Marwadzo ehupenyu hwemuviri wehupenyu hwekuzvarwa nekukuvara kana kurwara, uye kazhinji inyevero kuti chimwe chinhu chakaipa. Kana dambudziko racho rapora, tinowanzorega kuona zviratidzo izvi zvinorwadza, zvisinei, chii chinoitika apo marwadzo anoenderera kwenguva refu mushure mokunge mhaka yacho yapera? Kurwara kwenguva refu rinorondedzerwa sehutano hunoramba huripo hunoita 3 kumwedzi 6 kana kupfuura. Kurwara kwepanguva inenge iri mamiriro ezvinhu akaoma kuti ugare naye, zvichikanganisa zvose kubva pamabasa emunhu wega uye kukwanisa kwavo kushanda pamwe chete nehukama hwavo hwepamwe uye nemafungiro epfungwa. Asi, iwe unoziva here kuti kurwadziwa kusingaperi kunogona kuchinjawo maitiro uye basa rehupi hwako? Icho chinopera kuti uropi hunochinja hunoita kuti tive nemafungiro ekufungisisa uye mupfungwa.

 

Kuora mwoyo kwenguva refu hakungogadziri nzvimbo imwe chete yepfungwa, sechinhu chaicho, inogona kuguma nekuchinja kune nzvimbo dzakawanda dzinokosha dzeuropi, dzakawanda dzayo dzinobatanidzwa mune zvakawanda zvinoitwa nekuita uye mabasa. Kutsvakurudza kwakasiyana-siyana kwemakore kwakatsvaga kuchinja kune hippocampus, pamwe nekuderedza grey nenyaya kubva ku dorsolateral prefrontal cortex, amygdala, brainstem uye nechokunyoresa cortex, kutumidza vashomanana, vanobatana nekurwadziwa kusingaperi. Kuparara kwezvikamu zvishomanana zvezvivako zvezvikamu izvi uye mabasa avo akafanana zvinogona kubatsira kuisa uropi huno kuchinja mumamiriro ezvinhu, nokuda kwevanhu vakawanda vane kurwadziwa kusingaperi. Chinangwa chehurukuro inotevera ndechekuratidzira pamwe nekukurukura maitiro ehutano uye hunoita hunochinja hunoenderana nekurwadziwa kusingaperi, kunyanya pane izvo izvo zvinoratidza kuti hazvikuvadzi kana kuti atrophy.

 

Chimiro cheBurin Kuchinja Mukurwara Kusingaperi Kuratidza Zvichida Hapana Kukuvara Kana Atrophy

 

ngovepo

 

Kurwadziwa kusingaperi kunoratidzika kunge kunosanganisirwa nehuropi grey nyaya yekudzikisira munzvimbo dzinofungidzirwa kutapurirana kwekutambudzika. Ma morphological maitiro anokonzeresa shanduko idzi, pamwe zvichitevera kugadziriswazve kushanda uye kwepakati pepurasitiki muuropi, zvinoramba zvisina kujeka. Marwadzo muhudyu osteoarthritis ndeimwe yeaya mashoma maronda ekurwadziwa asingarapike ayo anonyanya kurapwa. Isu takaongorora varwere makumi maviri vane kurwadziwa kusingaperi nekuda kweiyo unilateral coxarthrosis (zvinoreva makore 20 63.25 (SD) makore, gumi mukadzi) pamberi pechiuno kubatana opoprosthetic kuvhiyiwa (kurwadziwa nyika) uye kuongororwa kwehuropi shanduko shanduko kusvika pagore rimwe mushure mekuvhiyiwa: mavhiki matanhatu ne9.46. , 10 1 mavhiki uye 6 8 mwedzi painorwadza zvachose. Varwere vane marwadzo asingagumi nekuda kweiyo unilateral coxarthrosis vaive neakaonda grey zvakanyanya kana ichienzaniswa neanodzora mune anterior cingate cortex (ACC), insular cortex uye operculum, dorsolateral prefrontal cortex (DLPFC) uye orbitofrontal cortex. Aya matunhu anoshanda seakawanda-anobatanidza masisitimu panguva yechiitiko uye kutarisira kurwadziwa. Varwere pavakarwadziwa vakasununguka mushure mekupora kubva mukuvhiya kwekupedzisira, grey nyaya inowedzera munzvimbo dzinenge dzakawanikwa. Isu takawanawo kuwedzera kunofambira mberi kwehuropi grey zvinhu mu premotor cortex uye yekuwedzera mota nzvimbo (SMA). Isu tinopedzisa kuti grey zvinhu zvisina kujairika mukurwadziwa kusingaperi handicho chinokonzeresa, asi chechipiri kuchirwere uye zvirinani muchikamu nekuda kwekushandurwa kwemotokari mashandiro uye kusangana kwemuviri.

 

ziviso

 

Uchapupu hwekushanda nekugadzirisa kurongeka kwevarwere vasingaperi vanorwadziwa vanotsigira pfungwa yekuti kurwadziwa kusingaperi hakufanirwe kungofungidzirwa sekushandurwa kwenyika inoshanda, asi zvakare semhedzisiro yekushanda uye kuumbwa kwehuropi hwepurasitiki [1], [2], [3], [4], [5], [6]. Mumakore matanhatu apfuura, zvidzidzo zvinopfuura makumi maviri zvakaburitswa zvichiratidza shanduko yehuropi mu20 syndromes echirwere chisingaperi. Chinhu chinokatyamadza pane zvese izvi zvidzidzo inyaya yekuti grey nyaya shanduko haina kugoverwa zvisina kurongeka, asi inoitika mune yakatsanangurwa uye inoshanda zvakanyanya nzvimbo dzehuropi - kureva, kubatanidzwa mune supraspinal nociceptive kugadzira. Izvo zvakanyanya kuzivikanwa zvakawanikwa zvaive zvakasiyana kune yega marwadzo chirwere, asi zvakaputirwa mune cingate cortex, iyo orbitofrontal cortex, iyo insula uye dorsal pons [14]. Zvimwe zvivakwa zvine thalamus, dorsolateral prefrontal cortex, basal ganglia uye hippocampal nzvimbo. Izvi zvakawanikwa zvinowanzokurukurwa senge cellul atrophy, inosimbisa iyo pfungwa yekukuvara kana kurasikirwa kwehuropi grey nyaya [4], [7], [8]. Muchokwadi, vaongorori vakawana kuwirirana pakati peuropi grey nyaya inoderera uye nguva yekurwadziwa [9], [6]. Asi iyo nguva yekurwadziwa inosanganisirwa nezera remurwere, uye zera rinotenderera pasirese, asi zvakare kudunhu kwakatarisana kuderera kweye grey kwakanyatsoratidzwa [10]. Kune rimwe divi, idzi shanduko dzemamiriro ezvinhu dzinogona zvakare kuve kuderera kwemasero maseru, zvinwiwa zvemukati memvura, synaptogenesis, angiogenesis kana kunyangwe nekuda kwekuchinja kweropa [11], [4], [12]. Chero zvingave zvichibva, kududziro yedu yezviwanikwa zvakakosha kuti uone izvi morphometric zviwanikwa muchiedza cheupfumi hwezvidzidzo zve morphometric mukuita muviri kunoenderana nepurasitiki, zvichipiwa kuti nharaunda dzakasarudzika huropi shanduko dzakaratidzirwa kakawanda zvichitevera kugona kwekuziva uye kwemuviri [ 13].

