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研究生:王宗熙
研究生(外文):Tzong-Shi Wang
論文名稱:學齡前男女兒童注意力及活動量與自主神經活性相關性研究
論文名稱(外文):Autonomic Activity and Attention/Activity Intensity in Preschool-Age Children
指導教授:楊靜修楊靜修引用關係郭博昭郭博昭引用關係
指導教授(外文):Cheryl C. H. YangTerry B. J. Kuo
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:腦科學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
語文別:英文
論文頁數:44
中文關鍵詞:學齡前兒童心率變異性注意力活動量性別差異自主神經男女差異
外文關鍵詞:preschool age childrenSNAP-IVheart rate variabilityautonomic activitygender difference
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目的:確認學齡前男女兒童自主神經活性變化與注意力及活動量之相關性及男女差異。
方法:本研究針對平均年齡5.61± 0.56歲學齡前兒童88人,男女比1: 1.1, 測量其白天5分鐘心率變異性(Heart Rate Variability; HRV)所得參數,如極低頻(Very Low Frequency, VLF, 0.003-0.004 Hz)、低頻(Low Frequency, LF, 0.04-0.15 Hz)、高頻(High Frequency, HF, 0.15-1.0 Hz)、全頻(Total Power, TP)、變異度(Variance, Var)、低頻成分與高頻成分之比值(LF/HF)、低頻成分比值(LF%)、及高頻成分比值(HF%)和其家長及教師所填寫之注意力缺陷過動症中文版Swanson, Nolan, and Pelham, Version IV (SNAP-IV)量表進行其相關性比較。結果:(1)家長與教師填寫之SNAP-IV量表,可分為注意力不集中、過動、對立性反抗、及注意力不集中及過動症狀四種次量表及總分等五個分數,其中男女之間之家長與教師版SNAP-IV量表,男生除父母版之對立性反抗分量表外,其餘各分量表分數及總分皆比女生較高;而HRV參數男女兼併無明顯差異。(2)以皮爾森相關統計分析方法檢驗兩者相關性結果發現:在父母版的SNAP-IV量表與HRV參數相關研究中發現:HF與對立性反抗、注意力不集中及過動症狀、和總分數及 HF%與SNAP-IV量表各次量表及加總分數呈現顯著正相關;LF%及LF/HF與SNAP-IV量表各次量表及加總分數呈現顯著負相關,其中以LF/HF相關最大。(3) 而老師版的SNAP-IV量表與HRV參數相關研究中,則有些不同,其結果僅LF%與注意力不集中、和注意力不集中及過動症狀及LF/HF與SNAP-IV各次量表及總分數呈現顯著負相關。(4)將男女分開分析,發現男生比女生有較高的SNAP-IV分數,且各分量表及總分與HRV參數之相關現象只存在於男生組中。結論:過去許多相關研究曾討論及證明注意力不集中及過動症疾患其自主神經反應度較正常控制組低。此研究反應出於健康學齡前兒童注意力較不集中、活動量較大者、或有較多對立性反抗行為者,交感神經活性較低,而副交感神經偏高有關,其中並以交感神經功能變化較為顯著,且男性比女性更加顯著,顯示自主神經功能與學齡前兒童注意力及活動量有顯著關係。
關鍵字: 學齡前兒童、男女差異、自主神經、心率變異性、注意力、活動量、性別差異
Objective: to investigate the relationship and gender difference between heart rate variability and activity rating scale scores (SNAP-IV) in preschool-age children. Methods: We estimated autonomic reactivity on preschool-age children by power spectrum analysis of heart rate variability (HRV). Swanson, Nolan and Pelham parents and teachers rating scale (SNAP-IV), Chinese version was applied to evaluate each subject’s severity of symptoms related to inattention, hyperactivity, and oppositional defiant disorder. The association between HRV parameters including variance, very low-frequency power (VLF, 0.003-0.04 Hz), LF (0.04-0.15 Hz), HF (0.15-1.0 Hz), LF/HF, normalized HF (HF%) and LF (LF%) and scores of SNAP-IV parents and teachers subscales and scales was calculated and two-sided by SPSS version 15.0 software. Results: (1) After dividing all subjects into two groups by gender difference, the boys’ group had significantly higher scores in SNAP-IV scales, parent and teacher forms than the girls’ one except ODD subscale in SNAP-IV parent form. No gender difference was found in HRV measurement (2) Between scores of SNAP-IV parent form and HRV measurements, the results of Pearson’s correlation analysis revealed that scores of four subscales and total scale of SNAP-IV parent form except impulsivity subscale had positive association with HF. All scores of SNAP-IV parent form scales had positive association with HF%. Scores of four subscales and total scales of SNAP-IV parent form had more identically negative association with LF% and LF/HF (3). Scores of inattention and ADHD subscales of SNAP-IV teacher form had merely negative association with LF%, but scores of four subscales and total scales of SNAP-IV teacher form had significantly negative association with LF/HF ratio of HRV measurements (4) The scores of four subscales and total scale of the boys’ SNAP-IV parent and teacher forms except ODD subscale of SNAP-IV teacher form had significantly negative association with LF% and LF/HF ratio. The scores of all scales of the boys’ SNAP-IV parent and teacher forms except ODD subscale of SNAP-IV teacher form showed positive association with HF%, but only ADHD subscale and total scale of SNAP-IV parent form had the same correlation with HF. The girls’ group did not have the same findings. Conclusions: Most studies investigate HRV in ADHD children, and the results showed less autonomic reactivity under stress task. In this study, we illustrate that preschool-age children who are more inattentive and hyperactive tend to have less sympathetic modulation and more parasympathetic activity. In addiction, the boys’ group contributed to our main findings more than girls’ one. These might implicate that autonomic reactivity have gender differences in inattention and hyperkinetic pathogenesis.

