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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 李旺祚 | zh_TW |
| dc.contributor.advisor | Wang-Tso Lee | en |
| dc.contributor.author | 鍾伊淳 | zh_TW |
| dc.contributor.author | Yi-Chun Chung | en |
| dc.date.accessioned | 2021-07-11T15:28:00Z | - |
| dc.date.available | 2024-02-28 | - |
| dc.date.copyright | 2018-10-09 | - |
| dc.date.issued | 2018 | - |
| dc.date.submitted | 2002-01-01 | - |
| dc.identifier.citation | Association, A. P. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC.
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/78903 | - |
| dc.description.abstract | 研究背景：妥瑞氏症（Tourette Syndrome, TS）是一種神經發展性疾病。第一次發病年齡通常於4至6歲，在性別上是男生多於女生，比例約2:1-4:1。症狀會在十至十二歲最嚴重，青少年期開始會減輕。但也有少數患者的症狀會持續到成年甚至更嚴重。妥瑞氏症的主要症狀為抽動（tics），其抽動方式有可能是以動作（motor tics）或聲音（vocal tics）方式表示。大多數的妥瑞氏症患者會合併有注意力不足過動症（ADHD）、強迫症（OCD）及憂鬱症（depression）。在過去的研究中，對於妥瑞氏症的機轉還不是很確定，懷疑CSTC迴路（cortico-striato-thalamo-cortical circuits）是造成妥瑞氏症症狀的可能路徑。同時發現大腦體積的改變也不一致。
研究目的：為了了解這個疾病對大腦結構的影響，本研究利用磁振造影（magnetic resonance imaging, MRI）檢測患者的灰質體積，進一步以影像結果及症狀嚴重度作相關，以了解抽搐嚴重度與結構變化的關連性。並探討基底核（basal ganglia）與潛在機轉之CSTC迴路的關連性。 研究方法：本研究共招募27位妥瑞氏症及27位健康受試者，年齡範圍為6-15，其中分別有21位男生與6位女生。腦部影像是以磁振造影獲得影像結構資訊。大腦結構是利用FreeSurfer軟體進行分析。使用問卷做為評估篩選工具，評估抽動的嚴重程度、排除神經精神方面疾病。 研究結果：我們發現2位患者有合併注意力缺失症（attention deficit disorder, ADD）。在智力測驗發現患者子測驗─記憶廣度（digit span）有顯著低於健康受試者。基底神經結中，殼核（putamen）、伏隔核（accumbens nucleus）的體積與健康受試者相比有顯著不對稱的差異，前者不對稱較低、健康受試者不對稱較高。 在大腦皮質體積中有發現少數區域有改變，但當經過多重比較後，只有發現右邊殼核體積與左邊的前中央溝下面（inferior part of the precentral sulcus）表面積有顯著差異。同時我們也觀察大腦體積與症狀嚴重度沒有差異，但在動作抽搐（motor tics）有發現與左腦的橫向額極迴和溝（transverse frontopolar gyri and sulci）、胼胝體周圍溝（pericallosal sulcus）及右腦的胼胝體區，胼胝體迴（subcallosal area, subcallosal gyrus）正相關:與枕骨下迴和溝（inferior occipital gyrus (O3) and sulcus）負相關。聲音抽搐（vocal tics）發現與左腦直腦迴（straight gyrus）、前橫向側支溝（anterior transverse collateral sulcus）、眼眶溝（orbital sulci）跟頂葉下溝（subparietal sulcus）顯示出負相關。 研究結論：在過去的研究中也有指出殻核的不對稱，但在體積減少的結果卻不一致。殻核與伏隔核都是紋狀體（striatum）的一部份。這個結果可能顯示紋狀體在抽搐的調節扮演重要角色。雖然這個研究有一些限制，但我們相信這些發現可以對未來的研究有所幫助。 | zh_TW |
| dc.description.abstract | Background: The Tourette Syndrome (TS) is a neuropsychiatric and neurodevelopmental disease. The onset time is about 4 to 6 years. The boy to girl ratio is around 2: 1 to 4: 1. The peak severity of TS appears at age 10 to 12 years and then declines in adolescence. The tics symptoms of a few people will continue to adulthood, and the tics symptoms are more severe than before. The main symptoms of TS are tics, which are represented by motor tics or vocal tics. The majority of TS comorbid with attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and depression. The mechanism of TS has not been ascertained in the past studies. The cortico-striato-thalamo-cortical circuits (CSTC) circuits are suspected to be the pathway of symptoms in TS.
