Pathophysiological evidence suggests an involvement of frontostriatal circuits in Tourette syndrome (TS) and cognitive\nabnormalities have been detected in tasks sensitive to cognitive deficits associated with prefrontal damage (verbal fluency, planning,\nattention shifting, working memory, cognitive flexibility, and social reasoning). A disorder in counterfactual thinking (CFT),\na behavioural executive process linked to the prefrontal cortex functioning, has not been investigated in TS. CFT refers to\nthe generation of a mental simulation of alternatives to past factual events, actions, and outcomes. It is a pervasive cognitive\nfeature in everyday life and it is closely related to decision-making, planning, problem-solving, and experience-driven learningââ?¬â?\ncognitive processes that involve wide neuronal networks in which prefrontal lobes play a fundamental role. Clinical observations\nin patients with focal prefrontal lobe damage or with neurological and psychiatric diseases related to frontal lobe dysfunction (e.g.,\nParkinsonââ?¬â?¢s disease, Huntingtonââ?¬â?¢s disease, and schizophrenia) show counterfactual thinking impairments. In this work, we evaluate\nthe performance of CFT in a group of patients with Touretteââ?¬â?¢s syndrome compared with a group of healthy participants. Overall\nresults showed no statistical differences in counterfactual thinking between TS patients and controls in the three counterfactual\nmeasures proposed.The possible explanations of this unexpected result are discussed below.
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