注意力缺陷過動症（ADHD）是一種神經行為發育缺陷的疾病，在台灣約有7.5％的兒童會罹患此種病症。許多磁振影像相關研究結果已顯示，ADHD患者在部分灰質出現體積的萎縮以及某些皮質區域發生功能障礙。近年來，使用擴散梯度的磁振擴散影像已被用來研究在中樞神經系統方面的神經纖維異常之疾病。而本研究即利用擴散張量影像來偵測ADHD患者與其年齡相仿的正常人在大腦白質上水分子的擴散非等向性，並進行受試者間的群體比較。
在本研究中透過兩個不同的群體比較方式，VBM與TBSS進行分析發現，患有ADHD病症的青少年和正常受試者相較之下在白質的FA數值有顯著的減少(FWE修正後p值小於0.05)，主要發生顯著差異的區域零散分布於大腦白質上，這些區域涵蓋了中小腦腳(middle cerebellar peduncle)、左下縱束(left inferior longitudinal fasciculus)、內囊(internal capsule)、左視放射、外囊(external capsule)、胼胝體壓部(splenium of corpus callosum)、上縱束(superior longitudinal fasciculus)、上額葉(superior frontal)與枕-頂葉(parietal-occipital)底下神經纖維等。

Attention deficit hyperactivity disorder (ADHD) is a neurobehavior developmental disorder that affects around 7.5% of Taiwan children. With the use of magnetic resonance imaging , many results have been reported that ADHD patients have volume atrophy in gray matter and dysfunction in couples of cortical regions. In recent years, diffusion MR imaging with diffusion-sensitizing gradients has been used to investigate the abnormality of neural fibers in disease involved with central nervous system. In this study, the anisotropy of white matter in both ADHD patients and age-matched healthy subjects was estimated using diffusion tensor imaging to undergo inter-subject comparison.
In this work, a significant decrease (FWE-corrected p-value <0.05) of FA values has been found in white matter of adolescents diagnosed as ADHD patients, compared with normal controls group. The areas that confirmed by two different algorithms of inter-subject comparison are mainly diffused on white matter region, including middle cerebellar peduncle, left inferior longitudinal fasciculus, internal capsule, left optic radiation, external capsule, splenium of the corpus callosum, superior longitudinal fasciculus, superior frontal and parietal-occipital nerve fibers.

封面 i
中文學位論文審定書 ii
英文學位論文審定書 iii
誌謝 iv
中文摘要 v
英文摘要 vi
英文縮寫對照表 x
第一章 簡介 1
1.1 背景 1
1.2 文獻回顧 5
1.3 研究動機 7
第二章 擴散理論與受試者的群體比較方法 9
2.1 擴散張量影像 9
2.2 VBM：voxel-based morphometry 12
2.3 TBSS：tract-based spatial statistics 13
第三章 實驗與分析方法 19
3.1 實驗對象 19
3.2 原始影像取得 19
3.3 數據分析 20
3.3.1 擴散張量與非等向性計算(dtifit) 20
3.3.2 群組分析一：VBM流程 21
3.3.2群組分析二：TBSS流程 22
3.4 統計分析(statistical analysis) 23
第四章 實驗結果 25
第五章 結論 34
參考文獻 38

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