Department of Psychology, McGill University, Montreal, QC, Canada.
Child Study Center, Yale University School of Medicine, New Haven, CT, USA.
Psychol Med. 2023 Dec;53(16):7857-7864. doi: 10.1017/S0033291723001940. Epub 2023 Jul 24.
Comprehensive Behavioral Intervention for Tics (CBIT) is recommended as a first-line treatment for Tourette syndrome in children and adults. While there is strong evidence proving its efficacy, the mechanisms of reduction in tic severity during CBIT are still poorly understood. In a recent study, our group identified a functional brain network involved in tic suppression in children with TS. We reasoned that voluntary tic suppression and CBIT may share some mechanisms and thus we wanted to assess whether functional connectivity during tic suppression was associated with CBIT outcome.
Thirty-two children with TS, aged 8 to 13 years old, participated in a randomized controlled trial of CBIT a treatment-as-usual control condition. EEG was recorded during tic suppression in all participants at baseline and endpoint. We used a source-reconstructed EEG connectivity pipeline to assess functional connectivity during tic suppression.
Functional connectivity during tic suppression did not change from baseline to endpoint. However, baseline tic suppression-related functional connectivity specifically predicted the decrease in vocal tic severity from baseline to endpoint in the CBIT group. Supplementary analyses revealed that the functional connectivity between the right superior frontal gyrus and the right angular gyrus was mainly driving this effect.
This study revealed that functional connectivity during tic suppression at baseline predicted reduction in vocal tic severity. These results suggest probable overlap between the mechanisms of voluntary tic suppression and those of behavior therapy for tics.
综合行为干预疗法（CBIT）被推荐为儿童和成人抽动障碍的一线治疗方法。尽管有强有力的证据证明其疗效，但 CBIT 减轻抽动严重程度的机制仍知之甚少。在最近的一项研究中，我们的研究小组确定了一个涉及儿童抽动障碍患者抽动抑制的功能性大脑网络。我们推断，自愿性抽动抑制和 CBIT 可能具有一些共同的机制，因此我们想评估在抽动抑制期间的功能连接是否与 CBIT 结果相关。
32 名年龄在 8 至 13 岁之间的抽动障碍儿童参加了 CBIT 的随机对照试验，作为常规治疗对照条件。所有参与者在基线和终点时都进行了抽动抑制期间的脑电图记录。我们使用源重建 EEG 连通性管道来评估抽动抑制期间的功能连通性。
抽动抑制期间的功能连接从基线到终点没有变化。然而，基线时与抽动抑制相关的功能连接特异性地预测了 CBIT 组从基线到终点时言语抽动严重程度的下降。补充分析表明，右侧额上回和右侧角回之间的功能连接主要驱动了这种效应。
这项研究表明，基线时抽动抑制期间的功能连接预测了言语抽动严重程度的降低。这些结果表明自愿性抽动抑制和抽动行为治疗的机制之间可能存在重叠。
