Tourette syndrome is a common neurodevelopmental disorder defined by characteristic involuntary movements, tics, with both motor and phonic components. Tourette syndrome is usually conceptualized as a basal ganglia disorder, with an emphasis on striatal dysfunction. While considerable evidence is consistent with these concepts, imaging data suggest diffuse functional and structural abnormalities in Tourette syndrome brain. Tourette syndrome exhibits features that are difficult to explain solely based on basal ganglia circuit dysfunctions. These features include the natural history of tic expression, with typical onset of tics around ages 5 to 7 years and exacerbation during the peri-pubertal years, marked sex disparity with higher male prevalence, and the characteristic distribution of tics. The latter are usually repetitive, somewhat stereotyped involuntary eye, facial and head movements, and phonations. A major functional role of eye, face, and head movements is social signalling. Prior work in social neuroscience identified a phylogenetically conserved network of sexually dimorphic subcortical nuclei, the Social Behaviour Network, mediating many social behaviours. Social behaviour network function is modulated developmentally by gonadal steroids and social behaviour network outputs are stereotyped sex and species specific behaviours. In 2011 O’Connell and Hofmann proposed that the social behaviour network interdigitates with the basal ganglia to form a greater network, the social decision-making network. The social decision-making network may have two functionally complementary limbs: the basal ganglia component responsible for evaluation of socially relevant stimuli and actions with the social behaviour network component responsible for the performance of social acts. Social decision-making network dysfunction can explain major features of the neurobiology of Tourette syndrome. Tourette syndrome may be a disorder of social communication resulting from developmental abnormalities at several levels of the social decision-making network. The social decision-making network dysfunction hypothesis suggests new avenues for research in Tourette syndrome and new potential therapeutic targets.

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抽动秽语综合征：社会决策网络的障碍

抽动秽语综合征是一种常见的神经发育障碍，由特征性非自愿运动，抽动症，运动和语音成分共同定义。抽动秽语综合征通常被概念化为基底神经节疾病，侧重于纹状体功能障碍。尽管大量证据与这些概念相符，但影像数据表明在Tourette综合征大脑中弥漫性功能和结构异常。抽动秽语综合征表现出仅基于基底神经节功能障碍难以解释的特征。这些特征包括抽动表达的自然历史，典型的抽动发生在5至7岁左右，并在青春期前后加剧，明显的性别差异和较高的男性患病率，以及抽动的特征分布。后者通常是重复的，刻板的非自愿眼，面部和头部运动以及发声。眼睛，面部和头部运动的主要功能角色是社交信号。社会神经科学领域的先前工作确定了性双态皮层下核的系统发育保守网络，即社交行为网络，该网络介导了许多社交行为。性行为类固醇在发育过程中调节了社会行为网络的功能，社会行为网络的输出是刻板的性别和特定物种的行为。2011年，O'Connell和Hofmann提出，社会行为网络与基底神经节相互交叉，形成一个更大的网络，即社会决策网络。社会决策网络可能具有两个功能互补的分支：基底神经节部分负责评估与社会相关的刺激和行为，而社会行为网络部分负责执行社会行为。社会决策网络功能障碍可以解释图雷特综合症神经生物学的主要特征。抽动秽语综合征可能是社交决策网络中多个级别的发育异常导致的社交沟通障碍。社会决策网络功能障碍假说为图雷特综合症的研究和新的潜在治疗靶点提供了新的途径。抽动秽语综合征可能是社交决策网络中多个级别的发育异常导致的社交沟通障碍。社会决策网络功能障碍假说为图雷特综合症的研究和新的潜在治疗靶点提供了新的途径。抽动秽语综合征可能是社交决策网络中多个级别的发育异常导致的社交沟通障碍。社会决策网络功能障碍假说为图雷特综合症的研究和新的潜在治疗靶点提供了新的途径。