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A collaborative genetic study \citep{25735483} demonstrated an association of TS with 33 genes related to glycolysis or glutamine metabolism. None of the individual genes would have survived correction for multiple testing and the results were consistent with a combined effect of many genetic variants of small effect. These results narrow the hunt for genes that may contribute to the development of TS and they also suggest a new direction for future electrophysiological, imaging and pharmacological studies.   Transcriptome analysis of the human striatum in Tourette syndrome \citep{25199956} | This important study \citep{25199956}  follows up on the autopsy results from the Vaccarino lab by comparing RNA transcripts from the basal ganglia of 9 TS and 9 matched control subjects. The most strongly associated set of downregulated transcripts involved striatal interneurons, consistent with the autopsy studies. The leading set of upregulated transcripts involved immune-related genes even though none of the TS subjects met the diagnostic criteria for pediatric autoimmune streptococcal-associated neuropsychiatric disorders or pediatric acute onset neuropsychiatric syndrome. There was a lack of overlap between the results obtained in the present study using brain tissue and previous studies using blood samples. The authors conclude that their results "strongly [implicate] disrupted interneuron signaling in the pathophysiology of severe TS and suggests that metabolic alterations may be linked to their death or dysfunction." The GAGA-A antagonist picrotoxin was injected into targets throughout corticostriatal regions in adult mice \cite{25597650}. Infusions into the central and dorsolateral striatum produced intermittent non-rhythmic stereotyped lifting of the front or hind paw or head jerks. Infusions into the dorsomedial striatum did not have a significant behavioral effect. Infusion into the ventral striaum produced locomotor activation with sterotypical sniffing and wall licking. Infusions into the sensorimotor cortex produced similar movements in addition to exploration of the cage. sniffing and occasional licking. When an NMDA receptor antagonist was infused into the dorsolateral striatum prior to infusing picrotoxin into the same location, tic frequency decreased significantly thus demonstrating the role of glutamateric activity in tic generation. Infusion of a GABA-A antagonist into the sensorimotor cortex 10 minutes before picrotoxin infusion into the dorsolateral striatum also resulted in significant tic suppression.EEG recordings allowed experimenters to determine whether the infusions were causing seizures or not. The interpretation of these results was that the tic-like movements were generated from enhanced striatal responsivity to afferent glutamatergic synaptic input rather than to autonomous striatal activity.  
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23 TS children aged 8-12 were compared to 67 controls on a battery of vibrotactile tasks \cite{26041822} with a subset also undergoing GABA-edited magnetic resonance spectroscopy. Lower GABA concentrations in the right sensorimotor cortex was associated with greater motor tic severity (r=-0.55). There were no significant differences between groups on reaction time and baseline amplitude discrimination threshold. Control children showed the expected increase in discrimination threshold after being exposed to a dyanamically increasing subthreshold stimulus while TS children did not. The authors suggest that this is related to abnormal GABAergic inhibition although they point out that larger studies are needed to determine to what extent the high proportion of TS subjects with ADHD influenced the results.  A whole brain analysis of cortical gray matter found reduced gray matter thickness in the insula and sensorimotor cortex for TS children and young adults compared to a matched control group \cite{26538289}. In addition, Premonitory Urge for Tics Scale scores were negatively correlated with grey matter thickness in these areas. Several studies examined dopamine receptors. Positron emission tomography was used to investigate striatal D2/D3 dopamine receptors using a D2/D3 receptor antagonist and an agonist with preferential binding to D3 dopamine receptors \cite{25788222}. As expected, binding potential for the D3 preferential agonist was greater in the ventral striatum while it was greater for the D2/D3 receptor antagonist in the motor and associative regions of the dorsal striatum. However, no differences were found for these 3 regions when the TS subjects were compared with the controls and there were no significant correlations between binding potentials and tic severity. Dopamine receptors and motor response inhibition \cite{25878272}|Stop-signal reaction time was negatively correlated with D1- and D2-type activation in the dorsal, but not ventral, striatum. No significant correlations involving the continuous performance task were found suggesting that different inhibitory mechanisms are involved in these two tasks. Another study examined D1 and D2 involvement in healthy adults and found that learning from positive outcomes was positively correlated with D1 receptor binding in the putamen and caudate while there was an inverted U-shaped relationship between learning from negative outcomes and D2R binding in the putamen\citep{25562824}. A dietary manipulation that reduced dopamine precursor levels significantly improved learning from negative outcomes. These results were interpreted as providing evidence that dopamine acts as a reward prediction error signal rather than as a saliency signal.