Premonitory urges are associated with decreased grey matter thickness within the insula and sensorimotor cortex in young people with Tourette syndrome.
Premonitory urges are associated with decreased grey matter thickness within the insula and sensorimotor cortex in young people with Tourette syndrome.
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DOI：
10.1111/jnp.12089
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发表时间：
2016-03
影响因子：
2.2
通讯作者：
Jackson SR
中科院分区：
文献类型：
--
作者：
Draper A;Jackson GM;Morgan PS;Jackson SR
Tourette综合征（TS）是一种以发声和运动性抽搐为特征的神经系统疾病，其与皮质-纹状体-丘脑-皮质回路（CSTC）功能障碍以及皮质边缘和运动区的过度兴奋有关，被认为是导致抽搐发生的原因。重要的是，患有TS的个体经常报告他们的抽搐之前有“先兆感觉现象”（PSP），其被描述为在执行抽搐之前的不舒服的认知或身体感觉，并且被体验为对运动放电的强烈冲动。虽然PSP在抽搐发生中所起的确切作用存在争议，但PSP在TS中具有相当大的理论和临床重要性，尤其是因为它们是目前用于治疗抽动障碍的许多行为疗法的核心组成部分。在这项研究中，我们研究了PSP的脑结构相关性。具体来说，我们对29名患有TS的儿童和年轻人进行了皮质（灰质）厚度的全脑分析，并研究了灰质厚度与PSP之间的关系。我们首次证明，PSP是负相关的灰质厚度测量在大脑皮层和感觉运动皮层。我们还证明，与年龄和性别密切匹配的典型发育个体组相比，TS患者这些区域的灰质厚度显着减少，并且PSP评分与抽动严重程度显着相关。
Tourette syndrome (TS) is a neurological disorder characterized by vocal and motor tics and is associated with cortical–striatal–thalamic–cortical circuit (CSTC) dysfunction and hyperexcitability of cortical limbic and motor regions, which are thought to lead to the occurrence of tics. Importantly, individuals with TS often report that their tics are preceded by ‘premonitory sensory phenomena’ (PSP) that are described as uncomfortable cognitive or 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 PSP in the occurrence of tics is controversial, PSP are nonetheless of considerable theoretical and clinical importance in TS, not least because they form the core component in many of the behavioural therapies that are currently used in the treatment of tic disorders. In this study, we investigated the brain structure correlates of PSP. Specifically, we conducted a whole‐brain analysis of cortical (grey matter) thickness in 29 children and young adults with TS and investigated the association between grey matter thickness and PSP. We demonstrate for the first time that PSP are inversely associated with grey matter thickness measurements within the insula and sensorimotor cortex. We also demonstrate that grey matter thickness is significantly reduced in these areas in individuals with TS relative to a closely age‐ and gender‐matched group of typically developing individuals and that PSP ratings are significantly correlated with tic severity.