshenziswe ngaphambilini kwizifundo zokugembula kwengcingo (46). Lo msebenzi unempahla emibili ebalulekile: (i-1) itholakale izigaba ezihlobene nokulingana nomvuzo okuhlobene nokulindela nomphumela, ngokulandelana, futhi (i-2) inikeza ithuba lokuqhathanisa isisusa esithi "ezihlobene nokulutha umlutha" (kulokhu, izithombe ezithinta izithombe ) ngomunye umvuzo omkhulu (ukuzuza kwezimali). Kulesi sifundo, amadoda nabangenayo i-CSB ahluke ekuphenduleni kwabo okuhlukumezayo ukukhomba ukubikezela izithombe ezibucayi, kodwa hhayi ezimpendulo zabo ezithombeni ezithandayo. Izihloko ze-CSB uma ziqhathaniswa nezihloko zokulawula zibonise ukukhushulwa kokusebenza kwe-ventral striatum ngokuqondile ngamaphuzu okubikezela izithombe ezithandanayo, kodwa hhayi ukukhomba ukubikezela ukuzuza kwezimali. Ukuzwela okuhlobene nokukhomba ukubikezela izithombe ezithandanayo ngokumelene nezindleko zemali kwakuhlobene kakhulu nokugqugquzela ukuziphatha okukhulayo ukubuka izithombe ezingathandeki (ukuphakamisa okuphezulu "okufunayo"), ubunzima be-CSB, inani lokusebenzisa izithombe zobulili ezingcolile ngeviki, nenani lamakhompiyutha amasonto onke. Ngaphandle kukaKühn noGallinat (38), ezinye izifundo ezibuyekezwayo ziphakamisa ukuzwela okwenziwe ukwedlulisa amandla (37, 39) noma ku-cues ukubikezela isenzo esithinta isithunzi (36) phakathi kwabantu abanamanani aphezulu ku-CSB.
Kweminye imfundo engahlosiwe ngokuqondile nokuqaphela noma ukukhokhelwa, uBraca et al. kubonise ukwehla kwemisebenzi eyenziwa yi-CSB uma iqhathaniswa nezilawuli njengempendulo yokungabi nalutho lomvuzo noma owenziwe ngemali emsebenzini (42). Klucken et al. (41) yabonisa ukwehlisa ukuhlanganiswa phakathi kwe-ventral striatum kanye ne-prefrontal cortex ku-CSB nethimba lokulawula ngenkathi kusetshenziselwa isimo sokucindezela [emsebenzini ofana no-Banca et al. (42)].
iziphetho
Uma sigxile kakhulu emsebenzini we-ventral striatum kuzo zonke izifundo ezibalulwe ngenhla, khona-ke uhlelo oluhambisanayo lwemiphumela luvela: izithombe ezithandwayo ezithandwayo (39), amavidiyo acacile (37), noma ucaphuna ukubikezela izithombe ezingezansi (36) kuvuselela izinyathelo eziqine kakhulu ze-ventral ezingaphezu kwezinye izinhlobo zezinkomba phakathi kwabantu abane-CSB (noma abasebenzisi bezithombe zobulili ezingcolile ngokuvamile) uma kuqhathaniswa nezilawuli. Idatha ehlinzekwa nguKühn noGallinat (38) futhi iqoqwe kusuka esampula engekho emtholampilo iphinde iphakamise ukunciphisa ukuzulazula kwe-ventral striatum phakathi kwabantu abanempilo abasebenzisa izithombe ezingcolile ezingaphezulu; Nokho, ukutholakala kwamuva (47) ungaqinisekisi lo mtheksthi emgqeni we-ventral striatum emkhatsini wemibandela ye-CSB yokulawula kanye nokulawula. Kusenjalo, akukho isifundo somhlangano we-CSB womhlangano wesifunda, ukuhlola izimpendulo ze-BOLD zezinyathelo ezithintekayo, nokuhlola izinguquko ze-volumetric ngasikhathi sinye, ngakho-ke noma yikuphi ukucabangela ebuhlotsheni phakathi kwe-volumetry ye-striatal ne-reactivity kuyobe kungakapheli kuleli phuzu.
