Supplementary file 1_Brain-heart coupling in tourette syndrome: a precision functional mapping study of discordant siblings.docx

Here, we examined time-resolved brain-heart interactions using densely sampled resting-state fMRI data and concurrent pulse oximetry in two sibling pairs (n = 4) discordant for Tourette syndrome (TS). Using two targeted network analyses organized around interoceptive/urge awareness and inhibitory control/action regulation processes, we quantified coupling between pulse-derived RMSSD and between-network functional connectivity using sliding-window analyses and Bayesian linear mixed-effects models.

We observed marked individual variability in functional network organization and autonomic measures. The most consistent observation was a pattern of opposing coupling directions between individuals with and without TS: those with TS showed positive associations between pulse-derived RMSSD with connectivity between internal-state and attentional networks, as well as among action-related systems, while unaffected siblings showed positive associations along broader integrative pathways linking internal-state and action-control networks.

These preliminary findings generate hypotheses regarding individualized patterns of brain-heart coupling in TS and illustrate the potential value of integrating individualized network mapping with time-resolved physiological measures in clinical populations.</p>