Key Words: preschool age children, gender difference, autonomic activity, heart rate variability, SNAP-IV
Table of Contents
Introduction 1
Material and Methods 5
Subjects-------------------------------------------------------------------------------------------------5
Swanson, Nolan, and Pelham-IV (SNAP-IV) Rating Scale--------------------------------------5
Processing of electrocardiogram signals------------------------------------------------------------7
Frequency-domain analysis of HRV-----------------------------------------------------------------8
Results 9
Discussion 11
References 15
Appendices
Appendix I
Diagnosis Criteria of Attention-Deficit and Hyperactivity Disorder (ADHD) in DSM-IV 26
Appendix II
Swanson, Nolan, and Pelham-IV (SNAP-IV) Rating Scale-------------------------------------------------------------------------28
Appendix III
人體試驗審查申請表--------------------------------------------------32
Reference
1. Diagnosis and statistical manual of mental disorder, fourth edition (DSM-IV). Washington DC, APA (American Psychiatric Association), c1994.
2. Fayyad J, Graaf RD, Kessler R, Alonso J, Angermeyer M, Demyttenaere K. Cross-national prevalence and correlates of adult attention-deficit hyperactivity disorder. Br J Psychiatry 2007; 190: 402-409.
3. Rowland AS, Lesesne CA, Abramowitz AJ:. The epidemiology of attention-deficithyperactivity disorder (ADHD)—A pubic health view. Mental Retardation and Dev Disabilities Res Rev 2002; 8: 162-170.
4. Lorch EP, Milich R, Astrin CC, Berthisume KS. Cognitive engagement and story comprehension in typically developing children and children with ADHD from preschool through elementary school. Dev Psychol 2006; 42: 1206-1219.
5. Stavro GM, Ettenhofer ML, Nigg JT. Executive functions and adaptive function in young adult attention-deficit/hyperactivity disorder. J Int Neuropsychol Soc 2007; 13: 324-334.
6. Pietrzak RH, Mollica CM, Maruff P, Snyder PJ. Cognitive effects of immediate-release methylphenidate in children with attention-deficit/hyperactivity disorder. Neurosci Biobehav Rev 2006; 30: 1225-1245.
7. Raine A, Venable PH, Dalais C, Mellingen K, Reynold C, Mednick SA. Early educational and health enrichment environment at age 3-5 years is associated with increased autonomic and central nervous system arousal and morientating at age 11 years: evidence from the Mauritius Child Health Project. Psychophysiology 2001; 38: 254-266.
8. Negrao AB, Deuster PA, Gold PW, Sigh A, Chrousos GP. Individual reactivity and physiology of the stress response. Biomed Pharmacother 2000; 54: 122-128.
9. Garralda ME, Connell J, Taylor DC. Psychophysiological abnormalies in children with emotional and conduct disorders. Psychol Med 1991; 21: 947-957.
10. Boyce WT, Quas J, Alkon A, Smider NA, Essex MJ, Kupfer DJ. Autonomic reactivity and psychopathology in middle childhoodren. Br J Psychiatry 2001; 179: 144-150.
11. Mezzacappa E, Tremblay RE, Kindlon D, Saul JP, Areseneault L, Seguin J, Pihl RO, Earls F. Anxiety, antisocial behavior, and heart rate regulation in adolescent males. J Child Psychol Psychiatry 1997; 38: 457-469.
12. Rogeness GA, Cepeda C, Macedo CA, Fischer C, Harris WR. Difference in heart rate and blood pressure in children with conduct disorder, major depression, and separation anxiety. Psychiatry Res 1990; 33: 199-206.

13. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Circulation 1996 Mar 1; 93(5): 1043-1065.
14. Toweill DL, Kovarik WD, Carr R, Kaplan D, Lai S, Bratton S. Linear and nonlinear analysis of heart rate variability during propofol anesthesia for short-duration procedures in children. Pediatr Crit Care Med 2003; 4(3): 308-314.
15. Fouad FM, Tarazi RC, Ferrario CM, Fighaly S, Alicandri C. Assessment of parasympathetic control of heart rate by a noninvasive method. Am J Physiol Heart Circ Physiol 1984; 246: H838-842.
16. Malliani A, Pagani M, Lombardi F, Cerutti S. Cardiovascular neural regulation explored in the frequency domain. Circulation 1991; 84: 482-492.
