Linking Brain and Behavior in Chronic Tic Disorder

描述（由申请人提供）：考虑到自愿抽动控制在经验支持的行为治疗中的作用，如习惯逆转训练（HRT）对慢性抽动障碍（CTDs）患者（包括图雷特综合征患者）的作用，抽动产生和抑制的神经回路尤为重要。尽管建立了研究基础，但CTDs的病因和病理生理学仍然知之甚少，现有的研究结果因样本量小、年龄范围广造成的发育影响、药物使用和未控制的精神共病而混淆。为了响应NIH R21对有可能推进生物医学研究的探索性或发展性研究的呼吁，我们建议应用一种创新的方法（移动脑/体成像[MoBI]）来表征CTDs中运动和冲动抑制的神经基质。MoBI方法包括同时记录和整合高清动作捕捉视频、皮质活动（脑电图）和肌肉运动（肌电图）。使用这一前沿技术将促进我们对运动启动和冲动抑制背后的神经基质的理解，并可能允许识别抽搐产生和抑制的假定生物标志物。目前的研究建议在48名8-12岁的儿童中使用MoBI方法，其中24名患有ctd， 24名年龄匹配的典型发育（TD）同龄人。我们将使用几个范例来模拟自主和非自主运动背后的神经基质，并测试相对于TD同行，CTDs是否涉及运动网络电路的定量或定性偏差。

DESCRIPTION (provided by applicant): The neural circuitry underlying tic production and suppression is particularly important given the role of voluntary tic control in empirically supported behavioral treatments such as Habit Reversal Training (HRT) for individuals with Chronic Tic Disorders (CTDs), including those with Tourette's Syndrome. Despite a building research base, the etiology and pathophysiology of CTDs remain poorly understood, with existing findings confounded by small sample sizes, developmental effects due to wide age range, medication usage, and uncontrolled psychiatric comorbidity. In response to the NIH R21 call for exploratory or developmental research that have the potential to advance biomedical research, we propose to apply an innovative approach (mobile brain/body imaging [MoBI] to characterizing the neural substrates underlying movement and urge suppression in CTDs. The MoBI approach involves the simultaneous recording and integration of high-definition motion capture video, cortical activity (electroencephalography; EEG) and muscle movements (electromyography; EMG). Use of this leading edge technology will advance our understanding of the neural substrates underlying movement initiation and urge suppression and may allow identification of putative biomarkers for tic generation and suppression. The current study proposes to use the MoBI approach on a sample of 48 children aged 8-12 years old, 24 with CTDs and 24 age-matched typically developing (TD) peers. We will use several paradigms to model the neural substrates underlying voluntary and involuntary movements and test whether CTDs involve quantitative or qualitative deviation in motor network circuitry relative to TD peers. Successful application of the MoBI approach to the problem of discovering and testing brain-based biomarkers for CTD is highly innovative in the context of current research, and also has clear potential for advancing clinical CTD research and practice.