 

Hazvina kunzwisiswa kuti nei chikamu chidiki chete chevanhu vachikura chirwere chisingaperi chekurwadziwa, tichifunga kuti kurwadziwa chiitiko chepasi rose. Mubvunzo unomuka kana mune vamwe vanhu musiyano wehurongwa pakati pehurombo hwekuparadzira masisitimu anogona kuita se diathesis yekurwadziwa kusingaperi. Grey nyaya inoshanduka mukurwadziwa kwepantom nekuda kwekutemwa [15] uye kukuvara kwemuzongoza [3] zvinoratidza kuti morphological shanduko yehuropi, zvirinani muchikamu, mhedzisiro yekurwadziwa kusingaperi. Zvisinei, kurwadziwa muhudyu osteoarthritis (OA) ndechimwe chevashoma chisingaperi kurwadziwa chirwere icho chinonyanya kurapwa, sezvo 88% yevarwere ava vanogara vasina marwadzo zvichitevera kuvhiyiwa kwechiuno kwese (THR) [16]. Mune chidzidzo chekutyaira isu takaongorora varwere gumi vane hudyu OA vasati uye munguva pfupi mushure mekuvhiyiwa. Isu takawana kuderera kweye grey nyaya mune anterior cingulated cortex (ACC) uye insula panguva yekurwadziwa kusingaperi pamberi pekuvhiyiwa kweTHR uye takawana kuwedzera kwenyaya yegrey munzvimbo dzinoenderana dzehuropi mumamiriro ekurwadziwa akasununguka mushure mekuvhiyiwa [17]. Tichitarisa pane uyu mhedzisiro, isu ikozvino takawedzera zvidzidzo zvedu tichiongorora vamwe varwere (n? =? 20) mushure mekubudirira THR uye kuongororwa kwehurongwa hwehuropi shanduko mukati menguva ina dzenguva, kusvika pagore rimwe zvichitevera kuvhiyiwa. Kudzora kweyegrey nyaya shanduko nekuda kwekuvandudza mota kana kushushikana isu zvakare takapa mibvunzo yemibvunzo inotarisana nekuvandudzwa kwemota basa uye hutano hwepfungwa.

 

Zvinhu uye Nzira

 

Vazvipiri

 

Varwere vanotaurwa pano iboka revarwere makumi maviri kubva pavarwere makumi matatu nevaviri vakaburitswa nguva pfupi yadarika avo vakafananidzwa nezera- nevakadzi-vakaenzana vane hutano hweboka [20] asi vakapinda mune rimwe gore rekutevera ongororo. Mushure mekuvhiyiwa 32 varwere vakasiya nekuda kwechipiri opoprosthetic kuvhiyiwa (n? =? 17), chirwere chakakomba (n? =? 12) uye kubviswa kwemvumo (n? =? 2). Izvi zvakasiya boka revarwere makumi maviri vane unilateral primary hip OA (zvinoreva makore 2 8 (SD) makore, gumi mukadzi) vakaferefetwa kane: vasati vavhiyiwa (kurwadziwa nyika) uyezve 63.25 9.46 uye 10-6 masvondo uye 8 12 mwedzi mushure mekuvhiyiwa kwekupedzisira, apo painorwadza zvachose. Vese varwere vane hudyu hwepakutanga OA vaive nenhoroondo yekurwadziwa kwenguva yakareba kupfuura mwedzi gumi nemaviri, kubva pa18 kusvika pamakore makumi matatu nematatu (zvinoreva makore 10) uye zvinorehwa zvinorwadza zve14 (kubva pa12 kusvika 1) pane inoonekwa analogue scale (VAS) kubva 33 (hapana kurwadziwa) kusvika zana (kurwadziwa kwakanyanya kufungidzira) Isu takaongorora chero zviitiko zvezviitiko zvidiki zvekurwadziwa, kusanganisira mazino-, nzeve- uye nemusoro kusvika kumavhiki e7.35 pasati chidzidzo. Isu takasarudzira zvakasarudzika dhata kubva kumakumi maviri ezvepabonde- uye zera rakaenzana kutonga zvine hutano (zvinoreva makore 65.5 40 (SD) makore, gumi mukadzi) wemakumi matatu nemaviri ezvidzidzo zvataurwa pamusoro apa [90]. Hapana mumwe wevarwere makumi maviri kana vevane makumi maviri ezvepabonde- uye zera rakaenzana nevanozvipira vane hutano vaine chero nhoroondo yehutano kana yemukati nhoroondo yekurapa. Chidzidzo chakapihwa mvumo yetsika nekomiti yemunharaunda yeEthics uye mvumo yakanyorwa ine ruzivo yakawanikwa kubva kune vese vatori vechikamu kudzidza usati waongororwa.

 

Dhiyabhorosi Data

 

Isu takaunganidza dhata pamusoro pekushungurudzika, kushushikana, kushushikana, kurwadziwa uye hutano hwepanyama uye hwepfungwa kune vese varwere uye ese mana nguva mapoinzi vachishandisa anotevera akaenzana emibvunzo: Beck Depression Inventory (BDI) [18], Pfupi Chiratidzo Inventory (BSI) [19], Schmerzempfindungs-Skala (SES? =? Kurwadziwa kusingafadzi chiyero) [20] uye Hutano Ongororo 36-Item Pfupi Fomu (SF-36) [21] uye Nottingham Hutano Mbiri (NHP). Takaita matanho anodzokororwa ANOVA uye takabatana maviri-miswe-t-Miedzo yekuongorora iyo yakareba nzira yekuita data tichishandisa SPSS 13.0 yeWindows (SPSS Inc., Chicago, IL), uye tikashandisa Greenhouse Geisser kururamisa kana fungidziro yechitema ikatyorwa. Iyo yakakosha nhanho yakaiswa pa p <0.05.

 

VBM - Data Acquisition

 

Image acquisition. Yakakwira-resolution MR scanning yakaitwa pane 3T MRI system (Siemens Trio) ine yakajairwa 12-chiteshi musoro coil. Kune yega yega yenguva ina mapoinzi, tarisa ini (pakati pe1 zuva nemwedzi mitatu pamberi pekuvhiya kwekupedzisira), scan II (mavhiki matanhatu kusvika masere mushure mekuvhiyiwa), tarisa III (vhiki gumi nemasere kusvika gumi nemasere mushure mekuvhiyiwa) uye tarisa IV (3-6 mwedzi mushure mekuvhiyiwa), T8 yakaremerwa yakarongeka MRI yakawanikwa kune mumwe murwere achishandisa 12D-FLASH kuteedzana (TR 18 ms, TE 10 ms, flip angle 14 , 1 mm zvimedu, FOV 3 15, voxel size 4.9 25 1 mm).

 

Image Processing uye Statistical Analysis

 

Data pre-processing uye kuongororwa kwakaitwa neSPM2 (Wellcome Dhipatimendi reCognitive Neurology, London, UK) inoshanda pasi peMatlab (Mathworks, Sherborn, MA, USA) uye ine voxel-based morphometry (VBM)-toolbox ye data longitudinal, iyo yakavakirwa pakugadziriswa kwepamusoro 3D MR mifananidzo uye inobvumira kushandisa voxel-huchenjeri manhamba kuona misiyano yedunhu mugrey nyaya density kana mavhoriyamu [22], [23]. Muchidimbu, pre-processing yaisanganisira spatial normalization, grey matter segmentation uye 10 mm spatial smoothing neGaussian kernel. Pamatanho ekutanga-kugadzirisa, takashandisa optimized protocol [22], [23] uye scanner- uye kudzidza-chaiyo grey nyaya template [17]. Isu takashandisa SPM2 pane SPM5 kana SPM8 kuita kuti ongororo iyi ifanane neyedu yekudzidza [17]. sezvo ichibvumira yakanakisa normalization uye segmentation yelongitudinal data. Nekudaro, sekuvandudzwa kwazvino kweVBM (VBM8) kwave kuwanikwa nguva pfupi yadarika (dbm.neuro.uni-jena.de/vbm/), takashandisawo VBM8.

