臺灣博碩士論文加值系統

眼球遮蔽為臨床上矯治視覺與視覺認知功能缺損的常用治療策略。本論文研究旨在檢測不同眼球遮蔽情境對於年輕健常男性對稱性視覺空間注意力表現的影響，同時藉由行為表現與腦部電生理訊號之分析來建構遮蔽治療的理論意涵，以作為進一步臨床應用的基礎。研究對象為十八名長庚大學大學部一、二年級慣用手為右利之男性學生。每名受測者在同意受測後，分別於兩階段的實驗中執行線段中分測驗與電腦化線段標記測驗，同時亦均需經歷未遮蔽、右眼完全遮蔽與雙眼右半側遮蔽的三種實驗處理情境，而其中事件相關電位的腦部電生理訊號之收集，則僅於線段標記測驗的實驗階段中進行。
研究結果顯示線段中分測驗表現與不同遮蔽情境有關（F(2.30, 17.28) = 5.27, effect size eta = .64, p = .01）。右眼完全遮蔽情境所判斷的直線中點有右偏之傾向，而雙眼右半側遮蔽情境則呈現更大幅度之左傾偏誤，以成對樣本t檢定的事後分析結果則顯示兩者呈現統計上顯著差異（t = 3.21, df = 17, effect size r = .61, p = .01）；同時三種眼球遮蔽情境在左右腦區電生理訊號之不對稱效應上，亦發現於刺激呈現後50至90毫秒，不同遮蔽情境間左右枕葉區之最大峰值差異存在統計上之顯著差異（F(2.84, 21.27) = 3.42, effect size eta = .56, p = .04），特別是雙眼右半側遮蔽情境之右腦枕葉活化趨勢，均顯著地較未遮蔽與右眼完全遮蔽情境來得明顯（t = -2.66, df = 17, effect size r = .54, p = .02; t = -2.70, df = 17, effect size r = .55, p = .02）；而在刺激呈現後140至300毫秒之中晚期效應，雖不若早期處理階段來得顯著，但仍可窺見雙眼右半側遮蔽情境於此階段之右腦頂葉激活傾向。
本研究結果除呈現出年輕健常成人於不同遮蔽情境下視覺空間注意力之行為表現差異外，也經由與神經學資料的統整證實了雙眼右半側遮蔽情境的提供，對於活化右腦半球的神經活動與增加左側向性空間之注意力具有正向的趨勢，而右眼完全遮蔽則呈現出相反地左腦激活及右傾偏移的注意力傾向。這重關係的發現對於瞭解視覺空間注意力缺損之形成機制與復健治療等臨床實務均將有所裨益。

Eye patching is a commonly used strategy for remediating vision and visual attention deficits. This thesis was designed to investigate the behavioral and neurological effects on the performance of bilateral symmetrical attention. Eighteen right handed college male students participated this study to perform the line bisection and the computerized landmark tasks under three conditions: (1) non-patching condition; (2) right monocular patching condition; and (3) right hemi-field patching condition. Besides the behavioral data collected in both tasks, the event -related potentials (ERPs) were also investigated in the landmark task.
Findings of the line bisection performance showed a more manifest leftward error under the right hemi-field patching condition than others (F(2.30, 17.28) = 5.27, effect size eta = .64, p = .01). Nevertheless, the right monocular patching presented greater rightward error than other conditions. The results of early event-related potentials (50-90 msec post stimulus) showed the peak amplitude differences between right/left occipital regions among three patching conditions were significant (F(2.84, 21.27) = 3.42, effect size eta = .56, p = .04). Especially, the right occipital regions were activated more under the right hemi-field patching condition. Similarly, in the late phase (140-300 msec post stimulus), the right lateralized effect was also found in the parietal regions under the condition of right hemi-field patching.
As a result, the right hemi-field patching might increase the right hemisphere activation and the awarness of left visual hemispace. Whereas, the right monocular patching condition was not able to achieve this right lateralized effect, it might induce the attentional bias to right hemispace. These behavioral and electrophysiological findings will be used to substantiate the meaning of eye patching on neurobehavioral theory and visual rehabilitation.

