I just reread this although I have to say it's way over my head unfortunately.
Contrary to what I had originally thought, I am seeing that asking the study participants to suppress their tics is actually an important point.
Some people of course have way more ability to suppress tics than others and it's common too for really young children to not be able to suppress their tics... I always saw that as a learned response but there's obviously much more to it than that.
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Postmortem examination has demonstrated that there are substantial decreases in the number of GABA interneurons found within the striatum of individuals with TS [2], and positron emission tomography imaging has revealed widespread reductions in GABAA receptor binding in TS
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Our finding of selectively increased concentrations of GABA within the SMA in individuals with TS (hereafter MRS-GABA) is consistent with the proposal that MRS-GABA primarily measures extracellular GABA concentrations that have been linked to alterations in levels of tonic inhibition
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If MRS primarily measures nonsynaptic, extracellular GABA concentrations that are linked to ambient levels of tonic inhibition [30, 31], then a key issue is to understand factors associated with MRS-GABA increases. One possibility is that MRS-GABA increases are triggered by neural projections arriving from other brain areas; another is that they are associated with tic severity scores.
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We cannot rule out that active suppression of tics contributed to the increased MRS-GABA in SMA that we observed. An increase in MRS-GABA in the SMA during tic suppression in TS would be consistent with previous reports that MRS-GABA concentrations within the SMA of neurologically healthy individuals correlate with individual levels of performance on behavioral tasks that index control of motor outputs
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In the last paragraph of the Discussion it says
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"We believe that these findings are particularly important for understanding how localized adaptive changes in brain function may accompany neurodevelopmental disorders and play a key role in the control of behavioral symptoms.
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nb -This is an open access article under the CC BY license (
http://creativecommons.org/licenses/by/3.0/).