 

Cross-Sectional Analysis

 

Isu takashandisa maviri-sampuro t-bvunzo kuitira kuti tione musiyano wedunhu muuropi grey nyaya pakati pemapoka (varwere panguva yekutora scan ini (kurwadziwa kusingaperi) uye hutano hwakanaka). Isu takaisa chikumbaridzo che p <0.001 (isina kukamurwa) kuyambuka huropi hwese nekuda kwesimba redu rekufungidzira, iro rakavakirwa pazvidzidzo zve9 zvakazvimirira uye macohort anoratidza kuderera kweyegrey nenyaya yevarwere vasingarware [7], [8], [ 9], [15], [24], [25], [26], [27], [28], kuti grey nyaya inowedzera ichaonekwa munzvimbo imwechete (yekugadzirisa kurwadziwa kwakakodzera) kumatunhu sekudzidza kwedu kwendege (17 ). Iwo mapoka akafananidzwa nezera uye bonde pasina mutsauko wakakura pakati pemapoka. Kuti tiongorore kana mutsauko uripo pakati pemapoka wakachinja mushure megore rimwe, isu takafananidza varwere panguva yekutora IV (kurwadziwa pasina, gore rimwe kuteedzerana) kuboka redu rekutonga rine hutano.

 

Longitudinal Analysis

 

Kuona misiyano pakati penguva nguva (Scan I IV) takafananidza zviyero tisati tavhiyiwa (mamiriro ekurwadziwa) uyezve mavhiki matanhatu ne6 ne8 uye gumi nemwedzi mushure mekuvhiyiwa kwekupedzisira (kurwadziwa pasina) sekudzokororwa chiyero ANOVA. Nekuti chero huropi hunoshanduka nekuda kwekurwadziwa kusingaperi kungangoda imwe nguva kudzora kuteedzera nekumiswa kwemarwadzo uye nekuda kwekurwadziwa kwekuvhiya kwepashure kunorondedzerwa nevarwere, isu takafananidza mune yekureba kuongorora scan I uye II ne scan III uye IV. Zvekuona shanduko dzisina kubatana zvakanyanya nekurwadziwa, isu takatarisirawo shanduko inofambira mberi pamusoro penguva dzese dzenguva. Isu takabvarura huropi hwevarwere vane OA yechiuno chekuruboshwe (n? =? 12) kuitira kuti vagadzikane nerutivi rwekurwadziwa kune ese ari maviri, iro boka rekuenzanisa uye nehurefu hwekuongorora, asi zvakanyanya kuongorora iyo isina kuvhurwa dhata. Isu takashandisa iyo BDI mamaki secovariate mune modhi.

 

Results

 

Dhiyabhorosi Data

 

Vese varwere vakarondedzera kurwadziwa kwechiuno kusati kwaitwa oparesheni uye vaisarwadziwa (maringe nekurwadziwa kusingaperi) nekukurumidza mushure mekuvhiyiwa, asi vakarondedzera kurwadziwa kwakanyanya mushure mekuvhiyiwa pa scan II yaive yakasiyana nemarwadzo nekuda kweosteoarthritis. Hutano hwepfungwa mamaki eSF-36 (F (1.925 / 17.322)? =? 0.352, p? =? 0.7) uye iyo BSI yepasi rose mamakisi GSI (F (1.706 / 27.302)? =? 3.189, p? =? 0.064 ) haina kuratidza shanduko pane iyo kosi yenguva uye hapana kusagadzikana kwepfungwa. Hapana chimwe chezviremera chakataura chero kurwadziwa kwakanyanya kana kusingaperi uye hapana chakaratidza chero zviratidzo zvekuora mwoyo kana kuremara kwepanyama / kwepfungwa.

 

Asati avhiyiwa, vamwe varwere vakaratidza zvinyoro nyoro kusvika pakuenzanisa zviratidzo zvekushushikana muBDI zvikoro zvakadzikira zvakanyanya pakuongorora III (t (17)? =? 2.317, p? =? 0.033) uye IV (t (16)? =? 2.132, p? =? 0.049). Uyezve, iyo SES zvikoro (kurwadziwa kusingafadzi) kwevarwere vese zvakagadziriswa zvakanyanya kubva pakuongorora I (pamberi pekuvhiya) kuongorora II (t (16)? =? 4.676, p <0.001), scan III (t (14)? =? 4.760, p <0.001) uye scan IV (t (14)? =? 4.981, p <0.001, 1 gore mushure mekuvhiyiwa) sekurwadziwa kusagadzikana kwakaderera nekurwadziwa kwakanyanya. Iyo yekurwadziwa chiyero pane scan 1 uye 2 yaive yakanaka, chiyero chakafanana pazuva re3 ne4 risina kunaka. Iyo SES inongotsanangudza mhando yemarwadzo anoonekwa. Saka zvaive zvakanaka pazuva 1 ne2 (kureva 19.6 pazuva 1 uye 13.5 pazuva 2) uye zvisina kunaka (na) pazuva 3 & 4. Zvisinei, vamwe varwere havana kunzwisisa maitiro aya uye vakashandisa iyo SES seyero yepasi rose. yehupenyu chiyero. Ichi ndicho chikonzero vese varwere vakabvunzwa pazuva rimwe chete mumwe nemumwe uye nemunhu mumwechete nezve marwadzo anoitika.

 

Muchidimbu fomu ongororo yehutano (SF-36), iyo ine zviyero zvepfupiso zvePhysical Health Score uye Mental Health Score [29], varwere vakavandudza zvakanyanya muchikamu chePhysical Health kubva pakuongorora ini kuongorora II (t ( 17)? =? 4.266, p? =? 0.001), scan III (t (16)? asi kwete muMental Health Score. Mhedzisiro yeNHP yaive yakafanana, mune subscale pain (reversed polarity) takaona shanduko yakakura kubva pakuongorora I to scan II (t (8.584)? = ?? 0.001, p <12, scan III (t (7.148) = ?? 0.001, p <14 uye scan IV (t (5.674)? (t (0.001)? = ?? 12, p? =? 7.040) uye scan IV (t (0.001)? = ?? 10, p? =? 3.258) .Pakave pasina shanduko yakakosha pakati pe scan I uye scan II ( vhiki nhanhatu mushure mekuvhiyiwa).

 

Structural Data

 

Cross-sectional analysis. Isu takasanganisira zera secovariate mune yakajairika modhi modhi uye hatina kuwana zera rinovhiringidzika. Kuenzaniswa nebonde uye zera rakaenzana kutonga, varwere vane hudyu yekutanga OA (n? =? 20) vakaratidzira pre-operatively (Scan I) yakadzora grey nyaya mune anterior cingate cortex (ACC), iyo insular cortex, operculum, dorsolateral prefrontal cortex ( DLPFC), kurudyi kwenguva tempile uye cerebellum (Tafura 1 uye Mufananidzo 1). Kunze kwekurudyi putamen (x? =? 31, y? = ?? 14, z? = ?? 1; p <0.001, t? =? 3.32) hapana kuwedzera kwakakura kweiyo grey nyaya kuwanda kwakawanikwa kune varwere vane OA vachienzaniswa kudzora zvine hutano. Kuenzanisa varwere panguva yekumisikidza scan IV pamwe neyakaenzana kutonga, mhedzisiro yakafanana yakawanikwa senge muchikamu chemuchinjikwa-chikamu uchishandisa scan ini ndichienzanisa neanodzora.

