Tourette syndrome (TS) is a neurological disorder of childhood onset that is characterised by the occurrence of motor and vocal tics. TS is associated with cortical-striatal-thalamic-cortical circuit [CSTC] dysfunction and hyper-excitability of cortical limbic and motor regions that are thought to lead to the occurrence of tics. Importantly, individuals with TS often report that their tics are preceded by 'premonitory sensory/urge phenomena' (PU) that are described as uncomfortable bodily sensations that precede the execution of a tic and are experienced as a strong urge for motor discharge. While the precise role played by PU in the occurrence of tics is largely unknown, they are nonetheless of considerable theoretical and clinical importance, not least because they form the core component in many behavioural therapies used in the treatment of tic disorders. Several lines of evidence indicate that the insular cortex may play a particularly important role in the generation of PU in TS and 'urges-for-action' more generally. In the current study we utilised voxel-based morphometry techniques together with 'seed-to-voxel' structural covariance network (SCN) mapping to investigate the putative role played by the right insular cortex in the generation of motor tics and the experience of PU in a relatively large group of young people TS. We demonstrate that clinical measures of motor tic severity and PU are uncorrelated with one another, that motor tic severity and PU scores are associated with separate regions of the insular cortex, and that the insula is associated with different structural covariance networks in individuals with TS compared to a matched group of typically developing individuals.

中文翻译：

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岛叶在运动性抽动产生中的作用和抽动秽语综合征中先兆性抽动冲动的经历。

Tourette 综合征 (TS) 是一种儿童期发病的神经系统疾病，其特征是发生运动和声音抽动。TS 与皮质-纹状体-丘脑-皮质回路 [CSTC] 功能障碍和皮质边缘和运动区域的过度兴奋有关，这被认为会导致抽搐的发生。重要的是，患有 TS 的人经常报告说，他们的抽动之前会出现“先兆性感觉/冲动现象”（PU），这些现象被描述为在执行抽动之前感到不舒服的身体感觉，并被体验为强烈的运动放电冲动。虽然 PU 在抽动发生中的确切作用在很大程度上是未知的，但它们仍然具有相当大的理论和临床重要性，尤其是因为它们构成了许多用于治疗抽动障碍的行为疗法的核心组成部分。一些证据表明，岛叶皮质可能在 TS 中 PU 的产生和更普遍的“行动冲动”中发挥特别重要的作用。在目前的研究中，我们利用基于体素的形态测量技术和“种子到体素”结构协方差网络 (SCN) 映射来研究右岛叶皮层在运动性抽动产生中所起的推定作用和 PU 在比较大的一群年轻人TS。我们证明运动抽动严重程度和 PU 的临床测量彼此不相关，运动抽动严重程度和 PU 评分与岛叶皮层的不同区域相关，