Inhibitory control in children with tic disorder: aberrant fronto-parietal network activity and connectivity Joseph Jurgiel, 1 Makoto Miyakoshi, 2 Andrea Dillon, 1 John Piacentini, 1 Scott Makeig 2 and Sandra K. Loo 1 Chronic tic disorders, including Tourette syndrome, are typically thought to have deficits in cognitive inhibition and top down cognitive control due to the frequent and repetitive occurrence of tics, yet studies reporting task performance results have been equivocal. Despite similar behavioural performance, individuals with chronic tic disorder have exhibited aberrant patterns of neural activation in multiple frontal and parietal regions relative to healthy controls during inhibitory control paradigms. In addition to these top down attentional control regions, widespread alterations in brain activity across multiple neural networks have been reported. There is a dearth, however, of studies examining event-related connectivity during cognitive inhibitory paradigms among affected individuals. The goal of this study was to characterize neural oscillatory activity and effective connectivity, using a case– control design, among children with and without chronic tic disorder during performance of a cognitive inhibition task. Electroencephalogram data were recorded in a cohort of children aged 8–12 years old (60 with chronic tic disorder, 35 typically developing controls) while they performed a flanker task. While task accuracy did not differ by diagnosis, children with chronic tic disorder displayed significant cortical source-level, event-related spectral power differences during incongruent flanker trials, which required inhibitory control. Specifically, attenuated broad band oscillatory power modulation within the anterior cingulate cortex was observed relative to controls. Whole brain effective connectivity analyses indicated that children with chronic tic disorder ex- hibit greater information flow between the anterior cingulate and other fronto-parietal network hubs (midcingulate cortex and pre- cuneus) relative to controls, who instead showed stronger connectivity between central and posterior nodes. Spectral power within the anterior cingulate was not significantly correlated with any connectivity edges, suggesting lower power and higher connectivity are independent (versus resultant) neural mechanisms. Significant correlations between clinical features, task performance and an- terior cingulate spectral power and connectivity suggest this region is associated with tic impairment (r ¼0.31, P ¼ 0.03) and flanker task incongruent trial accuracy (r’s ¼0.27 to 0.42, P’s ¼ 0.0008–0.04). Attenuated activation of the anterior cingulate along with dysregulated information flow between and among nodes within the fronto-parietal attention network may be neural adaptations that result from frequent engagement of neural pathways needed for inhibitory control in chronic tic disorder. 1 Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA 90095, USA 2 Swartz Center for Neural Computation, University of California, San Diego, La Jolla, CA 92093, USA Correspondence to: Sandra K. Loo, PhD Department of Psychiatry and Biobehavioral Sciences University of California, Los Angeles, 760 Westwood Plaza A7-456, Los Angeles, CA 90095, USA E-mail: sloo@mednet.ucla.edu Keywords: electroencephalography; neural oscillations; effective connectivity; movement disorders; Tourette syndrome Received September 30, 2020. Revised February 23, 2021. Accepted February 26, 2021 VC The Author(s) (2021). Published by Oxford University Press on behalf of the Guarantors of Brain. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. BBR AIN COMMUNICATIONS AIN COMMUNICATIONS doi:10.1093/braincomms/fcab067 BRAIN COMMUNICATIONS 2021: Page 1 of 15 | 1 Downloaded from https://academic.oup.com/braincomms/article/3/2/fcab067/6219298 by guest on 02 December 2021