Neuroimaging, Cannabis, le Ts'ebetso ea Boko le Ts'ebetso

"Ke nahana hore pitsa e lokela ho ba molaong. Ha ke e tsube, empa ke rata monko oa eona." -Andy Warhol

Cannabis e na le limolek'hule tse fapaneng tse tlamang li-receptors bokong, ka nepo li bitsoa "li-receptor tsa cannabinoid." Li-ligand tse tloaelehileng (tse tlamang ho li-receptor) li kenyelletsa cakir (tetrahydrocannabinol) le CBD (cannabidiol), e tlamang ho li-receptor tse kang li-receptor tsa CB1 le CB2 tse nang le likarolo tse fapaneng tse tlase tsa bokong.

Setsi sa mantlha sa methapo ea kutlo se amehang mesebetsing ea tlhaho ea li-cannabinoid ke "anandamide," e ikhethang "fatty acid neurotransmitter" eo lebitso la eona le bolelang "thabo", "thabo" kapa "thabo" ka Sanskrit le maleme a mang a khale a amanang. Sistimi ena ea methapo ea kutlo e sa tsoa batlisisoa ka botlalo, 'me biology ea mantlha e sebetsitsoe hantle (mohlala, Kovacovic & Somanathan, 2014), e ntlafatsa kutloisiso ea kalafo, boithabiso le litlamorao tse fapaneng tsa li-cannabinoids, le ho betla tsela bakeng sa nts'etsopele ea lithethefatsi tsa maiketsetso.

Thahasello e ntseng e eketseha ts'ebelisong ea kalafo le boithabiso ea hanf e hloka kutloisiso e kholo ea litlamorao tsa hanf bokong le boits'oarong. Ka lebaka la matekoane le lipolotiki tsa matekoane puong ea sechaba, litumelo tse matla mabapi le kannete li sitisa bokhoni ba rona ba ho ba le puisano e nang le mabaka mabapi le melemo le mathata a ts'ebeliso ea hanf hape e sitisitse merero ea lipatlisiso. Leha ho le joalo, linaha tse ngata li lumelletse ts'ebeliso ea bongaka le boithabiso ea litokisetso tsa hanf, ha mmuso oa koporasi o ntse o khutlela mekhoeng e thibelang.

Lekhotla le tsoa

Barekisi ba Cannabis, ka lehlakoreng le leng, ba ka taka setšoantšo se setle haholo sa melemo ea litokisetso tsa kannete, ba nyenyefatsa kapa ba lahla tlhaiso-leseling e nepahetseng mabapi le likotsi tsa hanf bathong ba bang ba kotsing ea mafu a mang a kelello, likotsi tsa ts'ebeliso ea ts'ebeliso ea kannete, le litlamorao tse mpe tsa kannete lits'ebetsong tse ling tsa ts'ebeliso ea kelello tse tsamaeang le litlamorao tse ka bang mpe, hape li bile li le kotsi ho nkeng liqeto le boits'oaro.

Mohlala, ha litokisetso tsa kannete li bontšitsoe li le molemo bakeng sa taolo ea bohloko le ntlafatso ea ts'ebetso maemong a fapaneng, ho ntlafatsa bophelo, kannete e kanna ea baka liphoso kahlolong le ho lieha ho sebetsanang le tlhaiso-leseling, e ka lebisang eseng feela mathateng ka bomong, empa e kanna ea kena tseleng ea likamano le mesebetsi ea profeshenale, ebile e ka lebisa ho kotsi ho ba bang ka ho kenya letsoho likotsing.

Cannabis e amahanngoa ka ho hlaka le ho fokotsa ho qala le ho mpefala ha mafu a mang, haholo maemo a kelello. Ho feta moo, ho na le thahasello e ntseng e hola ea ho utloisisa bokhoni ba kalafo le mafu a metsoako e fapaneng e fumanehang ka har'a litokisetso tsa kannete, haholoholo THC le CBD - leha bohlokoa ba likarolo tse ling bo ntse bo tsebahala. Mohlala, phuputso ea haufinyane ho American Journal of Psychiatry e fana ka maikutlo a hore CBD, e thusang ho phekola ho oela ho sa tsitsang (mohlala, Rosenberg et al., 2015), e kanna ea ba molemo o moholo joalo ka moemeli ea eketsang ba bang ba nang le schizophrenia (McGuire at al ., 2017).

