根據國立陽明大學論文”學齡前男女兒童注意力及活動量與自主神經活性相關性研究”發現副交感HF與對立性反抗、注意力不集中及過動症狀呈現顯著正相關；反之LF％及LF/HF與SNAP-IV量表各次量表及加總分數呈現顯著負相關，其中以LF /HF相關最大
Autonomic Activity and Attention/Activity Intensity in Preschool-Age Children

國立陽明大學博碩士論文全文影像檢索系統 作者: 王宗熙
Tzong-Shi Wang 關鍵詞: 學齡前兒童;心率變異性;注意力;活動量;性別差異;自主神經;男女差異
preschool age children;SNAP-IV;heart rate variability;autonomic activity;gender difference 日期: 2009-10-22 上傳時間: 2009-10-22T13:24:24Z 摘要: 目 的：確認學齡前男女兒童自主神經活性變化與注意力及活動量之相關性及男女差異。 方法：本研究針對平均年齡5.61± 0.56歲學齡前兒童88人，男女比1: 1.1， 測量其白天5分鐘心率變異性(Heart Rate Variability; HRV)所得參數，如極低頻(Very Low Frequency, VLF, 0.003-0.004 Hz)、低頻(Low Frequency, LF, 0.04-0.15 Hz)、高頻(High Frequency, HF, 0.15-1.0 Hz)、全頻(Total Power, TP)、變異度(Variance, Var)、低頻成分與高頻成分之比值(LF/HF)、低頻成分比值(LF%)、及高頻成分比值(HF%)和其家長及教師所填寫之注意力缺陷過動症中文版 Swanson, Nolan, and Pelham, Version IV (SNAP-IV)量表進行其相關性比較。結果：（1）家長與教師填寫之SNAP-IV量表，可分為注意力不集中、過動、對立性反抗、及注意力不集中及過 動症狀四種次量表及總分等五個分數，其中男女之間之家長與教師版SNAP-IV量表，男生除父母版之對立性反抗分量表外，其餘各分量表分數及總分皆比女生 較高；而HRV參數男女兼併無明顯差異。（2）以皮爾森相關統計分析方法檢驗兩者相關性結果發現：在父母版的SNAP-IV量表與HRV參數相關研究中發 現：HF與對立性反抗、注意力不集中及過動症狀、和總分數及 HF％與SNAP-IV量表各次量表及加總分數呈現顯著正相關；LF％及LF/HF與SNAP-IV量表各次量表及加總分數呈現顯著負相關，其中以LF /HF相關最大。（3） 而老師版的SNAP-IV量表與HRV參數相關研究中，則有些不同，其結果僅LF％與注意力不集中、和注意力不集中及過動症狀及LF/HF與SNAP- IV各次量表及總分數呈現顯著負相關。（4）將男女分開分析，發現男生比女生有較高的SNAP-IV分數，且各分量表及總分與HRV參數之相關現象只存在 於男生組中。結論：過去許多相關研究曾討論及證明注意力不集中及過動症疾患其自主神經反應度較正常控制組低。此研究反應出於健康學齡前兒童注意力較不集 中、活動量較大者、或有較多對立性反抗行為者，交感神經活性較低，而副交感神經偏高有關，其中並以交感神經功能變化較為顯著，且男性比女性更加顯著，顯示 自主神經功能與學齡前兒童注意力及活動量有顯著關係。 關鍵字： 學齡前兒童、男女差異、自主神經、心率變異性、注意力、活動量、性別差異
Objective: to investigate the relationship and gender difference between heart rate variability and activity rating scale scores (SNAP-IV) in preschool-age children. Methods: We estimated autonomic reactivity on preschool-age children by power spectrum analysis of heart rate variability (HRV). Swanson, Nolan and Pelham parents and teachers rating scale (SNAP-IV), Chinese version was applied to evaluate each subject’s severity of symptoms related to inattention, hyperactivity, and oppositional defiant disorder. The association between HRV parameters including variance, very low-frequency power (VLF, 0.003-0.04 Hz), LF (0.04-0.15 Hz), HF (0.15-1.0 Hz), LF/HF, normalized HF (HF%) and LF (LF%) and scores of SNAP-IV parents and teachers subscales and scales was calculated and two-sided by SPSS version 15.0 software. Results: (1) After dividing all subjects into two groups by gender difference, the boys’ group had significantly higher scores in SNAP-IV scales, parent and teacher forms than the girls’ one except ODD subscale in SNAP-IV parent form. No gender difference was found in HRV measurement (2) Between scores of SNAP-IV parent form and HRV measurements, the results of Pearson’s correlation analysis revealed that scores of four subscales and total scale of SNAP-IV parent form except impulsivity subscale had positive association with HF. All scores of SNAP-IV parent form scales had positive association with HF%. Scores of four subscales and total scales of SNAP-IV parent form had more identically negative association with LF% and LF/HF (3). Scores of inattention and ADHD subscales of SNAP-IV teacher form had merely negative association with LF%, but scores of four subscales and total scales of SNAP-IV teacher form had significantly negative association with LF/HF ratio of HRV measurements (4) The scores of four subscales and total scale of the boys’ SNAP-IV parent and teacher forms except ODD subscale of SNAP-IV teacher form had significantly negative association with LF% and LF/HF ratio. The scores of all scales of the boys’ SNAP-IV parent and teacher forms except ODD subscale of SNAP-IV teacher form showed positive association with HF%, but only ADHD subscale and total scale of SNAP-IV parent form had the same correlation with HF. The girls’ group did not have the same findings. Conclusions: Most studies investigate HRV in ADHD children, and the results showed less autonomic reactivity under stress task. In this study, we illustrate that preschool-age children who are more inattentive and hyperactive tend to have less sympathetic modulation and more parasympathetic activity. In addiction, the boys’ group contributed to our main findings more than girls’ one. These might implicate that autonomic reactivity have gender differences in inattention and hyperkinetic pathogenesis. Key Words: preschool age children, gender difference, autonomic activity, heart rate variability, SNAP-IV 關聯: http://140.113.39.130/cgi-bin/gs/ymgsweb.cgi?o=dymcdr&i=sGYB121228635.id