Introduction
tic, tic suppression, tic suppressibility, voluntary tic suppression, Tourette syndrome, tics
TOURETTE SYNDROME
Comprehensive Behavioral Intervention for Tics (CBIT) is recommended as a first-line treatment for Tourette syndrome (TS) in children and adults (Andrén et al., Recently, Essoe, Ramsey, Singer, Grados, and McGuire (Another process that may be linked with CBIT is voluntary tic suppression. Most people with TS can voluntarily suppress their tics, though tic suppressibility varies widely across individuals (Conelea et al., While the exact mechanism underlying tic suppression is still unclear, it could, just like behavior therapy, rely on a mix of reinforcement learning, cognitive control, and habituation. Prior research has found that tic suppression can be improved with positive reinforcement (Conelea et al., In a recent EEG study, our group identified a brain network in which functional connectivity was increased during tic suppression in children with TS (Morand-Beaulieu et al., Therefore, the first objective of this study was to test whether functional connectivity associated with tic suppression would change from baseline to endpoint. We predicted that functional connectivity in the tic suppression network would increase from baseline to endpoint in the CBIT group but not in the treatment-as-usual (TAU) condition. Our second objective was to test whether functional connectivity predicted reduction in tic severity following CBIT. We hypothesized that increased brain connectivity during tic suppression at baseline would predict greater decreases in tic severity at endpoint in the CBIT group.