Setšoantšo ha se-kapa, leha ho le joalo. Kutloisiso e tebileng ea hore na cannabis e ama libaka tse fapaneng tsa boko (tlasa maemo a fapaneng, mohlala, tšebeliso e matla le e sa foleng, e nang le mafu a kelello a fapaneng ntle le ts'ebeliso ea lithethefatsi, ka mefuta e fapaneng, jj.) Ea hlokahala ho theha ngangisano tsebong, le ho fana ka liphetho tse tiileng, tse tšepahalang tsa mahlale ho bula tsela bakeng sa lipatlisiso tsa nako e tlang. Kutloisiso ea mantlha ea haella, 'me ha ho ntse ho e-na le sehlopha se ntseng se hola sa lipatlisiso tse shebileng likarolo tse fapaneng tsa litlamorao tsa kannete, joalo ka ha ho lula ho le joalo ka sehlopha se ntseng se tsoela pele sa lipatlisiso pele, mokhoa o fapane ho lithuto tse ngata tse nyane, ntle le moralo o hlakileng oa khothaletsa mekhoa e ts'oanang ea lipatlisiso.

Potso e le 'ngoe ea bohlokoa bo totobetseng ke: Litlamorao tsa kannete libakeng tse bohlokoa tsa ts'ebetso ea boko ke life? Mosebetsi le khokahano li fetoha joang libakeng tsa mantlha tsa anatomic ("hubs," ho netweke ea netweke) li hasana ho marang-rang a boko ao li leng bohareng? Cannabis e sebelisa joang, ho isa moo re utloisisang litlamorao tsa eona, e bapalang mesebetsing e ikhethileng e sebelisetsoang ho ithuta ka boits'oaro? Ka kakaretso, phello ea kannete marang-rang a boko ke eng, ho kenyeletsoa mokhoa o ikhethileng, taolo ea phethahatso le marang-rang a marang-rang (marang-rang a mararo a bohlokoa sehlopheng se hokahaneng sa "sehlopha se ruileng" sa marang-rang a boko)?

Tsena le tse amanang le tsona li bohlokoa haholo ha re ntse re utloisisa hamolemo hore na lekhalo la kelello / boko le ka koaloa joang ke tsoelo-pele ea ho etsa 'mapa oa khokahano ea motho ea methapo. Tebello ke hore keketseho kapa ea fokotseha mesebetsing libakeng tse fapaneng tsa boko ho basebelisi (ha e bapisoa le bao e seng basebelisi) e tla tsamaellana le liphetoho tse pharalletseng marang-rang a sebetsang a boko, a bonts'ang ka mekhoa ea ts'ebetso e fapaneng sehlopheng se seholo sa lisebelisoa tsa lipatlisiso tsa kelello tse atisang ho sebelisoa. tse nkang likarolo tse fapaneng tsa ts'ebetso ea kelello le boits'oaro ba motho.

Boithuto ba hajoale

Ka mohopolo ona oa mantlha ka kelellong, sehlopha sa bafuputsi ba mefuta e mengata (Yanes et al., 2018) se ile sa qala ho bokella le ho lekola lingoliloeng tsohle tse amanang le neuroimaging tse shebileng litlamorao tsa hanf bokong le boits'oarong le thutong ea kelello.

Ho bohlokoa ho lekola mokhoa oa ho sekaseka litlhahlobo o sebelisitsoeng hanyane le ho buisana ka hore na ke lithuto tsa mofuta o fe tse kenyellelitsoeng le tse sa kenyellelitsoeng molemong oa ho etsa moelelo oa taba le ho toloka liphetho tsa bohlokoa. Ba shebile lingoliloeng tse kenyelletsang lithuto tse sebelisang fMRI (imaging magnetic resonance imaging) le PET scans (positron emission tomography), lisebelisoa tse tloaelehileng tsa ho lekanya lits'oants'o tsa ts'ebetso ea boko, mme ba etsa liteko tsa pele ho hlophisa data.

