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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 周泰立(Tai-Li Chou) | |
dc.contributor.author | Seng Chia | en |
dc.contributor.author | 謝成 | zh_TW |
dc.date.accessioned | 2021-05-15T18:00:53Z | - |
dc.date.available | 2017-03-12 | |
dc.date.available | 2021-05-15T18:00:53Z | - |
dc.date.copyright | 2015-03-12 | |
dc.date.issued | 2014 | |
dc.date.submitted | 2014-09-22 | |
dc.identifier.citation | References
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/5502 | - |
dc.description.abstract | 研究目的:Atomoxetine和methylphenidate是台灣以及許多其他國家用於治療注意力不足過動症(Attention Deficit/Hyperactivity Disorder, ADHD)僅有的兩種藥物。雖然這兩種藥物具有相似的藥效,過去許多臨床研究指出ADHD患者對這兩種藥物的臨床反應不盡相同,顯示兩者於藥理機制上具有差異存在。為了探討藥理機制和臨床藥效之間的關係,本研究作者觀察無用藥經驗的患童在長期接受藥物治療前後,在神經心理測驗及腦部活化程度的變化,以此針對兩種藥物進行直接比較研究。
研究方法:五十位未用藥ADHD患童(年齡介於7歲至17歲)被隨機分配服用atomoxetine(n=25)或methylphenidate (n=25),療程為十二星期。這些研究參與者在療程前後各接受一次功能性磁振造影的掃描,並同時進行數字Stroop測驗。另外,他們在每次掃描後會進行Conner’s Continuous Performance Test (CCPT),以評估其集中性注意力和衝動性在療程前後的變化。共有二十位atomoxetine療程的參與者,和二十二位methylphenidate療程的參與者完成最終的影像的分析。 研究成果:影像分析結果發現atomoxetine療程會降低背側前扣帶迴和背側前額葉皮質的活化程度,methylphenidate療程則是提升額下葉的活化程度。另外,前者腦區活化程度的改變,與參與者在集中性注意力的進步呈現正相關,而後者則與參與者於衝動性的減輕呈現正相關。 研究結論:本研究成果推論atomoxetine和methylphenidate於長期治療後的神經變化之差異,或許是導致每位ADHD患者對這兩種藥物臨床反應不一致的原因。 | zh_TW |
dc.description.abstract | Objective: Methylphenidate and atomoxetine are two primary medications approved for treating attention-deficit/hyperactivity disorder (ADHD). Despite comparable efficacy, clinical studies revealed a differential response of these medications, probably due to underlying distinct pharmacological mechanisms. To relate neural mechanisms to clinical efficacy, a head-to-head comparison study was conducted to discriminate changes in brain activation of drug-naive children with ADHD when performing neuropsychological tasks after long-term pharmacotherapy.
Method: Fifty drug-naive children with ADHD, aged 7 to 17, were randomized to 12 weeks of treatment with methylphenidate (n = 25) or atomoxetine (n = 25). They were scanned twice using functional magnetic resonance imaging (fMRI) during the counting Stroop task, before and after treatment. Their focused attention and impulsivity were also evaluated twice by the Conner’s Continuous Performance Test (CCPT). The final sample for fMRI analysis consisted of 20 and 22 in the methylphenidate and atomoxetine groups, respectively. Results: Atomoxetine down-regulated activations in the dorsal anterior cingulate cortex and dorsolateral prefrontal cortex, which were correlated with the improvement in focused attention assessed by the CCPT. In contrast, methylphenidate up-regulated activation in the inferior frontal gyrus, which was correlated with decreasing severity of impulsivity assessed by the CCPT. Conclusions: The current findings suggest that differential chronic therapeutic effects on neuronal changes induced by atomoxetine and methylphenidate may contribute to clinical improvement. | en |
dc.description.provenance | Made available in DSpace on 2021-05-15T18:00:53Z (GMT). No. of bitstreams: 1 ntu-103-R01454002-1.pdf: 3080493 bytes, checksum: b5710fefa49d9c6b170fbdf89aaeb58a (MD5) Previous issue date: 2014 | en |
dc.description.tableofcontents | 目錄
口試委員會審定書 i 誌謝 ii 中文摘要 iii Abstract v 1. Introduction 1 1.1 Attention-deficit/hyperactivity disorder (ADHD) 1 1.2 Clinical and pharmacological differences between atomoxetine and methylphenidate 1 1.3 Findings and limitations of previous imaging studies 2 1.4 Hypothesis of current study 4 2. Methods 5 2.1 Participants and procedures 5 2.2 Clinical Performance 7 2.3 Conners’ Continuous Performance Test (CCPT) 7 2.4 Functional activation task 8 2.5 MRI image acquisition 8 2.6 Image and statistical analysis 9 3. Results 11 3.1 Sample description and medication 11 3.2 Clinical and behavioral results 11 3.3 fMRI results 12 3.4 Correlations between brain activation and behavioral performance 13 4. Discussion 14 4.1 Summary of findings 14 4.2 Down-regulation of activation in DLPFC and ACC by atomoxetine 14 4.3 Up-regulation of activation in IFG by methylphenidate 17 4.4 Limitations 18 4.5 Strengths and novelties 18 4.6 Conclusions 19 References 20 Figures 27 Tables 32 Supplementary Tables 39 | |
dc.language.iso | zh-TW | |
dc.title | Atomoxetine與Methylphenidate對未用藥注意力不足過動症患童的長期療效之差異:數字Stroop測驗的功能性磁振造影研究 | zh_TW |
dc.title | Differential chronic therapeutic effects of
atomoxetine and methylphenidate on drug-naive children with attention-deficit/hyperactivity disorder: a counting Stroop functional MRI study | en |
dc.type | Thesis | |
dc.date.schoolyear | 103-1 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 高淑芬(Susan Shur-Fen Gau) | |
dc.contributor.oralexamcommittee | 吳恩賜(Joshua Oon-Soo Goh),藍先元(Hsien-Yuan Lane) | |
dc.subject.keyword | 數字Stroop測驗,功能性磁振造影,CCPT,衝動抑制,集中性注意力,atomoxetine,methylphenidate, | zh_TW |
dc.subject.keyword | counting Stroop fMRI,CCPT,inhibitory control,focused attention,atomoxetine,methylphenidate, | en |
dc.relation.page | 45 | |
dc.rights.note | 同意授權(全球公開) | |
dc.date.accepted | 2014-09-23 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 腦與心智科學研究所 | zh_TW |
顯示於系所單位: | 腦與心智科學研究所 |
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