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Takacs A, Toth‐Faber E, Schubert L, Tarnok Z, Ghorbani F, Trelenberg M, Nemeth D, Münchau A, Beste C. Neural representations of statistical and rule-based predictions in Gilles de la Tourette syndrome. Hum Brain Mapp 2024; 45:e26719. [PMID: 38826009 PMCID: PMC11144952 DOI: 10.1002/hbm.26719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/11/2024] [Accepted: 05/06/2024] [Indexed: 06/04/2024] Open
Abstract
Gilles de la Tourette syndrome (GTS) is a disorder characterised by motor and vocal tics, which may represent habitual actions as a result of enhanced learning of associations between stimuli and responses (S-R). In this study, we investigated how adults with GTS and healthy controls (HC) learn two types of regularities in a sequence: statistics (non-adjacent probabilities) and rules (predefined order). Participants completed a visuomotor sequence learning task while EEG was recorded. To understand the neurophysiological underpinnings of these regularities in GTS, multivariate pattern analyses on the temporally decomposed EEG signal as well as sLORETA source localisation method were conducted. We found that people with GTS showed superior statistical learning but comparable rule-based learning compared to HC participants. Adults with GTS had different neural representations for both statistics and rules than HC adults; specifically, adults with GTS maintained the regularity representations longer and had more overlap between them than HCs. Moreover, over different time scales, distinct fronto-parietal structures contribute to statistical learning in the GTS and HC groups. We propose that hyper-learning in GTS is a consequence of the altered sensitivity to encode complex statistics, which might lead to habitual actions.
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Affiliation(s)
- Adam Takacs
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of MedicineTechnische Universität DresdenDresdenGermany
- University Neuropsychology Center, Faculty of Medicine, Technische Universität DresdenDresdenGermany
| | - Eszter Toth‐Faber
- Institute of PsychologyELTE Eötvös Loránd UniversityBudapestHungary
- Brain, Memory and Language Research Group, Institute of Cognitive Neuroscience and Psychology, HUN‐REN Research Centre for Natural SciencesBudapestHungary
| | - Lina Schubert
- Institute of Systems Motor ScienceUniversity of LübeckLübeckGermany
| | - Zsanett Tarnok
- Vadaskert Child and Adolescent Psychiatry Hospital and Outpatient ClinicBudapestHungary
| | - Foroogh Ghorbani
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of MedicineTechnische Universität DresdenDresdenGermany
- University Neuropsychology Center, Faculty of Medicine, Technische Universität DresdenDresdenGermany
| | - Madita Trelenberg
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of MedicineTechnische Universität DresdenDresdenGermany
| | - Dezso Nemeth
- INSERMUniversité Claude Bernard Lyon 1, CNRS, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292BronFrance
- NAP Research Group, Institute of Psychology, Eötvös Loránd University and Institute of Cognitive Neuroscience and Psychology, HUN‐REN Research Centre for Natural SciencesBudapestHungary
- Department of Education and Psychology, Faculty of Social SciencesUniversity of Atlántico MedioLas Palmas de Gran CanariaSpain
| | | | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of MedicineTechnische Universität DresdenDresdenGermany
- University Neuropsychology Center, Faculty of Medicine, Technische Universität DresdenDresdenGermany
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Münchau A, Klein C, Beste C. Rethinking Movement Disorders. Mov Disord 2024; 39:472-484. [PMID: 38196315 DOI: 10.1002/mds.29706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 11/16/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024] Open
Abstract
At present, clinical practice and research in movement disorders (MDs) focus on the "normalization" of altered movements. In this review, rather than concentrating on problems and burdens people with MDs undoubtedly have, we highlight their hidden potentials. Starting with current definitions of Parkinson's disease (PD), dystonia, chorea, and tics, we outline that solely conceiving these phenomena as signs of dysfunction falls short of their complex nature comprising both problems and potentials. Such potentials can be traced and understood in light of well-established cognitive neuroscience frameworks, particularly ideomotor principles, and their influential modern derivatives. Using these frameworks, the wealth of data on altered perception-action integration in the different MDs can be explained and systematized using the mechanism-oriented concept of perception-action binding. According to this concept, MDs can be understood as phenomena requiring and fostering flexible modifications of perception-action associations. Consequently, although conceived as being caught in a (trough) state of deficits, given their high flexibility, people with MDs also have high potential to switch to (adaptive) peak activity that can be conceptualized as hidden potentials. Currently, clinical practice and research in MDs are concerned with deficits and thus the "deep and wide troughs," whereas "scattered narrow peaks" reflecting hidden potentials are neglected. To better delineate and utilize the latter to alleviate the burden of affected people, and destigmatize their conditions, we suggest some measures, including computational modeling combined with neurophysiological methods and tailored treatment. © 2024 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Alexander Münchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Christine Klein