Taba ea mantlha, ba ile ba arola lithuto hore e be moo liketsahalo tse ling tse fapaneng tsa boko li ekelitsoeng kapa li fokotsehang bakeng sa basebelisi ho bapisoa le bao e seng basebelisi mme li ts'oana le libaka tsa anatomic le likhokahano tsa boko tse sebetsang tseo e leng karolo ea tsona. Karolong ea bobeli ea ntlafatso, ba sebelisitse "ho khetholla ho sebetsang" ho khetholla le ho arola lihlopha tse fapaneng tsa ts'ebetso ea kelello e lekantsoeng hohle ho lingoliloeng tse seng li ntse li le teng.

Mohlala, liphuputso li sheba likarolo tse kholo empa tse fapaneng tsa ts'ebetso ea kelello ho bona hore na, haeba ho joalo, kannete e fetola phetoho ea kelello le maikutlo. Mesebetsi e amehang e kenyelletsa ho nka liqeto, ho lemoha liphoso, taolo ea likhohlano, ho ama taolo, moputso le mesebetsi e susumetsang, taolo ea tšusumetso, mesebetsi ea phethahatso le mohopolo, ho fana ka lenane le sa phethahalang. Hobane lithuto tse fapaneng li sebelisitse litlhahlobo tse fapaneng tlasa maemo a fapaneng, ho nts'etsapele mokhoa o kopaneng oa tlhahlobo ho hlokahala ho etsa tlhahlobo le tlhahlobo e felletseng.

Ho batlisisa marang-rang a mangata a tloaelehileng, ba khethile lithuto tse nang le litšoantšo tse bapisang basebelisi le bao e seng basebelisi, ka data e fumanehang ka sebopeho sa mefuta e metle e loketseng tlhahlobo e kopaneng, mme e kenyelletsang liteko tsa kelello tsa temoho, motsamao, maikutlo, ho nahana le ts'ebetso ea tlhaiso-leseling ea sechaba, ka mefuta e fapaneng. Ba khethile ba nang le maemo a bophelo bo botle ba kelello, le lithuto tse shebileng litlamorao tsa ts'ebeliso ea hanf. Ba ile ba sekaseka lintlha tsena tse hlophisitsoeng.

Ha ba sheba phetoho ea liphumano tsa neuroimaging liphuputsong tse sebelisang ALE (Activation Likelihood Estimate, e fetolang data ho mofuta o tloaelehileng oa 'mapa oa boko), ba supile hore na ke libaka life tse sa sebetseng haholo. Ba sebelisa MACM (Meta-Analytic Khokahano ea Modeling, e sebelisang database ea BrainMap ho etsa lipalo tsa ts'ebetso ea boko bo felletseng), ba ile ba supa lihlopha tsa libaka tsa boko tse ileng tsa sebetsa hammoho.

Ba qetile karolo ea ts'ebetso ea ho khetholla ka ho sheba pele le ho khutlisa mekhoa ea boits'oaro ho hokahanya ka mokhoa o ts'oanang ts'ebetso ea kelello le ts'ebetso ea kelello, le ts'ebetso ea kelello le ts'ebetso ea boko, ho utloisisa hore na lits'ebetso tse fapaneng tsa kelello li hokahana joang le mesebetsi libakeng tse fapaneng tsa boko.

Kakaretso ea "lipeipi" tsa meta-analytic ke ena:

Liphuputso

Yanes, Riedel, Ray, Kirkland, Nonyana, Boeving, Reid, Gonazlez, Robinson, Laird, le Sutherland (2018) ba hlahlobile lithuto tse 35 kaofela. Bohle bo boletsoe, ho ne ho e-na le maemo a 88 a thehiloeng mosebetsing, ka likarolo tsa 202 tse amanang le ho fokotseha ha ts'ebetso har'a basebelisi ba cannabis ba 472 le bao e seng basebelisi ba 466, le likarolo tsa 161 mabapi le ts'ebetso e eketsehileng har'a basebelisi ba 482 le bao e seng basebelisi ba 434. Ho ne ho na le libaka tse tharo tse kholo tsa liphuputso:

