@article{a2e9d3cb1bc0430fbbc188b7b9fb9fa6,
title = "Neural correlates of behavior therapy for Tourette's disorder",
abstract = "Tourette's disorder, also called Tourette syndrome (TS), is characterized by motor and vocal tics that can cause significant impairment in daily functioning. Tics are believed to be due to failed inhibition of both associative and motor cortico-striato-thalamo-cortical pathways. Comprehensive Behavioral Intervention for Tics (CBIT), which is an extension of Habit Reversal Therapy (HRT), teaches patients to become more aware of sensations that reliably precede tics (premonitory urges) and to initiate competing movements that inhibit the occurrence of tics. In this study, we used functional magnetic resonance imaging (fMRI) to investigate the neural changes associated with CBIT treatment in subjects with TS. Eight subjects with TS were matched with eight healthy controls in gender, education, age, and handedness. Subjects completed the Visuospatial Priming (VSP) task, a measure of response inhibition, during fMRI scanning before and after CBIT treatment (or waiting period for controls). For TS subjects, we found a significant decrease in striatal (putamen) activation from pre- to post-treatment. Change in VSP task-related activation from pre- to post-treatment in Brodmann's area 47 (the inferior frontal gyrus) was negatively correlated with changes in tic severity. CBIT may promote normalization of aberrant cortico-striato-thalamo-cortical associative and motor pathways in individuals with TS.",
keywords = "Behavior therapy, Habit reversal, Neuroimaging, Tourette's disorder",
author = "Thilo Deckersbach and Tina Chou and Britton, {Jennifer C.} and Carlson, {Lindsay E.} and Reese, {Hannah E.} and Jedidiah Siev and Lawrence Scahill and Piacentini, {John C.} and Woods, {Douglas W.} and Walkup, {John T.} and Peterson, {Alan L.} and Dougherty, {Darin D.} and Sabine Wilhelm",
note = "Funding Information: Dr. Wilhelm reports receiving support in the form of free medication and matching placebo from Forest Laboratories for clinical trials funded by the NIH and receiving book royalties from Guilford Publications, New Harbinger Publications, and Oxford University Press and speaking honoraria from PRIMEDIA Healthcare, a publicly traded company working as a logistics collaborator for the MGH Psychiatry Academy (the education programs conducted by the MGH Psychiatry Academy were supported through Independent Medical Education grants from pharmaceutical companies co-supporting the overall program, along with participant tuition). Funding Information: The research reported in this manuscript was funded by a Tourette Syndrome Association grant to Dr. T. Deckersbach. This research was supported in part by the Intramural Research Program of the National Institute of Mental Health to Dr. J. Britton (Grant number R00 MH091183 ). Funding Information: Recently, two large randomized multi-site trials funded by the National Institute of Mental Health (NIMH) investigated the efficacy of an expanded form of HRT, the Comprehensive Behavioral Intervention for Tics (CBIT). These two studies, one in children and the other one in adults, found that CBIT was associated with significantly greater reductions in tic severity and impairment relative to standardized psychoeducation plus supportive therapy ( Piacentini et al., 2010; Wilhelm et al., 2012 ). Treatment gains were well maintained at 6-month follow-up. The present study was a supplement to the study on adults with TS ( Wilhelm et al., 2012 ). Specifically, we investigated the neural correlates of CBIT with functional magnetic resonance imaging (fMRI). Publisher Copyright: {\textcopyright} 2014 Elsevier Ireland Ltd. All rights reserved.",
year = "2014",
doi = "10.1016/j.pscychresns.2014.09.003",
language = "English (US)",
volume = "224",
pages = "269--274",
journal = "Psychiatry Research - Neuroimaging",
issn = "0925-4927",
publisher = "Elsevier Ireland Ltd",
number = "3",
}
