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Tourettes Action Funded Research 2019

Developing novel brain imaging approaches to investigate the neural basis of premonitory urges in Tourette Syndrome

Prof Penny Gowland, Professor of Physics, University of Nottingham, UK

Award: £16,500

Study Duration: 2019 - ongoing

Aims of the study

Most individuals with Tourette syndrome (TS) report that their tics are preceded by ‘premonitory urges’ [PU] - uncomfortable bodily sensations that are experienced as a strong urge for motor discharge. Unfortunately, PU are particularly difficult to investigate using conventional brain imaging approaches, as they are spontaneous events that are not manifest as directly observable behaviour. PU are particularly important because individuals who experience PU often report that these experiences are more bothersome than their tics and that they would not exhibit tics if they did not experience PU. For this reason, it has been proposed that PU should be considered as the driving force behind the occurrence of tics, and it is timely and important to investigate the functional anatomy and pathophysiology of PU. To quantify brain activity associated with spontaneous events requires a model-free approach in which the timing of events is not known in advance. We propose to utilise a novel functional magnetic resonance imaging (fMRI) approach, developed at the University of Nottingham and that is termed ‘Sparse Paradigm Free Mapping’ (SPFM), for this purpose. We aim to demonstrate that by using this approach, we can reliably obtain fMRI measurements associated with premonitory sensory phenomena in TS that are not in themselves directly observable as overt behaviour. To achieve this objective we will validate the SPFM approach by investigating the functional anatomy of several common urge phenomena, including PU  in TS, and demonstrate that PU can be reliably measured in TS without the necessity for overt tic expression.

Click here to read the results of the research study