指導教授推薦書……………………………………………………………i
口試委員審定書………………………………………………………… ii
授權書……………………………………………………………………iii
誌謝……………………………………………………………………… iv
目錄…………………………………………………………………………v
圖表目錄…………………………………………………………………vii
中文摘要……………………………………………………………………x
英文摘要…………………………………………………………………xii
第一章 緒論
第一節 研究緣起與目的………………………………………………1
第二節 研究提問與研究假設…………………………………………5
第三節 重要名詞詮釋…………………………………………………6
第二章 文獻回顧
第一節 眼球遮蔽策略之效應……………………………………… 10
第二節 眼球遮蔽與視覺空間注意力忽略………………………… 16
第三節 影響線段中分測驗表現之相關因素探究………………… 24
第四節 腦部影像技術於對稱性視覺空間注意力之神經學發現… 32
第三章 研究方法
第一節 研究架構與研究設計……………………………………… 46
第二節 研究對象…………………………………………………… 48
第三節 研究工具…………………………………………………… 49
第四節 研究步驟與研究程序……………………………………… 57
第五節 資料分析…………………………………………………… 59
第四章 研究結果
第一節 樣本基本資料……………………………………………… 62
第二節 不同遮蔽情境於線段中分測驗之比較…………………… 62
第三節 不同遮蔽情境於電腦化線段標記測驗之比較…………… 64
第四節 不同遮蔽情境於事件相關電位之神經學發現…………… 71
第五章 討論
第一節 眼球遮蔽情境之行為效應……………...……………….93
第二節 眼球遮蔽情境於事件相關電位之神經學探討……………99
第三節 結合行為與神經學資料之探討………………………… 108
第六章 結論與建議
第一節 結論…………………………………………………………110
第二節 研究限制……………………………………………………110
第三節 未來研究的建議……………………………………………112
參考文獻………………………………………………………………… 114
附錄
附錄一 線段中分測驗…………………………………………128-130
附錄二 基本資料問卷………………………………………………131
附錄三 愛丁堡手側化問卷…………………………………………132
附錄四 人體試驗同意書……………………………………………133
表次
表3-1-1 交互平衡的重複量測設計…………………………………48
表4-2-1 不同眼球遮蔽情境之線段中分測驗比較…………………63
表4-2-2 不同眼球遮蔽情境於線段中分測驗之事後分析…………63
表4-3-1 不同眼球遮蔽情境於線段標記測驗整體正確率比較……64
表4-3-2 不同眼球遮蔽情境於正中標記點之錯誤率比較…………65
表4-3-3 不同眼球遮蔽情境於左標記點之錯誤率比較……………66
表4-3-4 不同眼球遮蔽情境於左標記點錯誤率之事後分析………66
表4-3-5 不同眼球遮蔽情境於右標記點之錯誤率比較……………68
表4-3-6 不同眼球遮蔽情境於右標記點錯誤率之事後分析………68
表4-3-7 不同眼球遮蔽情境於線段標記測驗整體反應時間比較…69
表4-3-8 不同眼球遮蔽情境於正中標記點之反應時間比較………69
表4-3-9 不同眼球遮蔽情境於左標記點之反應時間比較…………70
表4-3-10 不同眼球遮蔽情境於右標記點之反應時間比較……… 71
表4-4-1 各腦區於刺激呈現後50-90毫秒之負波最大峰值比較… 72
表4-4-2 各腦區於刺激呈現後90-140毫秒正波最大峰值比較……74
表4-4-3 各腦區於刺激呈現後140-200毫秒負波最大峰值比較… 75
表4-4-4 中央腦區於刺激呈現後140-200毫秒最大峰值之事後分析
比較…………………………………………………………76
表4-4-5 各腦區於刺激呈現後200-300毫秒之正波最大峰值比較
………………………………………………………… 76-77
表4-4-6 中央腦區於刺激呈現後200-300毫秒最大峰值之次序效
應事後分析…………………………………………………77
表4-4-7 頂葉區於刺激呈現後200-300毫秒最大峰值之次序效應
事後分析……………………………………………………77
表4-4-8 枕葉區於刺激呈現後200-300毫秒最大峰值之次序效應
事後分析……………………………………………………77
表4-4-9 各腦區於刺激呈現後50-90毫秒之負波潛伏期比較…… 79
表4-4-10 各腦區於刺激呈現後90-140毫秒之正波潛伏期比較… 80
表4-4-11 各腦區於刺激呈現後140-200毫秒之負波潛伏期比較…81
表4-4-12 各腦區於刺激呈現後200-300毫秒之正波潛伏期比較…82
表4-4-13 枕葉區於刺激呈現後200-300毫秒潛伏期之次序效應事
後分析…………………………………………………… 83
表4-4-14 相對應腦區於刺激呈現後50-90毫秒之負波峰值比較
…………………………………………………………85-86
表4-4-15 左右枕葉於刺激呈現後50-90毫秒峰值差異事後分析…86
表4-4-16 相對應腦區於刺激呈現後90-140毫秒之正波峰值比較
…………………………………………………………87-88
表4-4-17 左右枕葉區於刺激呈現後90-140毫秒峰值差異之事後
分析……………………………………………………… 88
表4-4-18 相對應腦區於刺激呈現後140-200毫秒之負波峰值比較
…………………………………………………………89-90
表4-4-19 相對應腦區於刺激呈現後200-300毫秒之正波峰值比較
…………………………………………………………90-91
圖次
圖3-1-1 研究架構圖…………………………………………………46
圖3-3-1雙眼右半側遮蔽與右眼完全遮蔽範例…………………… 50
圖3-3-2 刺激呈現方式………………………………………………53
圖3-3-3 電腦化線段標記測驗範例…………………………………53
圖3-4-1研究步驟圖………………………………………………… 57
圖4-2-1 不同眼球遮蔽情境之線段中分測驗表現…………………63
圖4-4-1 三種不同遮蔽情境早期左右枕葉區最大峰值波型趨勢…86
圖4-4-2 三種不同遮蔽情境於早期左右枕葉區最大峰值比較……87
圖4-4-3 三種不同遮蔽情境中晚期左右頂葉最大峰值波型趨勢…91
圖4-4-4 三種不同遮蔽情境於中晚期左右頂葉區最大峰值比較…92

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