 

 

 

Kubhedhenura data revarwere vane hudyu kuruboshwe OA (n? =? 7) uye kuvaenzanisa nehutano hwakanaka hakuna kushandura mhedzisiro zvakanyanya, asi pakuderera kwetalamus (x? =? 10, y? = ?? 20, z? =? 3, p <0.001, t? =? 3.44) uye kuwedzera kwecerebellum yekurudyi (x? =? 25, y? = ?? 37, z? = ?? 50, p <0.001, t? =? 5.12) iyo isina kusvika pakukosha mune isina kuvhurwa dhata yevarwere kana ichienzaniswa nemaitiro.

 

Longitudinal analysis. Mukuongorora kwenguva refu, kuwedzera kukuru (p <.001 isina kugadziriswa) yegrey nyaya kwakaonekwa nekufananidza yekutanga neyechipiri scan (kurwadziwa kusingaperi / kurwadziwa kwepashure kwekuvhiyiwa) neyechitatu neyechina scan (isina marwadzo) muACC, insular cortex, cerebellum uye pars orbitalis mune varwere vane OA (Tafura 2 uye Mufananidzo 1). Grey nyaya yakadzikira nekufamba kwenguva (p <.001 yakazara uropi kuongororwa isina kugadziridzwa) mune yechipiri somatosensory cortex, hippocampus, midcingate cortex, thalamus uye caudate nucleus mune varwere vane OA (Mufananidzo 2).

 

 

 

Kufambisa iyo data yevarwere vane kuruboshwe chiuno OA (n? =? 7) haina kuchinja mhedzisiro zvakanyanya, asi pakuderera kwehuropi grey nyaya muHeschl s Gyrus (x? = ?? 41, y? = ?? 21, z? =? 10, p <0.001, t? =? 3.69) uye Precuneus (x? =? 15, y? = ?? 36, z? =? 3, p <0.001, t? =? 4.60) .

 

Nekusiyanisa iyo yekutanga scan (presurgery) nematanho 3 + 4 (postsurgery), takawana kuwedzera kwegrey nyaya kumberi kwekortex uye mota cortex (p <0.001 isina kugadziriswa). Isu tinocherekedza kuti uyu musiyano hauna kuomesesa sezvo isu tine zvino zvishoma zviyero pamamiriro (marwadzo vs. asiri ekurwadziwa). Kana tikadzikisa chikumbaridzo tinodzokorora izvo zvatakawana tichishandisa kusiyana kwe1 + 2 vs. 3 + 4.

 

Nekutsvaga nzvimbo dzinowedzera pamusoro penguva dzese dzenguva, takawana kuchinja kwehuropi grey nyaya munzvimbo dzemotokari (nzvimbo 6) kune varwere vane coxarthrosis inotevera kuchinjwa kwehudyu yose (scan I.dbm.neuro.uni-jena.de/vbm/) tinogona kudzokorora kuwanikwa uku mune anterior uye pakati-cingulate cortex uye zvose anterior insulae.

 

Isu takaverenga kukura kwemhedzisiro uye kuyambuka-chikamu chikamu (varwere vs. kudzora) kwakapa Cohen sd ye1.78751 mune yepamusoro voxel yeACC (x? = ?? 12, y? =? 25, z? = ?? 16). Isu takaverengawo Cohen sd yekutarisa kwenguva refu (kusiyanisa scan 1 + 2 vs. scan 3 + 4). Izvi zvakaguma neCohen sd ye1.1158 muACC (x? = ?? 3, y? =? 50, z? =? 2). Nezve iyo insula (x? =? 33, y? =? 21, z? =? 13) uye inoenderana nemusiyano mumwe chete, Cohen sd ndeye 1.0949. Pamusoro pezvo, takaverenga zvinorehwa neasina zero zero voxel kukosha kweiyo Cohen sd mepu mukati meiyo ROI (ine chikamu chepamberi checingate gyrus uye subcallosal cortex, yakatorwa muHarvard-Oxford Cortical Structural Atlas): 1.251223.

 

Dr. Alex Jimenez's Insight

Varwere vanopererwa varwere vanogona kuona hupenyu hwehutano hwakasiyana-siyana kwenguva, kunze kwezviratidzo zvavo zvave zvichinyanyisa. Semuenzaniso, vanhu vakawanda vachawana zvinetso zvekurara nekuda kwekutambudzika kwavo, asi chinonyanya kukosha, kurwadziwa kusingaperi kunogona kutungamirira kune zvakasiyana-siyana nyaya dzehutano hwepfungwa pamwe chete, kusanganisira kushushikana uye kuora mwoyo. Migumisiro iyo inorwadza inogona kuva nayo pauropi inogona kuoneka yakanyanya kukura asi uchapupu hunokura hunoratidza kuti uropi hunochinja huri husingaperi uye hunogona kushandurwa apo varwere vasingaperi varwere vanowana kurapa kwakakodzera kwehupenyu hwehutano hwavo. Maererano nenyaya yacho, gorosi dambudziko risingakanganwiki rinowanikwa mukurwadziwa kusingaperi hakuratidzi kukanganisa kwehuropi, asi pane, iyo inogadziriswa inogadzirisa iyo inowanzoita apo marwadzo anogadziriswa zvakakwana. Nenzira yakanaka, nzira dzakasiyana-siyana dzekurapa dziripo kuti dzibatsire kusunungura zvirwere zvisingaperi zvezvirwere uye kudzorera chimiro uye basa reropi.

 

hurukuro

 

Kuongorora mamiriro ese ehuropi nekufamba kwenguva, tinosimbisa uye nekuwedzera yedu data yemutyairi yakaburitswa munguva pfupi yadarika [17] Isu takawana shanduko muhuropi grey nyaya mune varwere vane epakutanga hip osteoarthritis mune isingagumi marwadzo mamiriro, ayo anodzosera chikamu kana ava varwere vasingarwadziwe vakasununguka, zvichitevera chiuno chakabatana endoprosthetic kuvhiya. Iko kuwedzera kwakasarudzika kwegrey nyaya mushure mekuvhiyiwa kunenge kuri munzvimbo imwechete uko kuderera kwechena nyaya kwakaonekwa pamberi pekuvhiyiwa. Kubaya data revarwere vane hudyu yekuruboshwe OA (uye nekudaro kuomesa divi remarwadzo) kwaingova nemhedzisiro diki pamhedzisiro asi nekuwedzera kwakaratidza kuderera kweyegrey muHeschl s gyrus uye Precuneus yatisingakwanise kutsanangura uye, sezvo pasina a priori fungidziro iripo, tarisa nokungwarira kukuru. Nekudaro, mutsauko unoonekwa pakati pevarwere uye nehutano kudzora pakuongorora ini ndanga ndichiri kucherechedzwa muchinjika-chikamu chikamu kuongorora pa scan IV. Kuwedzera kwehukama hwegrey pamusoro penguva saka kune hunyengeri, kureva kuti hazvina kukwana zvakakwana kuva nemhedzisiro pakuongorora kwechikamu chemuchinjikwa, kutsvaga kwakatoratidzwa muzvidzidzo zvichiongorora chiitiko chinoenderana nepurasitiki [30], [31]. Tinocherekedza kuti chokwadi chekuti isu tinoratidza zvimwe zvikamu zvehuropi-shanduko nekuda kwekurwadziwa kusingaperi kudzoserwa hazvireve kuti zvimwe zvikamu zveiyi shanduko hazvigadzirisike.

