Modulation of event file coding during response selection and inhibition by repetitive transcranial magnetic stimulation in GTS

在第一个资助期，几项研究支持了Gilles de la Tourette综合征（GTS）可以被概念化为异常感知-动作处理障碍的概念。在成人GTS患者中，临床症状与事件文件范例中的结合增加相关，该事件文件范例与顶叶下皮层（BA 40）的激活增加相关。此外，在GTS儿童和青少年中，发现多模式Go/Nogo任务中的抑制改变，并与BA 40区域的皮质活动增加相关。初步数据表明，1Hz重复经颅磁刺激（rTMS）可以有效地降低异常的皮层兴奋性，并改善症状时，应用于补充运动区（SMA）。然而，没有研究结合临床（如抽搐频率和严重程度）和行为/神经生理学结果的感觉运动整合过程的措施后，GTS的rTMS。因此，在本项目中，我们将在儿童/青少年和成人GTS患者中比较应用于SMA的抑制性、神经导航1 Hz rTMS与BA 40 rTMS的效果，并结合临床测量、行为表现沿着以及在反应选择和反应抑制的事件文件处理期间的伴随EEG记录。我们的目的是提供机制的见解顶叶和额叶皮层区域的异常感知动作整合在GTS在不同年龄组的反应选择和运动反应抑制的作用。这将为GTS的认知理论概念化转移到临床应用提供基础。

In the first funding period, several studies lent support to the notion that Gilles de la Tourette syndrome (GTS) can be conceptualized as a disorder of abnormal perception-action processing. Clinical symptoms were related to increased binding in an event file paradigm associated with increased activation in the inferior parietal cortex (BA40) in adult GTS patients. In addition, in children and adolescents with GTS altered inhibition in a multi-modal Go/Nogo task was found and associated with increased cortical activity in the BA40 region. Preliminary data has shown that 1Hz repetitive transcranial magnetic stimulation (rTMS) can effectively decrease abnormal cortical excitability and improve symptoms when applied to the supplementary motor area (SMA). However, there is no study combining clinical (e.g. tic frequency and severity) and behavioral/neurophysiological outcome measures of sensorimotor integration processes following rTMS in GTS. Therefore, in this project, we will compare the effects of inhibitory, neuronavigated 1 Hz rTMS applied to the SMA with those of BA40 rTMS both in children/adolescents and adults with GTS combining clinical measures, and behavioral performance along with concomitant EEG recordings during event file processing in response selection and response inhibition. We aim at providing mechanistic insights about the role of parietal and frontal cortical regions for abnormal perception-action integration in GTS during response selection and motor response inhibition in different age groups. This will provide the basis for a transfer of the cognitive-theoretical conceptualization of GTS into clinical applications.