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Soler N, Perkes IE, Dale RC, Bray P. Parent-young person lived experience of sensory dysregulation in children with tic disorders: a qualitative study. Disabil Rehabil 2024:1-19. [PMID: 39324587 DOI: 10.1080/09638288.2024.2403727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/06/2024] [Accepted: 09/07/2024] [Indexed: 09/27/2024]
Abstract
PURPOSE To understand the breadth of sensory dysregulation on participation in daily tasks for young people with tic disorders, as research identified that sensory dysregulation experiences are broader than the symptoms being assessed. METHODS Eighteen semi-structured interviews were conducted with 16 families with children (5-16 years) with tic disorders. Interviews ranged from 45 to 120 min and were transcribed verbatim. Data collected from parents and young people were analysed and coded together. Thematic analysis using inductive and open coding methods was implemented using NVivo. RESULTS The impact of sensory dysregulation on daily life may be understood through the higher-order theme: ''sensory, emotions and tics; it's a ticking time bomb'', and three subthemes: (1) we sacrifice and adapt to get daily activities done in the home, (2) my child's experience of the community environment hinders participation, and (3) sensory preferences impact our entire family. CONCLUSION Sensory dysregulation experiences impact the entire family's quality of life, yet patient-reported sensory measures do not adequately capture the impact on the family unit and breath of symptoms. A sensory-based measure for children with tics is needed to comprehensively assess sensory dysregulation sensitivities for this population, ensuring patients' needs and effectiveness of therapy can be measured.
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Affiliation(s)
- Nicolette Soler
- Department of Psychological Medicine, The Sydney Children's Hospitals Network, Sydney, Australia
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Iain E Perkes
- Department of Psychological Medicine, The Sydney Children's Hospitals Network, Sydney, Australia
- Discipline of Psychiatry & Mental Health and Discipline of Paediatrics & Children's Health, School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Kensington, Australia
- School of Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Russell C Dale
- Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Department of Paediatric Neurology, The Children's Hospital at Westmead, Sydney, Australia
- Kids Neuroscience Centre, and Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Paula Bray
- The Sydney Children's Hospitals Network, Sydney, Australia and School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Quoilin C, Chaise F, Duque J, de Timary P. Relationship between transcranial magnetic stimulation markers of motor control and clinical recovery in obsessive compulsive disorder/Gilles de la Tourette syndrome: a proof of concept case study. Front Psychiatry 2024; 15:1307344. [PMID: 38304284 PMCID: PMC10832049 DOI: 10.3389/fpsyt.2024.1307344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/04/2024] [Indexed: 02/03/2024] Open
Abstract
Background Obsessive compulsive disorder (OCD) and Gilles de la Tourette syndrome (GTS) are neurodevelopmental disorders characterized by difficulties in controlling intrusive thoughts (obsessions) and undesired actions (tics), respectively. Both conditions have been associated with abnormal inhibition but a tangible deficit of inhibitory control abilities is controversial in GTS. Methods Here, we examined a 25 years-old male patient with severe OCD symptoms and a mild form of GTS, where impairments in motor control were central. Transcranial magnetic stimulation (TMS) was applied over the primary motor cortex (M1) to elicit motor-evoked potentials (MEPs) during four experimental sessions, allowing us to assess the excitability of motor intracortical circuitry at rest as well as the degree of MEP suppression during action preparation, a phenomenon thought to regulate movement initiation. Results When tested for the first time, the patient presented a decent level of MEP suppression during action preparation, but he exhibited a lack of intracortical inhibition at rest, as evidenced by reduced short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI). Interestingly, the patient's symptomatology drastically improved over the course of the sessions (reduced obsessions and tics), coinciding with feedback given on his good motor control abilities. These changes were reflected in the TMS measurements, with a significant strengthening of intracortical inhibition (SICI and LICI more pronounced than previously) and a more selective tuning of MEPs during action preparation; MEPs became even more suppressed, or selectively facilitated depending on the behavioral condition in which they we probed. Conclusion This study highlights the importance of better understanding motor inhibitory mechanisms in neurodevelopmental disorders and suggests a biofeedback approach as a potential novel treatment.
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Affiliation(s)
- Caroline Quoilin
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Fostine Chaise
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Julie Duque
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Philippe de Timary
- CoActions Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- Department of Adult Psychiatry, Cliniques universitaires Saint-Luc, Brussels, Belgium
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3
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Weissbach A, Moyé J, Takacs A, Verrel J, Chwolka F, Friedrich J, Paulus T, Zittel S, Bäumer T, Frings C, Pastötter B, Beste C, Münchau A. Perception-Action Integration Is Altered in Functional Movement Disorders. Mov Disord 2023; 38:1399-1409. [PMID: 37315159 DOI: 10.1002/mds.29458] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 04/25/2023] [Accepted: 05/12/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Although functional neurological movement disorders (FMD) are characterized by motor symptoms, sensory processing has also been shown to be disturbed. However, how the integration of perception and motor processes, essential for the control of goal-directed behavior, is altered in patients with FMD is less clear. A detailed investigation of these processes is crucial to foster a better understanding of the pathophysiology of FMD and can systematically be achieved in the framework of the theory of event coding (TEC). OBJECTIVE The aim was to investigate perception-action integration processes on a behavioral and neurophysiological level in patients with FMD. METHODS A total of 21 patients and 21 controls were investigated with a TEC-related task, including concomitant electroencephalogram (EEG) recording. We focused on EEG correlates established to reflect perception-action integration processes. Temporal decomposition allowed to distinguish between EEG codes reflecting sensory (S-cluster), motor (R-cluster), and integrated sensory-motor processing (C-cluster). We also applied source localization analyses. RESULTS Behaviorally, patients revealed stronger binding between perception and action, as evidenced by difficulties in reconfiguring previously established stimulus-response associations. Such hyperbinding was paralleled by a modulation of neuronal activity clusters, including reduced C-cluster modulations of the inferior parietal cortex and altered R-cluster modulations in the inferior frontal gyrus. Correlations of these modulations with symptom severity were also evident. CONCLUSIONS Our study shows that FMD is characterized by altered integration of sensory information with motor processes. Relations between clinical severity and both behavioral performance and neurophysiological abnormalities indicate that perception-action integration processes are central and a promising concept for the understanding of FMD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Anne Weissbach
- Institute of Systems Motor Science, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Josephine Moyé
- Institute of Systems Motor Science, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Adam Takacs
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Julius Verrel
- Institute of Systems Motor Science, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Fabian Chwolka