Proposes: To investigate the brain structural change in TS, we use magnetic resonance imaging (MRI) to detect the gray matter change in subjects. The correlation between the brain volume change and tics severity was done. Methods: We enrolled 27 TS and 27 healthy controls (HC), including 21 boys and 6 girls, respectively. The age ranged from 6 to 15 years. The structural imaging data from MRI were investigated. The brain structural imaging analysis was done using the FreeSurfer software. We also used the questionnaire as an assessment screening tool for tics severity and for excluding the neuropsychiatric diseases. Results: We found 2 TS comorbid with ADD. The full scale intelligence quotient (FSIQ) subtest of digit span was shown to be significant lower in TS compared with HC. We found the volume of putamen and accumbens nucleus had significant reduction of asymmetry in TS children compared with HC. We also found the region of cortical volume was altered in a few regions. However, after correction for multiple comparison, we only found the volume of right putamen and surface area of left inferior part of the precentral sulcus showed the significant difference. However, we found the left transverse frontopolar gyri and sulci, pericallosal sulcus, and right subcallosal area, subcallosal gyrus showed positive correlation with the severity of motor tics. The inferior occipital gyrus and sulcus negatively correlated with the severity of motor tics. We also found that the left straight gyrus, anterior transverse collateral sulcus, orbital sulci, and subparietal sulcus showed negative correlation with the severity of vocal tics. Conclusion: The changes of the brain volume in putamen and accumbens nucleus may indicate that the striatum plays an important role in tics regulation. Although this study had some limitations, we believe that these findings can be of some help for future research. | en |
| dc.description.provenance | Made available in DSpace on 2021-07-11T15:28:00Z (GMT). No. of bitstreams: 1 ntu-107-R05454016-1.pdf: 8333569 bytes, checksum: f5b4dd4c5f6b19c5eddd7baf78b2e799 (MD5) Previous issue date: 2018 | en |
| dc.description.tableofcontents | 目錄
中文摘要 I Abstract III I. Introduction 1 Neuroimaging change in Tourette syndrome 5 1.1 Frontal 6 1.2 Occipital and Temporal 9 1.3 Basal Ganglia 10 1.4 Thalamus 11 1.5 Striatum 12 1.6 Ventricle 15 1.7 Tics severity correlated of brain structure change 16 II. Material and Method 19 2.1 Participants 19 2.2 Image data acquisition and processing 20 Conventional MR imaging 20 2.3 Questionnaires 23 2.4 Statistical analysis 27 III. Results 29 3.1 Demographic data 29 3.2 Brain volume change 30 A. TS comparing to HC 30 B. In TS without comorbidity group 32 3.3 Brain cortical thickness change 34 A. TS comparing to HC 34 B. In TS without comorbidity group 34 3.4 Brain cortical surface area change 35 A. TS comparing to HC 35 B. In TS without comorbidity group 36 3.5 Brain volume correlate with tics severity 37 IV. Discussion 39 V. Conclusions 48 VI. Reference 49 VII. Appendix 55 Table 1. Demographic data 57 Table 2. WISC (IQ test) score 58 Table 3-1. Brain hemisphere volume change 59 Table 3-2. Brain hemisphere volume asymmetry 59 Table 4-1. Brain ventricle volume change 60 Table 4-2. Brain ventricle volume asymmetry ( 60 Table 5-1. Basal ganglia-related CSTC circuits 61 Table 5-2. Basal ganglia-related CSTC circuits asymmetry ( 61 Table 6-1. Suspected mechanism-motor 62 Table 6-2. Suspected mechanism-oculomotor 62 Table 6-3. Suspected mechanism-dorsolateral prefrontal 63 Table 6-4. Suspected mechanism-lateral orbitofrontal 63 Table 6-5. Suspected mechanism-anterior cingulate 64 Table 7. 