Are premonitory urges a prerequisite of tic inhibition in Gilles de la Tourette syndrome?

TY - JOUR

T1 - Are premonitory urges a prerequisite of tic inhibition in Gilles de la Tourette syndrome?

AU - Ganos, Christos

AU - Kahl, Ursula

AU - Schunke, Odette

AU - Kühn, Simone

AU - Haggard, Patrick

AU - Gerloff, Christian

AU - Roessner, Veit

AU - Thomalla, Götz

AU - Münchau, Alexander

PY - 2012/10

Y1 - 2012/10

N2 - BACKGROUND: Despite the common notion that premonitory urges facilitate tic inhibition, no studies have investigated this question systematically. We examined the relation of the trait of premonitory urges with tics and tic suppression. We hypothesised that patients with more urges would be more efficient at inhibiting tics.METHODS: 15 adult (14 men, mean age 32.2±7.9 years) pure Gilles de la Tourette syndrome patients participated. Tic severity was evaluated using the modified Rush Video Scale and by employing the Yale Global Tic Severity Scale. Tic suppressibility was assessed from videos of additional periods where patients were instructed to maximally suppress their tics. Rush score based inhibition potency was synthesised by combining the scores in the two conditions. A measure of pure motor tic inhibition potency was also generated based on the number of motor tics alone. Premonitory urges were assessed by the Premonitory Urge for Tics Scale.RESULTS: All participants reported urges preceding their tics and were able to voluntarily suppress their tics. However, there was no correlation between urge scores and the Rush score based inhibition potency or the pure motor tic inhibition potency. Scores of the Premonitory Urge for Tics Scale correlated with the interference subscale item of the Yale Global Tic Severity Scale.CONCLUSIONS: Urges and tic inhibition are not directly related. There seem to exist at least two distinct neurophysiological systems of urge/tic generation and tic control in adult Gilles de la Tourette syndrome patients.

AB - BACKGROUND: Despite the common notion that premonitory urges facilitate tic inhibition, no studies have investigated this question systematically. We examined the relation of the trait of premonitory urges with tics and tic suppression. We hypothesised that patients with more urges would be more efficient at inhibiting tics.METHODS: 15 adult (14 men, mean age 32.2±7.9 years) pure Gilles de la Tourette syndrome patients participated. Tic severity was evaluated using the modified Rush Video Scale and by employing the Yale Global Tic Severity Scale. Tic suppressibility was assessed from videos of additional periods where patients were instructed to maximally suppress their tics. Rush score based inhibition potency was synthesised by combining the scores in the two conditions. A measure of pure motor tic inhibition potency was also generated based on the number of motor tics alone. Premonitory urges were assessed by the Premonitory Urge for Tics Scale.RESULTS: All participants reported urges preceding their tics and were able to voluntarily suppress their tics. However, there was no correlation between urge scores and the Rush score based inhibition potency or the pure motor tic inhibition potency. Scores of the Premonitory Urge for Tics Scale correlated with the interference subscale item of the Yale Global Tic Severity Scale.CONCLUSIONS: Urges and tic inhibition are not directly related. There seem to exist at least two distinct neurophysiological systems of urge/tic generation and tic control in adult Gilles de la Tourette syndrome patients.

KW - Adult

KW - Aged

KW - Female

KW - Humans

KW - Inhibition (Psychology)

KW - Male

KW - Middle Aged

KW - Severity of Illness Index

KW - Tics

KW - Tourette Syndrome

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1136/jnnp-2012-303033

DO - 10.1136/jnnp-2012-303033

M3 - SCORING: Journal article

C2 - 22842713

VL - 83

SP - 975

EP - 978

JO - J NEUROL NEUROSUR PS

JF - J NEUROL NEUROSUR PS

SN - 0022-3050

IS - 10

ER -