Tourette syndrome (TS) is a neurological disorder of childhood onset that is characterized 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. 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 as they form a core component of many behavioural therapies used in the treatment of tic disorders. Recent evidence indicates that the cingulate cortex may play an important role in the generation of PU in TS, and in ‘urges-for-action’ more generally. In the current study, we utilized voxel-based morphometry (VBM) techniques, together with ‘seed-to-voxel’ structural covariance network (SCN) mapping, to investigate the putative role played by the cingulate cortex in the generation of motor tics and the experience of PU in a relatively large group of young people with TS. Whole-brain VBM analysis revealed that TS was associated with clusters of significantly reduced grey matter volumes bilaterally within: the orbito-frontal cortex; the cerebellum; and the anterior and mid-cingulate cortex. Similarly, analysis of SCNs associated with bilateral mid- and anterior cingulate ‘seed’ regions demonstrated that TS is associated with increased structural covariance primarily with the bilateral motor cerebellum; the inferior frontal cortex; and the posterior cingulate cortex.

中文翻译：

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扣带回皮层在运动性抽动发生中的作用和抽动秽语综合征前驱性抽动的体验

抽动秽语综合征 (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发声抽搐。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，这些区域被认为会导致抽搐的发生。患有 TS 的人经常报告说，他们的抽搐之前有“预感/冲动现象”（PU），这些现象被描述为在抽搐执行之前的不舒服的身体感觉，并且被体验为强烈的运动放电冲动。虽然 PU 在抽动发生中所起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，因为它们构成了用于治疗抽动障碍的许多行为疗法的核心组成部分。最近的证据表明，扣带回皮层可能在 TS 中 PU 的产生中起重要作用，并且更普遍地在“行动冲动”中起重要作用。在目前的研究中，我们利用基于体素的形态计量学 (VBM) 技术以及“种子到体素”结构协方差网络 (SCN) 映射来研究扣带回皮层在运动抽搐和PU在相对较大的TS青少年群体中的体验。全脑 VBM 分析显示，TS 与双侧灰质体积显着减少的簇相关：眶额皮质；小脑；和前扣带皮层和中扣带皮层。同样，对与双侧中部和前部扣带回“种子”区域相关的 SCN 的分析表明，TS 与主要与双侧运动小脑的结构协方差增加；下额叶皮层；和后扣带皮层。