Ho bile le libaka tse 'maloa tsa liphetoho tse lumellanang ("convergent") tse hlokometsoeng har'a basebelisi le bao e seng basebelisi, mabapi le ts'ebetso le ts'ebetso. Ho ile ha bonoa liphokotso ka mahlakore a mabeli (mahlakore ka bobeli a boko) li-ACC (anterior cingulate cortex) le DLPFC e nepahetseng (dorsolateral prefrontal cortex). Ka lehlakoreng le leng, ts'ebetso e ne e eketsehile khafetsa ho striatum e nepahetseng (le ho fetela sebakeng se nepahetseng sa insula). Ke habohlokoa ho hlokomela hore liphuputso tsena li ne li fapane, 'me ho haellana hona ho bolela hore li emela litlamorao tse ikhethang tsa hanf litsamaisong tse fapaneng.

Tlhahlobo ea MACM e bonts'itse hore ho na le lihlopha tse tharo tsa libaka tse sebetsanang le boko:

• Cluster 1 - ACC e kenyellelitse mekhoa ea ts'ebetso ea boko bo felletseng, ho kenyeletsoa khokahano le cortex ea insular le caudate, medial frontal cortex, precuneus, fusiform gyrus, culmen, thalamus le cingulate cortex.ACC ke senotlolo sa ho etsa liqeto le ho sebetsana le likhohlano 'me e kenyelelitsoe ho fuputseng le ho itlama ka tsela e fanoeng (mohlala, Kolling et al., 2016), mme libaka tsena tse amanang le tsona li akaretsa mesebetsi e mengata e amanang le ACC. Insula e ameha ka boithati, mohlala o ikhethang e le boiphihlelo ba pono ba ho inyonya.
• Cluster 2 - DLPFC e kenyellelitse tšebelisano 'moho le libaka tsa parietal, orbitofrontal cortex, occipital cortex le fusiform gyrus. Ha DLPFC e nka karolo mesebetsing ea bohlokoa ea botsamaisi, ho kenyelletsa ho laola maikutlo, boiphihlelo ba maikutlo, le tataiso ea lisebelisoa tsa tlhokomelo (mohlala, Mondino ho al., 2015) hammoho le likarolo tsa ts'ebetso ea puo, le libaka tse amanang le tsona li sebetsana le mesebetsi ea bohlokoa, ho kenyelletsa ts'ebetso ea tlhaiso-leseling ea sechaba, taolo ea tšusumetso le tse ling tse amanang le tsona.
• Cluster 3 - Striatum e kenyellelitse ho nka karolo ha boko bohle, haholo-holo insular cortex, frontal cortex, parietal lobule e phahameng, fusiform gyrus le culmen. Striatum e amana le moputso - seo ho thoeng ke "dopamine hit" e boletsoeng khafetsa-eo ha e laoloa ka nepo e re lumellang ho phehella katleho e ntle, empa maemong a tlasa ketso e lebisa ho ho se sebetse, mme ho tlatsetsa ho tlatselletsang mekhoeng e lemalloang le e tlamang . Bopaki bo hlahlojoang pampiring ea mantlha bo fana ka maikutlo a hore ts'ebeliso ea li-cannabis e kanna ea ba le meputso e meholo ho ithaopela ho lemalla, mme mohlomong le tšusumetso e hlabang ea mesebetsi e tloaelehileng.

Le ha lihlopha tsena li sebetsa ka mokhoa o ikhethileng ho latela hore na li angoa ke kannete joang, li kopana ka mokhoa oa tlhaho le sebaka, ho totobatsa bohlokoa ba bohlokoa ba tšebetso ea boko bo shebiloeng ho tsoa khokahanong, molemong oa ho utloisisa phetolelo ea liphihlelo tse fokotsang tsa boko ho kelello e sebetsa, le hore na sena se bapala joang bathong bophelong ba letsatsi le letsatsi.

Ho khetholla ho sebetsang ha lihlopha tse tharo ho bonts'itse mekhoa ea kamoo sehlopha ka seng se tsamaellanang le sehlopha sa liteko tsa kelello: mohlala, Stroop test, go / no-go task e kenyang liqeto tse potlakileng, mesebetsi ea ho lekola bohloko, le mesebetsi ea ho lekola meputso, ho bolela tse seng kae. Ha ke na ho li hlahloba kaofela, empa liphetho li bohlokoa, 'me tse ling tsa tsona lia totobala (sheba ka tlase).

