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研究生:陳思帆
研究生(外文):Sz-FanChen
論文名稱:視覺注意力與新奇偵測能力對極輕度阿茲海默氏症病人街景辨識及找路行為之影響
論文名稱(外文):Way-Finding and Scene Recognition in Patients with Very Mild Alzheimer’s disease: Effects of Visual Attention and Novelty Detection Ability
指導教授:白明奇白明奇引用關係郭乃文郭乃文引用關係
指導教授(外文):Ming-Chyi PaiMing-Chyi Pai
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:2012
畢業學年度:100
語文別:中文
論文頁數:98
中文關鍵詞:個人化街景視覺注意力新奇偵測
外文關鍵詞:personally familiar street scenevisual attentionnovelty detection
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目的:迷路是阿茲海默氏症 (Alzheimer’s disease, AD) 病人罹病初期常見的困擾之一,特別是在生活環境樣貌改變時,AD病人可能因無法辨識街景而發生認路障礙。本研究探討極輕度AD病人在環境樣貌改變時,對熟悉街景的認路能力。

方法:本研究邀請AD病人及年齡相配之認知健康控制組 (Cognitive healthy control, CHC) 參與研究。本研究共包含兩個實驗:習慣化作業、認路作業與改變偵測。在習慣化作業中,研究者透重覆播放相同的街景照片,穿插一張外縣市街景照片,來檢視受試者之視覺注意力。在認路作業中,研究者蒐集受試者住家附近之個人化熟悉街景照片,並修改照片中部份區塊,例如:改變商店招牌顏色,來檢視在環境改變時之認路能力。在認路作業完成後,再次撥放相同的個人街景照片,請受試者指出照片中與記憶不符之處,檢視受試者偵測改變的能力。並在所有實驗進行的過程中,記錄受試者之眼動訊息。

結果:34位AD及31位CHC參與本研究,兩組受試者在基本視覺能力 (basic visual acuity) 未有顯著差異。研究結果發現,在習慣化作業中,AD有較差的持續性注意力;認路作業研究結果顯示,在環境樣貌改變的狀況下,AD病人花費較長的時間才能作答,且與CHC組相較有較高的錯誤率。此外,AD病人的視覺搜尋效率也較差。在改變偵測的部分研究結果顯示,AD病人花費較長的時間才能作答,但仍有較高的錯誤率,顯示AD病人對環境改變的偵測能力較差,且AD病人在視覺搜尋時,視覺搜尋的速度較快且視覺搜尋幅度較大,整體而言紊亂而無規則,顯示個案有較差的視覺搜尋效率。

結論:AD病人在環境改變時的認路能力較差,對環境改變的偵測能力也較弱。其表現可能與較差的視覺注意力以及較差的視覺搜尋策略有關。

Objective: Way-finding difficulty is a common problem in many community-dwelling patients with Alzheimer’s disease (AD), particularly as changes occur in their neighborhood or community. In the present study, Participants in this study, including AD patients and age-matched cognitive healthy controls (CHC), were recruited to test their way-finding ability and change detection ability.

Method: We designed three experiments to examine subjects’ visual attention, way-finding ability and change detection ability. In habituation-dishabituation Task, we modify habituation-dishabituation paradigm to test subjects’ visual attention. The participants, including 34 very mild AD patients and 31 CHC with equal basic visual acuity, were not asked to answer any questions but to view the pictures freely. In way-finding task, we prepared several personally familiar street scenes, including 50% modified and 50% original pictures, to simulate changes in everyday life. The participants were asked to judge the correct direction to destination. After way-finding task, we manifested pictures in way-finding task again to measure subjects’ sensitivity to changes in environment. The accuracy of way-finding and change detection, reaction time, and eye-movement was measured.

Results: Compared with CHC, AD patients showed higher error rate in way-finding, poor sensitivity in change detection, longer time in both conditions. The AD patients also had poorer visual search skills than CHC when personally familiar scenes were displayed.

Conclusion: The present study demonstrated poorer way-finding ability and visual search inefficiency in very mild AD patients when personally familiar street scenes were displayed, and underlying mechanisms may relate to impaired visual attention. The deficits are a reflection of their difficulty in their everyday life when their familiar environments are changed.

第一章 緒論……………………………………………………………………1
第二章 文獻探討…………………………………………………………………3
第一節 阿茲海默氏症與找路………………………………………………3
壹、阿茲海默氏症的歷史、病理與臨床症狀……………………………3
貳、找路…………………………………………………………………5
第二節 視覺注意力與找路………………………………………………………11
壹、注意力在 AD 病人找路過程的角色………………………………11
第三節、基因多型性與尋求新奇性人格特質在找路的角色………………16
壹、DRD4基因多型性與注意力不足…………………………………………16
第四節、研究目的與研究假設………………………………………………21
壹、研究目的……………………………………………………………21
貳、研究假設……………………………………………………21
第三章 研究方法………………………………………………22
第一節、受試者……………………………………………22
壹、極輕度阿茲海默氏症組…………………………………………22
貳、認知健康控制組……………………………23
第二節、研究工具……………………………………………………………24
壹、神經心理測驗……………………………………………………24
貳、問卷………………………………………………………………27
叁、實驗…………………………………………………………………29
肆、血液檢驗……………………………………………………………33
伍、實驗流程……………………………………………………………33
陸、資料分析…………………………………………………………35
第四章 研究結果…………………………………………………….……………37
第一節、人口學變項、神經心理測驗與問卷結果………………………37
壹、人口學變項與神經心理測驗………………………………………37
貳、臨床失智評量表……………………………………………………………39
叁、迷路問卷………………………………………………………………………39
肆、神經精神量表………………………………….……………………40
伍、三向度人格問卷……………………………………………………41
第二節、血液分析與實驗結果………………………………………………42
壹、血液分析結果…………………………………………………………………42
貳、實驗結果…………………………………………………42
第五章 討論………………………………………………………75
第一節、習慣化作業……………………………………………75
第二節、找路作業與新奇偵測……………………………77
第三節、研究限制與未來建議……………………………81
第四節、研究貢獻…………………………………………82
第六章 結論…………………83
參考文獻……………………85


