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Biomedicines
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The Neurobiology of Tourette Syndrome along the Lifespan
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The Neurobiology of Tourette Syndrome along the Lifespan

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Neurobiology and Clinical Neuroscience".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 8222

Special Issue Editors

Prof. Dr. Aribert Rothenberger

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Guest Editor
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre Göttingen, Göttingen, Germany
Interests: psychiatric disorders
Prof. Dr. Veit Roessner

E-Mail Website
Guest Editor
Department of Child and Adolescent Psychiatry, Cognitive Neurophysiology, Faculty of Medicine of the TU Dresden, 01309 Dresden, Germany
Interests: Tic disorders; comorbidity; development; neurobiology

Special Issue Information

Dear Colleagues,

Tourette syndrome (TS) and other chronic tic disorders are characterized by fluctuating motor and vocal tics, often accompanied by premonitory sensory-motor urges and comorbidities like attention-deficit hyperactivity disorder (ADHD) and obsessive-compulsive behavior (OCB). Changes in cognitive processes have also often been reported. TS is a childhood-onset neurodevelopmental disorder which improves spontaneously during adolescence, which seems to be related to the maturation of the cortico-striato-thalamico-cortical circuit (CSTC), specifically its maturational links to the frontal and the sensory-motor cortex.

So far, there is no cure for TS, but treatment approaches like pharmacotherapy and behavior therapy may improve symptoms.

Despite intensive neurobiological research during the last decade, there remain many gaps and unanswered questions concerning the brain dynamics of TS psychophysiology, specifically its development from childhood to adolescence.

In order to provide an update on the progress of neurobiological research in TS, this Special Issue invites scientists to present and discuss their work (original papers, narrative reviews, meta-analyses) in children, adolescents and adults related to genetics; epigenetics; immunology/infectiology; neurotransmitters; stress hormones; brain structure; brain connectivity; cognition; electrophysiology like EEG, ERP, TMS, tDCS, MEG, fMRI, MRS, polysomnography and circadian recordings; as well as neuromodulation and neurofeedback, among other relevant topics.

Specifically, long-term studies, developmental and comorbid aspects as well as proof-of-principle testing could help to improve our understanding of the neurobiological background of TS and thus pave the way to better treatment approaches for this complex neurodevelopmental disorder.

Prof. Dr. Aribert Rothenberger
Prof. Dr. Veit Roessner
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • chronic tic disorders
  • Tourette syndrome
  • neurobiology
  • brain development
  • comorbidity
  • children
  • adolescents
  • adults

Published Papers (5 papers)

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Research

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14 pages, 872 KiB  
Article
Hair Cortisol and Perceived Stress—Predictors for the Onset of Tics? A European Longitudinal Study on High-Risk Children
by Josefine Rothe, Judith Buse, Anne Uhlmann, Benjamin Bodmer, Clemens Kirschbaum, Pieter J. Hoekstra, Andrea Dietrich and Veit Roessner
Biomedicines 2023, 11(6), 1561; https://doi.org/10.3390/biomedicines11061561 - 27 May 2023
Cited by 2 | Viewed by 993
Abstract
Some retrospective studies suggest that psychosocial stressors trigger the onset of tics. This study examined prospective hypothalamic–pituitary–adrenal (HPA) axis activity and perceived stress prior to tic onset. In the present study, 259 children at high risk for developing tics were assessed for hair [...] Read more.
Some retrospective studies suggest that psychosocial stressors trigger the onset of tics. This study examined prospective hypothalamic–pituitary–adrenal (HPA) axis activity and perceived stress prior to tic onset. In the present study, 259 children at high risk for developing tics were assessed for hair cortisol concentration (HCC) and parent-on-child-reported perceived stress four-monthly over a three-year period. We used (i) generalised additive modelling (GAM) to investigate the time effects on HCC (hair samples n = 765) and perceived stress (questionnaires n = 1019) prior to tic onset and (ii) binary logistic regression to predict tic onset in a smaller subsample with at least three consecutive assessments (six to nine months before, two to five months before, and at tic onset). GAM results indicated a non-linear increasing course of HCC in children who developed tics, and a steady HCC course in those without tics, as well as a linear-increasing course of perceived stress in both groups. Logistic regression showed that with a higher HCC in hair samples collected in a range of two to five months before tic onset (which refers to cortisol exposure in a range of four to eight months), the relative likelihood of tic onset rose. Our study suggests increased stress prior to tic onset, as evidenced by higher HCC several months before tic onset. Full article
(This article belongs to the Special Issue The Neurobiology of Tourette Syndrome along the Lifespan)
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15 pages, 1986 KiB  
Article
Theta Activity Dynamics during Embedded Response Plan Processing in Tourette Syndrome
by Paul Wendiggensen, Theresa Paulus, Annet Bluschke, Adam Takacs, Eszter Toth-Faber, Anne Weissbach, Tobias Bäumer, Christian Frings, Veit Roessner, Alexander Münchau and Christian Beste
Biomedicines 2023, 11(2), 393; https://doi.org/10.3390/biomedicines11020393 - 28 Jan 2023
Cited by 3 | Viewed by 1268
Abstract
Gilles de la Tourette syndrome (GTS) is a neuropsychiatric disorder. Because motor signs are the defining feature of GTS, addressing the neurophysiology of motor processes is central to understanding GTS. The integration of voluntary motor processes is subject to so-called “binding problems”, i.e., [...] Read more.
Gilles de la Tourette syndrome (GTS) is a neuropsychiatric disorder. Because motor signs are the defining feature of GTS, addressing the neurophysiology of motor processes is central to understanding GTS. The integration of voluntary motor processes is subject to so-called “binding problems”, i.e., how different aspects of an action are integrated. This was conceptualized in the theory of event coding, in which ‘action files’ accomplish the integration of motor features. We examined the functional neuroanatomical architecture of EEG theta band activity related to action file processing in GTS patients and healthy controls. Whereas, in keeping with previous data, behavioral performance during action file processing did not differ between GTS and controls, underlying patterns of neural activity were profoundly different. Superior parietal regions (BA7) were predominantly engaged in healthy controls, but superior frontal regions (BA9, BA10) in GTS indicated that the processing of different motor feature codes was central for action file processing in healthy controls, whereas episodic processing was more relevant in GTS. The data suggests a cascade of cognitive branching in fronto-polar areas followed by episodic processing in superior frontal regions in GTS. Patients with GTS accomplish the integration of motor plans via qualitatively different neurophysiological processes. Full article
(This article belongs to the Special Issue The Neurobiology of Tourette Syndrome along the Lifespan)
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Review

