Tinaz Sule, Malone Patrick, Hallett Mark, Horovitz Silvina G
Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Office of the Clinical Director, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.
Mov Disord. 2015 Aug;30(9):1190-7. doi: 10.1002/mds.26230. Epub 2015 Apr 8.
The mid-posterior part of the insula is involved in processing bodily sensations and urges and is activated during tic generation in Tourette syndrome. The dorsal anterior part of the insula, however, integrates sensory and emotional information with cognitive valuation and is implicated in interoception. The right dorsal anterior insula also participates in urge suppression in healthy subjects. This study examined the role of the right dorsal anterior insula in the urge to tic in Tourette syndrome.
Resting-state functional magnetic resonance imaging was performed in 13 adult Tourette patients and 13 matched controls. The role of the right dorsal anterior insula within the urge-tic network was investigated using graph theory-based neural network analysis. The functional connectivity of the right dorsal anterior insula was also correlated with urge and tic severity.
Even though the patients did not exhibit any overt tics, the right dorsal anterior insula demonstrated higher connectivity, especially with the frontostriatal nodes of the urge-tic network in patients compared with controls. The functional connectivity between the right dorsal anterior insula and bilateral supplementary motor area also correlated positively with urge severity in patients.
These results suggest that the right dorsal anterior insula is part of the urge-tic network and could influence the urge- and tic-related cortico-striato-thalamic regions even during rest in Tourette syndrome. It might be responsible for heightened awareness of bodily sensations generating premonitory urges in Tourette syndrome.
脑岛的中后部参与身体感觉和冲动的处理，在抽动秽语综合征的抽动发作期间被激活。然而，脑岛的背前部将感觉和情绪信息与认知评估整合在一起，并与内感受有关。右侧背前部脑岛也参与健康受试者的冲动抑制。本研究探讨了右侧背前部脑岛在抽动秽语综合征抽动冲动中的作用。
对13名成年抽动秽语综合征患者和13名匹配的对照者进行静息态功能磁共振成像。使用基于图论的神经网络分析研究右侧背前部脑岛在冲动-抽动网络中的作用。右侧背前部脑岛的功能连接性也与冲动和抽动严重程度相关。
尽管患者没有表现出任何明显的抽动，但与对照组相比，患者的右侧背前部脑岛显示出更高的连接性，尤其是与冲动-抽动网络的额纹状体节点。患者右侧背前部脑岛与双侧辅助运动区之间的功能连接性也与冲动严重程度呈正相关。
这些结果表明，右侧背前部脑岛是冲动-抽动网络的一部分，即使在抽动秽语综合征患者休息时也可能影响与冲动和抽动相关的皮质-纹状体-丘脑区域。它可能负责增强对身体感觉的意识，从而在抽动秽语综合征中产生预兆性冲动。
