Dhanieri G. Ameni, MD, mwana uye munhu mukuru wepfungwa, nyanzvi ye nyukireya yekufungidzira nyanzvi, uye imwe nyanzvi yeNew York Times inonyanya kukosha. Mabhuku ake anosanganisira kuporeswa kwepasisita ADD: The Breakthrough Program inokubvumira kuona uye kuporesa marudzi 7 eAdD , akabudiswa muna 2013.
Dr. Ameni ndiyewo nheyo ye-10 Amenikitiki muUnited States.
Pakati pamakiriniki, varwere vane imwe-photon yokubudisa komutori (SPECT) kuongorora kuropi kuti vaone rudzi rwekucherechedza / kukanganisa (ADHD) vane, vachiita kuti vagone kurapwa zvakarongwa. A SPECT scan inoratidza kuti ropa rinopinda sei muuropi.
Nzira Yese Yokugadzirisa DHD
Nzira yepamusoro yekuongorora uye kuongororwa kweDHD inoshandiswa nevadzidzisi vehutano hwepfungwa muUnited States ndeye kushandisa nzira yakagadzirirwa muDaagnostic uye Statistical Manual yeMental Disorders (DSM), iyo inoratidza zvikamu zvitatu zveDHDD:
- Kucherechedza-kukanganisa / kusagadzikana kwehutano, kusanganiswa mharidzo
- Kucherechedza-kukanganisa / kusagadzikana kwehutano, mhedziso isingatarisiri
- Kucherechedza-kukanganisa / kushaya huwandu hwehutano hwakanyanya, husinganzwisisiki-kusagadzikana mharidzo
Ameni Anozivikanwa 7 Mhando dze ADD
Kushandisa zvikamu zveSPECT pamakumi ezviuru zvevarwere, Dr. Ameni akacherechedza marudzi manomwe eAdD.
Dr. Ameni anoshandisa izwi ADD, pane ADHD, sezvaanofunga kuti ADD inonyanya kuratidza mamiriro acho ezvinhu.
Apo munhu ave akaonekwa kuti ane ADD, rudzi rweDDM runoshandisa kusanganiswa kwemishonga yekurapa, kuwedzera, uye mararamiro ekuchinja mararamiro. Mhando imwe neimwe yeAdD ine mazano ekurapa.
Neuroimaging in Psychiatry
Functional neuroimaging, yakadai sa SPECT scanning, inoonekwa sechinhu chinobatsira kune vanotsvakurudza. Yakave yakakosha pakunzwisisa neurocircuitry (basa muuropi) yemamiriro akasiyana-siyana emapfungwa. Kunyange zvakadaro, vanhu vakawanda vanorwara nechepfungwa havawanzovoni kuti ndeye nzira yakakodzera yekushandisa yekurapa nguva dzose. Vatsoropodzi vekuti Dr. Amen vanoti anoshandisa zviyero kuti atsigire kutengeswa kwemaitiro ake uye zvigadzirwa.
Ameni Ndeapi eAdD
Dr. Ameni anonyanya kushandisa ADHD sub-types uye purogiramu yake yekurudziro haisati yakasimbiswa uye inoratidza kusarura kwake. Nezvipamba izvi, heino Dr. Ameni mhando dze ADD uye mazano ake ekurapa:
Ropa 1. Classic ADD (ADHD)
Zviratidzo zvinosanganisira kusava nehanya, kusavhiringidzika, kusakanganiswa, kushaya simba, kusagadzikana, uye kusagadzikana. Kufungidzira kunogonawo kuva nyaya.
Vanhu vane ADD yekare vanoita kuti kuderera ropa kuve munzvimbo yeuropi ye prefrontal cortex, cerebellum, uye basal ganglia. Icho chinonzi basal ganglia chinobatsira kubereka dopamine.
Chinangwa chekurapa ndechekuwedzera dopamine maitiro nenzira dzinotevera:
- Pamwe uchishandisa mishonga inokurudzira, yakadai seAdderall® kana Concerta®, kana kushandisa zvigadzirwa zvinokurudzira, zvakadai seRoddiola, green tea, kana ginseng. Amino acid L-tyrosine inoshandiswa zvakare, sezvo iri chivakwa chekuvaka dopamine.
- Kudzidzira muviri kunokurudzirwa nokuti kunowedzera dopamine.
- Mafuta ehove anowedzera ayo akakwirira mu omega-3 fatty acids docosahexaenoic acid (DHA) uye eicosapentaenoic acid (EPA). Somuenzaniso, chiyero che 60:40 chinokurudzirwa.