4 lobes of the brain volume 65 Table 8-1. The sulco-gyral cortical brain volume change in the Left Hemisphere 66 Table 8-2. The sulco-gyral cortical brain volume change in the Right Hemisphere 70 Table 9-1. Brain hemisphere volume change in TS without comorbidity 74 Table 9-2. Brain hemisphere volume asymmetry ( in TS without comorbidity 74 Table 10-1. Brain ventricle volume change in TS without comorbidity 75 Table 10-2. Brain ventricle volume asymmetry ( in TS without comorbidity 75 Table 11-1. Basal ganglia-related CSTC circuits in TS without comorbidity 76 Table 11-2. Basal ganglia-related CSTC circuits asymmetry ( in TS without comorbidity 76 Table 12-1. Suspected mechanism-motor 77 Table 12-2. Suspected mechanism-oculomotor 77 Table 12-3. Suspected mechanism-dorsolateral prefrontal 78 Table 12-4. Suspected mechanism-lateral orbitofrontal 78 Table 12-5. Suspected mechanism-anterior cingulate 79 Table 13. 4 lobes of the brain volume in TS without comorbidity 80 Table 14-1. The sulco-gyral cortical brain volume change in the Left Hemisphere in TS without comorbidity 81 Table 14-2. The sulco-gyral cortical brain volume change in the Right Hemisphere in TS without comorbidity 85 Table 15. 4 lobes of the brain cortical thickness 89 Table 16-1. The sulco-gyral cortical thickness change in the Left Hemisphere 90 Table 16-2. The sulco-gyral cortical thickness change in the Right Hemisphere 94 Table 17. 4 lobes of the brain cortical thickness in TS without comorbidity 98 Table 18-1. The sulco-gyral cortical thickness change in the Left Hemisphere in TS without comorbidity 99 Table 18-2. The sulco-gyral cortical thickness change in the Right Hemisphere in TS without comorbidity 103 Table 19. 4 lobes of the brain surface area 107 Table 20-1. Change the sulco-gyral cortical surface area in the Left Hemisphere 108 Table 20-2. Change the sulco-gyral cortical surface area in the Right Hemisphere 112 Table 21. 4 lobes of the brain surface area in TS without comorbidity 116 Table 22-1. Change the sulco-gyral cortical brain surface area in the Left Hemisphere in TS without comorbidity 117 Table 22-2. Change the sulco-gyral cortical brain surface area in the Right Hemisphere in TS without comorbidity 121 Table 23-1 Correlation between motor tics and brain volume 125 Table 23-2 Correlation between vocal tics and brain volume 125 Figure 1-1. The right putamen area 126 Figure 1-2. The surface area of left inferior part of the precentral sulcus 127 Figure 2. Correlation between motor tics and brain volume in LH 128 Figure 3. Correlation between motor tics and brain volume in LH 129 Figure 4. Correlation between motor tics and brain volume in RH 130 Figure 5. Correlation between vocal tics and brain volume in LH 131 Figure 6. Correlation between vocal tics and brain volume in LH 132 | - |
| dc.language.iso | en | - |
| dc.title | 妥瑞氏症兒童大腦體積改變 | zh_TW |
| dc.title | Altered Brain Volume in Children with Tourette Syndrome | en |
| dc.type | Thesis | - |
| dc.date.schoolyear | 106-2 | - |
| dc.description.degree | 碩士 | - |
| dc.contributor.oralexamcommittee | 曾文毅;曾明宗;彭信逢 | zh_TW |
| dc.contributor.oralexamcommittee | Wen-I Tseng;Ming-Tsung Tseng;Hsin-Feng Peng | en |
| dc.subject.keyword | 妥瑞氏症,磁振造影,大腦表面積,大腦體積,大腦厚度,魏氏智力測驗,FreeSurfer, | zh_TW |
| dc.subject.keyword | Tourette syndrome,MRI,surface area,brain volume,cortical thickness,WISC,FreeSurfer, | en |
| dc.relation.page | 132 | - |
| dc.identifier.doi | 10.6342/NTU201804055 | - |
| dc.rights.note | 未授權 | - |
| dc.date.accepted | 2018-08-20 | - |
| dc.contributor.author-college | 醫學院 | - |
| dc.contributor.author-dept | 腦與心智科學研究所 | - |
| dc.date.embargo-lift | 2023-10-09 | - |
| 顯示於系所單位： | 腦與心智科學研究所 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-106-2.pdf 目前未授權公開取用 | 8.14 MB | Adobe PDF |
系統中的文件，除了特別指名其著作權條款之外，均受到著作權保護，並且保留所有的權利。