INDLELA: Ucwaningo olusha lokuskena ubuchopho ukuqhathanisa udaba olumhlophe lwe-porn / imilutha yezocansi (CSBD) kuzilawuli ezibikiwe umehluko omkhulu phakathi kokulawulwa nezihloko ze-CSB:
Lesi ngesinye sezifundo zokuqala ze-DTI zokuhlola umehluko phakathi kweziguli ezine-Compulsive Sexual Behaviors Disorder nezilawuli ezinempilo. Ukuhlaziywa kwethu kuveze ukwehliswa kwe-FA ezifundeni eziyisithupha zobuchopho ezifundweni ze-CSBD, uma kuqhathaniswa nezilawuli. Amapheshana ahlukanisayo atholakele ku-cerebellum (mhlawumbe bekukhona izingxenye zepheshana elifanayo ku-cerebellum), ingxenye ebuyayo ye-capsule yangaphakathi, i-corona radiata ephakeme kanye nodaba olumhlophe oluphakathi noma olungu-lateral.
Imiphumela yocwaningo lwethu iphakamisa ukuthi i-CSBD yabelana ngephethini efanayo yokungajwayelekile nge-OCD nokulutha.
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- 1 Institute of Psychology, IsiPolish Academy of Sciences, iWarsaw, ePoland
- 2 Isikhundla sePsychology, iSWPS University of Social Sciences and Humanities, eWarsaw, ePoland
- 3 ILaboratory of Brain Imaging, Neurobiology Center, Nencki Institute of Experimental Biology, iPolish Academy yeSayensi, iWarsaw, iPoland
- 4 IBiomedical Imaging Research Institute, eCedars-Sinai Medical Center, eLos Angeles, e-USA
- 5 Isikhungo seSwartz seComputerational Neuroscience, i-Institute for Neural Computations, University of California San Diego, San Diego, USA
abstract
Ingemuva futhi ihlose
Noma i-Compulsive Sexual Behaeve Disorder (CSBD) ingezwe ku-ICD-11 ngaphansi kwesigaba sokulawula umfutho ku-2019, kusalokhu kuphikiswana ngezindlela zayo ze-neural. Abaphenyi baqaphele ukufana kwayo kokubili ukuba umlutha kanye ne-Obssesive-Compulsive Disorder (OCD). Inhloso yocwaningo lwethu kwakuwukuphendula lo mbuzo ngokuphenya iphethini yokungajwayelekile kobuchopho be-anatomical phakathi kweziguli ze-CSBD.
izindlela
Ukubukeza ukushicilelwa okungama-39 ku-Diffusion Tensor Imaging (DTI) sikhombe ukungajwayelekile okuyinhloko okuqondene nezidakamizwa ne-OCD. Kunokuthi siqoqe idatha ye-DTI kusuka kwabesilisa abangama-36 abesilisa nabesifazane abathola ubungqingili abatholwe bene-CSBD kanye ne-31 ehambisana nezilawuli ezinempilo. Le miphumela yabe isiqhathaniswa nokulutha kanye namaphethini we-OCD.
Imiphumela
Uma kuqhathaniswa nezilawuli, abantu be-CSBD bakhombise ukunciphisa okuphawulekayo kwe-anisotropy (FA) epheshaneni eliphakeme le-corona radiata, ipheshana langaphakathi le-capsule, amapheshana e-cerebellar kanye nodaba olumhlophe lwe-occipital gyrus. Kuyathakazelisa ukuthi zonke lezi zifunda zikhonjwe nasezifundweni zangaphambilini njengezihlanganisi ezabiwe ze-DTI kuzo zombili i-OCD nokulutha.
Ingxoxo neziphetho
Imiphumela yocwaningo lwethu iphakamisa ukuthi i-CSBD yabelana ngephethini efanayo yokungajwayelekile nge-OCD nokulutha. Njengesinye sezifundo zokuqala ze-DTI eziqhathanisa umehluko wobuchopho obuhlelekile phakathi kwe-CSBD, ukuluthwa kanye ne-OCD, yize kuveza izici ezintsha ze-CSBD, akwanele ukuthola ukuthi ngabe i-CSBD ifana nokulutha ngokweqile noma i-OCD. Ucwaningo oluqhubekayo, ikakhulukazi ngokuqhathanisa ngqo abantu abanezinkinga ezintathu lunganikeza imiphumela ephelele.
