以功能性磁振造影研究大學生網路成癮之認知神經機轉

The Functional Magnet Resonance Image Study for Neurocognitive Mechanism of Internet Addiction among College Students.

柯志鴻(Chih-Hung Ko)

指導教授 ： 劉金昌 ； 蕭世朗 ； 楊明仁

高雄醫學大學/醫學院/醫學研究所/博士(2009年)

摘要

隨著網路科技的進步與普及，網路成癮已經成為資訊全球化過程中重要的身心問題之一。然而，由於網路成癮近年來才逐漸被注意，對於網路成癮行為失控之機轉，目前仍缺乏明確之結論。而在眾多的假設當中，將網路成癮視為一種行為成癮，而與物質依賴具有類似的機轉，是最被重視的假設之一。但是，除了流行病學的研究外，這個假設仍缺乏神經生物學研究的支持。本研究之目的即在以功能性磁振造影及認知神經工具來探討網路成癮之神經認知機轉是否與物質依賴一致。本研究假設：1.網路成癮具有與物質使用疾患相似之渴求(craving)反應；2.網路成癮者具有顯著之決策(decision making)缺陷；3.網路成癮者具有反應抑制(response inhibition)之缺陷；4.經由注意力偏誤之機轉，遊戲渴求將惡化網路成癮者反應抑制之缺陷。本研究以大學生為研究對象，先於功能性磁振造影之觀察下，以遊戲圖片誘發網路遊戲渴求，來觀察網路成癮者渴求之腦神經反應，結果顯示，網路遊戲成癮者具有與物質依賴近似之渴求表現。再以愛荷華博弈測驗觀察網路成癮者是否具有與物質依賴者相同之決策缺陷。然而，結果顯示網路成癮者並沒有明顯的決策缺陷，依據結果推論其決策較易受酬償或處罰所產生之身體化標記(somatic marker)之影響。最後以功能性磁振造影觀察網路遊戲成癮者進行反應抑制時之功能表現，同時，以遊戲線索加以干擾，以驗證注意力偏誤之機轉。結果顯示，無法顯示網路成癮者有顯著之反應抑制缺陷，但於遊戲之干擾下，呈現顯著之反應抑制功能下降。顯示，網路遊戲成癮者有注意力偏誤之傾向。上述結果顯示，網路成癮具有與物質依賴類似之神經機轉，例如渴求或注意力偏誤，但其認知能力如決策能力或反應抑制之能力則無顯著缺陷，顯示在成癮的機轉上近似於物質依賴，但是否會造成認知能力之缺損，則無法證實。此結果建議，治療網路遊戲成癮者須注意渴求之症狀及注意力偏誤之傾向，來建立有效之處置。而針對認知能力之影響，則需要更多的研究加以調查。

關鍵字

網路成癮 ； 功能性磁振造影 ； 渴求 ； 決策 ； 反應抑制 ； 注意力偏誤

並列摘要

The Intenret addiction became one of the most important mental heatlh problems under the globalization of Internet in these years. Until now, the underlining neurocognitive mechanisms of Internet addiction were not comprehensive understood. Internet addiction was suggested to be one type of behavior addiction and own the underline mechanism similar to substance dependence. However, the hypothesis had not been proved by neurobiological study. In this study, we hypothesized that: 1. the college students with Internet gaming addiction had craving response as which of substance use disorder; 2. the college students with Internet addiction had deficit on decrision making as those with substance use disorder; 3. they had the deficit on response inhibition; 4. based on the mechanism of attention bias, the response inhibition would be impaired by the cue induced craving response. We firstly investigated the gaming cue induced craving response with brain functional Magnetic Resonance Imaging (fMRI). The result demonstrated the brain response of gaming urge provoked by gaming picture was identical to substance craving. Then, the IOWA gambling task was utilized to evaluate the deficit of decision making of college students with Internet addiction. The result showed that the college students with Internet addiction did not have deficit on decision making. However, the result also suggested that their decision making was vulnerable to the effect of somatic marker. Lastly, we investigated the function of response inhibition with brain fMRI for college students with online gaming addiction. Besides, we also investgated the baising effet of cue induced craving response on the function of response inhibition. The result could not confirm the deficit of response inhibition among collge students with Intenret gaming addiction. However, the brain activiation of response inhibition was impaired by the cue induced activity. These results suggested that Internet addiction had share some mechanism of addiction such as craving and attention bias with substance use disorder. On the other hand, this study did not prove the deficit on cognition ability among college students with Internet addiction. Our reesarches indicated that the craving response and attention bias should be intervened for college students with Internet addiction. Besides, the impairment of cognition ability should be further evaluated in future.

並列關鍵字

Internet addiction ； functional magnetic resonance imaging ； craving ； decision making ； response inhibition ； attention bias

參考文獻

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