Excessive action monitoring in Tourette syndrome

Abstract

Tourette Syndrome (TS) has been related to hyperactive basal-ganglia thalamocortical pathways. This suggests that action monitoring might also be hyperactive. The present study used the event-related brain potential (ERP) technique to investigate this hypothesis. A simple "oddball" reaction time experiment was administered to a group of TS patients and a matched control group. In order to investigate variations in attentional allocation separate experimental runs were undertaken with target frequencies of 50% and 80%. The P3b component to targets was taken as an indicator of the target evaluation process and the response locked error-related negativity (ERN) served as an indicator of action monitoring. We hypothesized that the amplitudes of ERN and P3b would vary with respect to target frequency. The TS group would show an overall enhanced ERN but an unchanged P3b.ERN and P3b amplitudes were lower in the 80% target condition than in the 50% condition. In comparison with control subjects TS patients displayed an ERN of overall higher amplitude but with similar variations between target conditions. P3b amplitudes did not differ between groups. The data are interpreted to support the assumption of an abnormal action monitoring system in TS. A number of similarities to Obsessive-Compulsive Disorder are outlined and it is argued that the findings could be related to a hyperactive frontal-striatal-thalamic-frontal circuit.

Influence of comorbid obsessive-compulsive symptoms on brain event-related potentials in Gilles de la Tourette syndrome

“…Indeed, absence of P300 amplitude or latency differences in GTS (Johannes et al, 2001b(Johannes et al, , 2002van Woerkom et al, 1988) has been reported in earlier investigations, which could be ascribed to the influence of comorbid OCD in the sample of participants. Previous ERP studies either included GTS participants suffering from mild to severe OCS or provided no information about the presence of such symptoms in their sample.…”

Thalamocingulate Interactions In Performance Monitoring

“…The present findings may also be of potential clinical interest as deep brain stimulation (DBS) in nearby thalamic regions has recently been used for the treatment of Tourette's syndrome (Servello et al, 2008(Servello et al, , 2009). It will be important to see whether and how the impaired performance monitoring in this disorder (Johannes et al, 2002;Müller et al, 2003), reflected in increased ERN amplitudes, is modulated by DBS in the thalamus; moreover, the implantation of depth electrodes may allow direct recording of electrical activity in these regions (Marceglia et al, 2010) and link it to performance monitoring and other cognitive functions.…”

Neurocognitive Aspects of Tourette Syndrome and Related Disorders

“…This difficulty to inhibit interference could also rely on a problem of overfocused attention particularly salient in OCD (Savage et al, 1994). This hypothesis was confirmed in ERP research, where attention-related components peaked at a faster latency in OCD (Towey et al, 1990;Towey et al, 1993;Towey et al, 1994) than in a control group, which was not found with GTS (Johannes, Wieringa, Nager et al, 2001;Johannes et al, 2002;van Woerkom, Fortgens, Rompel-Martens, & Van de Wetering, 1988).…”