 

Zvinofadza kuti takaona kuti gorosi inowedzera muAAC mune varwere vasingaperi vasati vasangana nekuvhiyiwa inoita seinoenderera mberi kwemavhiki e6 mushure mekuvhiyiwa (scan II) uye inongowedzera kuongororwa III ne IV, zvichida nekuda kwekurwadziwa kwepashure, kana kuderera mumotokari basa. Izvi zvinowirirana nehutano hwehutano hwepanyama yekufamba kwepanyama yakabatanidzwa muNHP, iyo inotevera musingarati yakaratidza kushanduka kwakakosha panguva yakasarudzwa II asi yakanyanya kuwedzera kuenzana III uye IV. Nhoroondo, varwere vedu vanoti hapana marwadzo muhudyu mushure mekuvhiyiwa, asi akazovhiyiwa mushure mekuvhiyiwa marwadzo mumisungo yakakomba uye ganda iro rakaonekwa zvakasiyana zvikuru nevarwere. Zvisinei, sezvo varwere vachiri kurondedzera marwadzo ekutsvaga II, isu takafananidzawo yekutanga scan (pre-surgery) nekarwere III + IV (mushure mekuvhiyiwa), kuratidza kuwedzera kwemukati mutsvuku mumakona epamberi uye motori cortex. Tinocherechedza kuti kuenzanisa uku hakusi nyore pane zvishoma zvishoma pamamiriro ezvinhu (kurwadziwa kana kusina kurwadziwa). Apo patinoderedza chikumbaridzo tinodzokorora zvatakawana tichishandisa kusiyana kweI + II vs. III + IV.

 

Nhoroondo yedu inonyatsoratidza kuti grey nyaya shanduko muvarwere vasingaperi vanorwadziwa, ayo anowanzo kuwanikwa munzvimbo dzinobatanidzwa mukugadzira kwepasipasipo nociceptive [4] hazvikonzerwe neuronal atrophy kana kukuvara kwehuropi. Icho chokwadi chekuti shanduko dzinoonekwa mune chisingaperi chinorwadza mamiriro hachidzokere zvachose chinogona kutsanangurwa neiyo pfupi pfupi nguva yekucherechedza (gore rimwe mushure mekushanda maringe nerevo yemakore manomwe ekurwadziwa kusingaperi pamberi pekuvhiya). Neuroplastic huropi shanduko dzinogona kunge dzakasimudzira pamusoro pemakore akati wandei (semhedzisiro yekugara uchiratidzira kweinociceptive) inoda ingangove imwe nguva yekudzosera zvachose. Imwe nzira ingangoita kuti kuwedzerwa kwegrey nyaya kungoonekwa chete murefu urefu data asi kwete muchinjikwa-chikamu data (kureva pakati pemapoka panguva ye IV) ndeyekuti huwandu hwevarwere (n? =? 20) ishoma kwazvo. Izvo zvinofanirwa kuratidzwa kuti mutsauko uripo pakati pehuropi hwevanhu vakati wandei hwakakura uye kuti data rehurefu rine mukana wekuti mutsauko wacho uri mudiki sezvo iwo uropi hwakavhenekwa kanoverengeka. Nekudaro, shanduko dzisinganzwisisike dzinongowanikwa chete murefu kwenguva data [30], [31], [32]. Ehezve isu hatigone kusarudzira kuti shanduko idzi dzinenge pamwe dzinenge dzisingachinjiki kunyangwe izvo zvisingaite, zvichipiwa zvakawanikwa zvekurovedza muviri zvakasarudzika mapurasitiki nekugadzirisazve [4], [12], [30], [33], [34]. Kuti upindure uyu mubvunzo, zvidzidzo zvenguva yemberi zvinofanirwa kuongorora varwere kakawanda pamusoro pemafuremu akareba, pamwe makore.

 

Tinocherechedza kuti tinogona kungogumisa zvishoma pamusoro pemaitiro ehutano hwemarphological kuchinja munguva. Chikonzero ndechokuti patakagadzira chidzidzo ichi mu2007 uye chakaonekwa mu2008 uye 2009, chakanga chisingazivikanwe kana kuchinja kwemuitiro kwaizoitika zvachose uye nokuda kwechikonzero chekuita kwatakasarudza mazuva ekuongorora uye nguva dzakasarudzwa sezvinotsanangurwa pano. Mumwe anogona kutaura kuti gorozi inoshanduka munguva, izvo zvatinotsanangura zveboka revarwere, zvingadaro zvakaitika muboka rekutonga pamwe (nguva yekuita). Zvisinei, kuchinja chero kupi zvako kunokonzerwa nekukwegura, kana zvachose, kwaizotarisirwa kuva kuderera kwezwi. Kupiwa yedu priori pfungwa, pana 9 akazvimirira zveBhaibheri nevarwi kuratidza kunodzikira mune wachena nyaya marwadzo varwere [7], [8], [9], [15], [24], [25], [26], [27], [28], takatarira kuwedzera kwenharaunda kwenguva uye saka tinotenda kuti isu tinoona kuti haisi nguva yakaoma. Nhoroondo, hatigoni kutonga kuti gorosi inoderera kudarika nguva yatakawana muboka revarwere rinogona kuitika nekuda kwenguva, sezvo tisina kuongorora boka redu rekutonga panguva imwechete. Zvichigovera zvitsva, zvidzidzo zvemangwana zvinofanira kuronga nguva uye nguva shomanana, zvichizopiwa kuti maitiro anoenderana ne morphometric uropi hunoitika hunogona kuitika nokukurumidza sekunge 1 yevhiki [32], [33].

 

Mukuwedzera kune zvinokonzerwa nehupiceptive hutano hwehupfungwa hwehupfungwa hupfungwa huripo [17], [34] takaona kuti kuchinja mumotokari basa kunogonawo kuwedzera kuchinjwa chemugadziro. Takawana motokari uye nzvimbo dzinotangira nzvimbo (nzvimbo 6) kuti dziwedzere kudarika nguva dzese dzenguva (Mufananidzo 3). Intuitively izvi zvinogona kunge zvakakonzerwa nekuvandudzwa kwemotokari inoshandiswa kwenguva yakareba sezvo varwere vakanga vasingacharegi kurarama hupenyu hwehupenyu. Zvakanakira isu hatina kutarisa pamotokari basa asi kuvandudzwa mumarwadzo ekurwadziwa, kupa chido chedu chepakutanga chekuongorora kana kuderedzwa kunonyatsozivikanwa muhutano hwepfungwa muhutano husingaperi huripo huri kuchinja zvakare. Nekudaro, isu hatina kushandisa zvigadzirwa zvakananga kuti tiongorore motokari basa. Kunyange zvakadaro, (zvinoshandiswa) motokari cortex reorganization muvarwere vane marwadzo syndromes akanyatsoratidzwa [35], [36], [37], [38]. Uyezve, injini cortex ndeimwe chipfuro mune kuchirapa nzira mu pakurapa intractable marwadzo varwere vachishandisa zvakananga pfungwa dzishande [39], [40], transcranial zvakananga dzishande ano [41], uye yokudzokorora. transcranial rinobva dzishande [42], [43]. Nzira chaiyo dzekufananidza kwakadaro (kufambidzana kana kupindira, kana kungopindira muhutano hwakabatana) hazvina kujekeswa [40]. Ongororo yapfupi yakaratidza kuti chimwe chiitiko chemotokari chinogona kugadzirisa chimiro cheuropi [13]. Synaptogenesis, kugadziriswa kwemafambiro ekufambisa uye angiogenesis mumoto cortex inogona kuitika nezvikumbiro zvakakosha zvebasa remotokari. Tsao et al. akaratidzazve kugadziriswa mumoto cortex yevarwere vane chirwere chisingaperi chisingarware shure chinoratidzika sechinorwadza-chinonzi [44] uye Puri et al. akacherechedza kuderedzwa kwevasiyamu supplemental motokari grey nhau mumagetsi e fibromyalgia [45]. Chidzidzo chedu chakanga chisina kugadziriswa kuti tisazvinyengedze zvinhu zvakasiyana siyana zvingashandura uropi mukurwadziwa kusingaperi asi tinoshandura dheinhau redu pamusoro pehupfumi hwenyaya yehupfumi iyo iyo isingangori mirati yemigumisiro yekugara kwekushaya nociceptive. Kutaura zvazviri, kuongorora kwechangobva kuitika muhutano hwehutano hwehutano hwakaratidza kusakanganiswa kwehutano hwehutano hunobatana nemanzwiro evanhu, maonero ezvokuita, uye ekurwadziwa, zvichireva kuti vanoita basa rakakosha mumakiriniki epasi pose ekurwadziwa kusingaperi [28].

