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Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome

Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome
Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome

Premonitory urges are a cardinal feature in Tourette syndrome and are commonly viewed as the driving force of tics, building up before and subsiding after the execution of tics. Although the urge-tic interplay is one of the most preeminent features in Tourette syndrome, the temporal relationship between tics and urges has never been examined experimentally, mainly due to the lack of an appropriate assessment tool. We investigated the temporal relationship between urge intensity and tics in 17 Tourette patients and between urge intensity and eye blinks in 16 healthy controls in a free ticcing/blinking condition and a tic/blink suppression condition. For this purpose, an urge assessment tool was developed that allows real-time monitoring and quantification of urge intensity. Compared to free ticcing/blinking, urge intensity was higher during the suppression condition in both Tourette patients and healthy controls, while tics and blinks occurred less frequently. The data show that urge intensity increases prior to tics and decreases after tics in a time window of approximately ±10 sec. Tic suppression had a significant effect on the shape of the urge distribution around tics and led to a decrease in the size of the correlation between urge intensity and tics, indicating that tic suppression led to a de-coupling of tics and urges. In healthy controls, urges to blink were highly associated with eye blink execution, albeit in a narrower time frame (∼±5 sec). Blink suppression had a similar effect on the urge distribution associated with eye blinks as tic suppression had on the urge to tic in Tourette patients. These results corroborate the negative reinforcement model, which proposes that tics are associated with a relief in urges, thereby perpetuating ticcing behaviour. This study also documents similarities and differences between urges to act in healthy controls and urges to tic in Tourette syndrome.

Adolescent, Adult, Behavior, Blinking, Brain, female, Humans, Male, Reinforcement (Psychology), Severity of Illness Index, Tics, Tourette Syndrome, Young Adult, Journal Article, Research Support, Non-U.S. Gov't
0010-9452
24-37
Brandt, Valerie C.
e41f5832-70e4-407d-8a15-85b861761656
Beck, Christian
295b6a7f-13d4-4b89-8c70-d2c0ed8fc737
Sajin, Valeria
667cd9e9-7ea2-4d57-99cb-9b9769a4d922
Baaske, Magdalena K
4d2bcc65-3193-44e0-829e-25ea02b527f5
Bäumer, Tobias
90576a00-054a-4ab7-952e-d50b175f4cec
Beste, Christian
ba893a9b-c926-4133-afb1-06f33658d96e
Anders, Silke
4f965858-44ca-464d-afcb-d40a1ff20f9b
Münchau, Alexander
3254c1b7-9fd4-417d-96e2-b7bc1fe3c736
Brandt, Valerie C.
e41f5832-70e4-407d-8a15-85b861761656
Beck, Christian
295b6a7f-13d4-4b89-8c70-d2c0ed8fc737
Sajin, Valeria
667cd9e9-7ea2-4d57-99cb-9b9769a4d922
Baaske, Magdalena K
4d2bcc65-3193-44e0-829e-25ea02b527f5
Bäumer, Tobias
90576a00-054a-4ab7-952e-d50b175f4cec
Beste, Christian
ba893a9b-c926-4133-afb1-06f33658d96e
Anders, Silke
4f965858-44ca-464d-afcb-d40a1ff20f9b
Münchau, Alexander
3254c1b7-9fd4-417d-96e2-b7bc1fe3c736

Brandt, Valerie C., Beck, Christian, Sajin, Valeria, Baaske, Magdalena K, Bäumer, Tobias, Beste, Christian, Anders, Silke and Münchau, Alexander (2016) Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome. Cortex, 77, 24-37. (doi:10.1016/j.cortex.2016.01.008).

Record type: Article

Abstract

Premonitory urges are a cardinal feature in Tourette syndrome and are commonly viewed as the driving force of tics, building up before and subsiding after the execution of tics. Although the urge-tic interplay is one of the most preeminent features in Tourette syndrome, the temporal relationship between tics and urges has never been examined experimentally, mainly due to the lack of an appropriate assessment tool. We investigated the temporal relationship between urge intensity and tics in 17 Tourette patients and between urge intensity and eye blinks in 16 healthy controls in a free ticcing/blinking condition and a tic/blink suppression condition. For this purpose, an urge assessment tool was developed that allows real-time monitoring and quantification of urge intensity. Compared to free ticcing/blinking, urge intensity was higher during the suppression condition in both Tourette patients and healthy controls, while tics and blinks occurred less frequently. The data show that urge intensity increases prior to tics and decreases after tics in a time window of approximately ±10 sec. Tic suppression had a significant effect on the shape of the urge distribution around tics and led to a decrease in the size of the correlation between urge intensity and tics, indicating that tic suppression led to a de-coupling of tics and urges. In healthy controls, urges to blink were highly associated with eye blink execution, albeit in a narrower time frame (∼±5 sec). Blink suppression had a similar effect on the urge distribution associated with eye blinks as tic suppression had on the urge to tic in Tourette patients. These results corroborate the negative reinforcement model, which proposes that tics are associated with a relief in urges, thereby perpetuating ticcing behaviour. This study also documents similarities and differences between urges to act in healthy controls and urges to tic in Tourette syndrome.

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Accepted/In Press date: 8 January 2016
e-pub ahead of print date: 23 January 2016
Published date: April 2016
Additional Information: Copyright © 2016 Elsevier Ltd. All rights reserved.
Keywords: Adolescent, Adult, Behavior, Blinking, Brain, female, Humans, Male, Reinforcement (Psychology), Severity of Illness Index, Tics, Tourette Syndrome, Young Adult, Journal Article, Research Support, Non-U.S. Gov't

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Local EPrints ID: 413902
URI: https://eprints.soton.ac.uk/id/eprint/413902
ISSN: 0010-9452
PURE UUID: ca0dd38e-54e3-40ee-92db-f93d72445add

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Date deposited: 08 Sep 2017 16:31
Last modified: 14 Aug 2019 17:41

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Contributors

Author: Christian Beck
Author: Valeria Sajin
Author: Magdalena K Baaske
Author: Tobias Bäumer
Author: Christian Beste
Author: Silke Anders
Author: Alexander Münchau

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