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研究生:劉銘雄
研究生(外文):Ming-Hsiung Liu
論文名稱:以事件相關電位(ERPs)評估慢性疲勞症候群患者的訊息處理歷程
論文名稱(外文):Information processing in patients with chronic fatigue syndrome:An event-related potentials study
指導教授:游一龍游一龍引用關係
指導教授(外文):Lung Yu
學位類別:碩士
校院名稱:國立成功大學
系所名稱:行為醫學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2002
畢業學年度:90
語文別:中文
論文頁數:60
中文關鍵詞:持續性注意力分配性注意力PASAT警覺作業事件相關電位P300慢性疲勞
外文關鍵詞:divided attention.paced auditory serial addition taskP300PASATsustained attentionevent-related potentialscontinuous performancevigilance taskchronic fatigue syndrome
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目的:慢性疲勞 (Chronic fatigue syndrome, CFS) 是一種主訴為疲勞,但是無法以醫療因素來解釋的疾病。患者經常抱怨廣泛的認知功能受損,但在客觀的神經心理測驗的發現並不一致。本研究的第一個目的想經由事件相關電位 (event-related potential, ERPs) 的測量來了解CFS患者從事作業時間長、但難度簡單、測量持續性注意力 (sustained attention) 的認知作業時,訊息處理上是否有問題。本研究的第二個目的是測量患者進行作業時間短、但訊息處理上相當複雜、測量分配性注意力 (divided attention) 的作業時的訊息處理歷程。方法:本研究分別以10名CFS患者及9名健康受試為研究對象,測量他們進行較長時間(約30分鐘)的警覺作業(vigilance test)時的P300波形,以評估CFS患者在進行該作業時的認知資源或訊息處理速率是否有別於健康受試。另外,分別以6名CFS患者及5名健康受試為研究對象,測量他們進行呈現速率為4、3、2秒的Paced Auditory Serial Addition Task (PASAT) 時的ERPs波形。結果:警覺作業的ERPs的分析上,CFS患者的P300振幅及區域面積小於健康受試的,但CFS和健康受試在行為資料的測量上並沒有差異。PASAT的ERPs的分析上,CFS患者在FZ處的N130振幅(大小)大於健康受試,但N130的潛時、P230及N500的振幅及潛時上沒有差異、區域面積的測量上亦沒有差異,並且行為資料的測量上亦沒有差異。結論:CFS患者在進行較長時間的警覺作業時,中線位置 (FZ, CZ, PZ) P300的振幅及區域面積上小於健康受試者,顯示患者在tonic arousal低於健康受試。CFS患者在進行PASAT時所感受到的困難可能來自於早期知覺歷程的困難,而非較後面的訊息處理歷程。CFS患者可以依賴phasic arousal調節認知資源以達到警覺作業及PASAT的要求。
Objective: Chronic fatigue syndrome (CFS) is characterized by medically unexplained debilitating fatigue. Although patients with CFS usually report a wide range of cognitive complaints, neuropsychological studies found only mild dysfunctions. The first aim of present study was in an attempt to obtain neurophysiological evidence for cognitive dysfunction in CFS patients with event-related potentials (ERPs) recording during a prolonged cognitive task that required sustained attention. The second aim was to use ERPs recording to exploit the information processing of CFS patients while they were doing Paced Auditory Serial Addition Task (PASAT), a neuropsychological task of divided attention that commonly found impaired in patients with CFS. Methods: The ERPs were recorded from 10 patients with CFS and 9 healthy controls while they were doing a 30-minute vigilance task and from 6 patients with CFS and 5 health controls while they were doing PASAT (the presentation rates were 4, 3, and 2 seconds). Results: The patients with CFS compared to healthy controls had lower amplitude and area measurement of P300 while they were doing vigilance task. No difference in accuracy or reaction time was found. The amplitude of N130 at FZ was significantly higher in patients with CFS compared to healthy controls while they were doing PASAT, but there was no difference in N130 latency, P230 and N500 amplitude or latency, and no difference on area measurement. Also, no difference on behavior data between groups was found. Conclusion: The P300 amplitude and area measurement of patients with CFS tends to be smaller across electrode sites, implying that the tonic arousal is lower in patients with CFS. The difficulty in patients with CFS on PASAT comes form early process of information processing, not later process. Patients with CFS are able to modify their phasic arousal in response to presentation of vigilance task and PASAT.
目錄

