From urges to tics in children with Tourette syndrome: associations with supplementary motor area GABA and right motor cortex physiology

Travis R. Larsh, David A. Huddleston, Paul S. Horn, Steve W. Wu, Kim M. Cecil, Hannah S. Jackson, Richard A.E. Edden, Stewart H. Mostofsky, Donald L. Gilbert

Research output: Contribution to journalArticlepeer-review

Abstract

Tourette syndrome (TS) is a childhood-onset disorder in which tics are often preceded by premonitory sensory urges. More severe urges correlate with worse tics and can render behavioral therapies less effective. The supplementary motor area (SMA) is a prefrontal region believed to inf luence tic performance. To determine whether cortical physiological properties correlate with urges and tics, we evaluated, in 8–12-year-old right-handed TS children (n = 17), correlations of urge and tic severity scores and compared both to cortical excitability (CE) and short- and long-interval cortical inhibition (SICI and LICI) in both left and right M1. We also modeled these M1 transcranial magnetic stimulation measures with SMA gamma-amino butyric acid (GABA) levels in TS and typically developing control children (n = 16). Urge intensity correlated strongly with tic scores. More severe urges correlated with lower CE and less LICI in both right and left M1. Unexpectedly, in right M1, lower CE and less LICI correlated with less severe tics. We found that SMA GABA modulation of right, but not left, M1 CE and LICI differed in TS. We conclude that in young children with TS, lower right M1 CE and LICI, modulated by SMA GABA, may ref lect compensatory mechanisms to diminish tics in response to premonitory urges.

Original languageEnglish (US)
Pages (from-to)3922-3933
Number of pages12
JournalCerebral Cortex
Volume33
Issue number7
DOIs
StatePublished - Apr 1 2023

Keywords

  • GABA
  • Tourette syndrome
  • neurodevelopment
  • supplementary motor area
  • transcranial magnetic stimulation

ASJC Scopus subject areas

  • Cellular and Molecular Neuroscience
  • Cognitive Neuroscience

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