Abstract

Personal distress associated with tic urges or inhibition and relief associated with tic production are defining features of the personal experience in Gilles de la Tourette syndrome (GTS). These affective phenomena have not been studied using fMRI, hindering our understanding of GTS pathophysiology and possible treatments. Here, we present a novel cross-sectional fMRI study designed to map tic-related phenomenology using distress and relief as predicting variables. We adopted a mental imagery approach and dissected the brain activity associated with different phases of tic behaviors, premonitory urges, and the ensuing tic execution or inhibition: these were compared with the mental simulation of “relaxed situations” and pre-determined stereotyped motor behaviors. We then explored whether the ensuing brain patterns correlated with the distress or relief perceived for the different phases of the tasks. Patients experienced a higher level of distress during the imagery of tic-triggering scenarios and no relief during tic inhibition. On the other hand, patients experienced significant relief during tic imagery. Distress during tic-triggering scenarios and relief during tic imagery were significantly correlated. The distress perceived during urges correlated with increased activation in cortical sensorimotor areas, suggesting a motor alarm. Conversely, relief during tic execution was positively associated with the activity of a subcortical network. The activity of the putamen was associated with both distress during urges and relief during tic execution. These findings highlight the importance of assessing the affective component of tic-related phenomenology. Subcortical structures may be causally involved in the affective component of tic pathophysiology, with the putamen playing a central role in both tic urge and generation. We believe that our results can be readily translated into clinical practice for the development of personalized treatment plans tailored to each patient’s unique needs.

Details

Title
Mapping Gilles de la Tourette syndrome through the distress and relief associated with tic-related behaviors: an fMRI study
Author
Zapparoli, Laura 1   VIAFID ORCID Logo  ; Devoto, Francantonio 2 ; Mariano, Marika 2 ; Seghezzi, Silvia 3 ; Servello, Domenico 4 ; Porta, Mauro 4 ; Paulesu, Eraldo 1   VIAFID ORCID Logo 

 University of Milano-Bicocca, Psychology Department and NeuroMi – Milan Centre for Neuroscience, Milan, Italy (GRID:grid.7563.7) (ISNI:0000 0001 2174 1754); IRCCS Orthopedic Institute Galeazzi, fMRI Unit, Milan, Italy (GRID:grid.417776.4) 
 University of Milano-Bicocca, Psychology Department and NeuroMi – Milan Centre for Neuroscience, Milan, Italy (GRID:grid.7563.7) (ISNI:0000 0001 2174 1754) 
 University of Milano-Bicocca, Psychology Department and NeuroMi – Milan Centre for Neuroscience, Milan, Italy (GRID:grid.7563.7) (ISNI:0000 0001 2174 1754); University College London, Institute of Cognitive Neuroscience, London, UK (GRID:grid.83440.3b) (ISNI:0000000121901201) 
 IRCCS Orthopedic Institute Galeazzi, Tourette Center, Milan, Italy (GRID:grid.417776.4) 
Pages
7
Publication year
2024
Publication date
2024
Publisher
Nature Publishing Group
e-ISSN
21583188
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2911658151
Copyright
© The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.