- Institute of Systems Motor Science, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Julia Friedrich
- Institute of Systems Motor Science, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Theresa Paulus
- Institute of Systems Motor Science, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
- Department of Neurology, University of Lübeck, Lübeck, Germany
| | - Simone Zittel
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tobias Bäumer
- Institute of Systems Motor Science, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
| | - Christian Frings
- Department of Cognitive Psychology, Trier University Trier, Trier, Germany
| | - Bernhard Pastötter
- Department of Cognitive Psychology, Trier University Trier, Trier, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Alexander Münchau
- Institute of Systems Motor Science, Center of Brain, Behavior, and Metabolism (CBBM), University of Lübeck, Lübeck, Germany
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van der Veen S, Caviness JN, Dreissen YE, Ganos C, Ibrahim A, Koelman JH, Stefani A, Tijssen MA. Myoclonus and other jerky movement disorders. Clin Neurophysiol Pract 2022; 7:285-316. [PMID: 36324989 PMCID: PMC9619152 DOI: 10.1016/j.cnp.2022.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/29/2022] [Accepted: 09/11/2022] [Indexed: 11/27/2022] Open
Abstract
Myoclonus and other jerky movements form a large heterogeneous group of disorders. Clinical neurophysiology studies can have an important contribution to support diagnosis but also to gain insight in the pathophysiology of different kind of jerks. This review focuses on myoclonus, tics, startle disorders, restless legs syndrome, and periodic leg movements during sleep. Myoclonus is defined as brief, shock-like movements, and subtypes can be classified based the anatomical origin. Both the clinical phenotype and the neurophysiological tests support this classification: cortical, cortical-subcortical, subcortical/non-segmental, segmental, peripheral, and functional jerks. The most important techniques used are polymyography and the combination of electromyography-electroencephalography focused on jerk-locked back-averaging, cortico-muscular coherence, and the Bereitschaftspotential. Clinically, the differential diagnosis of myoclonus includes tics, and this diagnosis is mainly based on the history with premonitory urges and the ability to suppress the tic. Electrophysiological tests are mainly applied in a research setting and include the Bereitschaftspotential, local field potentials, transcranial magnetic stimulation, and pre-pulse inhibition. Jerks due to a startling stimulus form the group of startle syndromes. This group includes disorders with an exaggerated startle reflex, such as hyperekplexia and stiff person syndrome, but also neuropsychiatric and stimulus-induced disorders. For these disorders polymyography combined with a startling stimulus can be useful to determine the pattern of muscle activation and thus the diagnosis. Assessment of symptoms in restless legs syndrome and periodic leg movements during sleep can be performed with different validated scoring criteria with the help of electromyography.
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Affiliation(s)
- Sterre van der Veen
- Department of Neurology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, The Netherlands,Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen (UMCG), Groningen, The Netherlands
| | - John N. Caviness
- Department of Neurology, Mayo Clinic Arizona, Movement Neurophysiology Laboratory, Scottsdale, AZ, USA
| | - Yasmine E.M. Dreissen
- Department of Neurosurgery, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Christos Ganos
- Movement Disorders and Neuromodulation Unit, Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Abubaker Ibrahim
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Johannes H.T.M. Koelman
- Department of Neurology and Clinical Neurophysiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Ambra Stefani
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Marina A.J. Tijssen
- Department of Neurology, University of Groningen, University Medical Centre Groningen (UMCG), Groningen, The Netherlands,Expertise Centre Movement Disorders Groningen, University Medical Centre Groningen (UMCG), Groningen, The Netherlands,Corresponding author at: Department of Neurology, University of Groningen, University Medical Centre Groningen (UMCG), PO Box 30.001, 9700 RB Groningen, The Netherlands.
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Tics: neurological disorders determined by a deficit in sensorimotor gating processes. Neurol Sci 2022; 43:5839-5850. [PMID: 35781754 PMCID: PMC9474467 DOI: 10.1007/s10072-022-06235-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/20/2022] [Indexed: 11/21/2022]
Abstract
Tic related disorders affect 4–20% of the population, mostly idiopathic, can be grouped in a wide spectrum of severity, where the most severe end is Tourette Syndrome (TS). Tics are arrhythmic hyperkinesias to whom execution the subject is forced by a “premonitory urge” that can be classified as sensory tic, just-right experience or urge without obsession. If an intact volitional inhibition allows patients to temporarily suppress tics, a lack or deficit in automatic inhibition is involved in the genesis of the disorder. Studies have assessed the presence of intrinsic microscopic and macroscopic anomalies in striatal circuits and relative cortical areas in association with a hyperdopaminergic state in the basal forebrain. Prepulse inhibition (PPI) of the startle reflex is a measure of inhibitory functions by which a weak sensory stimulus inhibits the elicitation of a startle response determined by a sudden intense stimulus. It is considered an operation measure of sensorimotor gating, a neural process by which unnecessary stimuli are eliminated from awareness. Evidence points out that the limbic domain of the CSTC loops, dopamine and GABA receptors within the striatum play an important role in PPI modulation. It is conceivable that a sensorimotor gating deficit may be involved in the genesis of premonitory urge and symptoms. Therefore, correcting the sensorimotor gating deficit may be considered a target for tic-related disorders therapies; in such case PPI (as well as other indirect estimators of sensorimotor gating) could represent therapeutic impact predictors.
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Metzlaff J, Finis J, Münchau A, Müller-Vahl K, Schnitzler A, Bellebaum C, Biermann-Ruben K, Niccolai V. Altered performance monitoring in Tourette Syndrome: an MEG investigation. Sci Rep 2022; 12:8300. [PMID: 35585222 PMCID: PMC9117680 DOI: 10.1038/s41598-022-12156-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 05/03/2022] [Indexed: 11/09/2022] Open
Abstract
The error-related negativity (ERN) is an event-related potential component indexing processes of performance monitoring during simple stimulus-response tasks: the ERN is typically enhanced for error processing and conflicting response representations. Investigations in healthy participants and different patient groups have linked the ERN to the dopamine system and to prefrontal information processing. As in patients with Tourette Syndrome (TS) both dopamine release and prefrontal information processing are impaired, we hypothesized that performance monitoring would be altered, which was investigated with magnetencephalography (MEG). We examined performance monitoring in TS patients by assessing the magnetic equivalent of the ERN (mERN). The mERN was investigated in tic-free trials of eight adult, unmedicated TS patients without clinically significant comorbidity and ten matched healthy controls while performing a Go/NoGo task in selected frontocentral channels. The analysis of the response-related amplitudes of the event-related magnetic field showed that TS patients, in contrast to controls, did not show earlier amplitude modulation (between 70 and 105 ms after response onset) depending on response type (errors or correct responses). In both groups significant mERN amplitudes in the time-window between 105 and 160 ms after response onset were detected thus pointing at only later error processing in TS patients. In TS patients, early error-related processing might be affected by an enhanced motor control triggered by a conflict between the targeted high task performance and tic suppression. TS patients seem to tend to initially process all responses as erroneous responses.