- Zvokudya zvinowedzera muprotheni uye zvishoma muma carbohydrates zvinokurudzirwa.
Ropa 2. Inattentive ADD
Zviratidzo zvinosanganisira kuva asina hanya uye nyore nyore kuvhiringidzwa (asi kwete kushaya simba), kusviba, uye kunonoka kufamba, nechishuvo chikuru. Vanhu vane ADD isingatauri vanowanzotsanangurwa sepadet, nzvimbo dzinotsika, uye mubhedha. Mhando iyi inonyanya kuwanwa mumusikana kupfuura vakomana uye inowanzoonekwa kuti gare gare muupenyu nokuti vanhu ava havana matambudziko emitemo.
Vanhu vane antententive ADD vakaderedza basa mu prefrontal cortex pamwe chete nemazinga akaderera e dopamine. Kurapa kwakafanana neTekutanga 1.
Ropa 3. Overfocused ADD
Kunyanya kufungidzirwa ADD kunosanganisira zviratidzo zvekare zveDDD, pamwe nekunetseka kushandura pfungwa, nguva dzose kunonamatira mumatanda emafungiro asina kunaka kana maitiro, kukanganisa, kunyanya kunetseka , kusagadzikana, uye nguva dzose kushora uye mufambiro.
Vanhu vane ADD vakanyanyisa kuve nekushayikwa kwe serotonin uye dopamine. Chinangwa chekurapa ndechekuwedzera mavari maviri eurotransmitters, nervous system's chemical messengers. Dr. Ameni anotsanangura kuti nokuti vanhu vane chikwata ichi cheDAD vanova vanonetseka uye vachizvidya mwoyo pavanotora mishonga inokurudzira, anoedza zvigadzirwa zvekutanga. Anorayira mishonga chete kana zvidimbu zvisingabatsiri. Mishonga inosanganisira:
- Zvigadzirwa zvinoshandiswa kuwedzera dopamine, zvakadai seL-tryptophan. 5-Hydroxytryptophan, amino acid inowanzozivikanwa se5-HTP, inoshandiswa seyokurwisa mwoyo. Zvimwe zvidimbu zvinosanganisira safironi uye inositol, izvo zvinowedzera kuisa pfungwa uye kujekesa mupfungwa.
- Mishonga yekurapa zvinodhaka ndeyeEexexor®, Pristiq®, kana Cymbalta®.
- Neurofeedback inokurudzirwa zvakare. Inodzidzisa vanhu kutonga mauropi avo.
- Vanhu vane chikwata ichi cheDAD havaiti zvakanaka nepamusoro peprotein yezvokudya sezvo inogona kukurudzira kuita maitiro.
Ronga 4. Temporal Lobe ADD
Izvi zvinosanganisira zviratidzo zvekare zveDDD pamwe nekushungurudzika, nekukurumidza-kutsamwa uye nehasha, uye kuva nemafungiro mashoma, kusagadzikana kwemaitiro, uye paranoia munyoro. Vanhu vane rudzi urwu vanogona kuona kana kunzwa zvinhu zvisipo uye zvinetso zvekudzidza nekuyeuka zvinogona kuvapo.
Vanhu vane ruzivo rwemazuva eAdD vane zvikanganiso mumatongerwo avo emakore uye mabasa mashomanana mu prefrontal cortex chikamu cheuropi.
Chinangwa chekurapa ndechekugadzirisa neuronal basa uye kumisa masero emagetsi kubva kune-kupisa kana kupisa pasina chikonzero. Mishonga inosanganisira:
- Amino acid gamma-aminobutyric acid (GABA) kubatsira kubvisa masero emironda.
- A magnesium supplement anobatsira nokuzvidya mwoyo.
- Anticonvulsant mishonga inogona kubatsira kugadzirisa mafungiro.
- Gingko kana vinpocetine inogona kubatsira nekudzidza nekuyeuka nyaya.
- A ketogenic diet, iyo inodyiwa yakazara muprotheni, inogona kukurudzirwa.
Rudzi 5. Limbic ADD
Izvi zvinosanganisira zviratidzo zvekare zveDDD pamwe nekusuwa kusingaperi kwemazinga, asi kwete kuora mwoyo. Kusagadzikana, "girasi-hafu-isina chinhu," simba rakasimba, kazhinji manzwiro ekusava netariro uye kusakosha, uye kuzvidzora kune zvimwe zviratidzo zvemufananidzo uyu.
