Linking Brain and Behavior in Chronic Tic Disorder

描述(申请人提供)：抽动产生和抑制的神经回路尤其重要，因为自愿抽动控制在经验性支持的行为治疗中的作用，例如对包括抽动症在内的慢性抽动障碍(CTD)患者进行习惯逆转训练(HRT)。尽管建立了研究基础，但CTDS的病因学和病理生理学仍然知之甚少，现有的发现因样本量小、广泛年龄范围造成的发育影响、药物使用以及无法控制的精神共病而混乱。为了响应NIH R21对有潜力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/身体成像[MOBI])来表征CTD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晰度运动捕捉视频、皮质活动(脑电；EEG)和肌肉运动(肌电；EMG)。这一前沿技术的使用将促进我们对运动启动和冲动抑制背后的神经底物的理解，并可能识别可能的抽动产生和抑制的生物标志物。目前的研究建议在48名8-12岁的儿童、24名患有CTD的儿童和24名年龄匹配的典型发育中(TD)同龄人的样本中使用Mobi方法。我们将使用几种范例来模拟自愿和非自愿运动背后的神经基础，并测试CTD是否涉及相对于TD同龄人的运动网络回路的定量或定性偏差。 在目前的研究背景下，成功地应用Mobi方法来发现和测试CTD的脑生物标记物是非常具有创新性的，并且对于推进CTD的临床研究和实践也具有明显的潜力。

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.