 

 

Zvidzidzo zviviri zvemauto zvenguva pfupi zvakakonzerwa nehup replacement therapy mu osteoarthritis varwere, chete chirwere chisingaperi chinorwadza chirwere chinonyanya kuporesa nehuwandu hup replacement [17], [46] uye idzi data dzakabatwa nechidzidzo chechangobva kuitika mune varwere vasingaperi vanorwadziwa kurwadziwa [ 47]. Izvi zvidzidzo zvinoda kuonekwa muchiedza chenguva yakawanda yekuongorora zvidzidzo-zvinoenderana neuronal plastiki pakati pevanhu pachirongwa che [structural level] [30], [31] uye kuongorora kwechangobva kuitwa pamusoro pehupi hwehutano hunochinja kune vanozvipira vane ruzivo vanowedzera kukurudzira kunorwadza [34] . Mhedziso inokosha yezvose izvi zvidzidzo ndeyokuti kusiyana kukuru muhutano hwehutano pakati pevarwere vanorwadziwa uye kutonga kunogona kugadzikana apo marwadzo anopora. Zvisinei, inofanira kuonekwa kuti haisi kungojekesa kana kuchinja kwevarwere vasingagumi varwere kunongokonzerwa nekutora maitiro kana nekuda kwemigumisiro yemarwadzo kana maviri. Zvinonyanya kuitika kuti maitiro ekuchinja, zvakadai sekudzivirira kana kusimbiswa kwehukama hwevanhu, simba, kudzidzisa muviri uye mararamiro ehupenyu hunoita kuti hugadzire uropi [6], [12], [28], [48]. Kunyanya kuora mwoyo sekusagadzikana kana kukonzera marwadzo chinhu chinonyanya kukosha kutsanangura kusiyana kwevarwere nekutonga. Boka duku revarwere vedu vane OA rakaratidza zvishoma kusvika pakuenzanisa kuora mwoyo zviratidzo zvakashanduka nenguva. Hatina kuwana maitiro ekugadzirisa kuti zvive zvakakosha neBDI-chikwata asi mubvunzo unomuka maitiro mazhinji emamwe maitiro anochinja nekuda kwekusavapo kwemarwadzo nekuvandudzwa kwemotokari kunogona kuita kuti zvigumisiro uye kusvika pahuwandu hwavanoita. Izvi zvinogona kuchinja maitiro zvinogona kuita kuti gorosi iwedzere muhutwa husingaperi uye nenyaya yeguru inowedzera apo marwadzo apera.

 

Chimwe chinhu chinokosha chinogona kukanganisa kududzirwa kwemigumisiro ndeyekuti vanenge vose varwere vane marwadzo asingagumi vakatora mishonga pakurwadziwa, izvo vakamira apo vairwadziwa pasina. Mumwe anogona kutaura kuti NSAIDs dzakadai saDiclofenac kana ibuprofen dzine zvimwe zviitiko pane neural systems uye zvakafanana ndezvechokwadi kune opioid, antiepileptics uye antidepressants, mishonga inowanzoshandiswa muhutano husingaperi. Izvo zvinokonzera kuuraya vanouraya uye mamwe mishonga pane morphometric zvitsva zvinogona kunge zvakakosha (48). Hapana chidzidzo kusvika kure zvakaratidza migumisiro yemishonga inorwadza muuropi morphology asi mapepa akawanda akawana kuti kuchinja kwehutano hwehutano muvarwere vasingaperi vanorwara hakutsanangurwi chete nemarwadzo ane chokuita nekusaita [15], kana nemishonga inorwadza [7], [9], [49]. Zvisinei, zvidzidzo zvakananga zviriko. Kuwedzera kutsvakurudza kunofanira kutarisa ruzivo-runoenderana nekuchinja kwekortical plastiki, iyo inogona kuva nehutano hukuru hwekurapwa kwehupenyu husingaperi.

 

Isu takawanawo kuderera kwejena nyaya mukuongorora kwenguva refu, zvichida nekuda kwekugadzirisazve nzira dzinoenderana nekuchinja mumotokari uye kushungurudzika kwekuona. Pane zvishoma zvinyorwa zvinowanikwa pamusoro pekushanduka kwenguva refu muuropi hupfumi mumamiriro ezvinhu ekurwadziwa, nokuda kwechikonzero ichi hatina chikonzero chemuviri weguru kuderera munzvimbo idzi mushure mekushanda. Teutsch et al. [25] akawana kuwedzerwa kwehupfungwa hwepfungwa hupfungwa mumusatosensory uye pakati pekototikiti muvashandi vane hutano vakawana kukurudzirwa kunorwadza mune protocol yezuva rimwe kwemazuva masere anotevera. Kuwanikwa kwejena nyaya kunowedzera mushure mekuedza kwekuita nhengo yekushaya maitiro inoputika zvakananga kusvika pane imwe nguva nekuderera kweruzivo rwepfungwa dzepfungwa muchidzidzo ichi kune varwere vakaporeswa nekurwadziwa kwenguva refu. Izvi zvinoreva kuti rubatsiro rwekushaya ruzivo rwevamwe vanozvipira rwunofambisa kune hutano hunoenderana nekugadzirisa maitiro, sezvo zvichida kune varwere vane marwadzo asingagumi, uye kuti izvi zvinoshanduka zvinodzokorora kune avo vanozvipira vane hutano apo nhengo inopikisa inopera. Nekudaro, kuderera kwehupfumi muzviitiko zvakaratidzwa kune varwere vane OA zvinogona kududzirwa kutevera imwecheteyo inokosha: kushandiswa kwemishonga kunoshanduka kunochinja huropi hunochinja [50]. Sezvisiri nzira dzisina kukanganisa, MR Morphometry ndiyo yakakosha yekutsvaga kutsvaga morphological substrates yezvirwere, kuwedzera kunzwisisa kwedu kwehukama pakati pehutano hwehutano uye basa, uye kunyange kutarisa matanho ekurapa. Rimwe rematambudziko makuru mune ramangwana ndechokushandura chigadziro ichi chakasimba chemakondomu uye maitiro ekurapa ekurwadziwa kusingaperi.

