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Gilles de la Tourette综合征(GTS)可以被概念化为异常知觉-行为加工障碍的概念。临床症状与成人GTS患者顶叶下皮质(BA40)激活增加相关的事件文件范例中的结合增加有关。此外，在患有GTS的儿童和青少年中，在多模式GO/NOGO任务中发现了改变的抑制，并与BA40区皮质活动的增加有关。初步数据显示，1赫兹重复经颅磁刺激(RTMS)应用于辅助运动区(SMA)可有效降低皮质异常兴奋性，改善症状。然而，还没有研究结合临床(例如抽动频率和严重程度)和行为/神经生理学结果来衡量GTS患者rTMS后的感觉运动整合过程。因此，在本项目中，我们将比较应用于SMA的抑制性、神经导航的1 HZ rTMS和BA40 rTMS在GTS儿童/青少年和成人中结合临床措施的效果，以及在事件文件处理过程中在反应选择和反应抑制方面的行为表现和伴随的脑电记录。我们的目的是为不同年龄段的GTS在反应选择和运动反应抑制过程中顶叶和额叶皮质区域在异常知觉-动作整合中所起的作用提供机制方面的见解。这将为将GTS的认知理论概念化转化为临床应用提供基础。

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.