Ukuvumelana Ngokunciphisa Ukunciphisa Umvuzo
Ukuze sihlole imiphumela eshicilelwe ekukhanyeni kwe-RDS, kudingeka sibheke umehluko ekusebenziseni kwe-ventral emkhatsini we-CSB (noma emiphakathini engaphansi kwemitholampilo) namaqembu okulawula. I-RDS ibikezela ukungazenzisi ukuvuza ama-stimuli nokukhomba ukubikezela lesi simiso phakathi kokuqhathaniswa kweqembu. Akekho phakathi kwezifundo ezine ezihlolisisa ukucubungula okwenyukayo (36-39) kubonisa ukuzenzisa okunjalo uma kunesidingo esithintekayo. Nokho, kuVoon et al. (37), iqembu le-CSB uma liqhathaniswa nezilawuli libonisa ukungazenzisi okubonakalayo kwe-ventral striatum yezinyathelo ezithakazelisayo ezingezona ezobuciko [kuSeok and Sohn (40), kukhona ukungazenzisi okubonakalayo kuma-CSB abantu uma kuqhathaniswa nezilawuli zemizamo yokungathathi hlangothi]. Imiphumela ehlukile ihanjiswa kuGola et al. (36) lapho kungekho umehluko kwisiphetho se-BOLD ngemali yokuthola imali phakathi kwe-CSB nezihloko zokulawula. Ezintathu (36, 38, 39) ngezifundo ezine ezitholakalayo zikhuluma ngokucacile ngokumelene nokubikezela okwenziwe ngokusekelwe kohlaka lwe-RDS. Noma kunjalo, kubalulekile ukukhumbula ukungafani phakathi kwamaqembu kulezi zifundo. Ngesikhathi eVoon et al. (37), izihloko ezahlangabezana nezindlela ze-CSB zanikeza izinhlobo ezihlukahlukene zokuziphatha okubi ngokocansi, ku-Gola et al. (36) bonke abantu abahlangabezana nezindlela ze-CSB ezinikezwa ngezithombe zobulili ezingcolile eziyinkimbinkimbi zisebenzisa njengenkinga enkulu. Ngokufanayo, kokubili (38, 39) ezinye izifundo ezitholakala emitholampilo emincane, izinyathelo zokuqalisa ezenzakalelayo kanye ne-volumetry ezihambisana nenani lezithombe zobulili ezingcolile. Ayikho idatha eyanele yokwenza iziphetho eziqinile, kepha ezinye izinkolelo zezifundo zesikhathi esizayo zingenziwa.
Ngokombono wethu, kufanelekile ukuphenya ukuthi ngabe i-CSB ingahlukaniswa yini ngaphansi kwezigaba ezimbili ezihambisana ne: (1) iziphathamandla zokuziphatha zobulili ezizimele, kanye (2) ezizimele zodwa zobulili nezithombe zobulili ezingcolile ezibukele (48, 49). Ngokusekelwe ekutholeni okufanako ekusetshenzisweni kokuphuza utshwala, ngayinye yalezi zingxenye ezincane zingase zihlobene nama-genotypes ahlukahlukene kanye namaphethini wokusebenza okusebenzayo okuqhamukayo okuyizinkomba kanye nemivuzo (50, 51). Siphakamisa ukuthi sihlolisise ngezifundo zesikhathi esizayo ukuthi ngabe i-subtype echazwe ngokuziphatha kobulili okuzibandakanyeka ingabonakaliswa ngezinga eliphakeme lezinto ezintsha ekufuneni kanye nokungazenzisi okuphazamisayo okuhlongozwayo njengoba kuhlongozwa yi-RDS, kuyilapho i-subtype ehlobene nokubuka izithombe ezingcolile zobulili ezingcolile kanye nokuzibandakanya kocansi kungasetshenziswa esikhundleni sokwehla kwe-ventral reactivity ye-ventral ngenxa yezinhlamvu ezibukekayo kanye nemivuzo ngaphandle kwe-hypoactivation yemijikelezo yemivuzo.
Ukubambisana Ne-Incentive Salience Theory
Ngokusho kwe-IST, izinkulumo ezifundwayo (izinyathelo ezithintekayo) ezihlobene nokulutha izidakamizwa zivusa izimpendulo ezandisiwe emgodleni wokuvota futhi zikhuphula ukuziphatha okukhushukile (okusho ukuthi izikhathi ezimfushane zokuphendula kanye nokunemba okuphakeme) phakathi kwabantu abanomlutha, kuyilapho izimpendulo zemivuzo ngokwazo zingaguquki noma zihlushwa ngokuhamba kwesikhathi (26, 31). Ngakho-ke, ngokusho kwe-IST, uma i-CSB ikwabelana ngezinqubo zokudakwa, kufanele sibone impendulo ekhuphukile ye-BOLD emgodini we-ventral ngokuqondile ukukhomba ukubonisa okungafaniyo / ngokocansi phakathi kwabantu abane-CSB uma kuqhathaniswa nokulawulwa okunempilo futhi uma kuqhathaniswa nokuphendula ngokulandelana kokubikezela eminye imivuzo.