Isingeniso
ICompulsive Sexual Behaviors Disorder (CSBD) eyethulwe yiWorld Health Organisation (WHO) kuhlelo lwe-11th lwe-International Classification of Diseases (ICD-11) yisifo sengqondo esibonakala ngokwehluleka okuphindaphindiwe ukumelana nezinkanuko zobulili. Ekuqaleni, le misebenzi inomvuzo esigulini, kepha ngemuva kwesikhashana iba yingozi futhi ingasebenzi kahle, okuholela ekucindezelekeni okuphezulu komuntu. Ukuhlangabezana nenqubo yokuhlonza i-CSBD, isiguli kufanele sikhombise izimpawu ezishiwo ngenhla okungenani izinyanga eziyisi-6, futhi ukuxilongwa akukwazi ukwenziwa uma kungekho nkinga enkulu empilweni yomuntu siqu ebikiwe noma uma ukucindezeleka kuhlobene kuphela nokwahlulela kokuziphatha nokungavumelani nokuziphatha kocansi, ngoba isibonelo, ngokuya ngezinkolelo zenkolo / zokuziphatha (UKraus et al., 2018; Ubani, 2019). Imigomo ye-CSBD ehlongozwayo yi-WHO ngokunwetshwa okukhulu ibisuselwa kunqubo yokuphazamiseka kwe-hypersexual (HD) ehlongozwe ngu I-Kafka (2010) ukucatshangelwa esigabeni sezinkinga zocansi se-DSM-V. Ngokufanayo ne-HD, i-CSBD yacatshangelwa njengesifo sokucindezela isifiso sokuya ocansini esingenakuphikiswa nesakhi sokungabi namandla, okufana nokulutha, kepha ngokungafani ne-HD, i-CSBD umbandela wokulahlwa kwengcindezi nomthethonqubo womzwelo (ofana ne-OCD) (ukuze uthole ingxoxo eningiliziwe bheka: I-Gola et al., 2020).
I-WHO ihlukanise i-CSBD (ku-ICD-11) njengesifo sokulawula umfutho, kepha isici sokuphoqeleka sifakiwe egameni lesifo. Ngeshwa, isigaba sokuphazamiseka kokulawula umfutho sibanzi kakhulu futhi imingcele yaso ayinakucaciswa ngokusobala, okwenza ukuhlukaniswa kwe-CSBD kube yimpikiswano eqhubekayo, kugxile embuzweni wokuthi ngabe izimpawu ze-CSBD ziyacindezela noma ziyimpoqo yini, noma ngabe i-CSBD kufanele kunalokho uthathwe njengesibonakaliso sokulutha kokuziphatha (isb. UBőthe et al., 2019; UGola et al., 2017; IGriffiths, 2016; IKraus, Voon, & Potenza, 2016; UKühn & Gallinat, 2016; Potenza, Gola, Voon, Kor, & Kraus, 2017; Omncane, 2008) noma olunye uhlobo lwesifo sengqondo. Lapho bephikisana ngokufana kwayo nokulutha, abacwaningi bavame ukukhuluma ngezindlela zokunciphisa nokulangazelela ukwenza ucansi (IGola & Draps, 2018; UGola et al., 2017; IKlucken, Wehrum-Osinsky, Schweckendiek, Kruse, & Stark, 2016; UKowalewska et al., 2018; IVoon et al., 2014), ukubekezelelana okukhulayo nokwanda kwezimpawu, njengokujwayelekile kokuncika kwento (Reid et al., 2012; IZwiecha et al., 2018), kanye nesifo sokuhoxa (UGarcia & Thibaut, 2010). Ngakolunye uhlangothi, i-CSBD ibuye iqhathaniswe ne-Obsessive-Compulsive Disorder (OCD), njengoba ingakhombisa imijikelezo yemicabango emibi, ekhathazayo ehambisana nokuphoqelelwa, okungukuthi amasiko, isimilo esiphindaphindayo esinciphisa ukungezwani okubangelwa yimicabango engalawuleki, ebandakanyeka ukuvimbela noma ukunciphisa ukucindezeleka noma ukukhathazeka (Idiyakoni no-Abramowitz, 2005; UFineberg et al. 2014). Ukuziphatha ngokocansi kungadlala indima ekulweni namasu wokulawulwa ngokomzwelo (I-Lew-Starowicz, i-Lewczuk, i-Nowakowska, i-Kraus, ne-Gola, i-2020) Ngokuvumelana ne UColeman nozakwabo (2003), Iziguli ze-CSBD zizwa imicabango ephindaphindwayo yemvelo yezocansi edala ukungezwani (ukuthatheka), futhi ihlanganyele ekuziphatheni kocansi okuphoqelela ukunciphisa lokhu kuxabana (UColeman, uRaymond, noMcBean, 2003). Ngale ndlela, indlela yokuziphatha ngokocansi ingaqondakala njengokubonakaliswa kokuphoqelela (UMick & Hollander, 2006) nokuziphatha kocansi kudlala indima yecebo lokulawula ngokomzwelo (I-Kafka, i-2010; Umvukuzi, uDickenson, noColeman, 2019; Reid & Kafka, 2014). Njengamanje lo msebenzi wokubhekana nakho kuyisihloko okuxoxwa ngaso kumongo we-CSBD, njengoba manje wawufakiwe kunqubo ye-WHO (I-Gola et al., 2020).
