Modulation of clinical phenomena and event file coding by repetitive transcranial magnetic stimulation

辅助运动区（SMA）和前SMA在动作选择和准备过程中活跃，主要是内部产生的动作，在不同动作之间切换和克服习惯性反应。刺激和反应特征的结合和解除结合以及反应转换是事件编码过程中的关键要素，因此SMA和预SMA激活预计与这些过程特别相关。与抽动和冲动相关的异常神经激活（即当前状态）已被记录在患有Gilles de la Tourette综合征（GTS）的SMA患者中。此外，许多研究表明，在包括SMA和前SMA的运动网络中存在异常的结构和功能连接。此外，反应转换，特别是参与前sma，在GTS中受损独立于抽动严重程度，因此成为可能的GTS特征标记。在这个项目中，我们将检验抽搐和冲动代表与事件文件范式（S-R）和动作文件范式（R-R）中异常特征绑定相关的SMA超激活状态标记的假设。在抑制1Hz SMA rTMS以调节大脑激活之前和之后进行的行为任务中，使用脑电图研究潜在的神经生理过程。在对照条件下，我们将使用1hz sma前rTMS来特别解决反应切换缺陷，作为GTS可能的特征标记。

The supplementary motor area (SMA) and pre-SMA are active during action selection and preparation predominantly of internally generated movements, switching between different actions and overcoming habitual responses. Binding and unbinding of stimulus and response features and response switching are key elements during event coding, so that SMA and pre-SMA activations are expected to be particularly relevant for these processes. Abnormal neural activation related to tics and urges (i.e. the current state) has been documented in the SMA in patients with Gilles de la Tourette syndrome (GTS). Also, a number of studies have shown abnormal structural and functional connectivity in motor networks comprising the SMA and pre-SMA. In addition, response switching, particularly engaging the pre-SMA, is impaired in GTS independently of tic severity and has thus emerged as a possible GTS trait marker. In this project, we will test the hypothesis that tics and urges represent state markers of SMA hyper-activation correlating with abnormal feature binding in the event file paradigm (S-R) and the action file paradigm (R-R). The underlying neurophysiological processes will be investigated using EEG during the behavioral tasks, performed before and after inhibitory 1Hz SMA rTMS to modulate brain activation. In a control condition, we will use 1 Hz pre-SMA rTMS to particularly address response-switching deficits as a possible trait marker in GTS.