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More severe urges correlate with worse tics and can render behavioral therapies less effective. The supplementary motor area (SMA) is a prefrontal region believed to influence tic performance. To determine whether cortical physiological properties correlate with urges and tics, we evaluated, in 8\u201312-year-old right-handed TS children (n\u2009=\u200917), correlations of urge and tic severity scores and compared both to cortical excitability (CE) and short- and long-interval cortical inhibition (SICI and LICI) in both left and right M1. We also modeled these M1 transcranial magnetic stimulation measures with SMA gamma-amino butyric acid (GABA) levels in TS and typically developing control children (n\u2009=\u200916). Urge intensity correlated strongly with tic scores. More severe urges correlated with lower CE and less LICI in both right and left M1. Unexpectedly, in right M1, lower CE and less LICI correlated with less severe tics. We found that SMA GABA modulation of right, but not left, M1 CE and LICI differed in TS. We conclude that in young children with TS, lower right M1 CE and LICI, modulated by SMA GABA, may reflect compensatory mechanisms to diminish tics in response to premonitory urges.<\/jats:p>","DOI":"10.1093\/cercor\/bhac316","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T14:21:50Z","timestamp":1660659710000},"page":"3922-3933","source":"Crossref","is-referenced-by-count":18,"title":["From urges to tics in children with Tourette syndrome: associations with supplementary motor area GABA and right motor cortex physiology"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6214-2731","authenticated-orcid":false,"given":"Travis R","family":"Larsh","sequence":"first","affiliation":[{"name":"Division of Neurology, Cincinnati Children\u2019s Hospital Medical Center , 3333 Burnet Avenue, Cincinnati, OH 45267, United States"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , 3230 Eden Avenue, Cincinnati, OH 45267, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Huddleston","sequence":"additional","affiliation":[{"name":"Division of Neurology, Cincinnati Children\u2019s Hospital Medical Center , 3333 Burnet Avenue, Cincinnati, OH 45267, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S","family":"Horn","sequence":"additional","affiliation":[{"name":"Division of Neurology, Cincinnati Children\u2019s Hospital Medical Center , 3333 Burnet Avenue, Cincinnati, OH 45267, United States"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , 3230 Eden Avenue, Cincinnati, OH 45267, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve W","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Neurology, Cincinnati Children\u2019s Hospital Medical Center , 3333 Burnet Avenue, Cincinnati, OH 45267, United States"},{"name":"Department of Pediatrics, University of Cincinnati College of Medicine , 3230 Eden Avenue, Cincinnati, OH 45267, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M","family":"Cecil","sequence":"additional","affiliation":[{"name":"Department of Radiology , Cincinnati Children\u2019s Hospital Medical Center, , 3333 Burnet Avenue, Cincinnati, OH, United States"},{"name":"University of Cincinnati College of Medicine , Cincinnati Children\u2019s Hospital Medical Center, , 3333 Burnet Avenue, Cincinnati, OH, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah S","family":"Jackson","sequence":"additional","affiliation":[{"name":"Division of Neurology, Cincinnati Children\u2019s Hospital Medical Center , 3333 Burnet Avenue, Cincinnati, OH 45267, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A E","family":"Edden","sequence":"additional","affiliation":[{"name":"Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine , 733 N Broadway, Baltimore, MD 21205, United States"},{"name":"F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute , 707 N Broadway, Baltimore, MD 21205, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stewart H","family":"Mostofsky","sequence":"additional","affiliation":[{"name":"Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute , 707 N Broadway, Baltimore, MD 21205, United States"},{"name":"Department of Neurology, The Johns Hopkins University School of Medicine , 733 N Broadway, Baltimore, MD 21205, United States"},{"name":"Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine , 733 N Broadway, Baltimore, MD 21205, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald L","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Division of Neurology, Cincinnati Children\u2019s Hospital Medical Center , 3333 Burnet Avenue, Cincinnati, OH 45267, United 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