Ukufunda ngamunye wezincwadi ezinikeziwe (36-39) ngokwehlukana, umuntu angabutha ukuthi yonke idatha ihlale ibonisa izindlela ezihlongozwayo yi-IST, okungukuthi, ukuzwela okuphezulu kwezenzo ezithandwayo. Kodwa umbuzo owodwa obaluleke kakhulu uvela: Ukuhumusha kanjani lokhu okukwenzakalayo ekusunguleni i-laboratory? Uma umuntu eqala ukuthi isithombe esithandwayo noma ividyo idlala indima, khona-ke ukukhula kwe-ventral ekuhlaseleni kwezingxoxo phakathi kwezifundo nge-CSB (uma kuqhathaniswa nezilawuli) kuzokukhuluma ngokuvumelana nenkinga yokulutha. Kodwa-ke, uma umuntu eqala ukuthi lokho okushiwo yizindlela zokudlala kudlalwa indima yomvuzo, khona-ke lemiphumela ayisekeli izibikezelo ezenziwe ohlelweni lwe-IST. Ngokombono wethu, [ukuze uthole imininingwane, bheka i-Gola et al. (9)] ezimweni eziningi zangempela zokuphila, ukuhlukunyezwa ngokocansi okubonakalayo njengokwenqunu komlingani okhangayo ngokocansi kukwandisa ukuvuswa kobulili futhi kuholele ekuziphatheni kokuqala ukuqalisa umsebenzi wezocansi kanye nokuphela kwe-orgasm (52). Kulesi simo, siphikisa ukuthi isenzo sobulili sidlala indima yokubamba (isimiso somthetho), kanti i-orgasm idlala umvuzo (oyinhloko) umvuzo (isimiso esingenamthetho). Lokhu kungaba njalo ikakhulukazi ekulawuleni okunempilo kanye nasezifundweni ze-CSB ezinokuziphatha okubi ngokocansi ezizimele.
Ukucabanga kwethu kufana nezenzakalo eziningi zokuzibandakanya ngokocansi, ikakhulukazi ezifundweni ezinempilo. Imisindo ejwayelekile yokubonwa ngokocansi ebonakalayo yizithombe zobulili ezingcolile noma izithombe (okukhulunywa ngakho), okwandisa ukuvuswa kocansi nokuholela ekushaya indlwabu ephela nge-orgasm (umvuzo). Kodwa ocwaningweni (9), sibona lokhu okulandelayo: (1) abantu bayathola injabulo ngenkathi bebuka izithombe namavidiyo angathandeki, mhlawumbe ehambisana nokuphendula komzimba; (I-2) umsebenzi wabo wobuchopho obuhlobene nomvuzo uhambelana nale mizwa ejabulisayo ekuphenduleni isenzo socansi esibukwayo; (I-3) bazimisele ukwenza umzamo ukubuka lezi zici, ezifana nezinye izinkomba ezivuzayo, ezifana nemali; futhi (i-4) sibona futhi ukulungiswa kwezimpawu zokubikezela isenzo socansi. Ngakho-ke, sithatha ukuthi ukuboniswa kocansi okubukwayo kungaba nenzuzo evuzayo futhi, ukuthi ku-setup ye-laboratory [njengokwesifundo (36)], bangadlala indima yomvuzo. Kubantu be-CSB abanezimo ezizimele ezizimele kanye nezithombe zobulili ezingcolile ezibukele, lokhu kungase kube njalo ezimweni zangempela zokuphila, njengoba abaningi bebika amabhayisikobho wezithombe zobulili ezingcolile lapho i-orgasm ihlehliswa ngamabomu ukuze ilondoloze amahora okuthakazelisa ekubukeni izithombe zobulili ezingcolile (2). Ngakho-ke, ngokwemibono yethu, imiphumela yocwaningo olutholakalayo lisekela ukubikezela kwe-IST futhi ikhombisa ukukhuphuka kwe-ventral ekuhlaselweni kwezinto ezingathandeki [ezingase zidlale indima yokuqaphela umsebenzi wezocansi olandelayo (37, 39)] noma ukuze ulandele ukubikezela izithombe ezingezansi, okuyi ngayinye se kuyisisusa esikhuthazayo (36).