 

Zvikanganiso zveChidzidzo ichi

 

Kunyangwe chidzidzo ichi chiri chekuwedzera kwedzidzo yedu yapfuura kuwedzera dhata rekutevera kusvika kumwedzi gumi nemaviri uye kuongorora varwere vazhinji, pfungwa yedu yekuona kuti morphometric uropi hunochinja mukurwadziwa kusingaperi hunodzoserwa pane kungwara. Masikirwo acho madiki (ona pamusoro) uye mhedzisiro yacho inofambiswa nekumwe kuderedzwa kwehuropi hwegrey grey nyaya vhoriyamu panguva-yekutarisa 12. Kana tikabvisa iyo data kubva pakuongorora 2 (chaiko mushure mekuvhiya) zvakakosha chete inowedzera muuropi grey nyaya yemota cortex uye yepamberi cortex inopona pachikumbaridzo che p <2 isina kugadziriswa (Tafura 0.001).

 

 

mhedziso

 

Hazvibviri kukwanisa kusiyanisa kusvika pamatongerwo emararamiro ezvatakatarisa ndeyekushandurwa kwekuisa nociceptive, kuchinja mumotokari basa kana kushandiswa kwemishonga kana kuchinja mune hupenyu hwakadaro. Kuchengetedza boka rakasiyana-siyana nekutanga uye rokupedzisira rakatarisana nemumwe rakaratidza zvishoma kusiyana kudarika zvakatarirwa. Zvichida, kuchinja kweuropi kunokonzera kurwadziwa kusingaperi nemigumisiro yose iri kukura pane nguva yakareba kwenguva refu uye inogonawo kudikanwa nguva yekudzoka. Kunyange zvakadaro, izvi zvinowanzobudisa zvirongwa zvekugadzirisa zvakare, zvakanyatsoratidza kuti chisinganzwisisiki neciceptive input uye kukanganisa motokari mune ava varwere zvinoita kuti kuchinjwa kugadziriswe munzvimbo dzekortical uye zvichienderana nekugadzirisa kwehuropi hunochinja huripo huripo hunozoshandurwa.

 

Kutenda

 

Tinoonga vose vanozvipira kuti vabatanidzwe muchidzidzo ichi uye boka re Physics uye Methods paNeuroImage Nord muHamburg. Chidzidzo chacho chakapiwa mvumo yepamutemo kuburikidza neKomiti yeMitemo yepamutemo uye kubvumwa kwakanyorwa kwakanyorerwa kwakawanikwa kune vose vadzidza kudzidza vasati vaongorora.

 

Mari yeNhepfenyuro

 

Basa iri rakatsigirwa nezvipo kubva kuDFG (German Research Foundation) (MA 1862 / 2-3) uye BMBF (Federal Federal Education and Research) (371 57 01 neNeuroImage Nord). Vaya vaibhadhara mari vakanga vasina ruzivo mukugadzira kudzidza, kuunganidza deta uye kuongorora, chisarudzo chokubudisa, kana kugadzirira gwaro racho.

 

 

Iyo Endocannabinoid Sisitimu: Iyo Yakakosha Sisitimu Iwe yausina Kumbonzwa Nezve

 

Kana iwe usina kunzwa nezve endocannabinoid system, kana ECS, hapana chikonzero chokunyara. Kudzoka muC1960, vatsvakurudzi vakava nehanya nehupenyu hweCannabis pakupedzisira vakawana mazana emakemikari ayo anoshanda. Zvakatora imwe makore 30, zvisinei, kune vatsvakurudzi vanoongorora mhando dzemhuka kuti vawane mukana wemakemikari aya e ECS muhupenzi hwemakonzo, kuwanikwa kwakazarura nyika yose yekubvunzurudza mukati mekugara kwe ECS uye izvo zvinangwa zvepanyama.

 

Isu iye zvino tinoziva kuti mhuka dzakawanda, kubva kune hove kune shiri kuenda kumhuka, dzine demo endocannabinoid, uye tinoziva kuti vanhu havasi kungozvigadzira ivo pachavo pachavo vanobatana nehurongwa urwu, asi tinogadzirawo mamwe maitiro anobatana neEECS, avo iyo inowanikwa mumiti yakasiyana-siyana uye zvokudya, kunyanya kupfuura kweCannabis.

 

Sezvo chirongwa chemuviri womunhu, ECS haisi iyo yakasarudzwa yakarongwa senhandare yehurumende kana yemagetsi. Panzvimbo pezvo, iEECs inenge yakagadziriswa yakawanda yakapararira mumuviri wose iyo inoshandiswa kuburikidza nemagadzirirwe e ligands isu pamwe chete tinoziva sekuti endocannabinoids, kana endogannous cannabinoids. Zvose zvinotsigirwa zvinogamuchirwa zvinongonzi CB1 uye CB2, kunyange kune zvimwe zvakasarudzirwa. PPAR neTPP mitsara inobatanidza mamwe mabasa. Saizvozvowo, uchawana mbiri dzakanyorwa zvakanyorwa endocannabinoids: anadamide uye 2-arachidonoyl glycerol, kana 2-AG.

 

Uyezve, zvakakosha kune endocannabinoid system ndiyo inymesiti inogadzira uye inoparadza endocannabinoid. Endocannabinoids inofungidzirwa kuti inogadzirwa mune imwe nheyo inoda. Izvozvo zvinokonzerwa nemakemikari zvinosanganisira diacylglycerol lipase uye N-acyl-phosphatidylethanolamine-phospholipase D, iyo iyo inobatanidza 2-AG uye anandamide. Iyo miviri miviri inonyadzisa yakawanda inonzi fatty acid amide hydrolase, kana FAAH, iyo inoputsa anandamide, uye monoacylglycerol lipase, kana MAGL, iyo inoputsa 2-AG. Mutemo weiyi maviri enzymes inogona kuwedzera kana kuderedza kuenzanisa kweEECS.

 

Basa rei re ECS?

 

IEECs ndiyo inonyanya kugadzirisa zvirongwa zvemuviri. Inogona kuonekwa nyore nyore semuviri wepakati adaptogenic system, nguva dzose kushanda kuti ichengetedze kuenzanisa kwezvinhu zvakasiyana-siyana. Endocannabinoids yakawanda yakashanda seyeuromodulators uye, saizvozvowo, inodzora huwandu hwakawanda hwezvirongwa zvenyama, kubvira pakubereka kusvika pakurwadziwa. Mamwe emabasa aya anozivikanwa zviri nani kubva kune ECS ndeaya anotevera:

 

huta System

 

Kubva pakati penheyo yenheyo, kana CNS, kukurudzirwa kwevanhu vakawanda veCX1 receptors kuchadzivisa kusunungurwa kwe glutamate uye GABA. MuCSS, iyo ECS inobatanidzwa mukuyeuka kugadzirisa uye kudzidza, inokurudzira neurogenesis mu hippocampus, inotungamirirawo neuronal kusununguka. IEECs inobatanidzwawo nenzira iyo uropi huchaita pakukuvara nekuputika. Kubva pamutsipa weropa remutsipa, ECS inoderedza marwadzo ekuratidza uye inowedzera mhuka dzakasununguka. Munharaunda yehutachiona yehutachiona, iyo CB2 yakagadziriswa inotungamirira, ECS inoshandisa kunyanya muhurongwa hwemutsitsi unonzwira tsitsi kuronga mabasa ematurumbu emukumbo, urinary, uye kubereka.