Kunomzimba okhulayo wobufakazi obukhuluma ngokufana kwe-neurobiological phakathi kwe-CSBD nokulutha, isb., Ukuphinda kusebenze okuhlobene nezocansi kohlelo lomvuzo (ukubukeza bheka IGola & Draps, 2018 or Kowalewska et al., 2018). Phakathi kwemiphumela ethakazelisa kakhulu yilena: ukwanda kokusebenza kabusha kwe-ventral striatal kwezithombe ezithandwayo (uma kuqhathaniswa nezithombe ezingakhethwanga) ezihambisana kahle nemiphumela ku-Internet Addiction Test Modified for Cybersex (Umkhiqizo, uSnagowski, uLaier, noMaderwald, 2016), noma ukusebenza okukhulu ngaphakathi: i-dorsolateral prefrontal cortex, i-caudate, i-gyrus engaphansi kwe-parietal lobe, i-dorsal anterior cingulate cortex ne-thalamus, yezimpawu ezithandekayo phakathi kwabantu be-CSBD uma kuqhathaniswa nezilawuli (Seok & Sohn, 2015). Abantu be-CSBD baphinde babonisa ukwanda kokusebenza kabusha kwe-striatal (uma kuqhathaniswa nezilawuli) zamavidiyo abeka obala ezocansi (I-Voon et al., I-2014) noma izinkomba ezivusa inkanuko kepha hhayi zemali (I-Gola et al., 2017) nokunciphisa ukuxhumana okusebenzayo phakathi kwe-ventral striatum ne-prefrontal cortex (Klucken et al., 2016), kanye nokuhlangana okubalulekile okungahambi kahle phakathi kobukhali bezimpawu ze-CSBD nokuxhumana okusebenzayo phakathi kwe-gyrus ephakeme yesikhashana ephezulu kanye ne-nucleus eyi-caudate (Seok & Sohn, 2018). Ngokuphathelene nemiphumela yobuchopho ehlelekile ehlobene ne-CSBD, UKühn noGallinat (2014) ithole ubudlelwane obuhlukile phakathi kwesibalo se-caudate volumetry kanye nemvamisa yokusetshenziswa kwezithombe zobulili ezingcolile phakathi kwabasebenzisi bezithombe zocansi ezingezona ezemitholampilo. Ucwaningo lwamuva oluvela eqenjini lethu (UDraps et al., 2020) kukhombisile ukuthi abantu abane-CSBD, umlutha wotshwala kanye nokuphazamiseka kokugembula babelana ngevolumu encane yempunga esigxotsheni esingaphambili sangakwesobunxele (ikakhulukazi kwi-orbitofrontal cortex) uma kuqhathaniswa nezihloko ezinempilo. Imininingwane eshiwo ngenhla isekela i-hypothesis ngokufana phakathi kwe-CSBD nokulutha. Ngeshwa, azikho izifundo ze-neurobiological ezitholakala ngokuqhathanisa i-CSBD ne-OCD.
Enye indlela yokutadisha ukufana okungaba khona phakathi kwe-CSBD nokulutha noma i-OCD ukubuka ubucayi bezinto ezimhlophe zobuchopho. I-Diffusion Tensor Imaging (DTI) iyindlela yokufanekisa kazibuthe ezwelana nezakhi zezicubu zemiklamo, okuvumela ukuhlolwa kwekhwalithi yamapheshana amhlophe wezindaba (IBasser & Jones, 2002; IGuevara, iGuevara, iRomán, neMangin, i-2020; Le Bihan, 2003; ULe Bihan et al., 2001). Kunamasu amaningi we-DTI, ngokwesibonelo indlela ye-Tract-Based Spatial Statistics (TBSSs) esetshenziswa kakhulu ukuthola ukungahambi kahle kwezinto ezimhlophe kubantu (USmith et al., 2006), egxile ngqo ekwehlukaneni kwe-anisotropy ye-fractional (FA). Ekuhlaziyweni kwe-TBSS i-algorithm yokubhalisa engahambisani nomugqa isetshenziselwa ukuveza idatha ngazinye ekumeleleni ipheshana elisho, elibizwa ngamathambo ashiwo i-FA. Sithole ukushicilelwa okungu-39 ku-OCD (31) nokulutha (8) kusetshenziswa i-TBSS. Kulezi zifundo, ababhali bakhombise umehluko we-FA phakathi kokulawulwa okuphelele kwe-1,050 kanye neziguli zabantu abadala eziyi-1,188 ezitholwe ngemitholampilo zine-OCD noma isifo sokulutha. Amaqembu amancane kunabo bonke ababambiqhaza ngokulandelana: ama-22 kumlutha (UChumin et al., 2019) nabayisishiyagalombili eqenjini le-OCD (UCannistraro et al., 2007). Izifundo ezingamashumi amabili nesishiyagalombili zibike imiphumela ebalulekile nge- P <0.05 ngemuva kokulungiswa kokuqhathanisa okuningi no-6 okungalungisiwe P <0.001, ngosayizi weqoqo lama-voxels angama-20 noma ngaphezulu. Ukwehluka kwesifunda kwaziwa kakhulu ku-OCD, ngemiphumela ephakamisa umehluko omkhulu we-FA emapheshaneni amaningana njenge-corpus callosum, i-cingulum bundle, i-forceps encane ne-corona radiata. Imiphumela yayihlukumezekile ekuluthweni, ngezifunda ezimbalwa ezihlukanisa phakathi kwamaqembu eziguli nokulawula. Kuyathakazelisa ukuthi izifunda eziyisishiyagalolunye (okungukuthi i-corona radiata ephezulu, i-capsule yangaphakathi, i-cerebellum, i-occipital ne-frontal ndaba emhlophe, i-fasciculus ephezulu, i-posterior thalamic radiata, i-corpus callosum ne-thalamus) ivezwe njenge-DTI ihlobanisa zombili, ze-OCD nezidakamizwa (bheka I-Fig. 1).
