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Aperiodic Neural Activity as a Marker of Excitation/Inhibition Balance in Children with Tourette Syndrome

Poster Session E - Monday, March 9, 2026, 2:30 – 4:30 pm PDT, Fairview/Kitsilano Ballroom

Elizabeth Kaplan¹ (), Sarah Chang¹, Sujin Park¹, Manasa Pooni¹, Tania Mungai², Abbigal Baim¹, Jon Ahern¹, Sana Ali¹, Ben Ahn¹, Sarah Hodap², G Reiner², James Friedman³, Christian Cazares¹, Michael-Paul Schallmo², Bradley Voytek¹, Christine Conelea², Sonya Wang⁴, Deanna Greene¹; ¹UC San Diego, ²University of Minnesota, ³Rady Children's Hospital

Tourette Syndrome (TS) is characterized by motor disinhibition, which may reflect altered cortical excitation and inhibition (E/I) balance in frontal and motor regions. Evidence shows that individuals with TS exhibit flatter aperiodic (1/f) spectral slopes compared to controls, suggesting elevated cortical excitability and neural noise across development. However, whether E/I balance changes with behavioral therapy, and how it develops in children with TS remains poorly understood. We are investigating aperiodic EEG activity before and after Comprehensive Behavioral Intervention for Tics (CBIT) in children (target N: 20, current N: 2, ages 10-14) with TS. CBIT involves 8 weekly sessions of awareness training, competing response practice, and managing tic triggers to strengthen inhibitory control over tics. Data is collected using 64-channel EEG. Preprocessing includes artifact removal, noise correction, and time-locked coding of tics. Aperiodic activity is extracted using SpecParam, and preliminary analyses focus on the aperiodic exponent as an index of cortical E/I balance. We hypothesize that lower exponents at baseline will indicate elevated cortical excitability, and that increases in the exponents following CBIT will reflect improved inhibitory control and a shift towards balanced E/I dynamics. While results are preliminary, this work aims to establish aperiodic activity as a non-invasive marker of cortical excitability in TS and to test whether behavioral therapy can modulate E/I balance. Understanding these dynamics as a mechanism of tic reduction may guide future interventions, including behavioral, pharmacological, or neuromodulatory approaches, ultimately improving individualized care for youth with TS.

Topic Area: EXECUTIVE PROCESSES: Monitoring & inhibitory control