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Affiliation(s)
- Jacqueline Metzlaff
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, 40225, Duesseldorf, Germany.
| | - Jennifer Finis
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, 40225, Duesseldorf, Germany
| | - Alexander Münchau
- Institute of Systems Motor Science, University of Luebeck, Luebeck, Germany
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, 40225, Duesseldorf, Germany
| | - Christian Bellebaum
- Department of Biological Psychology, Institute of Experimental Psychology, Heinrich-Heine-University, Duesseldorf, Germany
| | - Katja Biermann-Ruben
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, 40225, Duesseldorf, Germany
| | - Valentina Niccolai
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University, 40225, Duesseldorf, Germany
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7
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He JL, Mikkelsen M, Huddleston DA, Crocetti D, Cecil KM, Singer HS, Edden RA, Gilbert DL, Mostofsky SH, Puts NA. Frequency and Intensity of Premonitory Urges-to-Tic in Tourette Syndrome Is Associated With Supplementary Motor Area GABA+ Levels. Mov Disord 2022; 37:563-573. [PMID: 34854494 PMCID: PMC9014425 DOI: 10.1002/mds.28868] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/05/2021] [Accepted: 10/26/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Individuals with Tourette syndrome (TS) often report that they express tics as a means of alleviating the experience of unpleasant sensations. These sensations are perceived as an urge to act and are referred to as premonitory urges. Premonitory urges have been the focus of recent efforts to develop interventions to reduce tic expression in those with TS. OBJECTIVE The aim of this study was to examine the contribution of brain γ-aminobutyric acid (GABA) and glutamate levels of the right primary sensorimotor cortex (SM1), supplementary motor area (SMA), and insular cortex (insula) to tic and urge severity in children with TS. METHODS Edited magnetic resonance spectroscopy was used to assess GABA+ (GABA + macromolecules) and Glx (glutamate + glutamine) of the right SM1, SMA, and insula in 68 children with TS (MAge = 10.59, SDAge = 1.33) and 41 typically developing control subjects (MAge = 10.26, SDAge = 2.21). We first compared GABA+ and Glx levels of these brain regions between groups. We then explored the association between regional GABA+ and Glx levels with urge and tic severity. RESULTS GABA+ and Glx of the right SM1, SMA, and insula were comparable between the children with TS and typically developing control subjects. In children with TS, lower levels of SMA GABA+ were associated with more severe and more frequent premonitory urges. Neither GABA+ nor Glx levels were associated with tic severity. CONCLUSIONS These results broadly support the role of GABAergic neurotransmission within the SMA in the experience of premonitory urges in children with TS. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jason L. He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Mark Mikkelsen
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - David A. Huddleston
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Deana Crocetti
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Kim M. Cecil
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Harvey S. Singer
- Department of Neurology, Kennedy Krieger Institute, Baltimore, Maryland, USA,Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard A.E. Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Donald L. Gilbert
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Stewart H. Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA,Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicolaas A.J. Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom,MRC Centre for Neurodevelopmental Disorders, King’s College London, London, United Kingdom,Correspondence to: Dr. Nicolaas Puts, Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AB, London, United Kingdom;
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8
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Isaacs D, Key AP, Cascio CJ, Conley AC, Riordan H, Walker HC, Wallace MT, Claassen DO. Cross-disorder comparison of sensory over-responsivity in chronic tic disorders and obsessive-compulsive disorder. Compr Psychiatry 2022; 113:152291. [PMID: 34952304 PMCID: PMC8792289 DOI: 10.1016/j.comppsych.2021.152291] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/22/2021] [Accepted: 11/30/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Sensory over-responsivity (SOR) refers to excessively intense and/or prolonged behavioral responses to environmental stimuli typically perceived as non-aversive. SOR is prevalent in several neurodevelopmental disorders, including chronic tic disorders (CTDs) and obsessive-compulsive disorder (OCD). Few studies have examined the extent and clinical correlates of SOR across disorders, limiting insights into the phenomenon's transdiagnostic clinical and biological relevance. Such cross-disorder comparisons are of particular interest for CTDs and OCD given their frequent co-occurrence. OBJECTIVE We sought to compare the magnitude of SOR between adults with CTD and adults with OCD and to identify the clinical factors most strongly associated with SOR across these disorders. METHODS We enrolled 207 age- and sex-matched participants across four diagnostic categories: CTD without OCD (designated "CTD/OCD-"; n = 37), CTD with OCD ("CTD/OCD+"; n = 32), OCD without tic disorder ("OCD"; n = 69), and healthy controls (n = 69). Participants completed a self-report battery of rating scales assessing SOR (Sensory Gating Inventory, SGI), obsessive-compulsive symptoms (Dimensional Obsessive-Compulsive Scale, DOCS), inattention and hyperactivity (Adult ADHD Self-Report Screening Scale for DSM-5, ASRS-5), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9). CTD participants were also administered the Yale Global Tic Severity Scale (YGTSS). To examine between-group differences in SOR, we compared SGI score across all groups and between pairs of groups. To examine the relationship of SOR with other clinical factors, we performed multivariable linear regression. RESULTS CTD/OCD-, CTD/OCD+, and OCD participants were 86.7%, 87.6%, and 89.5%, respectively, more likely to have higher SGI total scores than healthy controls. SGI total score did not differ between CTD/OCD-, CTD/OCD+, and OCD groups. In the regression model of log-transformed SGI total score, OCD diagnosis, DOCS score, and ASRS-5 score each contributed significantly to model goodness-of-fit, whereas CTD diagnosis and YGTSS total tic score did not. CONCLUSION SOR is prevalent in adults with CTD and in adults with OCD but does not significantly differ in magnitude between these disorders. Across CTD, OCD, and healthy control adult populations, SOR is independently associated with both obsessive-compulsive and ADHD symptoms, suggesting a transdiagnostic relationship between these sensory and psychiatric manifestations. Future cross-disorder, longitudinal, and translational research is needed to clarify the role and prognostic import of SOR in CTDs, OCD, and other neurodevelopmental disorders.
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Affiliation(s)
- David Isaacs
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Alexandra P Key
- Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, United States.
| | - Carissa J Cascio
- Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, United States; Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Alexander C Conley
- Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Heather Riordan
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Harrison C Walker
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, United States.
| | - Mark T Wallace
- Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, United States; Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, United States; Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Pharmacology, Vanderbilt University, Nashville, TN, United States; Department of Psychology, Vanderbilt University, Nashville, TN, United States.
| | - Daniel O Claassen
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
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Towards an Ideology-Free, Truly Mechanistic Health Psychology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111126. [PMID: 34769644 PMCID: PMC8583446 DOI: 10.3390/ijerph182111126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/12/2021] [Accepted: 10/20/2021] [Indexed: 01/04/2023]
Abstract
Efficient transfer of concepts and mechanistic insights from the cognitive to the health sciences and back requires a clear, objective description of the problem that this transfer ought to solve. Unfortunately, however, the actual descriptions are commonly penetrated with, and sometimes even motivated by, cultural norms and preferences, a problem that has colored scientific theorizing about behavioral control—the key concept for many psychological health interventions. We argue that ideologies have clouded our scientific thinking about mental health in two ways: by considering the societal utility of individuals and their behavior a key criterion for distinguishing between healthy and unhealthy people, and by dividing what actually seem to be continuous functions relating psychological and neurocognitive underpinnings to human behavior into binary, discrete categories that are then taken to define clinical phenomena. We suggest letting both traditions go and establish a health psychology that restrains from imposing societal values onto individuals, and then taking the fit between behavior and values to conceptualize unhealthiness. Instead, we promote a health psychology that reconstructs behavior that is considered to be problematic from well-understood mechanistic underpinnings of human behavior.