 

Kushungurudzika uye Maitiro

 

Izvo zveEECs zvinokanganisa zvakanyanya pamusana pekushushikana kwepfungwa nekuraira kwepfungwa, sekutanga kwemukana uyu wemuviri kune zvakanyanya kushungurudzika nekugadziriswa kwechinguva kusvika kune dzimwe nguva kwenguva refu manzwiro, zvakadai sekutya uye kuzvidya mwoyo. A healthy working endocannabinoid system inokosha kumabatiro anoita vanhu pakati pehuwandu hunogutsa hwekumutsa nekuenzaniswa nehuwandu huwandu uye husingafadzi. IEECs inobatsirawo pakuyeuchidza uye zvichida nenzira iyo iyo uropi hunoita kuti zviyeuchidzo kubva pakunetseka kana kukuvara. Nokuti ECS inoderedza kusunungurwa kwedopamine, noradrenaline, serotonin, uye cortisol, inogonawo kuita kuti vanhu vakawanda vaite manzwiro nemafungiro.

 

Digestive System

 

Nzira yekudya inowanikwa neyese CB1 uye CB2 receptors inodzora zvinhu zvinoverengeka zvinokosha zvehutano hweGI. Zvinofungidzirwa kuti ECS inogona kunge iine "kusina kubatana" mukutsanangura kugadzirisa-utachiona-hutachiona hunobatsira hunoita hutano hunoshanda hwehutano hwekudya. IEECS inoronga mutumbi wehutachiona, pamwe nekudzivirira masimba ezvirwere zvekuzvidzivirira kubva pakuparadza maruva ane utano, uyewo kuburikidza nekugadzirisa kwechiratidzo chechitokine. IEECS inogadzirisa zvinokonzerwa nokuputika kwepanyama mumugwagwa wezvokudya, izvo zvinoita kuti zvive nehuwandu hwehutano hwakasiyana-siyana. Gastric uye general GI motility inoratidzika kunge inotungamirirwa neEECS.

 

Appetite uye Metabolism

 

IEECS, kunyanya yeBEC1 receptors, inotora chikamu mukudya, kusagadzikana kwemasikirini, nekugadzirisa muviri wemafuta. Kukurudzirwa kwevanokwidziridza CB1 kunosimudzira maitiro ekutsvaga kwekudya, kunosimudzira kuziva kwekunhuhwira, uye kunotarisa simba rekuita. Zvose mhuka nevanhu vane uremu hwepamusoro vane ECS dysregulation iyo inogona kuita kuti chirongwa ichi chive chisina kunaka, izvo zvinoita kuti zvose kudya uye kuderedza simba rekushandisa mari. Kupararira mazinga eAnandamide uye 2-AG ave akaratidzirwa kuti akakwidziridzwa mukudisa, izvo zvingave zviri chikamu pamusana pokuderera kwekugadzirwa kwe FAAH inonyadzisa enzyme.

 

Immune Health and Resplammatory Response

 

Masero uye nhengo dzomuviri wechirwere chekuzvidzivirira muviri dzakapfuma ne endocannabinoid receptors. Cannabinoid receptors inoratidzwa mu thymus gland, spleen, tonsils, uye marrow bone, pamwe neT-B ne-B-lymphocytes, macrophages, mast cells, neutrophils, uye masero ehupenyu anouraya. IEECs inonzi inofambisa mutungamiriri we immune system balance uye homeostasis. Kunyange zvazvo zvisingaiti mabasa ose eEEC kubva mumuviri wezvirwere zvinonzwisiswa, ECS inoratidzika kutonga kukwidziridzwa kwegytokine uyewo kuva nechinangwa mukudzivirira kusagadzikana mune zvirwere zvemuviri. Kuvhiringidza chikamu chemuviri wehutachiona hwemuviri, uye chinotamba chikamu chakanaka mukunyomba kwakanyanya mumuviri, kusanganisira kukuvara uye zvirwere; zvisinei, kana zvisiri kuchengetedzwa zvinogona kuva zvisingagumi uye zvinokonzera kukonzera zvinetso zveutano zvakashata, zvakadai sekurwadziwa kusingaperi. Nokuchengetedza maitiro ekudzivirira zvirwere mumuviri, checker ECS inobatsira kuchengetedza kupindira kwakanyanyisa kupindura kuburikidza nemuviri.

 

Dzimwe nzvimbo dzehutano dzinotungamirirwa neEECS:

 

• Bone utano
• Fertility
• Ganda rehutano
• Arterial and breathing respiratory
• Kurara uye circadian rhythm

 

Nzira yekugadzirisa zvakanakisisa ECS ine utano ndeye mubvunzo vazhinji vatsvakurudzi vari kuedza kupindura. Ramba wakatarisa kuti uwane mamwe mashoko pamusoro penyaya iyi inotangira.

 

Mukupedzisa,Uturu hwehutachiona hwave huchibatanidzwa nekuchinja kwehuropi, kusanganisira kudzikiswa kweruvara rwegrey. Nekudaro, chinyorwa chiri pamusoro chakaratidza kuti kurwadziwa kusingaperi kunogona kuchinja mamiriro ese uye mashandiro ehuropi. Kunyangwe kurwadziwa kusingaperi kuchizotungamira kune izvi, pakati pezvimwe zvehutano nyaya, kurapwa kwakakodzera kwezviratidzo zvevarwere kunogona kudzora shanduko dzehuropi uye kutonga grey zvinhu. Uyezve, zvidzidzo zvekutsvagisa zvakabuda shure kwekukosha kweiyo endocannabinoid system uye iri basa mukudzora pamwe nekugadzirisa kurwadziwa kusingaperi uye nezvimwe zvehutano. Ruzivo rwunotsanangurwa kubva kuNational Center yeBiotechnology Ruzivo (NCBI) .Kureba kweruzivo rwedu kunogumira kuchiropractic pamwe nekukuvara kwepamuviri nemamiriro. Kuti ukurukure nyaya yacho, ndapota inzwa wakasununguka kubvunza Dr. Jimenez kana kutibata nesu pa us915-850-0900 .

 

Yakarongedzwa naDkt Alex Jimenez

Zvimwe Zvinyorwa: Kubva Painini

Kutambudzika shure ndechimwe chezvikonzero zvakakosha zvikuru zvekuremara uye mazuva asina kukwana kubasa pasi rose. Sezvakangoitika, kurwadziwa kwekudzokera shure kwave kuchiitwa sechipiri chikonzero chikuru chechiremba chekushanyira, chakanyanya kupfurikidza nehutachiona hwepamusoro-kuporesa. Inenge 80 muzana yevanhu vanozoona rumwe rudzi rwemarwadzo emutsipa kamwechete kamwe chete muupenyu hwavo hwose. Iyo musana inorongwa yakaoma yakaumbwa nemapfupa, mafundo, magirasi nemasumbu, pakati pezvimwe zvinyoro zvishoma. Nemhaka yeizvi, kukuvadzwa uye / kana mamiriro ezvinhu akawandisa, akadai herniated discs, zvinogona kutungamirira kune zviratidzo zvekurwadziwa shure. Kukuvara kwemitambo kana kukuvara kwepamberi yemotokari kazhinji kunowanzokonzera kukonzera kurwadziwa, zvisinei, dzimwe nguva kufamba kwakanyanya kunogona kuva nemigumisiro inorwadza. Nenzira yakanaka, nzira dzakasiyana dzokurapa, dzakadai sechiropractic, dzinogona kubatsira kuderedza marwadzo shure kuburikidza nekushandurwa kwepelinha nekugadzirisa maitiro, pakupedzisira kunatsiridza marwadzo ekurwadziwa.

 

 

 

NHAURWA INOKOSHA INOKOSHA: Low Back Pain Management

 

DZIMWE NYAYA: DZIMWE DZIMWE DZIDZISO: ronicKusingaperi Kurwadziwa & Marapirwo