Imiphumela yokubuyekezwa kwemibhalo. Ukuncishiswa kwe-Frisional anisotropy (FA) okuqondene nokulutha (okuluhlaza okwesibhakabhaka), ukwehliswa kwe-FA okuqondene ne-OCD (okuluhlaza okotshani), kanye nezindawo ezihlukanisa iziguli ezimbili ze-Addiction ne-OCD ekulawuleni okunempilo (okuphuzi)
Isikhombo: Ijenali Yezidakamizwa Zokuziphatha JBA I-2021; 10.1556/2006.2021.00002
Esifundweni sethu sasihlose (1) ukukhomba okungajwayelekile kwe-FA okuqondene ne-OCD nokulutha ngokubukeza izincwadi, (2) ukuqoqa idatha ye-DTI kwiziguli ze-CSBD kanye nezilawuli ezinempilo (kusetshenziswa indlela ye-TBSS ukukhomba umehluko ku-FA), kanye (3) nokuqhathanisa imiphumela yethu ngokutholakele okubikwe ngaphambilini ku-OCD nokulutha, ukukhomba ukufana noma / nokwehluka phakathi kwe-OCD, ukulutheka ne-CSBD.
izindlela
Ucwaningo lwe-DTI
Izihloko nokuqashwa
Isampula lalinabesilisa abangama-67 abesilisa nabesifazane abahlukaniswe ngamaqembu amabili: iziguli ezingama-36 ze-CSBD kanye nezilawuli ezinempilo ezingama-31 (HCs). Izihloko bezihambisana nobudala nemali engenayo (bona imininingwane yemininingwane ku- Ithebula 1). Izifundo ze-CSBD zaqashwa phakathi kwamadoda afuna ukwelashwa emitholampilo eWarsaw, ePoland. Kwaxoxwa nodokotela bengqondo nodokotela bengqondo ukuqinisekisa ukutholakala kwesifo ngokuya ngemibandela kaKafka HD (I-Kafka, i-2010). Zonke zihlangabezane nenqubo engu-XNUMX kwemihlanu ka-A, zaphinde zagcwalisa inqubo ka-B no-C (I-Kafka, i-2014). I-HC yaqashwa ngezimemezelo ezenziwa online, futhi ayikhombisanga zimpawu zengqondo futhi yayinempilo enhle. Izindlela zokukhishwa kuwo womabili la maqembu bekungumlando wezinye izifo zengqondo, izingqinamba ezibucayi zemizwa noma zezokwelapha, nokuphikiswa kwezinqubo ze-magnetic resonance imaging (MRI). Bonke ababambiqhaza bagcwalise imibuzo yokulinganisa izimpawu ze-CSBD: Isivivinyo Sokuhlolwa Komlutha Wezocansi (Uhlobo lwesiPolish: I-SAST-PL-M: I-Gola et al., 2016) kanye ne-Screen Brief Pornography (I-Kraus et al., I-2020). Ngesikhathi sokuqashwa kwabahlanganyeli baphinde bahlolwe ukuthi bathambekele kwezocansi, umlando wokusebenzisa kabi utshwala nezinkinga zokugembula. Izindlela zokufakwa zawo womabili la maqembu yilezi: kuphela noma ikakhulukazi abesilisa nabesilisa abesilisa nabesifazane abalinganayo kwiKinsey Scale (ukuguqulwa kwePoland: I-Wierzba et al., 2015); izikolo <10 ku-Alcohol Use Disorder Identification Test (Babor, de la Fuente, Saunders, & Grant, 1989); futhi uthole amaphuzu <4 kusikrini se-South Oaks Ukugembula (IStchchfield, i-2002). Abahlanganyeli abafanelekile bamenywa ukuthi bavakashele iLaboratory of Brain Imaging yeNencki Institute, PAS (Warsaw, Poland) ukuqoqwa kwedatha.
Ithebula 1.Abahlanganyeli isici
| CSBD (kusho [sd]); n = 36 | HC (kusho [sd]); n = 31 | P-ngqayizivele | |
| Ubudala eminyakeni | I-31.11 [6.018] | I-31.84 [7.142] | NS |
| Ukuhlolwa kokuhlolwa komlutha wezocansi - kubuyekezwe | I-11.63 [4.664] | I-2.67 [1.918] | P <0.001 |
| Isikrini esifushane sezithombe zocansi | I-6 [2.854] | I-1.73 [1.929] | P <0.001 |
| South oaks ukugembula kwesikrini | I-0.33 [0.816] | 0 | NS |
| Isivivinyo sokuhlonza inkinga yotshwala | I-7.5 [2.07] | I-4 [1.414] | P = 0.013 |
| Uhlu Lokubheka Olucindezelayo-libuyekeziwe | I-17.18 [10.825] | I-13.1 [8.786] | NS |
| I-Monarch Choice Questionnaire - isiyonke K Inani | I-0.0249 [0.0429] | I-0.0307 [0.0481] | NS |
Iphrothokholi yokuskena ye-DTI
Zonke izithombe ze-DTI ziqoqwe kuskena se-3-Tesla MRI (i-Nokia Magnetom Trio TIM, i-Erlangen, eJalimane) ifakwe ikhoyili yekhanda elinezigaba eziyi-12. Ukulandelana kwe-Spin-echo diffusion enesisindo se-echo planar imaging (DW_EPI) kwenziwa ngamapharamitha alandelayo: TR = 8,300 ms; TE = 87 ms; I-GRAPPA; i-flip angle 90 °, usayizi we-voxel = 2 × 2 × 2 mm3, Izinkomba ze-gradient ezingama-64 binani le-1,000 s / mm2, kanye nezithombe ezimbili ezingenayo i-gradient yokusabalalisa esetshenzisiwe (binani = 0). Ukulandelana kwe-DW_EPI kwaphindaphindwa kwizikhombisi-ndlela ezihlukile zokufaka amakhodi anterior-posterior (AP) nange-posterior-anterior (PA).