表目錄
表3-1:研究對象之納入與排除標準……………………………………23
表4-1:人口學變項與神經心理測驗之比較…………………………38
表4-2:AD組受試者在神經精神量表之總分………………………40
表4-3:兩組受試者在三組照片中凝視時間比較………………………42
表4-4:兩組受試者在不同類型照片凝視時間的比較………………43
表4-5:兩組受試者在台南市地標照片重複播放五次之凝視時間比較44
表4-6:兩組受試者在個人化熟悉街景照片重複播放五次之凝視時間比較45
表4-7:兩組受試者在台南市地標四段時間內凝視時間比較……………46
表4-8:兩組受試者在個人化街景照片四段時間內凝視時間比較………47
表4-9:兩組受試者在台南市地標照片四段時間內凝視數量比較………49
表4-10:兩組受試者在個人化街景照片四段時間內凝視數量比較………50
表4-11:兩組受試者在個人化街景照片重複五次之掃視持續時間比較……51
表4-12:兩組受試者在台南地標照片四段時間之掃視持續時間比較……52
表4-13:兩組受試者在不同性質照片之掃視持續時間比較……………54
表4-14:兩組受試者在台南地標照片重複五次之掃視次數比較………55
表4-15:兩組受試者在個人化街景照片重複五次之掃視次數比較……56
表4-16:兩組受試者在台南地標照片四段時間之掃視次數比較……57
表4-17:兩組受試者在個人化街景四段時間之掃視次數比較……58
表4-18:兩組受試者在找路作業中不同類型照片之反應時間比較……61
表4-19:兩組受試者在找路作業中不同類型照片中平均一張照片凝視數量比62
表4-20:兩組受試者在找路作業中不同類型照片平均一張照片掃視次數之比較63
表4-21:兩組受試者在新奇偵測作業中不同類型照片反應時間之比較……66
表4-22:兩組受試者在不同類型照片中平均掃視次數之比較…………68
表4-23:兩組受試者在不同類型照片中平均掃視時間之比較………69
表4-24:兩組受試者在不同類型照片中平均掃視幅度之比較……71
表4-25:兩組受試者在不同類型照片中平均掃視速度之比較…………72
表4-26:兩組受試者在不同類型照片中平均潛伏時間之比較…………73

圖目錄
圖3-1:HDT街景照片播放圖例………30
圖3-2:找路作業路線規劃及沿途拍攝地點示意圖…………32
圖3-3:WFT 及NDT實驗刺激圖例………32
圖3-4:眼動儀與實驗情境示意圖…………34
圖4-1:兩組受試者在三組照片中凝視時間比較…………43
圖4-2:兩組受試者在不同類型照片凝視時間的比較………44
圖4-3:兩組受試者在台南市地標照片重複播放五次凝視時間比較………45
圖4-4:兩組受試者在個人化熟悉街景照片重複播放五次之凝視時間比較………46
圖4-5:兩組受試者在台南市地標四段時間內凝視時間比較…………47
圖4-6:兩組受試者在個人化街景照片四段時間凝視時間比較………48
圖4-7:兩組受試者在台南市地標照片四段時間凝視數量比較……49
圖4-8:兩組受試者在個人化街景照片四段時間凝視數量比較………50
圖4-9:兩組受試者在個人化街景照片重複五次掃視時間比較……52
圖4-10:兩組受試者在台南地標照片四段時間掃視持續時間比較……53
圖4-11:兩組受試者在不同性質照片之掃視次數比較…………54
圖4-12:兩組受試者在台南街景重覆五次之掃視次數比較………55
圖4-13:兩組受試者在個人化街景重覆五次之掃視次數比較………56
圖4-14:兩組受試者在台南地標照片四段時間掃視次數比較……57
圖4-15:兩組受試者在個別化街景四段時間掃視次數比較………58
圖4-16:兩組受試者在個別化街景照片重複播放五次掃視幅度比較…59
圖4-17:兩組受試者在不同類型照片之掃視幅度比較……60
圖4-18:兩組受試者在找路作業中不同類型照片之反應時間比較………61
圖4-19:兩組受試者在找路作業中答題錯誤率比較…62
圖4-20:兩組受試者在找路作業中不同類型照片凝視數量比較…63
圖4-21:兩組受試者在找路作業中不同類型照片平均一張照片掃視次數比較.64
圖4-22:兩組受試者在找路作業中已修改照片之回視次數比較……65
圖4-23:兩組受試者在新奇偵測作業中兩種性質照片之反應時間比較…67
圖4-24:兩組受試者在新奇偵測作業中答題錯誤率比較……67
圖4-25:兩組受試者在新奇偵測作業中答題正確率比較……68
圖4-26:兩組受試者在不同類型照片平均每張照片之掃視次數比較……69
圖4-27:兩組受試者在不同類型照片平均掃視時間比較……70
圖4-28:兩組受試者在不同類型照片單次掃視之平均掃視時間比較…70
圖4-29:兩組受試者在不同類型照片之平均掃視幅度比較………71
圖4-30:兩組受試者在不同類型照片單次掃視之平均掃視幅度比較……72
圖4-31:兩組受試者在不同類型照片單次掃視之平均掃視幅度比較……73
圖4-32:兩組受試者在不同類型照片平均潛伏時間比較………74
圖4-33:兩組受試者在修改的照片中回視次數比較………74
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