Somatomotor cortical mapping in Tourette syndrome using neuro-navigated transcranial magnetic stimulation

Smith, CM; Sigurdsson, HP; Dyke, K; Sanchez, Panchuelo, R; Francis, ST; Jackson, GM; Jackson, SR

doi:10.1016/bs.irmvd.2021.11.008

Somatomotor cortical mapping in Tourette syndrome using neuro-navigated transcranial magnetic stimulation

Lookup NU author(s): Dr Hilmar Sigurdsson ORCiD

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Abstract

© 2021 Published by Elsevier Inc. Tourette syndrome (TS) is a neurological disorder of childhood onset characterized by the occurrence of vocal and motor tics; however, there is mounting evidence to indicate that TS may be associated with the altered processing of somatosensory information, including alterations in both interoceptive and exteroceptive awareness. Importantly, the majority of individuals with TS report that their tics are preceded by premonitory sensory phenomena that are described as uncomfortable bodily sensations that occur prior to the execution of a tic and are experienced as a strong urge for motor discharge. TS is also associated with the impaired operation of GABA (inhibitory) signaling within both striatum and cortical motor areas which has been linked to hyper-excitability of limbic and sensorimotor regions that are thought to contribute to the occurrence of tics. In this chapter, we review evidence for alterations in somatosensory function in TS and consider the potential contribution of altered GABA signaling to sensorimotor dysfunction in TS. Finally, we discuss our recent efforts to develop methods for the precise mapping of cortical sensorimotor representations in TS using ultra-high-field (7 Tesla) functional magnetic resonance imaging mapping and neuro-navigated transcranial magnetic stimulation mapping.