Abstract
Tic disorders (TD) are characterized by the presence of non-voluntary contractions of functionally related groups of skeletal muscles in one or multiple body parts. Patients with body-focused repetitive behaviors (BFRB) present frequent and repetitive behaviors, such as nail biting or hair pulling. TD and BFRB can be treated with a cognitive-behavioral therapy (CBT) that regulates the excessive amount of sensorimotor activation and muscular tension. Our CBT, which is called the cognitive-psychophysiological (CoPs) model, targets motor execution and inhibition, and it was reported to modify brain activity in TD. However, psychophysiological effects of therapy are still poorly understood in TD and BFRB patients. Our goals were to compare the event-related potentials (ERP) of TD and BFRB patients to control participants and to investigate the effects of the CoPs therapy on the P200, N200, and P300 components during a motor and a non-motor oddball task. Event-related potential components were compared in 26 TD patients, 27 BFRB patients, and 27 control participants. ERP were obtained from 63 EEG electrodes during two oddball tasks. In the non-motor task, participants had to count rare stimuli. In the motor task, participants had to respond with a left and right button press for rare and frequent stimuli, respectively. ERP measures were recorded before and after therapy in both patient groups. CoPs therapy improved symptoms similarly in both clinical groups. Before therapy, TD and BFRB patients had reduced P300 oddball effect during the non-motor task, in comparison with controls participants. An increase in the P300 oddball effect was observed posttherapy. This increase was distributed over the whole cortex in BFRB patients, but localized in the parietal area in TD patients. These results suggest a modification of neural processes following CoPs therapy in TD and BFRB patients. CoPs therapy seems to impact patients' attentional processes and context updating capacities in working memory (i.e., P300 component). Our results are consistent with a possible role of the prefrontal cortex and corpus callosum in mediating interhemispheric interference in TD.
Highlights
Tic disorders (TD) are characterized by repetitive non-voluntary contractions of functionally related groups of skeletal muscles in one or more parts of the body, including blinking, cheek twitches, and head or knee jerks among others
The therapy induced a reduction in tics and habits symptoms in TD and body-focused repetitive behaviors (BFRB) patients, respectively
There was a therapy by group interaction on the YGTSS motor tics/habits subscale [F(1,51) = 5.84, p < 0.05], which showed that motor tics/habits severity decrease following CoPs therapy in both patient groups, but improvements were more pronounced in the BFRB group
Summary
Tic disorders (TD) are characterized by repetitive non-voluntary contractions of functionally related groups of skeletal muscles in one or more parts of the body, including blinking, cheek twitches, and head or knee jerks among others. Tics can be more complex and take the form of self-inflicted repetitive actions, such as teeth grinding, head slapping, or tense-release hand gripping cycles. They appear as more purposive and stereotyped movements of longer duration, such as facial gestures and grooming-like movements. The tics may wax and wane over the course of weeks, months, and years They can appear in bouts many times a day with onset longer than a year and arise prior to 18 years old with a peak in symptoms intensity around 12 years old. Tourette syndrome and persistent TD patients are often pooled together as a sole group, and the need for a distinction between both has been debated, since phonic tics have an inherent motor component [1]
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