從腦波分析探討興奮劑藥物對注意力不足過動症學齡兒童之療效

Electroencephalographic Evidence of Stimulant-Induced Improvements in School-Aged Children with Attention Deficit Hyperactivity Disorder

研究目的：興奮劑藥物是注意力不足／過動症（attention-deficit／hyperactivity disorder，ADHD）的主要治療方式。本研究採事件相關腦波（event-related oscillations，EROs）與腦區相關（coherence）分析藥物對ADHD兒童大腦活動效果。研究方法：本研究招募54位6-12歲ADHD兒童，依服藥與否分為服藥組與無服藥組。每位參與者均由研究者協助經歷兩階段（靜息態與認知作業）腦波儀檢查。人口學與臨床特徵的類別變項採卡方檢定，連續變項採用變異數分析。腦波資料則使用Mann-Whitney U檢定。研究結果：未服藥組33人（年齡8.18±2.01歲，男女比= 28：5）與服藥組21人（年齡8.81±1.78歲，男女比= 17：4）。靜息態下，服藥者全腦慢波頻段（即Alpha波以下）的神經活動明顯低於未服藥者。執行認知作業時，服藥兒童於額頂葉慢波頻段（即Delta、Theta與Alpha）的神經連結皆明顯高於未服藥組。研究結論：本研究發現，未服藥ADHD兒童易呈現心神漫遊（即低頻波較高）。相較之下，服藥ADHD兒童的大腦於休息與進行認知活動時，其腦內連結顯著較強。換言之，興奮劑藥物對ADHD學齡兒童的預備學習與注意力控制有明顯助益。

Purpose: The existing literature using electroencephalographic (EEG) measures (i.e., theta/beta ratios, resting-state absolute power, and event-related potentials) has supported the benefits of stimulant medication in the treatment of attention-deficit/hyperactivity disorder (ADHD). However, event-related oscillations (EROs), which provide advantages in capturing cognitive processing through time-frequency decomposition, remain underexplored as a tool in this domain. We investigated the differences in brain activity between medicated and unmedicated children with ADHD using EROs and EEG coherence analysis as a measure of functional brain connectivity. Methods: We recruited 54 children aged 6 to 12 years who had been diagnosed with ADHD by child psychiatrists. We divided them into 2 groups based on their treatment status: a medicated group (21 children, mean age = 8.81, male-to-female ratio = 17:4) and an unmedicated group (33 children, mean age = 8.18, male-to-female ratio = 28:5). Each participant underwent an electroencephalography (EEG) device recording with assistance from researchers and participated in 2 phases of the study: a 3-minute eyes-open resting state (EO-RS), and a cognitive task. We analyzed their demographic and clinical characteristics using chi-square tests for categorical variables and an ANOVA for continuous variables. We analyzed the EEG data using the Mann-Whitney U test. Results: During the EO-RS, the medicated group exhibited significantly lower power across the slow-wave frequency bands (Delta, Theta, and Alpha) than the unmedicated group. During the cognitive task, the medicated group showed significantly greater coherence in slow-wave bands between the frontal and parietal regions than the unmedicated group. Conclusion: These results indicate that unmedicated children with ADHD tend to let their minds wander, as reflected by the increased low-frequency power. In contrast, medicated children demonstrated stronger brain connectivity during EO-RS and cognitive tasks. In other words, stimulant medication appears to enhance brain readiness for learning and improve attention control in school-aged children with ADHD. These findings suggest that continuous monitoring of dynamic cognitive states and associated brain activity, indexed by EROs and coherence analyses, may serve as an ecologically valid and effective method for evaluating the treatment process.