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Neuroimaging the Emotional Modulation of Urge Inhibition in Tourette Syndrome
Cortex ( IF 3.6 ) Pub Date : 2020-11-01 , DOI: 10.1016/j.cortex.2020.10.010
Tracy Bhikram 1 , Adrian Crawley 2 , Paul Arnold 3 , Elia Abi-Jaoude 4 , Paul Sandor 5
Affiliation  

Tourette Syndrome (TS) is a neuropsychiatric condition characterized by tics that are typically preceded by uncomfortable urges that build until the tic is performed. Both tics and their associated urges are commonly exacerbated during states of heightened emotion. However, the neural substrates that are responsible for the development of urges have not been fully elucidated, particularly with regards to the influence of emotion. In this study, we investigate the brain areas associated with the development of urges and their modulation by emotion in patients with TS. Moreover, we explore the influence of obsessive-compulsive symptoms (OCS) which are commonly comorbid in TS. Forty patients with TS and 20 healthy controls completed an emotional blink suppression paradigm while undergoing functional magnetic resonance imaging. For the paradigm, participants completed alternating blocks of blink inhibition and free blinking while viewing pictures of angry and neutral facial expressions. Compared to controls, patients exhibited greater activity in the superior temporal gyrus and midcingulate during the inhibition of urges. Within the patient group, tic severity was associated with activity in the superior frontal gyrus during the angry inhibition contrast as compared to neutral; greater premonitory urge severity was associated with greater activity in the hippocampus, middle temporal gyrus and in the subcortex; blink inhibition ability was negatively associated with activity in the thalamus and insula. There were no significant associations with OCS severity for the emotion-related contrasts. The observed activated regions may represent a network that produces urges in patients, or alternatively, could represent compensatory cortical activity needed to keep urges and tics under control during emotional situations. Additionally, our findings suggest that OCS in the context of TS is similar to traditional obsessive-compulsive disorder and is neurobiologically dissociable from tics.



中文翻译:

神经成像对抽动秽语综合征中抑制性冲动的情绪调节

抽动秽语综合症(TS)是一种神经精神疾病,其特征为抽动症,通常在抽动之前会产生不舒服的冲动。在情绪高涨的状态下,抽动症及其相关的冲动通常会加剧。然而,尚未完全阐明负责冲动发展的神经基质,特别是在情感影响方面。在这项研究中,我们调查了与TS患者冲动的发展及其情绪调节有关的大脑区域。此外,我们探索了强迫症(TSS)中常见的强迫症(OCS)的影响。40名TS患者和20名健康对照者在接受功能性磁共振成像的同时完成了情绪眨眼抑制范例。对于范式,参与者在观看生气和中性面部表情的图片时,完成了眨眼抑制和自由眨眼的交替练习。与对照相比,在抑制冲动的过程中,患者在颞上回和中齿显示了更大的活动。在患者组中,与中性相比,在愤怒抑制对比期间,抽动的严重程度与上额回的活动有关。监测前冲动的严重程度越高,海马,颞中回和皮层下层的活动越多;眨眼抑制能力与丘脑和岛状岛的活动负相关。与情绪相关的对比与OCS严重程度没有显着关联。观察到的激活区域可能代表一个在患者中产生冲动的网络,或者可以表示在情绪状况下控制冲动和抽动所需的补偿性皮层活动。此外,我们的研究结果表明,在TS中,OCS与传统的强迫症相似,并且在神经生物学上与抽搐无关。

更新日期:2020-11-02
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