Gilles de la Tourette syndrome is a multifaceted neurodevelopmental disorder characterized by multiple motor and vocal tics. Research in Tourette syndrome has traditionally focused on the motor system. However, there is increasing evidence that perceptual and cognitive processes play a crucial role as well. Against this background it has been reasoned that processes linking perception and action might be particularly affected in these patients with the strength of perception-action binding being increased. However, this has not yet been studied experimentally. Here, we investigated adult Tourette patients within the framework of the ‘Theory of Event Coding’ using an experimental approach allowing us to directly test the strength of perception-action binding. We included 24 adult patients with Tourette syndrome and n = 24 healthy control subjects using a previously established visual-motor event file task with four levels of feature overlap requiring repeating or alternating responses. Concomitant to behavioural testing, EEG was recorded and analysed using temporal signal decomposition and source localization methods. On a behavioural level, perception-action binding was increased in Tourette patients. Tic frequency correlated with performance in conditions where unbinding processes of previously established perception-action bindings were required with higher tic frequency being associated with stronger perception-action binding. This suggests that perception-action binding is intimately related to the occurrence of tics. Analysis of EEG data showed that behavioural changes cannot be explained based on simple perceptual or motor processes. Instead, cognitive processes linking perception to action in inferior parietal cortices are crucial. Our findings suggest that motor or sensory processes alone are less relevant for the understanding of Tourette syndrome than cognitive processes engaged in linking and restructuring of perception-action association. A broader cognitive framework encompassing perception and action appears well suited to opening new routes for the understanding of Tourette syndrome.

中文翻译：

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图雷特综合症的知觉-动作结合增加。

Gilles de la Tourette综合征是一种多发性神经发育障碍，其特征是多发运动和发声抽动。传统上，对抽动秽语综合征的研究集中在运动系统上。但是，越来越多的证据表明，感知和认知过程也起着至关重要的作用。在这种背景下，有理由认为，在这些患者中，将感知－行动结合的强度提高了，可能会特别影响连接感知和行动的过程。但是，这还没有进行实验研究。在这里，我们使用实验方法在“事件编码理论”框架内调查了成年的抽动症患者，从而使我们能够直接测试知觉-动作结合的强度。我们纳入了24名患有抽动秽语综合征的成年患者，其中n = 24名健康对照受试者使用先前建立的视觉运动事件文件任务，具有四个级别的特征重叠，需要重复或交替响应。伴随行为测试，使用时间信号分解和源定位方法记录并分析了脑电图。在行为水平上，图雷特患者的知觉-动作结合增加。在需要先前建立的知觉-动作结合的解除结合过程的条件下，tic频率与性能相关，而较高的tic频率与较强的知觉-动作结合相关。这表明知觉行为结合与抽动的发生密切相关。对脑电数据的分析表明，不能基于简单的感知或运动过程来解释行为改变。代替，将知觉与下顶叶皮层的动作联系起来的认知过程至关重要。我们的研究结果表明，仅运动或感觉过程与对图雷特综合症的理解没有相关性，而与参与感知和行动关联的重组和认知过程相关。涵盖感知和行动的更广泛的认知框架似乎非常适合为理解图雷特综合症开辟新途径。