Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095, United States of America.
Swartz Center for Neural Computation, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0559, United States of America.
Neuroimage Clin. 2019;24:101956. doi: 10.1016/j.nicl.2019.101956. Epub 2019 Jul 27.
The pathophysiology of Chronic Tic Disorders (CTDs), including Tourette Syndrome, remains poorly understood. The goal of this study was to compare neural activity and connectivity during a voluntary movement (VM) paradigm that involved cued eye blinks among children with and without CTDs. Using the precise temporal resolution of electroencephalography (EEG), we used the timing and location of cortical source resolved spectral power activation and connectivity to map component processes such as visual attention, cue detection, blink regulation and response monitoring. We hypothesized that neural activation and connectivity during the cued eye blink paradigm would be significantly different in regions typically associated with effortful control of eye blinks, such as frontal, premotor, parietal, and occipital cortices between children with and without CTD.
Participants were 40 children (23 with CTD, 17 age-matched Healthy Control [HC]), between the ages of 8-12 (mean age = 9.5) years old. All participants underwent phenotypic assessment including diagnostic interviews, behavior rating scales and 128-channel EEG recording. Upon presentation of a cue every 3 s, children were instructed to make an exaggerated blink.
Behaviorally, the groups did not differ in blink number, latency, or ERP amplitude. Within source resolved clusters located in left dorsolateral prefrontal cortex, posterior cingulate, and supplemental motor area, children with CTD exhibited higher gamma band spectral power relative to controls. In addition, significant diagnostic group differences in theta, alpha, and beta band power in inferior parietal cortex emerged. Spectral power differences were significantly associated with clinical characteristics such as tic severity and premonitory urge strength. After calculating dipole density for 76 anatomical regions, the CTD and HC groups had 70% overlap of top regions with the highest dipole density, suggesting that similar cortical networks were used across groups to carry out the VM. The CTD group exhibited significant information flow increase and dysregulation relative to the HC group, particularly from occipital to frontal regions.
Children with CTD exhibit abnormally high levels of neural activation and dysregulated connectivity among networks used for regulation and effortful control of voluntary eye blinks.
慢性抽动障碍（CTD）的病理生理学，包括图雷特综合征，仍然知之甚少。本研究的目的是比较伴有和不伴有 CTD 的儿童在自愿运动（VM）范式中进行提示性眼眨眼时的神经活动和连接。使用脑电图（EEG）的精确时间分辨率，我们使用皮质源分辨光谱功率激活和连接的时间和位置来绘制组件过程，例如视觉注意、提示检测、眨眼调节和反应监测。我们假设，在伴有和不伴有 CTD 的儿童之间，与费力控制眨眼相关的典型区域（如额、前运动、顶和枕叶皮质）的提示性眼眨眼范式期间，神经激活和连接会有显著差异。
参与者为 40 名儿童（23 名患有 CTD，17 名年龄匹配的健康对照组 [HC]），年龄在 8-12 岁之间（平均年龄为 9.5 岁）。所有参与者都接受了表型评估，包括诊断访谈、行为评定量表和 128 通道 EEG 记录。当每 3 秒出现一个提示时，孩子们被指示做出夸张的眨眼。
在行为方面，两组在眨眼次数、潜伏期或 ERP 幅度上没有差异。在位于左侧背外侧前额叶皮质、后扣带回和补充运动区的源分辨聚类中，患有 CTD 的儿童的伽马带光谱功率相对于对照组更高。此外，在顶下叶皮质中出现了 theta、alpha 和 beta 带功率的显著诊断组差异。频谱功率差异与临床特征（如抽动严重程度和预感冲动强度）显著相关。在计算了 76 个解剖区域的偶极密度后，CTD 和 HC 组有 70%的重叠的具有最高偶极密度的顶级区域，这表明相似的皮质网络被用于执行 VM。与 HC 组相比，CTD 组表现出显著的信息流增加和失调，特别是从前额到顶叶区域。
患有 CTD 的儿童在自愿性眼眨眼的调节和费力控制中使用的网络之间表现出异常高的神经激活和失调的连接。
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