Non-invasive Brain Stimulation for the Treatment of Gilles de la Tourette Syndrome

Tourette syndrome as a motor disorder revisited – Evidence from action coding

“…If so, this might have repercussions for the conceptualization of GTS and also for clinical studies suggesting that in addition to motor readouts more sophisticated measures focusing on perception–action integration should also be used to capture the effectiveness of interventions. Along the same lines this will also have repercussion on TEC, since such a pattern of results together with previously observed hyper-binding in event files in GTS (M. Kleimaker et al, 2020b ) will suggest that binding mechanism differ between action files and event files.…”

“…Given that patients have an increased tendency to form habits ( Brandt et al, 2016a , Brandt et al, 2016b , Delorme et al, 2016 , Kleimaker et al, 2020aa ), a relation between motor learning and tic occurrence has been suggested and is supported by observations of a high prevalence of tics in people professionally engaging in activities requiring the execution of habitual, over-learned behavior, for instance musicians ( Tunc and Münchau, 2017 ). Taken together, these data suggest that GTS is a complex disorder where in addition to motor processes also perception–action integration and cognitive control processes play a role ( Beste et al, 2016 , Beste and Münchau, 2018 , Buse et al, 2016 , Buse et al, 2018 , Kim et al, 2019 , Kleimaker et al, 2020aa , Kleimaker et al, 2020bbd , Kleimaker et al, 2020cc , Petruo et al, 2019 , Petruo et al, 2020 ). This view has been corroborated by experimental work showing that in GTS associations between sensory and motor processes are abnormally strong and that this (partly) predicts tic frequency ( Kleimaker et al, 2020bbd , Weissbach et al, 2020 ).…”

“…Taken together, these data suggest that GTS is a complex disorder where in addition to motor processes also perception–action integration and cognitive control processes play a role ( Beste et al, 2016 , Beste and Münchau, 2018 , Buse et al, 2016 , Buse et al, 2018 , Kim et al, 2019 , Kleimaker et al, 2020aa , Kleimaker et al, 2020bbd , Kleimaker et al, 2020cc , Petruo et al, 2019 , Petruo et al, 2020 ). This view has been corroborated by experimental work showing that in GTS associations between sensory and motor processes are abnormally strong and that this (partly) predicts tic frequency ( Kleimaker et al, 2020bbd , Weissbach et al, 2020 ). Against this background it appears likely that abnormalities of restructuring of perception–action associations rather than action coding per se are a core feature of GTS.…”

“…The equipment and the parameters of EEG measurement were identical across the participating labs in Lübeck and Dresden. EEG was recorded from 60 Ag/AgCl electrodes and processed as described previously ( Kleimaker et al, 2020b ). Electrodes were mounted in an elastic cap with equidistant layout (EasyCap, Wörthsee, Germany).…”

“…Therefore, we also explore, how far the r-LRP is modulated by experimental variations. If increased binding as shown to be evident for perception–action integration in GTS ( Kleimaker et al, 2020b ) is also evident within the motor domain, then there should be an interaction between the overlap in motor elements constituting an action and group. This is also possible since, at present, TEC draws no distinctions in binding mechanisms between action files and event files.…”