Kakaretso ena ea likamano tsa mesebetsi ea sehlopha e na le thuso. Haholo-holo ho hlokomelehang ke boteng ba boemo ba mosebetsi oa ho ea / ho se ee libakeng tsohle tse tharo tse sebetsang:

Lintlha tse ling hape

Ha ho kopantsoe hammoho, liphetho tsa tlhahlobo ena ea litlhahlobo li tebile ebile li fihlela sepheo sa ho tsepamisa maikutlo le ho hlakola liphuputso ho lingoliloeng tse amehang tse fuputsang litlamorao tsa ts'ebeliso ea kannete ts'ebetsong ea boko ho batho ba se nang bokuli ba kelello, ba shebileng keketseho le ts'ebetso e fokotsehileng ea lehae libaka tsa boko, likarolo tse ajoang tsa bohlokoa bo ikhethang, le kameho mesebetsing ea bohlokoa ea ts'ebetso ea kelello le ts'ebetso.

Cannabis e theola tšebetso lihlopheng ka bobeli tsa ACC le DLPFC, le bakeng sa batho ba nang le ts'ebetso e tloaelehileng ea boko, sena se ka baka mathata ho ts'ebetso ea phethahatso le ho nka liqeto. Cannabis e kanna ea baka ho se nepahala ha ho lekola liphoso, ho lebisang ho ho se utloisise le ho sebetsana le mathata ka lebaka la liphoso, mme ho ka sitisa tšebetso nakong ea likhohlano tse kholo, ho tloha liphosong ka bobeli kahlolong le ho fetoleng liqeto le phethisong e latelang. Ho fokotseha ha ts'ebetso ea DLPFC ho ka lebisa mathateng a taolo ea maikutlo, hape le ho fokotseha mohopolong le ho fokotsa taolo ea tlhokomelo.

Bakeng sa batho ba nang le maemo a kelello le a bongaka, litlamorao tse tšoanang tsa boko e ka ba tsa kalafo, mohlala ho fokotsa moroalo oa bohloko ka ho fokotsa ts'ebetso ea ACC, ho fokotsa mehopolo e sithabetsang le ho hatella litoro tse bohloko tsa morao-rao, ho phekola matšoenyeho ka litla-morao tse fokolang, kapa ho fokotsa matšoao a kelello (McGuire, 2017) ka ho thibela tšebetso libakeng tse amehang tsa boko.

Empa li-cannabinoids le tsona li ka baka mafu, tsa baka khatello ea maikutlo kapa psychosis, le maemo a mang, ho batho ba tlokotsing. Ts'ebeliso ea kannabis e boetse e baka mathata bakeng sa boko bo ntseng bo hola, bo lebisang liphellong tse sa rateheng tsa nako e telele (mohlala, Jacobus le Tappert, 2014), joalo ka ts'ebetso e fokotsehileng ea ts'ebetso ea methapo le liphetoho tsa sebopeho bokong.

Cannabis e bontšitsoe, ka lehlakoreng le leng, ho eketsa ts'ebetso ho striatum le libakeng tse amanang ka kakaretso. Bakeng sa batho ba nang le tšebetso e tloaelehileng ea mantlha, sena se ka lebisa tlhokomelong ea lipotoloho tsa meputso, 'me joalo ka ha ho bonoe liphuputsong tse ngata, ho ka eketsa kotsi ea boits'oaro le boits'oaro bo tlamang, bo lebisang mefuteng e meng ea mafu. Kholiso ena ea tšebetso ea moputso (e kopantsoe le litlamorao ho lihlopha tse peli tsa pele) e ka kenya letsoho ho "phahameng" ha botahoa ba matekoane, ho matlafatsa monyaka le ts'ebetso ea boqapi, ho etsa hore ntho e ngoe le e ngoe e be matla le ho feta, nakoana.