Ukufaniswa nokusetshenziswa kweMpahla nokuGembula Disorder
Ukuhlaziywa kwe-meta yakamuva kakhulu (32) kwezinguquko ze-25 ekusebenziseni kwe-ventral okukhipha izidakamizwa ezidakamizwa nokugembula okubonisa ukuthi ngesikhathi sokulindela umvuzo (ukuvezwa kwecala), abantu ababenokusetshenziswa kwemithi nokugembula babonise ukwehla ukuvuselelwa kokuhlukumeza uma kuqhathaniswa nabantu abaphethe kahle. Phakathi nomphumela wokuvuza, abantu abanomlutha wezinto ezidakamizwa babonise ukuqhutshwa okuqhubekayo ku-striral striatum, kanti abantu abanomlutha wokugembula babonisa ukwehlisa ukusebenza ku-striorum ye-dorsal uma kuqhathaniswa nokulawulwa kwabantu abanempilo. Ngokusho kwabalobi, ukungazenzisi kwabantu abahlukumezayo kubantu abanomlutha ngesikhathi sokulindela kanye nabantu abanomlutha wokugembula ngesikhathi somphumela kuhambisana ne-RDS indaba yokulutha. Kubalulekile ukuqaphela ukuthi zonke izifundo ezifakwe kulo meta-analysis zasebenzisa izikhuthazo zemali; Ngakho-ke, kuchaza amaphethini wokubuyisela kabusha ama-cues kanye nemivuzo ayengewona okwehlukile kwezinye izidakamizwa ezihlobene nezidakamizwa. Ukufunda kuphela ngezindaba ze-CSB-ezingafaniswa ngokuqondile nezifundo ezibuyekezwe eLuijten et al. (32) -IGola et al. (36), esebenzisa umsebenzi wokubambezeleka kokunciphisa imali. Lapha, akukho ukungazenzisi kwe-ventral striatum ku-CSB (kuqhathaniswa nokulawula) kwaqashelwa. Sibona isidingo sokuqhuba izifundo ngokuqhathanisa nabantu be-CSB nabantu abasebenzisa izidakamizwa noma ukugembula besebenzisa imisebenzi ejwayelekile njengokunciphisa umsebenzi wokubambezeleka ekuhloleni ngokuqondile ukufana nokungafani phakathi kwe-CSB kanye nokulutha kwemithi ekusebenzeni kabusha kwe-ventral striatum.
Isifinyezo kanye neziqondiso zesikhathi esizayo
Isibalo sezifundo ezitholakalayo kwi-CSB (kanye nabasebenzisi abangaphansi kwemitholampilo yabasebenzisi bezithombe zobulili ezingcolile) zikhula njalo. Phakathi kwezifundo ezitholakalayo okwamanje, sakwazi ukuthola izincwadi ezingu-9 (ithebula 1) okusetshenziselwa ukufaneka kwemifanekiso ephezulu yokusebenza. Kuphela kwabane kuphela (36-39) uphenyo ngokuqondile ukucubungula izici ezithintekayo kanye / noma umvuzo kanye nokuthola okutholwe ngokuphathelene nokusebenza kwe-ventral striatum. Ucwaningo oluthathu lubonisa ukukhula okuqhubekayo kwe-ventral yokuhlasela okuyingozi (36-39) noma okushiwo ukubikezela lesi simiso (36-39). Lezi zithole zihambisana ne-IST (28), esinye sezihlaka ezivelele kakhulu ezichaza ukusebenza kobuchopho ekudakiseni. Ukusekelwa kuphela komunye uhlaka lwamacebo okubikezela ukungazenzisi kwe-ventral striatum ngokweqile, inkolelo ye-RDS (29, 30), ivela kancane kusuka kwesifundo esisodwa (37), lapho abantu abane-CSB beveze ukuqaliswa kwe-ventral engezansi kwezinto ezijabulisayo uma kuqhathaniswa nezilawuli.