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10
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Somatosensory perception-action binding in Tourette syndrome. Sci Rep 2021; 11:13388. [PMID: 34183712 PMCID: PMC8238990 DOI: 10.1038/s41598-021-92761-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/07/2021] [Indexed: 11/21/2022] Open
Abstract
It is a common phenomenon that somatosensory sensations can trigger actions to alleviate experienced tension. Such “urges” are particularly relevant in patients with Gilles de la Tourette (GTS) syndrome since they often precede tics, the cardinal feature of this common neurodevelopmental disorder. Altered sensorimotor integration processes in GTS as well as evidence for increased binding of stimulus- and response-related features (“hyper-binding”) in the visual domain suggest enhanced perception–action binding also in the somatosensory modality. In the current study, the Theory of Event Coding (TEC) was used as an overarching cognitive framework to examine somatosensory-motor binding. For this purpose, a somatosensory-motor version of a task measuring stimulus–response binding (S-R task) was tested using electro-tactile stimuli. Contrary to the main hypothesis, there were no group differences in binding effects between GTS patients and healthy controls in the somatosensory-motor paradigm. Behavioral data did not indicate differences in binding between examined groups. These data can be interpreted such that a compensatory “downregulation” of increased somatosensory stimulus saliency, e.g., due to the occurrence of somatosensory urges and hypersensitivity to external stimuli, results in reduced binding with associated motor output, which brings binding to a “normal” level. Therefore, “hyper-binding” in GTS seems to be modality-specific.
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Mielke E, Takacs A, Kleimaker M, Schappert R, Conte G, Onken R, Künemund T, Verrel J, Bäumer T, Beste C, Münchau A. Tourette syndrome as a motor disorder revisited - Evidence from action coding. NEUROIMAGE-CLINICAL 2021; 30:102611. [PMID: 33740752 PMCID: PMC7985708 DOI: 10.1016/j.nicl.2021.102611] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/04/2021] [Accepted: 02/18/2021] [Indexed: 12/02/2022]
Abstract
Feature Binding/integration in the motor domain in Tourette Syndrome (TS) is examined. Motor binding processes and interleaved action are intact in TS. Binding processes are differentially modulated in the motor domain and sensori-motor processes.
Because tics are the defining clinical feature of Tourette syndrome, it is conceptualized predominantly as a motor disorder. There is some evidence though suggesting that the neural basis of Tourette syndrome is related to perception–action processing and binding between perception and action. However, binding processes have not been examined in the motor domain in these patients. If it is particularly perception–action binding but not binding processes within the motor system, this would further corroborate that Tourette syndrome it is not predominantly, or solely, a motor disorder. Here, we studied N = 22 Tourette patients and N = 24 healthy controls using an established action coding paradigm derived from the Theory of Event Coding framework and concomitant EEG-recording addressing binding between a planned but postponed, and an interleaved immediate reaction with different levels of overlap of action elements. Behavioral performance during interleaved action coding was normal in Tourette syndrome. Response locked lateralized readiness potentials reflecting processes related to motor execution were larger in Tourette syndrome, but only in simple conditions. However, pre-motor processes including response preparation and configuration reflected by stimulus-locked lateralized readiness potentials were normal. This was supported by a Bayesian data analysis providing evidence for the null hypothesis. The finding that processes integrating different action-related elements prior to motor execution are normal in Tourette syndrome suggests that Tourette it is not solely a motor disorder. Considering other recent evidence, the data show that changes in “binding” in Tourette syndrome are specific for perception–action integration but not for action coding.
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Affiliation(s)
- Emily Mielke
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Adam Takacs
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Maximilian Kleimaker
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany; Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
| | - Ronja Schappert
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Giulia Conte
- Department of Human Neuroscience, Institute of Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Italy
| | - Rebecca Onken
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Till Künemund
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Julius Verrel
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Tobias Bäumer
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.
| | - Alexander Münchau
- Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany.
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12
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Isaacs D, Riordan H. Sensory hypersensitivity in Tourette syndrome: A review. Brain Dev 2020; 42:627-638. [PMID: 32600840 DOI: 10.1016/j.braindev.2020.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 04/06/2020] [Accepted: 06/07/2020] [Indexed: 12/12/2022]
Abstract
Tourette syndrome (TS) is a neurodevelopmental disorder defined by tics, but most patients also experience bothersome sensory phenomena, in the form of premonitory urges and/or sensory hypersensitivity. Whereas premonitory urges are temporally paired with tics, sensory hypersensitivity is a constant, heightened awareness of external and/or internal stimuli. The intensity of sensory hypersensitivity does not strongly correlate with the severity of tics or premonitory urges, suggesting it is a dissociable clinical phenomenon. At least 80% of TS patients report subjectively enhanced perception of various sensory stimuli. These same patients demonstrate normal static detection thresholds. However, individuals with TS habituate abnormally to repetitive stimuli, indicating incapacity to appropriately filter redundant sensory input, i.e. impaired sensory gating. Physiologic support for this hypothesis is provided by abnormal pre-pulse inhibition (PPI) and event-related potential (ERP) investigations. Preclinical data implicates parvalbumin-positive (PV+) interneuron dysfunction in altered sensory gating in TS and other neurodevelopment disorders. Studies probing TS sensory hypersensitivity must methodically account for comorbid psychiatric conditions, namely obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), as these entities appear to involve pathophysiologic processes shared with TS. The presence of psychiatric comorbidities in TS is associated with even more profound sensory processing dysfunction. A deepened understanding of TS sensory hypersensitivity will afford novel insights into disease mechanisms, clinical phenotype, and therapeutic management.