中文摘要 I
ABSTRACT III
目錄 V
表目錄 VIII
圖目錄 X
圖目錄 X
1.緒論 1
1.1.盛行率 1
1.2.診斷標準 2
1.3.認知功能的客觀測量上沒有嚴重受損 2
1.4.研究目的一 3
1.4.1.CFS患者在警覺作業的表現 3
1.4.2.ERPs的簡介 4
1.4.3.CFS在ERPs方面的研究 6
1.5.研究目的二 7
1.5.1.CFS患者在PASAT的表現 7
1.5.2.PASAT的簡介 7
1.5.2.結合PASAT及ERPs的過去研究 8
2.材料與方法 9
2.1.研究對象 9
2.2.進行步驟 10
2.3.研究工具 10
2.3.1.警覺作業 10
2.3.2.PASAT 11
2.3.3.腦波收集 11
2.3.4.腦波分析 12
2.3.4.1.警覺作業的腦波分析 12
2.3.4.2.PASAT的腦波分析 13
2.4.統計分析 14
2.4.1.警覺作業及PASAT的行為資料 14
2.4.2.警覺作業及PASAT的ERPs資料 14
3.結果 15
3.1警覺作業 15
3.1.1.行為資料 15
3.1.2.ERPs分析 15
3.2.PASAT 16
3.2.1.行為資料 16
3.2.2.ERPs分析 16
4.討論 17
4.1.警覺作業 17
4.2.PASAT 19
4.4.研究限制 21
4.5.研究貢獻 21
4.6.未來研究方向 22
參考文獻 53
附件 59
自述 60

表目錄

表格1: 個案特徵 23
表格2: CFS患者及健康受試在警覺作業上的行為表現 23
表格3: CFS患者及健康受試在進行警覺作業時P300振幅的平均數及標準差。 24
表格4: CFS患者及健康受試在進行警覺作業時P300潛時的平均數及標準差。 26
表格5: CFS患者及健康受試在進行警覺作業時P300區域面積的平均數及標準差。 28
表格6: CFS患者及健康受試在PASAT上的行為表現 30
表格7: CFS患者及健康受試在進行PASAT時N130振幅的平均數及標準差。 31
表格8: CFS患者及健康受試在進行PASAT時N130潛時的平均數及標準差。 32
表格9: CFS患者及健康受試在進行PASAT時N130區域面積的平均數及標準差。 33
表格10: CFS患者及健康受試在進行PASAT時P230振幅的平均數及標準差。 34
表格11: CFS患者及健康受試在進行PASAT時P230潛時的平均數及標準差。 35
表格12: CFS患者及健康受試在進行PASAT時P230區域面積的平均數及標準差。 36
表格13: CFS患者及健康受試在進行PASAT時N500振幅的平均數及標準差。 37
表格14: CFS患者及健康受試在進行PASAT時N500潛時的平均數及標準差。 38
表格15: CFS患者及健康受試在進行PASAT時N500區域面積的平均數及標準差。 39

圖目錄

圖1: 警覺作業中所使用的刺激 40
圖2: 研究中依據10-20系統所黏貼的電極位置 40
圖3: 9名健康受試在進行為時30分鐘的警覺作業時的ERPS波形。 41
圖4: 10名CFS患者在進行為時30分鐘的警覺作業時的ERPS波形。 42
圖5: 10名CFS患者與9名健康受試在進行警覺作業時的ERPS波形。兩組在目標刺激上的比較。 43
圖6: 10名CFS患者與9名健康受試在進行警覺作業時的ERPS波形。兩組在非目標刺激上的比較。 44
圖7: 10名CFS患者與9名健康受試在進行警覺作業時的ERPS波形。中線位置P300波形比較。 45
圖8: 10名CFS患者與9名健康受試在進行警覺作業時的ERPS波形。中線位置P300波形比較。 46
圖9: 10名CFS患者與9名健康受試在進行警覺作業時,健康受試減去CFS患者後的ERPS波形。中線位置P300波形比較。 47
圖10: 10名CFS患者與9名健康受試在進行警覺作業時,目標刺激減去非目標刺激的ERPS波形。中線位置P300波形比較。 48
圖11: 6名CFS患者與5名健康受試在進行PASAT時的ERPS波形。在刺激呈現間隔為2秒的情形下。 49
圖12: 6名CFS患者與5名健康受試在進行PASAT時的ERPS波形。在刺激呈現間隔為3秒的情形下。 50
圖13: 6名CFS患者與5名健康受試在進行PASAT時的ERPS波形。在刺激呈現間隔為4秒的情形下。 51
圖14: 6名CFS患者與5名健康受試在進行PASAT時的ERPS波形。中線位置ERPS波形比較。 52
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