Ukucutshungulwa kwesithombe se-DTI
Izithombe ze-DTI zacutshungulwa ngephakeji le-FSL (3.2.0) elivela ku-FMRIB Software Library (FSL, www.fmrib.ox.ac.uk/fsl) (USmith et al., 2004). Okokuqala, umyalo we-FSL's fslroi wasetshenziselwa ukukhipha izithombe ze-b0. Esinyathelweni esilandelayo, idatha yalungiswa kusetshenziswa izilungiso zomsebenzi wokuthambekela (topup) ngesisekelo sezithombe ezimbili ze-b0 ezitholwe ngezikhombisi-ndlela ezihlukile zokufaka ikhodi. Ukutholwa kwezikhombisi-ndlela ze-AP ne-PA kuhlanganiswe kwaba yifayela elilodwa elilinganayo. Usebenzisa i-FSL Brain Extraction Tool (ukubheja), wonke ama-voxels okungewona obuchopho nawo wonke ama-voxel anomnikelo omncane wevolumu encane akhishiwe emfanekisweni wobukhulu. Ukunyakaza okujwayelekile nokulungiswa kwamanje kwe-eddy kwenziwa ngethuluzi le-eddy le-FSL. Ukulingana imodeli ye-tensor diffusion ku-voxel ngayinye, izithombe ze-FA zabalwa nge-dtifit.
Ipayipi le-TBSS lalinezinyathelo ezijwayelekile ezilandelayo (USmith et al., 2006): (1) Izithombe ze-FA ezithathwe ku-DTI zibhaliswe ndawonye kusifanekiso. Isithombe sesikhala esivamile se-FMRIB58_FA sisetshenziswe njengokuqondiwe ku-TBSS. (2) Okulandelayo, ukuguqulwa okungekho emgqeni okubalwe esinyathelweni esedlule kusetshenziswe kuzo zonke izifundo ukuletha idatha yabo esikhaleni esijwayelekile se-1x1x1 MNI152. (3) Kubalwa i-FA kanye namathambo avela ezifundweni ezibambe iqhaza esifundweni. (4) Kugciniwe umfanekiso wamathambo we-FA asezingeni le-0.2 kusetshenzisiwe ukukhomba izindlela ezinkulu zodaba olumhlophe.
Ukuhlaziywa kwezibalo kwedatha ye-DTI
Okwe-TBSS, ukuhlaziywa kwemodeli okujwayelekile kwe-voxelwise kwenziwa kumininingwane yonke yobuchopho, kusetshenziswa izimvume ezingahleliwe ze-1,000 ukuthola ama-voxels we-FA anomehluko omkhulu phakathi kwezilawuli ezinempilo neqembu le-CSBD. Kusetshenziswe imodeli yokwahlukaniswa kwamaqembu amabili yeminyaka (kusho okugxile ngaphakathi kweqembu). Awekho ama-voxel asinde ukulungiswa kwe-FDR (isilinganiso sokutholwa okungamanga) sokuqhathanisa okuningi. Ukuhlaziywa okungalungisiwe nakho kwenziwa, ngamanani we-P asukela ku-0.05 kuye ku-0.01 kanye nosayizi obalulekile weqoqo> ama-voxels angama-50. Ukubalwa kokulungiswa kwezinga lokutholwa okungelona iqiniso (FDR) kwenziwa kusetshenziswa iskripthi seMatlab kusuka ku- UGenovese, uLazar, noNichols, (2002). Izindawo ezinomehluko omkhulu ngaphansi komkhawulo ongalungisiwe we P <0.02 enebanga elingu-50-voxel yethulwe ngezansi. Izifunda zokwakheka kwamathambo ezibonisa umehluko omkhulu weqembu kupharamitha ethathwe ku-tensor (kusho i-FA) zabe sezikhonjwa zabhalwa amalebula ngokuya ngezakhiwo ezichazwe endabeni emhlophe (WM) Atlas (U-Oishi, Faria, Van Zijl, & Mori, 2010). Lezo zifunda ze-anatomical zazisetshenziselwa ukwenza ukuhlaziywa kokuhambisana nezimpawu ezilinganiswe yi-Sexual Addiction Screening Test (I-Gola et al., 2016) kanye ne-Screen Brief Pornography (I-Kraus et al., I-2020) eqenjini le-CSBD.