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Affiliation(s)
- David Isaacs
- Department of Neurology, Division of Movement Disorders, Vanderbilt University Medical Center, A-0118 Medical Center North, Nashville, TN 37232, United States.
| | - Heather Riordan
- Department of Pediatrics, Division of Child Neurology, Vanderbilt Children's Hospital, United States
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13
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Kleimaker M, Takacs A, Conte G, Onken R, Verrel J, Bäumer T, Münchau A, Beste C. Increased perception-action binding in Tourette syndrome. Brain 2020; 143:1934-1945. [DOI: 10.1093/brain/awaa111] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/26/2020] [Accepted: 02/20/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Gilles de la Tourette syndrome is a multifaceted neurodevelopmental disorder characterized by multiple motor and vocal tics. Research in Tourette syndrome has traditionally focused on the motor system. However, there is increasing evidence that perceptual and cognitive processes play a crucial role as well. Against this background it has been reasoned that processes linking perception and action might be particularly affected in these patients with the strength of perception-action binding being increased. However, this has not yet been studied experimentally. Here, we investigated adult Tourette patients within the framework of the ‘Theory of Event Coding’ using an experimental approach allowing us to directly test the strength of perception-action binding. We included 24 adult patients with Tourette syndrome and n = 24 healthy control subjects using a previously established visual-motor event file task with four levels of feature overlap requiring repeating or alternating responses. Concomitant to behavioural testing, EEG was recorded and analysed using temporal signal decomposition and source localization methods. On a behavioural level, perception-action binding was increased in Tourette patients. Tic frequency correlated with performance in conditions where unbinding processes of previously established perception-action bindings were required with higher tic frequency being associated with stronger perception-action binding. This suggests that perception-action binding is intimately related to the occurrence of tics. Analysis of EEG data showed that behavioural changes cannot be explained based on simple perceptual or motor processes. Instead, cognitive processes linking perception to action in inferior parietal cortices are crucial. Our findings suggest that motor or sensory processes alone are less relevant for the understanding of Tourette syndrome than cognitive processes engaged in linking and restructuring of perception-action association. A broader cognitive framework encompassing perception and action appears well suited to opening new routes for the understanding of Tourette syndrome.
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Affiliation(s)
- Maximilian Kleimaker
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany
- Department of Pediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, Center for Brain, Behaviour and Metabolism, University of Lübeck, Lübeck, Germany
| | - Adam Takacs
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Giulia Conte
- Department of Human Neuroscience, Institute of Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Italy
| | - Rebecca Onken
- Department of Pediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, Center for Brain, Behaviour and Metabolism, University of Lübeck, Lübeck, Germany
| | - Julius Verrel
- Department of Pediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, Center for Brain, Behaviour and Metabolism, University of Lübeck, Lübeck, Germany
| | - Tobias Bäumer
- Department of Pediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, Center for Brain, Behaviour and Metabolism, University of Lübeck, Lübeck, Germany
| | - Alexander Münchau
- Department of Pediatric and Adult Movement Disorders and Neuropsychiatry, Institute of Neurogenetics, Center for Brain, Behaviour and Metabolism, University of Lübeck, Lübeck, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
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Kurvits L, Martino D, Ganos C. Clinical Features That Evoke the Concept of Disinhibition in Tourette Syndrome. Front Psychiatry 2020; 11:21. [PMID: 32161555 PMCID: PMC7053490 DOI: 10.3389/fpsyt.2020.00021] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/09/2020] [Indexed: 01/14/2023] Open
Abstract
The capacity to efficiently control motor output, by either refraining from prepotent actions or disengaging from ongoing motor behaviors, is necessary for our ability to thrive in a stimulus-rich and socially complex environment. Failure to engage in successful inhibitory motor control could lead to aberrant behaviors typified by an excess of motor performance. In tic disorders and Tourette syndrome (TS) - the most common tic disorder encountered in clinics - surplus motor output is rarely the only relevant clinical sign. A range of abnormal behaviors is often encountered which are historically viewed as "disinhibition phenomena". Here, we present the different clinical features of TS from distinct categorical domains (motor, sensory, complex behavioral) that evoke the concept of disinhibition and discuss their associations. We also present evidence for their consideration as phenomena of inhibitory dysfunction and provide an overview of studies on TS pathophysiology which support this view. We then critically dissect the concept of disinhibition in TS and illuminate other salient aspects, which should be considered in a unitary pathophysiological approach. We briefly touch upon the dangers of oversimplification and emphasize the necessity of conceptual diversity in the scientific exploration of TS, from disinhibition and beyond.
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Affiliation(s)
- Lille Kurvits
- Department of Neurology, Charité University Hospital, Berlin, Germany
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Christos Ganos
- Department of Neurology, Charité University Hospital, Berlin, Germany
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15
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Soler N, Hardwick C, Perkes IE, Mohammad SS, Dossetor D, Nunn K, Bray P, Dale RC. Sensory dysregulation in tic disorders is associated with executive dysfunction and comorbidities. Mov Disord 2019; 34:1901-1909. [PMID: 31505086 DOI: 10.1002/mds.27817] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/04/2019] [Accepted: 07/19/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Tics are conceptualized as a sensorimotor phenomenon with a premonitory urge typically described by patients. As observed in other neurodevelopmental disorders, we have observed sensory dysregulation symptoms, such as tactile hypersensitivity to clothing, in children with tic disorders; however, formal clinical research in this area is limited. OBJECTIVE To define the presence of sensory dysregulation symptoms in tic disorders, and their clinical associations. METHODS Prevalence of sensory dysregulation in 102 children with tic disorders was compared to 61 age- and sex-matched healthy controls. Sensory dysregulation, executive function, and quality of life data were obtained through the Short Sensory Profile-2, Sensory Profile-2, Sensory Processing Measure, Behaviour Rating Inventory of Executive Function-2, and Strength and Difficulties Questionnaire and Pediatric Quality of Life Inventory. Tics were assessed with the Yale Global Tic Severity Scale. RESULTS Children with tics, in the presence of comorbidity, had elevated sensory dysregulation compared to healthy controls (P < 0.001). There was a positive correlation between sensory dysregulation and global executive difficulties in children with tics and comorbidity (n = 87; rho = 0.716; P < 0.001) and a negative correlation of sensory dysregulation with quality of life (n = 87; rho = -0.595; P < 0.001). In children with tics, there was an association between sensory dysregulation and number of comorbidities (P < 0.001). CONCLUSION In the presence of comorbidity, children with tic disorders have broad sensory dysregulation symptoms beyond the premonitory urge. There was a statistically significant association between sensory dysregulation and executive function difficulties and the presence of neurodevelopmental and psychiatric comorbidity. Sensory dysregulation can be considered neurodevelopmental symptoms, providing insight into the neurobiology of tics and opportunities for therapeutic intervention. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Nicolette Soler
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia
| | - Chris Hardwick
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Iain E Perkes
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,The University of New South Wales, School of Psychiatry, Faculty of Medicine, & School of Psychology, Faculty of Science, Sydney, Australia
| | - Shekeeb S Mohammad
- Department of Pediatric Neurology, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia
| | - David Dossetor
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia
| | - Paula Bray
- The University of Sydney, Faculty of Health Sciences, Sydney, Australia
| | - Russell C Dale
- Department of Pediatric Neurology, The Children's Hospital at Westmead, Sydney, Australia.,Faculty of Medicine and Health, The University of Sydney, Children's Hospital Westmead Clinical School, Sydney, Australia.,Kids Neuroscience Centre, and Brain and Mind Centre, Sydney, Australia
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16
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A peek into premonitory urges in Tourette syndrome: Temporal evolution of neurophysiological oscillatory signatures. Parkinsonism Relat Disord 2019; 65:153-158. [DOI: 10.1016/j.parkreldis.2019.05.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/13/2019] [Accepted: 05/30/2019] [Indexed: 11/24/2022]
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17
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Morand-Beaulieu S, Leclerc JB, Valois P, Lavoie ME, O'Connor KP, Gauthier B. A Review of the Neuropsychological Dimensions of Tourette Syndrome. Brain Sci 2017; 7:E106. [PMID: 28820427 PMCID: PMC5575626 DOI: 10.3390/brainsci7080106] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/10/2017] [Accepted: 08/15/2017] [Indexed: 11/29/2022] Open
Abstract
Neurocognitive functioning in Tourette syndrome (TS) has been the subject of intensive research in the past 30 years. A variety of impairments, presumably related to frontal and frontostriatal dysfunctions, have been observed. These impairments were found in various domains, such as attention, memory, executive functions, language, motor and visuomotor functions, among others. In line with contemporary research, other neurocognitive domains have recently been explored in TS, bringing evidence of altered social reasoning, for instance. Therefore, the aims of this review are to give an overview of the neuropsychological dimensions of TS, to report how neuropsychological functions evolve from childhood to adulthood, and to explain how various confounding factors can affect TS patients' performance in neuropsychological tasks. Finally, an important contribution of this review is to show how recent research has confirmed or changed our beliefs about neuropsychological functioning in TS.