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14 pages, 703 KiB  
Review
Cognitive and Neural Mechanisms of Behavior Therapy for Tics: A Perception–Action Integration Approach
by Julia Friedrich, Tina Rawish, Annet Bluschke, Christian Frings, Christian Beste and Alexander Münchau
Biomedicines 2023, 11(6), 1550; https://doi.org/10.3390/biomedicines11061550 - 26 May 2023
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Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue The Neurobiology of Tourette Syndrome along the Lifespan)
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18 pages, 526 KiB  
Review
Co-Occurrence of Tic Disorders and Attention-Deficit/Hyperactivity Disorder—Does It Reflect a Common Neurobiological Background?
by Aribert Rothenberger and Hartmut Heinrich
Biomedicines 2022, 10(11), 2950; https://doi.org/10.3390/biomedicines10112950 - 17 Nov 2022
Cited by 1 | Viewed by 2440
Abstract
Background: The co-existence of tic disorders and attention-deficit/hyperactivity disorder (TD + ADHD) has proven to be highly important in daily clinical practice. The factor ADHD is not only associated with further comorbidities, but also has a long-term negative psychosocial effect, while the factor [...] Read more.
Background: The co-existence of tic disorders and attention-deficit/hyperactivity disorder (TD + ADHD) has proven to be highly important in daily clinical practice. The factor ADHD is not only associated with further comorbidities, but also has a long-term negative psychosocial effect, while the factor TD is usually less disturbing for the major part of the patients. It remains unclear how far this is related to a different neurobiological background of the associated disorders or whether TD + ADHD reflects a common one. Objective: This review provides an update on the neurobiological background of TD + ADHD in order to better understand and treat this clinical problem, while clarifying whether an additive model of TD + ADHD holds true and should be used as a basis for further clinical recommendations. Method: A comprehensive research of the literature was conducted and analyzed, including existing clinical guidelines for both TD and ADHD. Besides genetical and environmental risk factors, brain structure and functions, neurophysiological processes and neurotransmitter systems were reviewed. Results: Only a limited number of empirical studies on the neurobiological background of TD and ADHD have taken the peculiarity of co-existing TD + ADHD into consideration, and even less studies have used a 2 × 2 factorial design in order to disentangle the impact/effects of the factors of TD versus those of ADHD. Nevertheless, the assumption that TD + ADHD can best be seen as an additive model at all levels of investigation was strengthened, although some overlap of more general, disorder non-specific aspects seem to exist. Conclusion: Beyond stress-related transdiagnostic aspects, separate specific disturbances in certain neuronal circuits may lead to disorder-related symptoms inducing TD + ADHD in an additive way. Hence, within a classificatory categorical framework, the dimensional aspects of multilevel diagnostic-profiling seem to be a helpful precondition for personalized decisions on counselling and disorder-specific treatment in TD + ADHD. Full article
(This article belongs to the Special Issue The Neurobiology of Tourette Syndrome along the Lifespan)
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Other

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9 pages, 1000 KiB  
Brief Report
The Role of the Left Inferior Parietal Cortex in Gilles de la Tourette Syndrome—An rTMS Study
by Theresa Paulus, Lynn Wernecke, Annik Lundie, Julia Friedrich, Julius Verrel, Tina Rawish, Anne Weissbach, Christian Frings, Christian Beste, Tobias Bäumer and Alexander Münchau
Biomedicines 2023, 11(3), 980; https://doi.org/10.3390/biomedicines11030980 - 22 Mar 2023
Cited by 1 | Viewed by 1654
Abstract
Increased activity in the left inferior parietal cortex (BA40) plays a role in the generation of tics in the Gilles de la Tourette syndrome (GTS). Thus, inhibitory repetitive transcranial magnetic stimulation (rTMS) applied to BA40 was hypothesized to alleviate symptoms in GTS. We [...] Read more.
Increased activity in the left inferior parietal cortex (BA40) plays a role in the generation of tics in the Gilles de la Tourette syndrome (GTS). Thus, inhibitory repetitive transcranial magnetic stimulation (rTMS) applied to BA40 was hypothesized to alleviate symptoms in GTS. We investigated the immediate effects of single-session 1 Hz rTMS and sham stimulation delivered to the left BA40 on tics assessed with the Rush video protocol in 29 adults with GTS. There were no significant effects on tic symptoms following rTMS or sham stimulation. Moreover, there was no difference when comparing the effects of both stimulation conditions. Bayesian statistics indicated substantial evidence against an intervention effect. The left BA40 appears not to be a useful target for 1 Hz rTMS to modulate tic symptoms in GTS patients. Full article
(This article belongs to the Special Issue The Neurobiology of Tourette Syndrome along the Lifespan)
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