Bangoli ba hlokomela hore lihlopha tsohle tse tharo li ne li kenyelletsa mosebetsi oa go / no-go, boemo ba liteko bo hlokang thibelo kapa ts'ebetso ea ts'ebetso ea makoloi. Baa hlokomela:

"Mona, taba ea hore litšitiso tse ikhethileng tse ikhethileng tsa tikoloho e ne e hokahantsoe le tlhophiso e tšoanang ea ts'ebetso e kanna ea supa phello e amanang le hanf e bonts'itsoeng lipatlisisong. ts'ebetso ea pele (ACC le DL-PFC) le ho phahamisa tšebetso ea pelehi. "

Bakeng sa bakuli ba bang, kannete ho thoe e fokotsa matšoao a khatello ea maikutlo, a khetholloang ke boiphihlelo ba mantlha ba ho lahleheloa ke thabo, maemo a mabe a maikutlo, le ho hloka tšusumetso har'a matšoao a mang, empa basebelisi ba boima ba kotsing e kholo ea ho mpefala ho tepella maikutlo (Manrique-Garcia et al ., 2012).

Leha ho le joalo, ntle le tlatsetso ea ho lemalla lik'hemik'hale tse ling le boiphihlelo bo matlafatsang ba thabelang ho tahoa ke matekoane (ba bang ba fumana e hlahisa dysphoria, matšoenyeho, pherekano e sa thabiseng, kapa le paranoia), basebelisi ba ka fumana hore ha ho na tšebeliso ea hanf , ha ba na tjantjello ea mesebetsi e tloahelehileng ha e sa phahama, e lebisang ho fokotseheng ha thabo le tšusumetso.

Litholoana tsena li fapane ho latela maemo a amanang le ts'ebeliso ea li-cannabis, joalo ka nako le ho se sebetse ha ts'ebeliso, hammoho le mofuta oa hanf le chemistry e amanang, e fuoeng mefuta-futa har'a mefuta le mefuta e fapaneng. Le ha boithuto bona bo ne bo sa khone ho khetholla lipakeng tsa litlamorao tsa THC le CBD, kaha lintlha li ne li sa fumanehe ka lipalo kapa litekanyo tsa likarolo tsena tse peli tsa bohlokoa tsa kannete, ho ka etsahala hore li na le litlamorao tse fapaneng ts'ebetsong ea boko e hlokang lipatlisiso tse ling ho hlophisa ho tsoa bokhoni ba kalafo bo tsoang litlamong tsa boithabiso le mafu.

Phuputso ena ke thuto ea mantlha, e behang sethala sa lipatlisiso tse tsoelang pele ka litlamorao tsa li-cannabinoids tse fapaneng bokong ka bophelo bo botle le bokuli, le ho fana ka lintlha tsa bohlokoa ho utloisisa litlamorao tsa kalafo le likotsi tsa li-cannabinoids tse fapaneng. Mokhoa o motle le o thata thutong ena o khantša leseli la hore na kannete e ama bokong joang, e fana ka lintlha tsa bohlokoa mabapi le litlamorao tse fumanehang marang-rang a boko le ts'ebetsong ea kelello le maikutlo.

Lipotso tse khahlisang li kenyelletsa ho etsa 'mapa o eketsehileng oa marang-rang a boko le ho hokahanya liphuputso tsena le meetso e teng ea kelello, ho sheba phello ea mefuta e fapaneng ea li-cannabis le mekhoa ea ts'ebeliso, le ho batlisisa phello ea li-cannabinoids (tse hlahang ka tlhaho, tse sa feleng le tse iketselitsoeng. ) bakeng sa merero ea kalafo maemong a fapaneng a kliniki, ts'ebeliso ea boithabiso, le monyetla oa ho ntlafatsa ts'ebetso.

Kamora nako, ka ho fana ka moralo o lumellanang oa ho utloisisa lingoliloeng tse teng tse kenyelletsang litlamorao tse ntle le tse mpe tsa hanf bokong, pampiri ena e fana ka lipatlisiso tsa kannete ka mokhoa o hlakileng haholo lithutong tsa mahlale, ho fana ka sethala se sa nke lehlakore, se khethiloeng ho lumella ngangisano ka hanf ho iphetola ha litsela tse hahang ho feta nalane.

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