Vanhu vane chimiro cheDDD vane basa rakawandisa muchikamu chechimiro cheuropi, iyo ndiyo mafungiro anotungamirirwa. Vakapedza basa mu prefrontal cortex vose kana vachizorora kana kutarisa pane basa. Mishonga inosanganisira:
- DL-phenylalanine (DLPA), L-tyrosine, uye SAMe (S-adenosylmethionine) ndiyo inobatsira zvikuru.
- An anti-depressant, Wellbutrin® kana imipramine, inogona kurongerwa.
- Kudzidzira muviri, mafuta ehove, uye kudya kwakakodzera zvinokurudzirwawo.
- Chikafu chinopera, uko dairy, shuga, gorosi, uye gorosi zvichibviswa kubva pakudya kwevhiki vatatu, zvichabatsira kuziva kana munhu ane zvinonzwisisika zvekudya.
Ropa 6. Ring of Fire ADD
Iyi ndiyo yakanyanya kunyanya kushandiswa yeClass ADD, uye kunyanya kusakanganisika, kutsamwa , kutsamwa, uye kunyanya kushaya ruzha, chiedza, nguo, nekubata. Vanhu vane rudzi urwu vanowanzosununguka, kunyanya kutaura, kupikisa, uye kuva nemanzwiro ekunyanyisa.
Vanhu vane chindori chemoto BADA vane uropi hunopfurikidza. Iko kune zvakawanda zvinowanikwa mubasa iri mu cerebral cortex nedzimwe nzvimbo dzeuropi. Mishonga inosanganisira:
- Kutanga nekudya kwekudzikisa kana zvichiita sezvokudya zvinokonzera zvokudya zvinogona kuvapo.
- Zvinokurudzira chete zvinogona kuita kuti zviratidzo zviwedzere. GABA, 5-HTP, uye L-tyrosine zvinowedzera kubatsira kubatsira GABA uye serotonin mazinga.
- Mishonga inogona kunyorwa ndeye anticonvulsant uye ropa ropa remishonga se guanfacine kana clonidine kubatsira kubatsira kuderedza kusagadzikana.
Tora 7. Anxious ADD
Kunetseka ADD kunosanganisira zviratidzo zveDDD zvekare uye kunzwa kunzwa kunetseka uye kunetseka, zviratidzo zvepfungwa zvinokonzerwa nemusoro uye simba, kushungurudza kana pane mamiriro ezvinhu anokonzera kushungurudzika, uye kutarisira zvakanyanya.
Vanhu vane kushushikana ADD vane huwandu hwakawanda hwebasa mu basal ganglia, iyo inobatsira pakuita dopamine. Izvi zvakasiyana nehuwandu humwe huwandu hweDDD, iyo ine basa shoma muchikamu chino cheuropi.
Chinangwa chekurapa ndechekubatsira nekuzorora uye kuwedzera GABA uye dopamine mazinga. Mishonga inosanganisira:
- Zvigadzirwa zvinopedza kugadzirisa, saL-theanine, relora, magnesium, uye basil dzvene.
- Zvinokurudzira zvinotorwa pachavo zvinogona kukonzera kushungurudzika. Zvisinei, mishonga inobatsira kuderedza kushungurudzika ndiwo tricyclic anodzvinyirira imipramine kana desipramine.
- Neurofeedback inogona kubatsira kuderedza kuzvidya mwoyo uye kugadzirisa prefrontal cortex.
Kuva Nehuwandu Kune Chimwe Chete NdeyeKutenda
Zvinokwanisika kuva nemamwe emhando idzi dzeAdD. Semuenzaniso, kuwirirana kwakajairika kunonyanya kufungidzirwa, chimiro, uye kuzvidya mwoyo.
Dr. Ameni anotenda kuti kunzwisisa kwekusiyanisa uye kusanzwisisika kweumwe neumwe wezvikamu zvinomwe zvinotenderera kunobvumira kunyatsoongorora nekurapa kwevana nevakuru vane ADHD.
Shoko Rinobva
Nguva dzose bvunza chiremba wako usati waita chero shanduko kune iwe pachako. Anofanirwa kuziva nezvekuwedzera kwemishonga uye mishonga yaunotora kuitira kuti uve wakangwarira kune zvingaita zvekubatana kana matambudziko nemamwe mamiriro ezvinhu iwe ungave nawo.