Ethics
Imvume yabahlanganyeli enolwazi yatholakala ekuqaleni kwesifundo. Ukuqinisekisa ukungaziwa, kwaqashwa inqubo eyimpumputhe, ukuze amalungu ethimba locwaningo elibhekele ukuthola idatha ye-DTI angatholi amarekhodi okuqashwa futhi engazi ukuthi ngabe umuntu othile onikwe i-CSBD noma iqembu le-HC. Zonke izinqubo zenziwa ngokuhambisana neSimemezelo saseHelsinki. Ucwaningo luvunyelwe yikomidi lendawo yokuziphatha e-Institute of Psychology, PAS.
Imiphumela
Abahlanganyeli
Ithebula 1 iqukethe imininingwane ngabantu abangama-36 abane-CSBD kanye nezilawuli ezifanayo ezingama-31, idatha yazo ye-DTI eyahlaziywa kulolu cwaningo. Kwakungekho mehluko phakathi kweqembu eminyakeni yobudala. Iziguli ze-CSBD zithole amaphuzu aphezulu kakhulu ezikalini ezilinganisa ubunzima be-CSBD (SAST-R: t = 9.738 P <0.001; I-BPS: t = 6.623 P<0.001). Kubo bonke ababambiqhaza, amaphuzu okulinganisa izimpawu zokulutha umlutha abengaphansi kombundu (i-AUDIT: t = 3.012 P = 0.013, SOGS: t = 0.81 P <0.001). Iziguli ze-CSBD zithole amaphuzu aphakeme kakhulu kunezilawuli ku-Alcohol Use Disorder Identification Test (UBabor et al., 1989), kepha akekho oweqe umkhawulo wokuphazamiseka kokusetshenziswa kotshwala (amaphuzu ayi-16). Amaqembu awazange ahluke e-Obsessive-Compulsive Inventory-Revised (t = 1.580, P = 0.12; I-OCI-R, UFoa et al., 2002) kanye nohlu lwemibuzo lokukhetha imali (t = -0.482, P = 0.632; MCQ, UKirby noMarakovic, ngo-1996) ukukala ukungabi nomdlandla kanye nesaphulelo (UMarcowski et al., Emaphephandabeni).
Imiphumela ye-DTI
Sithole umehluko omkhulu weqembu ezigabeni eziyisithupha ze-anatomical (yonke imiphumela ayilungisiwe, enamanani womkhawulo we P kusuka ku-0.05 kuye ku-0.01 nosayizi weqoqo elibalulekile lama-voxels okungenani angama-50). Ngokwe-White Matter Atlas (U-Oishi et al., 2010), la maqoqo aqukethe izifunda ezilandelayo: amapheshana amathathu ku-cerebellum, ingxenye ye-retrolenticular yepheshana langaphakathi le-capsule, ingxenye ephezulu yepheshana le-corona radiata nengxenye yendaba emhlophe ye-occipital gyrus (imininingwane ku Ithebula 2 futhi I-Fig. 2). Kwakungekho ukuxhumana okuphawulekayo phakathi kwe-FA yencazelo yomuntu ngamunye ezifundeni eziyisithupha ze-anatomical kanye nobukhulu bezimpawu ze-CSBD, njengoba kulinganiswa yi-Testing Screening Testing Test (I-Gola et al., 2016) kanye ne-Screen Brief Pornography (I-Kraus et al., I-2020). Lokhu bekungalindelekile, ngoba, ngokusho kwemibhalo yokuphazamiseka kwengqondo njengokulutha ne-OCD, ubunzima bezimpawu buvame ukuhambisana nokwehluka kwe-FA (ngokulutha, bona: UMorales, uJones, uHarman, uPatching-Bunch, noNagel, 2020; UDe Santis et al., 2019; naku-OCD: de Salles Andrade et al., 2019; UFitzgerald, Liu, Reamer, Taylor, noWelsh, 2014; I-Koch et al., 2012; USaito et al., 2008; U-Wang et al., I-2018; U-Zhou et al., 2018).
Ithebula 2.Imiphumela yocwaningo lwe-DTI eqhathanisa iziguli ezingama-36 ze-CSBD ezinezilawuli ezingama-31 ezifanayo
| Index | Usayizi weCluster | x | y | z | T-stat inani le-peak | P inani lokuphakama | Isayizi yethonyaa | Igama leTrektha elivela kwa-Atlas |
| 1 | 61 | 30 | -45 | -28 | 5.3103 | 0.000027776 | 1.290118 | ch, i-cerebellar hemisphere |
| 2 | 65 | -17 | -49 | -20 | 5.1651 | 0.000046134 | 1.071367 | ch, i-cerebellar hemisphere |
| 3 | 88 | 24 | -51 | -20 | 5.0823 | 0.000061393 | 1.015533 | ch, i-cerebellar hemisphere |
| 4 | 64 | 33 | -29 | 6 | 5.1738 | 0.000044763 | 1.125174 | i-rlic, ingxenye e-retrolenticular ye-capsule yangaphakathi |
| 5 | 52 | -40 | -62 | 20 | 4.9949 | 0.000082731 | 1.151454 | I-O2-WM, maphakathi noma ngemuva kwe-occipital gyrus ndaba emhlophe |
| 6 | 71 | -25 | 14 | 28 | 4.1236 | 0.0013267 | 0.829666 | scr, ephakeme corona radiata |
Ama-Cohen's d usayizi womphumela ubalwe njengomehluko ophakathi kwamaqembu amabili ahlukaniswe ukuphambuka okujwayelekile okuhlanganisiwe.
