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The role of the cingulate cortex in the generation of motor tics and the experience of the premonitory urge-to-tic in Tourette syndrome

Jackson, Stephen R.; Sigurdsson, Hilmar P; Dyke, Katherine; Condon, Maria; Jackson, Georgina M

The role of the cingulate cortex in the generation of motor tics and the experience of the premonitory urge-to-tic in Tourette syndrome Thumbnail


Authors

STEPHEN JACKSON stephen.jackson@nottingham.ac.uk
Professor of Cognitive Neuroscience

Hilmar P Sigurdsson

Maria Condon

Georgina M Jackson



Abstract

Tourette syndrome (TS) is a neurological disorder of childhood onset that is characterized by the occurrence of motor and vocal tics. TS is associated with cortical-striatal-thalamic-cortical circuit [CSTC] dysfunction and hyper-excitability of cortical limbic and motor regions that are thought to lead to the occurrence of tics. Individuals with TS often report that their tics are preceded by ‘premonitory sensory/urge phenomena’ (PU) that are described as uncomfortable bodily sensations that precede the execution of a tic and are experienced as a strong urge for motor discharge. While the precise role played by PU in the occurrence of tics is largely unknown, they are nonetheless of considerable theoretical and clinical importance as they form a core component of many behavioural therapies used in the treatment of tic disorders. Recent evidence indicates that the cingulate cortex may play an important role in the generation of PU in TS, and in ‘urges-for-action’ more generally. In the current study, we utilized voxel-based morphometry (VBM) techniques, together with ‘seed-to-voxel’ structural covariance network (SCN) mapping, to investigate the putative role played by the cingulate cortex in the generation of motor tics and the experience of PU in a relatively large group of young people with TS. Whole-brain VBM analysis revealed that TS was associated with clusters of significantly reduced grey matter volumes bilaterally within: the orbito-frontal cortex; the cerebellum; and the anterior and mid-cingulate cortex. Similarly, analysis of SCNs associated with bilateral mid- and anterior cingulate ‘seed’ regions demonstrated that TS is associated with increased structural covariance primarily with the bilateral motor cerebellum; the inferior frontal cortex; and the posterior cingulate cortex.

Journal Article Type Article
Acceptance Date Feb 4, 2021
Online Publication Date Mar 27, 2021
Publication Date 2021-09
Deposit Date Feb 10, 2021
Publicly Available Date Mar 28, 2022
Journal Journal of Neuropsychology
Print ISSN 1748-6645
Electronic ISSN 1748-6653
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 15
Issue 3
Pages 340-362
DOI https://doi.org/10.1111/jnp.12242
Public URL https://nottingham-repository.worktribe.com/output/3842489
Publisher URL https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/jnp.12242

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