目的：注意力不足/過動症（Attention-Deficit/Hyperactivity Disorder, ADHD）為常見的神經發展疾患（neurodevelopmental disorder），對其長期適應造成廣泛性的影響，有進行治療的必要性。廖御圻、郭乃文、陳信昭、蔡幸芳、蘇倍儀（2015）建構結合神經回饋訓練與認知作業的自我監控式神經回饋模組Will Well Neurofeedback （WWNF），學齡期ADHD孩童進行WWNF後在注意力監控與日常生活行為上都有顯著的改善，且有初步的研究證實此WWNF訓練之療效持續性。然而，ADHD是一個異質性高的診斷，在內生表現型之客觀神經生理指標Theta/Beta Ratio(TBR)上亦有較高之TBR腦波次族群。且文獻發現ADHD受試者在NF之療效有所不同，基線期之腦波可能預測NF之療效。過去研究多以靜息狀態為腦波之測量，且對於TBR高次族群之功能探討較少，另，少有依據精準醫療的概念，探討基線期之腦波在NF治療療效不同。因此，本研究欲分析並探討在ADHD孩童WWNF之療效變異，並以前測時的基礎執行注意力之神經生理指標探討TBR腦波次族群，以討論功能間的差異，與WWNF治療對於不同腦波型態是否有不同程度的療效。
方法：本研究分為三大部分，第一部分欲探討過去治療個案資料中(n=68)，整理並分析8~12歲的ADHD個案(n=44)，以討論NF治療對於ADHD之療效變異。正常組則為配對人口學變項後之46名正常發展孩童。所有參與者進行問卷填寫、神經心理衡鑑，並測量腦波，以獨立樣本t檢定探討ADHD組與正常組之功能差異。再者，ADHD組接受評估後，接受10週的WWNF訓練，並於結束訓練後的一週進行後測，以相依樣本t檢定探討ADHD組治療之療效並以前後測之差異值探討變異。第二部分以進行CNAT之集中注意力分測驗時之前額葉的TBR數值，將ADHD組分為21位(47.7%)TBR高組與23位(52.3%)TBR低組探討其神經心理與日常生活功能之差異。第三部分探討WWNF後，TBR腦波次族群在神經心理與日常生活功能之療效差異。
結果：（1）ADHD組在WWNF後，前後測差異值之標準差大；於神經心理功能層次（注意力之衝動錯誤、漏失錯誤、違反錯誤指標；彈性、計畫能力）、日常功能層次之指標上皆有顯著提升之療效。（2）TBR高組雖在日常行為功能層次沒有顯著的比TBR低組來得差，不過在CNAT之搜尋、抗拒分心、轉逆注意力分測驗上有顯著較多的衝動錯誤數，於轉逆分測驗上有較多的漏失錯誤數。（3）TBR高組與TBR低組在以神經心理治療為基礎的神經回饋訓練後在神經心理功能、日常行為功能皆有顯著的進步，兩組之療效並無顯著差異。然而，尤其TBR高組在集中注意力分測驗上之衝動錯誤與反應時間變異率以及轉逆注意力之反應時間與變異率療效不如預期。
結論：（1）ADHD個案在WWNF後個別療效差異大，尤其是在執行注意力上。（2）相比與過去之行為與症狀表現之評估，TBR指標可能作為預測ADHD在衝動控制上的困難，並作為不同腦波次族群之證據。（3）在療效部分，有較高TBR的ADHD進步之功能不穩定，建議可根據其困難（集中注意力、彈性轉換等）進行個別化治療之計畫，以達到精準醫療。而TBR低之ADHD較合適於使用WWNF進行治療。未來研究仍需更大樣本數的探討，以了解神經生理指標之測量作為預後之指標。

ADHD is a heterogeneous disorder, and there might be a subgroup of elevated Theta/Beta Ratio (TBR). The effectiveness of treatment might be affected by initial neurological function difficulties and baseline EEG. Therefore, in the present study, we included a total of 44 ADHD subjects from 8~12 years old, and separated them into two subgroups based on prefrontal TBR value at baseline, which are 21 subjects (47.7%) in TBR-high subgroup and 23 subjects (52.3%) in TBR low subgroup in order to compared the difference of functions and effectiveness after treatment between two subgroups. All participants filled out questionnaires, tested with neuropsychological assessment, and recorded EEG. The result showed that TBR-high subgroup has more errors on executive attention assessment, especially inhibition error.Moreover, even though there are significant improvements for both TBR high and low subgroup on the level of neuropsychological function and daily-life behavior,the effectiveness on sustained attention and alternative attention are worse than pretest in TBR-high subgroup.The elevated TBR might be a feasible marker to predict inhibition control problem in ADHD.ADHD with lower TBR might be more suitable for the WWNF treatment, and it is recommended to alternate individual treatment module base on problems(sustained attention, flexibility, etc.) in ADHD with elevated TBR.

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