Umehluko ku-anisotropy ye-fractional (FA) phakathi kweziguli nezilawuli ze-CSBD. Amathambo e-FA asemqoka kuzo zonke izifundo akhonjiswa ngombala oluhlaza ngaphezulu kwesifanekiso se-FMRIB58_FA_1mm. Imiphumela iye yaqina ngenhloso yokubona kusetshenziswa umyalo ojwayelekile we-tbss_fill FSL. Amaqoqo anamanani aphezulu we-FA (P <0.02, usayizi wamaqoqo> 50) eqenjini lokulawula ngokuqhathanisa neziguli ze-CSBD kuboniswa ngokubomvu. Kwakungekho miphumela ebalulekile yokuqhathanisa okuphambene (iziguli ze-CSBD> iqembu lokulawula)
Isikhombo: Ijenali Yezidakamizwa Zokuziphatha JBA I-2021; 10.1556/2006.2021.00002
Ingxoxo
Lesi ngesinye sezifundo zokuqala ze-DTI zokuhlola umehluko phakathi kweziguli ezine-Compulsive Sexual Behaviors Disorder nezilawuli ezinempilo. Ukuhlaziywa kwethu kuveze ukwehliswa kwe-FA ezifundeni eziyisithupha zobuchopho ezifundweni ze-CSBD, uma kuqhathaniswa nezilawuli. Amapheshana ahlukanisayo atholakele ku-cerebellum (mhlawumbe bekukhona izingxenye zepheshana elifanayo ku-cerebellum), ingxenye ebuyayo ye-capsule yangaphakathi, i-corona radiata ephakeme kanye nodaba olumhlophe oluphakathi noma olungu-lateral.
Ukubheka le miphumela kumongo obanzi wayo yonke inqwaba yezifo zengqondo ezingacindezelekile nezicindezelayo, kusuka ekubeni umlutha ngokweqile kuye kwe-OCD ngakolunye, senze ukubuyekeza okuphelele kwezincwadi ze-DTI kuzo zombili lezi zinhlaka zokwelapha ezingenhla. Izifundo ezingamashumi amathathu nesishiyagalolunye (eziyisishiyagalombili ngokulutha kanye ne-31 ku-OCD) ezitholakala ezincwadini zikhombisile ukuthi, ngokuya nge-DTI, kunokuhlukahluka okuncane kwe-neuronal ekuluthweni kune-OCD. Emibhalweni ye-OCD, umphumela omkhulu futhi obikwe njalo uthinta ukwehliswa kwe-FA ezindaweni ezifana ne-corpus callosum kanye nenqwaba ye-cingulum (UBenedetti et al., 2013; I-Bora et al., 2011; UCannistraro et al., 2007; de Salles Andrade et al., 2019; UFan et al., 2016; UGan et al., 2017; UGaribotto et al., 2010; U-Li et al., 2011; UNakamae et al., 2011; Oh et al., 2012; USaito et al., 2008; Spalletta, Piras, Fagioli, Caltagirone, & Piras, 2014; I-Versace et al., 2019; Yoo et al., 2007; UZhou et al., 2018). Ngokuphambene nalokho, izincwadi eziluthayo zikhuluma nge-posterior corona radiata, i-capsule yangaphandle, i-fornix, i-insula ne-hippocampus njengezindawo ezahlukanisa iziguli nezilawuli ngokwe-FA (UChumin et al., 2019; UDe Santis et al., 2019; UPandey et al., 2018; I-Yip et al., 2017; UZou et al., 2017), kanye nezinye izifunda ezitholakala ku-OCD, okungukuthi, i-corona radiata ephakeme, i-capsule yangaphakathi, i-cerebellum, udaba olumhlophe olungaphambili nolwe-occipital, i-fasciculus ephezulu, i-posterior thalamic radiata, i-corpus callosum ne-thalamus (UBenedetti et al., 2013; UCannistraro et al., 2007; UChumin et al., 2019; UFan et al., 2012; UFontenelle et al., 2011; UGan et al., 2017; UHartmann, Vandborg, Rosenberg, Sørensen, & Videbech, 2016; UKim, Jung, Kim, Jang, & Kwon, 2015; ULochner et al., 2012; UPandey et al., 2018; USegobin et al., 2019; USzeszko et al., 2005; I-Yip et al., 2017; Yoo et al., 2007; UZhong et al., 2019; UZou et al., 2017). Ezinye izifunda ezitholakala kuma-OCD sudies zisendaweni eluhlaza ngaphakathi Amakhiwane. 1 no-3 (UGlahn, Prell, Grosskreutz, Peschel, noMüller-Vahl, 2015; He et al., 2018; Li, Ji, Li, Li, & Feng, 2014; UMenzies et al., 2008; UNakamae et al., 2008; USegobin et al., 2019).