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Affiliation(s)
- Simon Morand-Beaulieu
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de neurosciences, Université de Montréal, 2960 Chemin de la Tour, Montréal, QC H3T 1J4, Canada.
| | - Julie B Leclerc
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de psychologie, Université du Québec à Montréal, 100, rue Sherbrooke Ouest, Montréal, QC H2X 3P2, Canada.
| | - Philippe Valois
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de psychologie, Université du Québec à Montréal, 100, rue Sherbrooke Ouest, Montréal, QC H2X 3P2, Canada.
| | - Marc E Lavoie
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de neurosciences, Université de Montréal, 2960 Chemin de la Tour, Montréal, QC H3T 1J4, Canada.
- Département de psychiatrie, Université de Montréal, 2900, boulevard Édouard-Montpetit, Montréal, QC H3T 1J4, Canada.
| | - Kieron P O'Connor
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de psychologie, Université du Québec à Montréal, 100, rue Sherbrooke Ouest, Montréal, QC H2X 3P2, Canada.
- Département de psychiatrie, Université de Montréal, 2900, boulevard Édouard-Montpetit, Montréal, QC H3T 1J4, Canada.
| | - Bruno Gauthier
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, 7331 rue Hochelaga, Montréal, QC H1N 3V2, Canada.
- Département de psychologie, Université de Montréal, Campus Laval, 1700 rue Jacques-Tétreault, Laval, QC H7N 0B6, Canada.
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Lavoie ME, O'Connor K. Toward a Multifactorial Conception of the Gilles de la Tourette Syndrome and Persistent Chronic Tic Disorder. Brain Sci 2017; 7:brainsci7060061. [PMID: 28574423 PMCID: PMC5483634 DOI: 10.3390/brainsci7060061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 05/31/2017] [Indexed: 12/28/2022] Open
Abstract
Despite recent giant leaps in understanding Gilles de la Tourette’s syndrome (now Tourette Disorder in the DSM 5), accurate multi-modal description, rigorous assessment procedures, and the improvement of evidence-based treatment currently pose a considerable challenge. In this context, the current special edition aims to elaborate three important dimensions in Tourette Disorder. Firstly, the effective characterization and etiological basis of the disorder are reviewed, since such characterization impacts accurate assessment. Secondly, subsequent articles cover the comprehensive evaluation and assessment of tic disorders, essential for treatment planning. Thirdly, the final group of articles propose novel and innovative treatment strategies for pharmacologically and behaviorally reducing tic frequency. In the current editorial address, two main issues seem crucial to the development of interventions for Tourette disorder. Primarily, integrating new technology in treatments, while supporting cognitive and behavioral recovery through learning self-controlled strategies. Additionally, the dissemination of study results to frontline resources, needs streamlining and empirically validated treatments for tic disorders should be the subject of knowledge translation to community organizations and be more widely available to the public.
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Affiliation(s)
- Marc E Lavoie
- Department of Psychiatry, University of Montréal, Montréal H1N-3V2, Canada.
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal H1N-3V2, Canada.
| | - Kieron O'Connor
- Department of Psychiatry, University of Montréal, Montréal H1N-3V2, Canada.
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal H1N-3V2, Canada.
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Morand-Beaulieu S, Grot S, Lavoie J, Leclerc JB, Luck D, Lavoie ME. The puzzling question of inhibitory control in Tourette syndrome: A meta-analysis. Neurosci Biobehav Rev 2017; 80:240-262. [PMID: 28502600 DOI: 10.1016/j.neubiorev.2017.05.006] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 05/04/2017] [Accepted: 05/08/2017] [Indexed: 02/02/2023]
Abstract
Tourette syndrome (TS) is a neuropsychiatric disorder involving motor and phonic tics. Inhibitory control is a key issue in TS, and many disruptive or impulsive behaviors might arise from inhibitory deficits. However, conflicting findings regarding TS patients' inhibitory performance in neuropsychological tasks have been reported throughout the literature. Therefore, this meta-analysis aimed to evaluate inhibitory control through neuropsychological tasks, and to analyze the factors modulating inhibitory deficits. To this end, a literature search was performed through MEDLINE and PsycINFO, to retrieve studies including neuropsychological tasks that assessed inhibitory control in TS patients. Of the 4020 studies identified, 61 were included in the meta-analysis, for a total of 1717 TS patients. Our analyses revealed a small to medium effect in favor of inhibitory deficits in TS patients. This effect was larger in TS+ADHD patients, but pure TS patients also showed some inhibitory deficits. Therefore, deficits in inhibitory control seem to be an inherent component of TS, and are exacerbated when ADHD is concomitant.
