{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T04:08:23Z","timestamp":1784606903449,"version":"3.55.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T00:00:00Z","timestamp":1692835200000},"content-version":"vor","delay-in-days":235,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003754","name":"Dr. Mortimer and Theresa Sackler Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003754","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Many people with Tourette syndrome are able to volitionally suppress tics, under certain circumstances. To understand better the neural mechanisms that underlie this ability, we used functional magnetic resonance neuroimaging to track regional brain activity during performance of an intentional inhibition task. On some trials, Tourette syndrome and comparison participants internally chose to make or withhold a motor action (a button press), while on other trials, they followed \u2018Go\u2019 and \u2018NoGo\u2019 instructions to make or withhold the same action. Using representational similarity analysis, a functional magnetic resonance neuroimaging multivariate pattern analysis technique, we assessed how Tourette syndrome and comparison participants differed in neural activity when choosing to make or to withhold an action, relative to externally cued responses on Go and NoGo trials. Analyses were pre-registered, and the data and code are publicly available. We considered similarity of action representations within regions implicated as critical to motor action release or inhibition and to symptom expression in Tourette syndrome, namely the pre-supplementary motor area, inferior frontal gyrus, insula, caudate nucleus and primary motor cortex. Strikingly, in the Tourette syndrome compared to the comparison group, neural activity within the pre-supplementary motor area displayed greater representational similarity across all action types. Within the pre-supplementary motor area, there was lower response-specific differentiation of activity relating to action and inhibition plans and to internally chosen and externally cued actions, implicating the region as a functional nexus in the symptomatology of Tourette syndrome. Correspondingly, patients with Tourette syndrome may experience volitional tic suppression as an effortful and tiring process because, at the top of the putative motor decision hierarchy, activity within the population of neurons facilitating action is overly similar to activity within the population of neurons promoting inhibition. However, not all pre-supplementary motor area group differences survived correction for multiple comparisons. Group differences in representational similarity were also present in the primary motor cortex. Here, representations of internally chosen and externally cued inhibition were more differentiated in the Tourette syndrome group than in the comparison group, potentially a consequence of a weaker voluntary capacity earlier in the motor hierarchy to suppress actions proactively. Tic severity and premonitory sensations correlated with primary motor cortex and caudate nucleus representational similarity, but these effects did not survive correction for multiple comparisons. In summary, more rigid pre-supplementary motor area neural coding across action categories may constitute a central feature of Tourette syndrome, which can account for patients\u2019 experience of \u2018unvoluntary\u2019 tics and effortful tic suppression.<\/jats:p>","DOI":"10.1093\/braincomms\/fcad224","type":"journal-article","created":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T11:55:07Z","timestamp":1692878107000},"source":"Crossref","is-referenced-by-count":8,"title":["Elevated representational similarity of voluntary action and inhibition in Tourette syndrome"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4503-4971","authenticated-orcid":false,"given":"Charlotte L","family":"Rae","sequence":"first","affiliation":[{"name":"School of Psychology, University of Sussex , Brighton BN1 9QH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Raykov","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Sussex , Brighton BN1 9QH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor M","family":"Ambridge","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Sussex , Brighton BN1 9QH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lincoln J","family":"Colling","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Sussex , Brighton BN1 9QH , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra D","family":"Gould van Praag","sequence":"additional","affiliation":[{"name":"Wellcome Centre for Integrative Neuroimaging, University of Oxford , Oxford OX3 7JX , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Bouyagoub","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Brighton & Sussex Medical School , Brighton BN1 9RY , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Polanski","sequence":"additional","affiliation":[{"name":"Center for Lifespan Psychology, Max Planck Institute for Human Development , Berlin 14195 , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8931-6065","authenticated-orcid":false,"given":"Dennis E O","family":"Larsson","sequence":"additional","affiliation":[{"name":"School of Psychology, University of Sussex , Brighton BN1 9QH , UK"},{"name":"Department of Neuroscience, Brighton & Sussex Medical School , Brighton BN1 9RY , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo D","family":"Critchley","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Brighton & Sussex Medical School , Brighton BN1 9RY , UK"},{"name":"Sussex Partnership NHS Foundation Trust , Worthing BN3 7HZ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,24]]},"reference":[{"key":"2023091217570442000_fcad224-B1","first-page":"209","volume-title":"International review of movement disorders: The neurobiology of the Gilles de La Tourette syndrome and chronic tics. 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