Friedrich Julia, Rawish Tina, Bluschke Annet, Frings Christian, Beste Christian, Münchau Alexander
Institute of Systems Motor Science, Center for Brain, Behavior and Metabolism (CBBM), University of Lübeck, 23562 Lübeck, Germany.
Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany.
Biomedicines. 2023 May 26;11(6):1550. doi: 10.3390/biomedicines11061550.
European clinical guidelines recommend the use of Exposure and Response Prevention (ERP) and Comprehensive Behavioral Intervention for Tics (CBIT) as first-line treatments for tic disorders. Although ongoing efforts in research are being made to understand the mechanisms underlying these behavioral approaches, as of yet, the neurophysiological mechanisms behind behavioral interventions are poorly understood. However, this is essential to tailor interventions to individual patients in order to increase compliance and efficacy. The Theory of Event Coding (TEC) and its derivative BRAC (Binding and Retrieval in Action Control) provide a theoretical framework to investigate cognitive and neural processes in the context of tic disorders. In this context, tics are conceptualized as a phenomenon of enhanced perception-action binding, with premonitory urges constituting the perceptual and the motor or vocal expression constituting the action part of an event file. Based on this, CBIT is assumed to strongly affect stimulus-response binding in the context of response selection, whereas the effects of ERP presumably unfold during stimulus-response binding in the response inhibition context. Further studies are needed to clarify the neurophysiological processes underlying behavioral interventions to enable the individualization and further development of therapeutic approaches for tic disorders.
欧洲临床指南推荐将暴露与反应阻止疗法（ERP）和抽动综合行为干预疗法（CBIT）作为抽动障碍的一线治疗方法。尽管目前正在进行研究以了解这些行为疗法背后的机制，但截至目前，行为干预背后的神经生理机制仍知之甚少。然而，为了提高患者的依从性和治疗效果，针对个体患者量身定制干预措施至关重要。事件编码理论（TEC）及其衍生理论行动控制中的绑定与检索（BRAC）提供了一个理论框架，用于研究抽动障碍背景下的认知和神经过程。在这种背景下，抽动被概念化为一种增强的感知 - 行动绑定现象，预感冲动构成感知部分，运动或发声表达构成事件文件的行动部分。基于此，假定CBIT在反应选择的背景下强烈影响刺激 - 反应绑定，而ERP的效果可能在反应抑制背景下的刺激 - 反应绑定过程中显现。需要进一步研究以阐明行为干预背后的神经生理过程，从而实现抽动障碍治疗方法的个体化和进一步发展。
