The Effects of Tic Suppression on Current and Subsequent Cognitive Functioning: A Multisite Investigation

Grant Type
Grant Year
Institution Location
Institution Organization Name
University of Utah
Investigators Name
Himle, Michael, PhD

Although tics are involuntary, they can be temporarily suppressed with active inhibitory effort. Such suppression appears to rely upon frontal-subcortical networks that subserve goal-oriented cognitive control functions of the prefrontal cortex (PFC), including inhibition, cognitive flexibility, sustained attention, and working memory. These “executive functions” are responsible for behavioral control and other important neurocognitive processes, such as acquisition of new information, and thus are crucial for school performance and intellectual growth. To date, most research examining the role of executive function (EF) in TS has focused on group differences in cognitive function and/or has explored the relationship between EF performance and tic severity, remission, and treatment response (i.e., tic suppression). Findings from these studies are inconsistent, with some studies finding normal and others abnormal performance. No studies have investigated activity-dependent changes in EF over short periods of time in TS, yet there is a growing body of research showing that EF has limited capacity and is temporarily depletable. If voluntary tic suppression requires executive resources, it is possible that children who are engaged in tic suppression may show decreased performance on concurrent EF-demanding tasks (e.g., academic and skill learning) and that suppression may undermine performance on subsequent cognitive and behavioral control tasks such as behavioral inhibition and sustained attention. This phenomenon has been termed “executive depletion” and has been linked to a variety of self-regulatory failures. The current project will investigate whether attempts at tic suppression interfere with or depletes cognitive resources, thus leading to concurrent/subsequent lapses in motor, attentional, and cognitive control. A better understanding of EF in tic suppression is important for understanding the role of the PFC in TS and may guide educational and therapeutic recommendations and interventions. . Michael B. Himle, Ph.D., University of Utah, Salt Lake City, UT Yana Suchy, Ph.D., University of Utah, Salt Lake City, UT Susanna Chang, Ph.D., University of California at Los Angeles, Los Angeles, CA Award: $65,755 Commentary: Although tics are involuntary, many people with TS try to temporarily suppress them. Previous research has shown that suppression uses a specific part of the brain that controls attention, learning, and behavior. This study will examine how attempts (successful or unsuccessful) at suppression affect learning and attention. Children’s performance on attention and learning tasks before, during, and after periods of voluntary tic suppression will be compared to see whether their performance is better, worse, or the same during and after a tic suppression task. This will help us better understand TS and may guide educational and therapeutic recommendations and interventions. Tourette Association of America Inc. – Research Grant Award 2011-2012