Idatha yethu ye-DTI ikhombisa ukuthi ama-neural correlates we-CSBD ayagqagqana nezifunda ezibikwe ngaphambilini ezincwadini njengoba zihlobene zombili, ukuba umlutha kanye ne-OCD (bona indawo ebomvu ku I-Fig. 3). Ngakho-ke, isifundo samanje sikhombise ukufana okubalulekile ekunciphiseni okwabiwe kwe-FA phakathi kwe-CSBD nakho kokubili i-OCD nokulutha. Ngeshwa, le miphumela ayikhombisi ukuthi yiziphi kulezi zinto ezimbili ezisemtholampilo eziseduze ne-CSBD ngokuya ngezixhumanisi ze-DTI.
Imiphumela edlulayo evela ekubuyekezweni kwezincwadi kwi-fractional anisotropy (FA) ku-Addiction ne-OCD, nemiphumela yocwaningo lwethu lwe-DTI kwiziguli ze-CSBD. Ukwehliswa kwe-FA okuqondene ngqo nokulutha (okuluhlaza okwesibhakabhaka), ukwehliswa kwe-FA okuqondene ne-OCD (okuluhlaza okotshani), izifunda ezihlukanisa iziguli ezimbili ze-Addiction kanye ne-OCD ekulawuleni okunempilo (okuphuzi), kanye nezifunda ezahlukanisa iziguli ze-CSBD ekulawuleni okunempilo (okubomvu): Amapheshana ama-3 ku-cerebellum, ingxenye e-retrolenticular yengxenye yangaphakathi ye-capsule, ingxenye ephezulu yepheshana le-corona radiata nengxenye yendaba emhlophe ye-occipital gyrus
Isikhombo: Ijenali Yezidakamizwa Zokuziphatha JBA I-2021; 10.1556/2006.2021.00002
Ukulinganiselwa
Ngenkathi isifundo samanje siletha imininingwane emisha ngokuhluka kwezindaba ezimhlophe ekungafani kobuchopho ku-CSBD, imiphumela yayo inokulinganiselwa okuthile. Umkhawulo omkhulu uvamile kulolu hlobo lwesifundo sokuhlangana, futhi luthinta iqiniso lokuthi ukwehliswa okubonakalayo kokwehluka kwe-FA phakathi kwamasampuli amabili kungaba yinto esivele ikhona noma umphumela wokuthuthukiswa kwe-CSBD. Le nkinga ithinta ezinye izifundo eziningi zokuhluka kobuchopho obusebenzayo noma obusebenzayo kusetshenziswa ukwakheka kwesigaba esiphambanweni (I-Yuan et al., I-2010). Idizayini yesikhathi eside iyadingeka ukuhlola indima yezinguquko zobuchopho njengoba zihlobene nokuthuthuka nokuqhubekela phambili kwezimpawu ze-CSBD.
Omunye umkhawulo uhlobene nokuqashwa kwabahlanganyeli be-CSBD, okwakungenxa yeHypersexual Disorder (HD; I-Kafka, i-2010), hhayi imigomo ye-ICD-11, njengoba idatha yethu yaqoqwa ngaphambi kokukhishwa kwemanuwali entsha ye-WHO. Imigomo ephathelene nokucindezeleka nokulawulwa ngokomzwelo ikhona phakathi kwe-HD, kodwa hhayi incazelo ye-CSBD (bona I-Gola et al., 2020), ngakho-ke isampula lethu lomtholampilo kungenzeka lifane nenani labantu be-OCD. Okubaluleke kakhulu, isampula lethu lalilincane futhi wonke amaqembu ayenabesilisa abathandana nabobulili obufanayo abalinganayo, izakhamuzi zasePoland. Ezifundweni ezizayo zesisekelo se-neurobiological se-CSBD, amasampula amakhulu futhi ahlukahlukene kakhulu kudingeka aqashwe. Usayizi omncane wesampula kungaba yisizathu sokuthi kungani imiphumela yethu ingasindanga ukulungiswa kwe-FWE yakudala, futhi lokhu kungomunye umkhawulo wocwaningo. Futhi, ukuqhathanisa okuqondile kubantu abanomlutha ne-OCD (kunokuba nje kube yimiphumela ebikwe ezincwadini) kungahle kusekele iziphetho ezinamandla ezifundweni ezizayo.
iziphetho
Imiphumela yocwaningo lwethu iphakamisa ukuthi i-CSBD yabelana ngephethini efanayo yokungajwayelekile nge-OCD nokulutha. Uma kuqhathaniswa nezilawuli, abantu be-CSBD bakhombise ukwehliswa okuphawulekayo kwe-FA kumgudu ophakeme we-corona radiata, ipheshana langaphakathi le-capsule, amapheshana e-cerebellar kanye nodaba olumhlophe lwe-occipital gyrus. Njengesinye sezifundo zokuqala ze-DTI eziqhathanisa umehluko wobuchopho obuhlelekile phakathi kwe-CSBD, ukuluthwa kanye ne-OCD, yize kuveza izici ezintsha ze-CSBD, akwanele ukuthola ukuthi ngabe i-CSBD ifana nokulutha ngokweqile noma i-OCD. Ucwaningo oluqhubekayo, ikakhulukazi ngokuqhathanisa ngqo abantu abanezinkinga ezintathu lunganikeza imiphumela ephelele.
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