功能性磁振造影顯示密集式感覺運動訓練對注意力缺陷過動症學童的療效
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Date
2006-12-??
Authors
鄭信雄
葉子成
盧信宏
莊銘爐
顏樂美
方慧琴
林麗慎
Journal Title
Journal ISSN
Volume Title
Publisher
國立台灣師範大學特殊教育中心
National Taiwan Normal University Special Education Center
National Taiwan Normal University Special Education Center
Abstract
本研究採用功能性磁振造影（BOLD Fmri）的方法，檢查8個正常男性學童（XI 組），8個接受過感覺運動訓練3個月後的ADHD男性學童（X2組）以及8個訓練前的ADHD男性學童（X3組）。X2和X3 兩組學童都未服用藥物，都接受感覺發展檢核表、注意力缺陷過動症檢測表、以及家長和老師評估的前後測驗。學童都來自高年級國小學生，年齡上沒顯示有差異；這些測驗前後測的變異分析都顯示X2組和X3組有顯著的差別，改善來自X2組的感覺運動訓練（P<0.05）。 比較3組BOLD fMRI中Response control結果，在大腦的前額葉（Pre-frontal area）、內額葉（Medial frontal area）、扣帶葉（Cingulate gyrus）和尾狀核（Caudate nucleus）顯示有意義的差別。X3組在這些區域顯示很少的血氧流量；Xl 組顯示這些區域很濃厚的血氧流量；X2組顯示中間偏XI 的血氧流量。X2組和X3組差不多都達到或接近統計上有顯著的差別（P<0.05）。 X2組在BOLD fMRI的發現符合臨床上導師和家長觀察到上課和寫功課的專注、靈巧和良好執行能力，以及注意力缺陷過動症檢測表的改善。證實俯臥伸張姿勢的密集式感覺運動訓練，對好動分心學童是長期有效治療方法。
8 normal male students (Xl group), 8 male students with ADHD after intensive sensor-motor integration (SMI) training (X2 group), and 8 ADHD male students without SMI training (X3 group) were compared in this study. All students in group Xl, X2 and X3 aged 9-12 without medications and were examined by parents' SMI checklist, ADHD checklist, and parents' also teachers' rating on behavior before and after SMI trainings. The MANOVA analysis of all behavioral ratings showed significant difference (P <0.05) which came from SMI training in X2 group. The results of response control in BOLD-based fMRI compared by three groups showed significant difference (P< 0.05) between group X2 and X3 in pre-frontal area, medial frontal area, cingulate gyrus and caudate nucleus. Group X2 showed intermediate perfusion while group X3 showed little scattered blood oxygen perfusion and group Xl showed very thick blood oxygen perfusion. BOLD-based fMRI findings correlated to clinical improvements by teachers' and parents' observations, and checklist findings improved full concentration, skillful fine movement and execution ability. Intensive SMI training was an effective long-term therapeutic intervention for children with ADHD.
8 normal male students (Xl group), 8 male students with ADHD after intensive sensor-motor integration (SMI) training (X2 group), and 8 ADHD male students without SMI training (X3 group) were compared in this study. All students in group Xl, X2 and X3 aged 9-12 without medications and were examined by parents' SMI checklist, ADHD checklist, and parents' also teachers' rating on behavior before and after SMI trainings. The MANOVA analysis of all behavioral ratings showed significant difference (P <0.05) which came from SMI training in X2 group. The results of response control in BOLD-based fMRI compared by three groups showed significant difference (P< 0.05) between group X2 and X3 in pre-frontal area, medial frontal area, cingulate gyrus and caudate nucleus. Group X2 showed intermediate perfusion while group X3 showed little scattered blood oxygen perfusion and group Xl showed very thick blood oxygen perfusion. BOLD-based fMRI findings correlated to clinical improvements by teachers' and parents' observations, and checklist findings improved full concentration, skillful fine movement and execution ability. Intensive SMI training was an effective long-term therapeutic intervention for children with ADHD.