Linking Brain and Behavior in Chronic Tic Disorders

摘要 神经回路潜在的先兆冲动和抽搐抑制是特别重要的，因为 自愿抽动控制在改善生活质量和增强经验支持的有效性中的作用 行为治疗，如慢性抽动障碍患者的习惯保持训练（HRT） （CTDs），包括那些患有Tourette综合征的人。尽管建立了研究基地， CTD的病理生理学仍然知之甚少，现有的发现被小样本量所混淆， 由于广泛的年龄范围、药物使用和不受控制的精神病合并症而引起的发育影响。在 在当前的项目中，我们建议采用一种创新的方法（移动的脑/体成像[MoBI]）， 表征CTD中先兆冲动和抽搐抑制的神经基质。MoBI 方法涉及同时记录和集成的高清晰度运动捕捉视频，皮层 活动（脑电图; EEG）和肌肉运动（肌电图; EMG）。使用此引导 边缘技术将促进我们对冲动抑制背后的神经基质的理解， 允许鉴定先兆冲动和抽搐抑制的推定生物标志物。目前的研究 建议使用MoBI方法对175名8-12岁的儿童，125名CTD和50名儿童进行抽样。 年龄匹配的健康对照（HC）同伴。我们将使用几种范例来模拟神经基质 潜在的自愿和不自愿运动，并测试CTD是否涉及定量或定性 运动网络电路相对于HC同龄人的偏差。成功应用MoBI方法， 发现和测试CTD的基于大脑的生物标志物的问题在以下背景下是高度创新的： 目前的研究，也有明确的潜力，为推进临床CTD的研究和实践。

Abstract The neural circuitry underlying premonitory urge and tic suppression is particularly important given the role of voluntary tic control in improved quality of life and enhanced effectiveness of 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 the current project, we propose to apply an innovative approach (mobile brain/body imaging [MoBI] to characterizing the neural substrates underlying premonitory urge and tic 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 urge suppression and may allow identification of putative biomarkers for premonitory urge and tic suppression. The current study proposes to use the MoBI approach on a sample of 175 children aged 8-12 years old, 125 with CTDs and 50 age-matched healthy control (HC) 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 HC 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.