Isimo samanje sedatha sisenza sikwazi ukuphetha ngokuthi i-CSB ihlobene nokwenyuka kwe-ventral reactivity ngenxa yokwenza izinto ezingenakuqhathaniswa nokukhomba ukubikezela lokho okushiwo yi-stimuli. Kodwa-ke, imibuzo eminingi eyisisekelo evumela ukuqhathaniswa okuqondile nezidakamizwa ezidakamizwa kanye nokugembula okufuywayo okuqhubekayo kungavunyelwe. Sibona isidingo sezifundo ngokuqhathanisa ngokuqondile nabantu be-CSB nabantu abasebenzisa izidakamizwa (ukuqinisekisa izibikezelo ezisekelwe ku-RDS) kanye nomsebenzi wokuhlola ngaphezulu wokucubungula nokubuyiswa komvuzo ku-CSB (ukuze kuqinisekiswe ukubikezela okusekelwe ku-IST). Ucwaningo lwesikhathi esizayo kufanele luzame ukulawula amaphethini aphezulu e-CSB (isib., Umsebenzi wokuzibandakanya ngokocansi).
Sifuna nokuqaphela ukuthi i-ventral striatum yindawo eyodwa yobuchopho ehlobene nokuvuza nokufunda, nokuthi isithombe esinzima kakhulu se-CSB singethulwa uma sikwazi ukuhlanganisa ulwazi emisebenzini yonke yobuchopho.
Ukulinganiselwa
Ukubuyekezwa kwethu kunemikhawulo ehlobene nenani elincane locwaningo lwe-FMRI neziguli ze-CSB. Ngenxa yalokhu kunciphisa, sazama ukufaka zonke izifundo, naphezu kokungafani okwehlukile ezindleleni zokuxilonga, kanye nemigomo efakazelayo (bheka ithebula 1), yimuphi umphumela ngamasampuli angewona ama-homogenous. Okwesibili, sithatha incazelo ebanzi ye-ventral striatum, kuhlanganise nesifunda esikhulu se-caudate nucleus ne-rostroventral putamen nge-nucleus accumbens (19). Sithemba ukuthi ubufakazi obuningi bomzimba buzovumela ukuhlaziywa okuthe xaxa esikhathini esizayo.
Iminikelo Yomlobi
Bonke abalobi abalwe kuhlule benze umnikelo omkhulu, oqondile nangokwengqondo emsebenzini, futhi bawamukela ukuze ushicilelwe.
Izimali
Abalobi bale mbhalo wesandla basekelwa yi-Polish National Science Center, isibonelelo se-OPUS, inombolo 2014 / 15 / B / HS6 / 03792 (MG) kanye nenombolo yesibonelelo se-PRELUDIUM 2016 / 23 / N / HS6 / 02906 (MD).
Ukungqubuzana kwesitatimende senzalo
Abalobi bamemezela ukuthi ucwaningo lwaluqhutshwa ngokungabikho kobudlelwane bezohwebo noma zezimali ezingase zithathwe njengokungqubuzana okungase kube khona.
Okubhekwayo
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Amagama angukhiye: ukuziphatha okucindezelayo ngokobulili, izithombe zobulili ezingcolile eziyinkimbinkimbi, ukuxhashazwa ngokobulili, ukuxoshwa kwe-ventral, i-nucleus accumbens
Isikhombo: I-Gola M ne-Draps M (2018) ye-Ventral Striatal Reactivity kuma-Compulsive Sexual Behaviors. Ngaphambili. I-Psychiatry 9: 546. i-doi: 10.3389 / fpsyt.2018.00546
Itholiwe: 15 April 2018; Yamukelwe: 12 Okthoba 2018;
Ishicilelwe: 14 November 2018.
Kuhlelwe ngu:
I-Jung-Seok Choi, SMG-SNU Medical Center, eNingizimu Korea
Review yenziwe ngu:
UChantal Martin Soelch, University of Fribourg, eSwitzerland
Elisabet Jerlhag, I-University of Gothenburg, eSweden
I-copyright © 2018 i-Gola ne-Draps. Lokhu kuyisihloko sokufinyelela okuvulekile esasakazwa ngaphansi kwemigomo ye- Ilayisense ye-Creative Commons Attribution (CC BY). Ukusetshenziswa, ukusatshalaliswa noma ukukhiqizwa kwamanye amaforamu kuvumelekile, uma ngabe abalobi bokuqala kanye nabanikazi be-copyright bebhaliwe nokuthi ukushicilelwa kokuqala kulo magazini kubhalwe, ngokuhambisana nomkhuba wokufunda wemfundo. Akukho ukusetshenziswa, ukusatshalaliswa noma ukukhiqizwa okuvunyelwe okungavumelani nale migomo.
* Ukuxhumana: Mateusz Gola, [i-imeyili ivikelwe]
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