Neural correlates of tic generation in Tourette syndrome: an event-related functional MRI study

S. Bohlhalter
2006 Brain  
These authors contributed equally to this work. Little is known about the neural correlates of tics and associated urges. In the present study, we aimed to explore the neural basis of tics in patients with Tourette syndrome by using event-related functional MRI (fMRI). Ten patients (6 women, 4 men; age: mean 6 SD = 31 6 11.2) were studied while spontaneously exhibiting a variety of motor and vocal tics. On the basis of synchronized video/audio recordings, fMRI activities were analysed 2 s
more » ... analysed 2 s before and at tic onset irrespective of the clinical phenomenology. We identified a brain network of paralimbic areas such as anterior cingulate and insular cortex, supplementary motor area (SMA) and parietal operculum (PO) predominantly activated before tic onset (P < 0.05, corrected for multiple comparisons). In contrast, at the beginning of tic action, significant fMRI activities were found in sensorimotor areas including superior parietal lobule bilaterally and cerebellum. The results of this study indicate that paralimbic and sensory association areas are critically implicated in tic generation, similar to movements triggered internally by unpleasant sensations, as has been shown for pain or itching. Abbreviations: ACC = anterior cingulate cortex; ADHD = attentional deficit hyperactivity disorder; BA = Brodmann area; BOLD = blood-oxygen level-dependent; fMRI = functional magnetic resonance imaging; DLPFC = dorsolateral prefrontal cortex; OCD = obsessive compulsive disorder; PO = parietal operculum; SMA = supplementary motor area; SPL = superior parietal lobules; SPM = statistical parametric map; TS = Tourette syndrome
doi:10.1093/brain/awl050 pmid:16520330 fatcat:tugxwhts7zhk7nv74zpvpde3am