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The sooner the better: clinical and neural correlates of impulsive choice in Tourette disorder.

Published version
Peer-reviewed

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Authors

Atkinson-Clement, Cyril  ORCID logo  https://orcid.org/0000-0001-9499-3485
de Liege, Astrid 
Klein, Yanica 
Beranger, Benoit 
Valabregue, Romain 

Abstract

Reward sensitivity has been suggested as one of the central pathophysiological mechanisms in Tourette disorder. However, the subjective valuation of a reward by introduction of delay has received little attention in Tourette disorder, even though it has been suggested as a trans-diagnostic feature of numerous neuropsychiatric disorders. We aimed to assess delay discounting in Tourette disorder and to identify its brain functional correlates. We evaluated delayed discounting and its brain functional correlates in a large group of 54 Tourette disorder patients and 31 healthy controls using a data-driven approach. We identified a subgroup of 29 patients with steeper reward discounting, characterised by a higher burden of impulse-control disorders and a higher level of general impulsivity compared to patients with normal behavioural performance or to controls. Reward discounting was underpinned by resting-state activity of a network comprising the orbito-frontal, cingulate, pre-supplementary motor area, temporal and insular cortices, as well as ventral striatum and hippocampus. Within this network, (i) lower connectivity of pre-supplementary motor area with ventral striatum predicted a higher impulsivity and a steeper reward discounting and (ii) a greater connectivity of pre-supplementary motor area with anterior insular cortex predicted steeper reward discounting and more severe tics. Overall, our results highlight the heterogeneity of the delayed reward processing in Tourette disorder, with steeper reward discounting being a marker of burden in impulsivity and impulse control disorders, and the pre-supplementary motor area being a hub region for the delay discounting, impulsivity and tic severity.

Description

Funder: Fondation pour la Recherche Médicale (Foundation for Medical Research in France); doi: https://doi.org/10.13039/501100002915

Keywords

Article, /631/477/2811, /692/699/476, /631/378, /59/36, /59/57, article

Journal Title

Transl Psychiatry

Conference Name

Journal ISSN

2158-3188
2158-3188

Volume Title

11

Publisher

Springer Science and Business Media LLC
Sponsorship
Agence Nationale de la Recherche (French National Research Agency) (ANR-18-CE37-0008-01)