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Affiliation(s)
- Simon Morand-Beaulieu
- Cognitive and Social Psychophysiology Lab, Montreal, Qc, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Qc, Canada; Département de neurosciences, Université de Montréal, Montreal, Qc, Canada.
| | - Stéphanie Grot
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Qc, Canada; Département de psychiatrie, Université de Montréal, Montreal, Qc, Canada.
| | - Jacob Lavoie
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Qc, Canada; Département de neurosciences, Université de Montréal, Montreal, Qc, Canada.
| | - Julie B Leclerc
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Qc, Canada; Département de psychologie, Université du Québec à Montréal, Montreal, Qc, Canada.
| | - David Luck
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Qc, Canada; Département de neurosciences, Université de Montréal, Montreal, Qc, Canada; Département de psychiatrie, Université de Montréal, Montreal, Qc, Canada.
| | - Marc E Lavoie
- Cognitive and Social Psychophysiology Lab, Montreal, Qc, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Qc, Canada; Département de neurosciences, Université de Montréal, Montreal, Qc, Canada; Département de psychiatrie, Université de Montréal, Montreal, Qc, Canada.
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20
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Godar SC, Bortolato M. What makes you tic? Translational approaches to study the role of stress and contextual triggers in Tourette syndrome. Neurosci Biobehav Rev 2017; 76:123-133. [PMID: 27939782 PMCID: PMC5403589 DOI: 10.1016/j.neubiorev.2016.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/17/2016] [Accepted: 10/05/2016] [Indexed: 01/04/2023]
Abstract
Tourette syndrome (TS) is a neurodevelopmental condition characterized by multiple, recurring motor and phonic tics. Rich empirical evidence shows that the severity of tics and associated manifestations is increased by several stressors and contextual triggers; however, the neurobiological mechanisms responsible for symptom exacerbation in TS remain poorly understood. This conceptual gap partially reflects the high phenotypic variability in tics, as well as the existing difficulties in operationalizing and standardizing stress and its effects in a clinical setting. Animal models of TS may be highly informative tools to overcome some of these limitations; these experimental preparations have already provided critical insights on key aspects of TS pathophysiology, and may prove useful to identify the neurochemical alterations induced by different stressful contingencies. In particular, emerging knowledge on the role of contextual triggers in animal models of TS may inform the development of novel pharmacological interventions to reduce tic fluctuations in this disorder.
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Affiliation(s)
- Sean C Godar
- Dept. of Pharmacology and Toxicology, College of Pharmacy, United States; University of Utah, Salt Lake City, UT, United States
| | - Marco Bortolato
- Dept. of Pharmacology and Toxicology, College of Pharmacy, United States; University of Utah, Salt Lake City, UT, United States.
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21
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Cavanna AE, Black KJ, Hallett M, Voon V. Neurobiology of the Premonitory Urge in Tourette's Syndrome: Pathophysiology and Treatment Implications. J Neuropsychiatry Clin Neurosci 2017; 29:95-104. [PMID: 28121259 PMCID: PMC5409107 DOI: 10.1176/appi.neuropsych.16070141] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Motor and vocal tics are relatively common motor manifestations identified as the core features of Tourette's syndrome (TS). Although traditional descriptions have focused on objective phenomenological observations, such as anatomical location, number and frequency of tics, patients' first-person accounts have consistently reported characteristic subjective correlates. These sensory phenomena are often described as a feeling of mounting inner tension or urge to move ("premonitory urge"), which is transiently relieved by tic expression. This article reviews the existing literature on the clinical and neurobiological aspects of the premonitory urge in patients with TS, with focus on its pathophysiology and possible treatment implications.
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Affiliation(s)
- Andrea E. Cavanna
- Department of Neuropsychiatry Research Group, BSMHFT and University of Birmingham, Birmingham, UK,School of Life and Health Sciences, Aston University, Birmingham, UK,University College London and Institute of Neurology, London, UK,Corresponding author: Andrea E. Cavanna, MD PhD FRCP, Department of Neuropsychiatry, The Barberry National Centre for Mental Health, 25 Vincent Drive, Birmingham B152FG, United Kingdom, , Tel: +44 121 3012280
| | - Kevin J Black
- Departments of Psychiatry, Neurology, Radiology, and Anatomy & Neuroscience, Washington University School of Medicine, St. Louis, MO, USA
| | - Mark Hallett
- Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Behavioural and Clinical Neurosciences Institute, Cambridge, UK,Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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Abstract
Tourette syndrome (TS) is a childhood onset neurologic disorder with manifestations including multiple motor and phonic tics, and in most cases a variety of behavioral comorbidities such as attention deficit hyperactivity disorder, obsessive compulsive disorder, and other impulse control disorders. Although it is considered a hereditary disorder, likely modified by environmental factors, genetic studies have yet to uncover relevant causative genes and there is no animal model that mimics the broad clinical phenomenology of TS. There has been a marked increase in the number of neurophysiological, neuroimaging, and other studies on TS. The findings from these studies, however, have been difficult to interpret because of small sample sizes, variability of symptoms across patients, and comorbidities. Although anti-dopaminergic drugs are the most widely used medications in the treatment of TS, there has been increasing interest in other drugs, behavioral therapies, and surgical approaches including deep brain stimulation. Herein, we review the current literature and discuss the complexities of TS and the challenges in understanding its pathophysiology and in selecting the most appropriate treatment. We also offer an expert's view of where the field of TS may be headed.
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Nespoli E, Rizzo F, Boeckers TM, Hengerer B, Ludolph AG. Addressing the Complexity of Tourette's Syndrome through the Use of Animal Models. Front Neurosci 2016; 10:133. [PMID: 27092043 PMCID: PMC4824761 DOI: 10.3389/fnins.2016.00133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/16/2016] [Indexed: 01/06/2023] Open
Abstract
Tourette's syndrome (TS) is a neurodevelopmental disorder characterized by fluctuating motor and vocal tics, usually preceded by sensory premonitions, called premonitory urges. Besides tics, the vast majority—up to 90%—of TS patients suffer from psychiatric comorbidities, mainly attention deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). The etiology of TS remains elusive. Genetics is believed to play an important role, but it is clear that other factors contribute to TS, possibly altering brain functioning and architecture during a sensitive phase of neural development. Clinical brain imaging and genetic studies have contributed to elucidate TS pathophysiology and disease mechanisms; however, TS disease etiology still is poorly understood. Findings from genetic studies led to the development of genetic animal models, but they poorly reflect the pathophysiology of TS. Addressing the role of neurotransmission, brain regions, and brain circuits in TS disease pathomechanisms is another focus area for preclinical TS model development. We are now in an interesting moment in time when numerous innovative animal models are continuously brought to the attention of the public. Due to the diverse and largely unknown etiology of TS, there is no single preclinical model featuring all different aspects of TS symptomatology. TS has been dissected into its key symptomst hat have been investigated separately, in line with the Research Domain Criteria concept. The different rationales used to develop the respective animal models are critically reviewed, to discuss the potential of the contribution of animal models to elucidate TS disease mechanisms.
