Temporo-parietal dysfunction in Tourette syndrome: Insights from an fMRI study of Theory of Mind |
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| Affiliation: | 1. Department of Neuropsychiatry, BSMHFT National Centre for Mental Health, Birmingham, UK;2. Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK;3. Birmingham University Imaging Centre and School of Psychology, College of Life and Environmental Sciences, University of Birmingham, UK;1. Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Foundation Trust, The Barberry National Centre for Mental Health, Birmingham, UK;2. School of Clinical and Experimental Medicine, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK;3. School of Life and Health Sciences, Aston University, Birmingham, UK;4. Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and University College London, London, UK;1. Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, University of Lübeck, Germany;2. Department of Neurology, University of Lübeck, Germany;3. Institute of Neurology and Neurosurgery, Chişinău, Republic of Moldova;4. Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany;1. Institute of Cognitive Neuroscience, University College London, UK;2. Department of Neurology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany;3. Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, University of Lübeck, Lübeck, Germany;1. Magnetic Resonance and Image Analysis Research Centre (MARIARC), University of Liverpool, UK;2. Department of Psychology, Edge Hill University, UK;3. Department of Computer Science, University of Liverpool, UK;4. Institute of Psychology, Health and Society, University of Liverpool, UK;5. Department of Psychological Sciences, University of Liverpool, UK;6. Department for Biostatistics, University of Liverpool, UK;1. Department of Psychology, Peking University, Beijing, China;2. Department of Applied Social Studies, City University of Hong Kong, Kowloon, Hong Kong, China |
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| Abstract: | Tourette syndrome (TS) is a neurodevelopmental disorder characterized by tics, repetitive movements and vocalizations which are prompted by a sensory-cognitive premonitory urge. Complex tics include environmentally dependent social behaviors such as echoing of other people's speech and actions. Recent studies have suggested that adults with TS can show differences to controls in Theory of Mind (ToM): reasoning about mental states (e.g. beliefs, emotions). In this study, twenty-five adults with uncomplicated TS (no co-morbid disorders, moderate tic severity), and twenty-five healthy age and gender matched controls were scanned with fMRI during an established ToM task. Neural activity was contrasted across ToM trials involving reasoning about false-belief, and matched trials requiring judgments about physical states rather than mental states. Contrasting task conditions uncovered differential fMRI activation in TS during ToM involving the right temporo-parietal junction (TPJ), right amygdala and posterior cingulate. Further analysis revealed that activity within the right TPJ as localised by this task covaried with the severity of symptoms including echophenomena, impulse control problems and premonitory urges in TS. Amygdala activation was also linked to premonitory urges, while activity in the left TPJ during ToM was linked to ratings of non-obscene socially inappropriate symptoms. These findings indicate that patients with TS exhibit atypical functional activation within key neural substrates involved in ToM. More generally, our data could highlight an important role for TPJ dysfunction in driving compulsive behaviors. |
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| Keywords: | Compulsions Social cognition Temporo-parietal junction Theory of mind Tics Tourette syndrome |
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