醫學院: 物理治療學研究所指導教授: 鄭素芳黃希文Huang, Hsi-WenHsi-WenHuang2017-03-032018-07-082017-03-032018-07-082016http://ntur.lib.ntu.edu.tw//handle/246246/273315前言與目的：抑制功能是執行功能中的核心功能之一。雖然過去文獻顯示正常發展兒童的抑制功能與其日後適應能力及學業表現有關，但有關學齡期極低出生體重早產兒童（出生體重低於1500克）之抑制功能以及與認知功能和學校表現關聯的研究則相當有限。因此本研究將使用相關電位事件分析比較極低出生體重早產兒童與足月兒童在學齡期的抑制功能，並探討抑制功能與認知功能以及學校表現的相關性。方法：本實驗共徵召19位極低出生體重早產兒童與34位足月兒童，測量其7歲時之抑制功能、認知功能與學校表現。本研究使用腦波/事件相關電位分析進行旁側抑制作業與按鍵反應作業，以及使用連續操作試驗測量其抑制功能；使用魏氏兒童智力量表第四版評估其認知功能，學校表現則使用在校學期成績。結果：學齡期極低出生體重早產兒在旁側抑制作業（783.4±143.8毫秒相較688.1±73.8毫秒, p=0.01）與按鍵反應作業的反應時間均顯著較足月兒為長（575.4±81.6毫秒相較524.4±65.8 毫秒, p=0.02）；早產兒在旁側抑制作業中的腦部N2最大振幅的差異較足月兒明顯為大（Cz：-2.02±3.99微伏特相較0.16±3.47微伏特, p=0.04; Pz：-2.37±5.61微伏特相較1.61±5.91微伏特, p=0.02）。同時早產兒的全量表智商（97.1±10.5相較108.2±14.5, p<0.01）及學業表現則明顯較足月兒為差（優等比例47%相較97% , p<0.01）。抑制功能參數中只有按鍵反應作業的反應時間與學業表現呈現顯著負相關（β[95%CI]= -0.03[-0.05至-0.01], p=0.02)。結論：學齡期極低出生體重早產兒童比足月兒童呈現較差的抑制功能、認知功能以及學業表現，而抑制功能中較長反應時間似乎是影響學業表現的因子之一。臨床應用：本研究的結果將提供重要訊息幫助了解極低出生體重學齡期早產兒童的抑制功能之神經電生理變化，以及未來提升在校學習及學業測驗的可能改善方向。Background and Purpose: Inhibitory control is the core ability of executive function that has been found to predict subsequent adaptive function and academic performance in school-aged children with normal development. Preterm children with very low birth weight (VLBW, birth weight <1,500 g) are at risk of cognitive impairment and poor academic performance at school age, however, the information concerning their inhibitory control and relation to cognition and academic performance has been limited. The aims of this study were therefore to examine the inhibitory control with electroencephalogram/event-related potential (EEG/ERP) and to assess its relation to cognition and academic performance in school-aged term children and VLBW preterm children. Methods: Nineteen seven-year-old VLBW preterm children and 35 age-matched term children were prospectively assessed for their inhibitory control using the flanker, go-nogo, and continuous performance tasks, cognitive function using the Wechsler Intelligence Scale for Children-4th edition, and school performance using the academic test performance among classmates. Results: VLBW preterm children exhibited significantly longer reaction time in the flanker (783.4±143.8 ms vs. 688.1±73.8 ms, p=0.01) and go-nogo tasks (575.4±81.6 ms vs. 524.4±65.8 ms, p=0.02), larger difference of N2 peak amplitude between congruent and incongruent trials in the flanker task (Cz: -2.02±3.99 μV vs. 0.16±3.47 μV, p=0.04; Pz: -2.37±5.61 μV vs. 1.61±5.91 μV, p=0.02), lower full-scale IQ score (97.1±10.5 vs. 108.0±14.5, p<0.01) and lower percent of excellent academic test performance than term children (47% vs. 97%, p<0.01). Furthermore, the reaction time of go-nogo task was the only factor significantly associated with the academic test performance in both preterm and term children (β[95%CI]= -0.03[-0.05 to -0.01], p=0.048). Conclusion: School-aged VLBW preterm children showed poorer inhibitory control ability, cognitive function and school performance than their term counterparts. The reaction time of inhibitory control partly contributed to the school performance in both preterm and term children. Implications: The results provide insightful information for understanding the neurophysiological mechanisms underlying inhibitory control and for planning academic learning and testing in school-aged VLBW preterm children.1682428 bytesapplication/pdf論文公開時間: 2019/8/26論文使用權限: 同意有償授權(權利金給回饋學校)早產抑制功能學業表現學齡期prematurityinhibitory controlschool performanceschool agethesis10.6342/NTU201602979http://ntur.lib.ntu.edu.tw/bitstream/246246/273315/1/ntu-105-R01428003-1.pdf