17. Pagani M, Montano N, Porta A, Malliani A, Abbound FM, Birkett C, Somers VK. Relationship between spectral components of cardiovascular variabilities and direct measures of muscle sympathetic nerve activity in humans. Circulation 1997; 95: 1441-1448.
18. Richards JE, Casey BJ. Heart rate variability during attention phases in young infants. Psychophysiology 1991; 28: 43-53.
19. Suess PE, Porges SW, Plude DJ. Cardiac vagal tone and sustained attention in school-age children. Psychophysiology 1994; 31: 17-22.
20. Hansen AL, Johnson BH, Thayer JF. Vagal influence on working memory and attention. Int J Psychophysiol 2003; 48: 263-274.
21. Wood R, Maraj B, Lee CM, Reyes R. Short-term heart rate variability during a cognitive challenge in young and older adults. Age Aging 2002; 31: 131-135.
22. Swanson JM. School based assessments and interventions for ADD students. 1992.
23. Collett BR, Ohan JL, Myers KM. Ten-year review of rating scales: scales assessing attention-deficit/hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry, 2003, 42(9):1015–1037
24. Liu YC, Liu SK, Shang CY, Lin CH, Tu CL, Gau SF. Norm of the Chinese version of the Swanson, Nolan, and Pelham, version IV scale for ADHD. Taiwanese J Psychiatry 2006; 20: 209-304.
25. Kuo TBJ, Lin T, Yang CCH, Li CL, Chen CF, Chou P. Effect of aging on gender differences in neural control of heart rate. Am J Physiol Heart Circ Physiol 1999; 277: H2233-H2239.
26. Yang CCH, Chao TC, Kuo TBJ, Yin CS, Chen HI. Preeclamptic pregnancy is associated with increased sympathetic and decreased parasympathetic control of HR. Am J Physiol Heart Circ Physiol 2000; 278: H1269-H1273.
27. Lin CC, Kuo TBJ, Yang CCH. Effects of estrogen on gender-related autonomic differences in humans. Am J Physiol Heart Circ Physiol 2003; 285: H2188-H2193.
28. Kuo TBJ, Chan SHH. Continuous, on-line, real-time spectral analysis of arterial blood pressure using a personal computer. Am J Physiol Heart Circ Physiol 1993; 264: H2208-H2213.
29. Buchman TG, Stein P, Goldstein B. Heart rate variability in critical illness and critical care. Curr Opin Crit Care 2002; 8: 311–315.
30. Akselrod S, Gordon D, Ubel FA. Power spectral analysis of heart rate fluctuation: A quantitative probe of beat-to-beat cardiovascular control. Science 1981; 213: 220–222.
31. Goldstein B, Woolf PD, DeKing DE,. DeLong DJ, Cox C, Kempski MH. Heart Rate Power Spectrum and Plasma Catecholamine Levels after Postural Change and Cold Pressor Test. Power spectral analysis of heart rate variability and plasma catecholamine levels after postural change and cold pressor testing in man. Pediatr Res 1994; 36: 3538–363.
32. Amat J, Baratta MV, Paul E, Bland ST, Watkin LR, Maier SF. Medial prefrontal cortex determines how stressor controllability affects behavior and dorsal raphe nucleus. Nat. Neurosci 2005; 8: 365-371.
33. Thayer JF, Brosschot JF. Psychosomatics and psychopathology: looking up and down from the brain. Psychoneuroendocrinology 2005; 30: 1050-1058.
34. Beauchaine TP, Kathin ES, Strassberg Z, Snarr J. Disinhibitory psychopathology in male adolescents: discriminating conduct disorder from attention-deficit/hyperactivity disorder through concurrent assessment of multiple autonomic states. J Abnormal Psychol 2001; 110: 610-624.
35. Garralda ME, Connel J, Taylor DC. Psychophysiological anomalies in children with emotional and conduct disorders. Psychol Med 1991; 21: 947-957.
36. Herpertz SC, Mueller B, Wenning B, Qunaibi M, Lichterfeld C, Herpertz-Dahlmann B. Autonomic responses in boys with externalizing disorders. J Neural Trans 2003; 110: 1181-1195.
37. Zahn TP, Kruesi MJ. Autonomic activity in boys with disruptive behavior disorders. Psychophysiology 1993; 30: 605-614.
38. van Goozen SH, Matthys W, Cohen-Kettenis PT, Gispen-de Wied C, Wiegant VM, van Engeland H. Salivary cortisol and cardiovascular activity druing stress in oppositional-defiant disorder boys and normal controls. Biol Psychiatry 1998; 43: 531-539.
39. van Lang NDJ, Tulen JHM, Kallen VL, Rosbergen B, Dieleman G, Ferdinand RF. Autonomic reactivity in clinically referred children attention-deficit/hyperactivity disorder versus anxiety disorder. Eur Child Adolesc Psychiatry 2007; 16: 71-78.
40. Lenard Z, Studinger P, Mersich B, Kocsis L, Kollai M. Maturation of cardiovagal autonomic function from childhood to young adult age. Circulation 2004; 110:2307-2312
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