健康與注意力不足過動症青年抑制控制之神經發展變化：數字史楚普測驗與功能性磁振造影研究

患有注意力不足過動症（Attention-Deficit/Hyperactivity Disorder, ADHD）孩童成為青少年時，其抑制控制（inhibitory control）會有顯著的進步。然而，鮮少研究探討此一認知發展的神經變化。因此，本研究藉功能性核磁共振造影技術，以縱貫性研究法來探究此一問題。本研究招募了平均年齡11歲的ADHD孩童40位與正常發展孩童38位，所有實驗參與者皆進行了數字史楚普作業（counting Stroop task）同時接受腦部掃描，四年後再接受一次掃描。腦造影結果發現在背側前扣帶迴皮質（dorsal anterior cingulate cortex, dACC）與右側額下迴（right inferior frontal gyrus, rIFG）有顯著的交互作用效果：ADHD組dACC的活化程度隨年齡增長而上升，但在第二次掃描時仍略少於TD組；ADHD組IFG的活化程度並未隨年齡增長有顯著變化，有別於正常發展組在此腦區的活化有顯著上升趨勢。更重要的是，迴歸分析結果發現ADHD組在第一次掃描的dACC活化情形得以預測其在作業表現的進步幅度。這些結果顯示當ADHD的孩童邁入青少年時期後，dACC活化的增長可能涉及了行為監控的成熟，此能力也與抑制控制的發展有高度相關；相對地，rIFG活化仍保持低落，意味著反應抑制的能力尚未發展成熟，與同年紀的正常發展青年相比仍嚴重落後。

關鍵字

注意力不足過動症；功能性核磁共振造影；抑制控制；數字史楚普作業；縱貫性研究

並列摘要

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) have much improvement in their inhibitory control as they reach adolescence. However, little is known about the neural substrates of such a neurocognitive change. To fill this gap, the current study aimed to use a longitudinal approach by using the counting Stroop task with functional magnetic resonance imaging (fMRI). In this study, 40 children with ADHD and 38 typically developing (TD) children (mean age: 11-year-old) were recruited. All participants received two scans while fulfilling a counting Stroop task in a 4-year interval. We examined the developmental change for the ADHD group compared with the TD group. The neuroimaging results revealed an interaction in both the dorsal anterior cingulate cortex (dACC) and right inferior frontal gyrus (rIFG). In particular, the dACC activity improved much from time 1 to time 2, but not fully normalized to the level of the TD group at time 2. By contrast, the rIFG activity in the ADHD group remained low throughout development, and this developmental change was deviant from that in the TD group. More importantly, the regression analysis indicated that the dACC activity at time 1 uniquely predicted the improvement of behavioral performance. Our findings suggest that when children with ADHD enter adolescence, their ability of monitoring performance enhances, which associates with the improvements in inhibitory control; their ability of response inhibition still lags behind age-matched counterparts.

並列關鍵字

Attention-Deficit/Hyperactivity Disorder (ADHD) ； counting Stroop task ； function magnetic resonance imaging (fMRI) ； inhibitory control ； longitudinal study

參考文獻

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健康與注意力不足過動症青年抑制控制之神經發展變化：數字史楚普測驗與功能性磁振造影研究

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