臺灣博碩士論文加值系統

中文摘要

研究目的：過去研究指出長期疲勞症候群（Chronic Fatigue Syndrome, CFS）的個案在認知功能上的主要問題可能在於訊息處理功能的缺損及處理速度不足，而影響了個案的記憶力及注意力功能，但也有相當不一致的研究結果，同時缺乏直接觀察CFS個案在執行認知作業的過程中大腦活動狀態的研究，因此無法了解CFS個案認知功能缺損的原因及內在能量的運用情形。本研究主要是利用Quantitative EEG (QEEG) 來測量CFS個案在執行持續性的認知作業的過程中，腦部活動及能量運用的變化，藉此了解CFS個案在執行長時間的認知作業時所呈現的行為表現及腦部活動的現象，進一步能夠了解CFS個案認知功能缺損及容易疲倦的可能原因。方法：本研究共收了12個CFS個案，12個健康控制組，使用警覺性測驗、高難度及低難度運作記憶作業為工具。在作業進行過程中除了記錄個案的反應時間、正確與否等行為表現，同時也持續測量個案的腦波。另外，在測驗前後皆請個案填寫情緒評量表，也分別測量六分鐘的resting EEG。結果：研究分析結果顯示，CFS個案在執行低難度運作記憶作業時的反應時間較控制組長，但其正確率並無明顯問題，而其腦波呈現出CFS個案一開始維持較高的警覺度，但也很快呈現疲勞的現象，此外，控制組的反應時間上呈現明顯的學習效果及疲勞或無聊效果，但CFS個案卻無這樣的表現。在高難度的作業表現上，CFS個案在反應錯誤率上比控制組低，但腦波變化並無不同的表現。CFS個案和控制組個案在警覺性作業的行為表現及腦波變化則無明顯不同。另外，CFS個案在一段長時間熟悉作業後，主觀的緊張程度仍明顯增加。整體而言，CFS個案在處理訊息的過程中，似乎維持了較高的警覺性，而未有效地運用內在能量，這可能是造成CFS個案在進行一些花費心力的工作後容易疲勞的原因。

Abstract
Objective: The purpose of this study was to explore the pattern of inner resources utilization while doing continuous cognitive tasks in chronic fatigue syndrome (CFS) patients, in order to understand the cognitive impairments and the phenomenon of fatigue in these patients. Methods: Twelve CFS subjects and twelve healthy control subjects participated in this study. Their reaction time and EEG were recorded when they were performing an easy and a difficult version of working memory tasks, and a vigilance task. Also, 6 minutes of resting EEG were collected for all subjects and they were asked to complete a mood visual analogue scale before and after doing all the tasks. Results: When performing the easy version of working memory task, CFS subjects had longer reaction time but same omission and commission rate. When the task were divided into 4 segments over time, the average reaction time in healthy control subjects showed a learning effect as well as a boredom or fatigue effect, which were not present in CFS group. For the EEG measures, CFS subjects had higher arousal level even while performing the easy version of working memory task, but showed EEG pattern of fatigue level sooner. In difficult version of working memory, CFS subjects had lower commission rate than control subjects had, but there were no differences in EEG pattern. After performing all the tasks, CFS subjects rated their subjective anxiety level higher than in the beginning of all the tasks. In contrast, control subjects showed a decline in their level of anxiety. Conclusion: Behaviorally, CFS patients tend to maintain a constant level of performance, disregarding the increase in familiarity with the task. However, EEG data indicated earlier sign of fatigue and increased level of arousal in CFS patients. The results suggested a defect in the utilization of inner resources in CFS patients. They strive to maintain a constant level of performance and lack of the flexibility to modulate their mental efforts according to outside situation. This might contribute to their reported fatigue and impaired cognitive function.

目錄

中文摘要 ………………………………….. 1-2
英文摘要 ………………………………….. 3-4
誌謝 ………………………………….. 5-6
目錄 ………………………………….. 7
表目錄 ………………………………….. 8-10
圖目錄 ………………………………….. 11
序論 ………………………………….. 12-20
方法 ………………………………….. 21-28
結果 ………………………………….. 29-42
討論 ………………………………….. 43-47
結果圖表 ………………………………….. 48-68
參考文獻 ………………………………….. 69-75


表目錄

表一 個案年齡、教育年數的平均數（標準差）
、性別比例的統計結果…………………………………………………48
表二 執行運作記憶作業不同時間點的平均反應時間（標準差）
及統計結果(以秒為單位) ……………………………………..49
表三 執行運作記憶作業時不同時間點反應遺漏率
(omission rate)的平均數（標準差）及統計結………………..50
表四 執行運作記憶作業時不同時間點的反應錯誤率
(commission rate)平均數（標準差）及統計結果…………….51
表五 執行運作記憶作業時不同時間點log alpha power
平均數（標準差）及統計結果……………………………….52
表六 執行運作記憶作業時不同時間點log beta2 power
的平均數（標準差）及統計結果…………………………….53
表七 執行運作記憶作業時不同時間點log theta power
的平均數（標準差）及統計結果……………………..………54
表八 執行運作記憶作業時不同時間點log beta1 power
的平均數（標準差）及統計結果……………………………55

表九 執行警覺性作業時不同時間點的平均反應時間
（標準差）及統計結果（以秒為單位）…………………………..56
表十 執行警覺性作業時不同時間點反應遺漏率
（omission rate）的平均數（標準差）及統計結果…………….…57
表十一 執行警覺性作業時不同時間點反應錯誤率
（commission rate）的平均數（標準差）及統計結果…………....58
表十二 執行警覺性作業時不同時間點的d’ 值（標準差）
及統計結果…………………………………………………….59
表十三 執行警覺性作業時不同時間點log alpha power
的平均數（標準差）及統計結果………………………….…60
表十四 執行警覺性作業時不同時間點log theta power
的平均數（標準差）及統計結果………………………………61
表十五 執行警覺性作業時不同時間點log beta2 power
的平均數（標準差）及統計結果…………………………….62
表十六 執行警覺性作業時不同時間點log beta1 power
的平均數（標準差）及統計結果…………………………….63
表十七 睜眼及閉眼狀況下的前後測Resting EEG 的
log alpha power 平均數（標準差）及統計結果…………….64
表十八 睜眼及閉眼狀況下的前後測Resting EEG 的
log theta power 平均數（標準差）及統計結果…………….65
表十九 睜眼及閉眼狀況下的前後測Resting EEG 的
log beta2 power 平均數（標準差）及統計結果……………66
表二十 睜眼及閉眼狀況下的前後測Resting EEG 的
log beta1 power 平均數（標準差）及統計結果……………67
表二十一 情緒評量表前後測的平均數（標準差）及統計結果……..68


圖目錄

圖一 認知作業施測順序 ………………………………………… 24

圖二 警覺性作業目標刺激及非目標刺激圖…………………….26

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