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
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Becker LF, Rawish T, Bäumer T, Beste C, Roessner V, Münchau A, Verrel J. "The Rush Video-Based Tic Rating Scale-Revised: A Practice-Oriented Revision". Mov Disord Clin Pract 2024; 11:105-106. [PMID: 38291838 PMCID: PMC10828614 DOI: 10.1002/mdc3.13922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/11/2023] [Indexed: 02/01/2024] Open
Affiliation(s)
- Leonie Felicia Becker
- Institute of Systems Motor Science, University of LübeckLübeckGermany
- Department of PediatricsUniversity Hospital Medical Center Schleswig‐HolsteinLübeckGermany
| | - Tina Rawish
- Institute of Systems Motor Science, University of LübeckLübeckGermany
| | - Tobias Bäumer
- Institute of Systems Motor Science, University of LübeckLübeckGermany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of MedicineTU DresdenDresdenGermany
- University Neuropsychology Centre, Faculty of Medicine, TU DresdenDresdenGermany
- Cognitive Psychology, Faculty of PsychologyShandong Normal UniversityJinanChina
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of MedicineTU DresdenDresdenGermany
| | - Alexander Münchau
- Institute of Systems Motor Science, University of LübeckLübeckGermany
| | - Julius Verrel
- Institute of Systems Motor Science, University of LübeckLübeckGermany
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Hartmann A, Andrén P, Atkinson-Clément C, Czernecki V, Delorme C, Monique Debes NM, Müller-Vahl K, Paschou P, Szejko N, Topaloudi A, Ueda K, Black KJ. Tourette syndrome research highlights from 2022. F1000Res 2023; 12:826. [PMID: 37691732 PMCID: PMC10483181 DOI: 10.12688/f1000research.135702.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 09/12/2023] Open
Abstract
This is the ninth yearly article in the Tourette Syndrome Research Highlights series, summarizing selected research reports from 2022 relevant to Tourette syndrome. The authors briefly summarize reports they consider most important or interesting.
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Affiliation(s)
- Andreas Hartmann
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, 75013, France
| | - Per Andrén
- Department of Psychology, University of Lund, Lund, Sweden, Sweden
| | | | - Virginie Czernecki
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, 75013, France
| | - Cécile Delorme
- Department of Neurology, Pitié-Salpêtrière Hospital, Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, 75013, France
| | | | | | | | - Natalia Szejko
- Department of Neurology, University of Calgary, Calgary, Alberta, Canada
| | | | - Keisuke Ueda
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, 63110-1010, USA
| | - Kevin J. Black
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri, 63110-1010, USA
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Friedrich J, Rawish T, Bluschke A, Frings C, Beste C, Münchau A. Cognitive and Neural Mechanisms of Behavior Therapy for Tics: A Perception-Action Integration Approach. Biomedicines 2023; 11:1550. [PMID: 37371645 DOI: 10.3390/biomedicines11061550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
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 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.
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Affiliation(s)
- Julia Friedrich
- Institute of Systems Motor Science, Center for Brain, Behavior and Metabolism (CBBM), University of Lübeck, 23562 Lübeck, Germany
| | - Tina Rawish
- Institute of Systems Motor Science, Center for Brain, Behavior and Metabolism (CBBM), University of Lübeck, 23562 Lübeck, Germany
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
| | - Christian Frings
- Department of Cognitive Psychology, Faculty of Psychology, University of Trier, 54296 Trier, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
- University Neuropsychology Centre, Faculty of Medicine, Technische Universität Dresden, 01307 Dresden, Germany
- Cognitive Psychology, Faculty of Psychology, Shandong Normal University, Jinan 250014, China
| | - Alexander Münchau
- Institute of Systems Motor Science, Center for Brain, Behavior and Metabolism (CBBM), University of Lübeck, 23562 Lübeck, Germany
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