Motor cortical excitability during voluntary inhibition of involuntary tic movements

Mov Disord. 2018 Nov;33(11):1804-1809. doi: 10.1002/mds.27479. Epub 2018 Oct 31.

Abstract

Background: Tics can be voluntarily inhibited. However, the neurophysiology of voluntary tic inhibition remains underexplored. The objective of this study was to explore state-dependent effects of voluntary tic inhibition on M1 excitability.

Methods: Neurophysiological assessments (single motor-evoked potentials, corticospinal recruitment curves, short-interval intracortical inhibition, H-reflex) were performed in 14 adults with Tourette syndrome during voluntary tic inhibition and free ticcing. Regressions between behavioral performance and neurophysiological measures were also performed.

Results: Voluntary tic inhibition reduced corticospinal excitability: the greater the ability to inhibit tics, the greater was the reduction in excitability. Voluntary tic inhibition was not associated with changes in the excitability of short-interval intracortical inhibition or the H-reflex.

Conclusions: Voluntary inhibition of tics reduces the excitability of corticospinal output. The pattern of neurophysiological findings is consistent with a withdrawal of excitation, but not with modulation of the inhibitory interneuronal mechanisms involved in short-interval intracortical inhibition. © 2018 International Parkinson and Movement Disorder Society.

Keywords: motor cortical excitability; tic disorders; transcranial magnetic stimulation; voluntary motor control; voluntary tic inhibition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cortical Excitability / physiology*
  • Dyskinesias / etiology*
  • Evoked Potentials, Motor / physiology
  • Female
  • H-Reflex / physiology
  • Humans
  • Inhibition, Psychological*
  • Male
  • Middle Aged
  • Motor Cortex / physiology*
  • Movement / physiology*
  • Tics / physiopathology*
  • Transcranial Magnetic Stimulation