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Affiliation(s)
- Ester Nespoli
- Competence in Neuro Spine Department, Boehringer Ingelheim Pharma GmbH & Co. KGBiberach an der Riss, Germany; Department of Child and Adolescence Psychiatry/Psychotherapy, University of UlmUlm, Germany
| | - Francesca Rizzo
- Department of Child and Adolescence Psychiatry/Psychotherapy, University of UlmUlm, Germany; Institute of Anatomy and Cell Biology, University of UlmUlm, Germany
| | - Tobias M Boeckers
- Institute of Anatomy and Cell Biology, University of Ulm Ulm, Germany
| | - Bastian Hengerer
- Competence in Neuro Spine Department, Boehringer Ingelheim Pharma GmbH & Co. KG Biberach an der Riss, Germany
| | - Andrea G Ludolph
- Department of Child and Adolescence Psychiatry/Psychotherapy, University of Ulm Ulm, Germany
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Morand-Beaulieu S, O'Connor KP, Richard M, Sauvé G, Leclerc JB, Blanchet PJ, Lavoie ME. The Impact of a Cognitive-Behavioral Therapy on Event-Related Potentials in Patients with Tic Disorders or Body-Focused Repetitive Behaviors. Front Psychiatry 2016; 7:81. [PMID: 27242551 PMCID: PMC4861894 DOI: 10.3389/fpsyt.2016.00081] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/25/2016] [Indexed: 12/19/2022] Open
Abstract
CONTEXT Tic disorders (TD) are characterized by the presence of non-voluntary contractions of functionally related groups of skeletal muscles in one or multiple body parts. Patients with body-focused repetitive behaviors (BFRB) present frequent and repetitive behaviors, such as nail biting or hair pulling. TD and BFRB can be treated with a cognitive-behavioral therapy (CBT) that regulates the excessive amount of sensorimotor activation and muscular tension. Our CBT, which is called the cognitive-psychophysiological (CoPs) model, targets motor execution and inhibition, and it was reported to modify brain activity in TD. However, psychophysiological effects of therapy are still poorly understood in TD and BFRB patients. Our goals were to compare the event-related potentials (ERP) of TD and BFRB patients to control participants and to investigate the effects of the CoPs therapy on the P200, N200, and P300 components during a motor and a non-motor oddball task. METHOD Event-related potential components were compared in 26 TD patients, 27 BFRB patients, and 27 control participants. ERP were obtained from 63 EEG electrodes during two oddball tasks. In the non-motor task, participants had to count rare stimuli. In the motor task, participants had to respond with a left and right button press for rare and frequent stimuli, respectively. ERP measures were recorded before and after therapy in both patient groups. RESULTS CoPs therapy improved symptoms similarly in both clinical groups. Before therapy, TD and BFRB patients had reduced P300 oddball effect during the non-motor task, in comparison with controls participants. An increase in the P300 oddball effect was observed posttherapy. This increase was distributed over the whole cortex in BFRB patients, but localized in the parietal area in TD patients. DISCUSSION These results suggest a modification of neural processes following CoPs therapy in TD and BFRB patients. CoPs therapy seems to impact patients' attentional processes and context updating capacities in working memory (i.e., P300 component). Our results are consistent with a possible role of the prefrontal cortex and corpus callosum in mediating interhemispheric interference in TD.
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Affiliation(s)
- Simon Morand-Beaulieu
- Laboratoire de psychophysiologie cognitive et sociale, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada; Département de neurosciences, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
| | - Kieron P O'Connor
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada; Département de psychiatrie, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
| | - Maxime Richard
- Laboratoire de psychophysiologie cognitive et sociale, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada; Département de neurosciences, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
| | - Geneviève Sauvé
- Laboratoire de psychophysiologie cognitive et sociale, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | - Julie B Leclerc
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada; Département de psychologie, Faculté des sciences humaines, Université du Québec à Montréal, Montreal, QC, Canada
| | - Pierre J Blanchet
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada; Département de stomatologie, Faculté de médecine dentaire, Université de Montréal, Montreal, QC, Canada
| | - Marc E Lavoie
- Laboratoire de psychophysiologie cognitive et sociale, Montreal, QC, Canada; Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada; Département de psychiatrie, Faculté de médecine, Université de Montréal, Montreal, QC, Canada
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25
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Niccolai V, van Dijk H, Franzkowiak S, Finis J, Südmeyer M, Jonas M, Thomalla G, Siebner HR, Müller-Vahl K, Münchau A, Schnitzler A, Biermann-Ruben K. Increased beta rhythm as an indicator of inhibitory mechanisms in tourette syndrome. Mov Disord 2015; 31:384-92. [DOI: 10.1002/mds.26454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 09/24/2015] [Accepted: 09/28/2015] [Indexed: 02/06/2023] Open
Affiliation(s)
- Valentina Niccolai
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty; Düsseldorf University; Düsseldorf Germany
| | - Hanneke van Dijk
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty; Düsseldorf University; Düsseldorf Germany
| | - Stephanie Franzkowiak
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty; Düsseldorf University; Düsseldorf Germany
| | - Jennifer Finis
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty; Düsseldorf University; Düsseldorf Germany
| | - Martin Südmeyer
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty; Düsseldorf University; Düsseldorf Germany
| | - Melanie Jonas
- Department of Psychology; Hamburg University; Hamburg Germany
| | - Götz Thomalla
- Department of Neurology; University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - Hartwig Roman Siebner
- Danish Research Center for Magnetic Resonance; Copenhagen University Hospital; Copenhagen Denmark
- Department of Neurology; Copenhagen University Hospital Bispebjerg
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School; Hannover Germany
| | - Alexander Münchau
- Department of Pediatric and Adult Movement Disorders and Neuropsychiatry; University of Lübeck
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty; Düsseldorf University; Düsseldorf Germany
| | - Katja Biermann-Ruben
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty; Düsseldorf University; Düsseldorf Germany
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26
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Godar SC, Mosher LJ, Di Giovanni G, Bortolato M. Animal models of tic disorders: a translational perspective. J Neurosci Methods 2014; 238:54-69. [PMID: 25244952 DOI: 10.1016/j.jneumeth.2014.09.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/09/2014] [Accepted: 09/11/2014] [Indexed: 12/30/2022]
Abstract
Tics are repetitive, sudden movements and/or vocalizations, typically enacted as maladaptive responses to intrusive premonitory urges. The most severe tic disorder, Tourette syndrome (TS), is a childhood-onset condition featuring multiple motor and at least one phonic tic for a duration longer than 1 year. The pharmacological treatment of TS is mainly based on antipsychotic agents; while these drugs are often effective in reducing tic severity and frequency, their therapeutic compliance is limited by serious motor and cognitive side effects. The identification of novel therapeutic targets and development of better treatments for tic disorders is conditional on the development of animal models with high translational validity. In addition, these experimental tools can prove extremely useful to test hypotheses on the etiology and neurobiological bases of TS and related conditions. In recent years, the translational value of these animal models has been enhanced, thanks to a significant re-organization of our conceptual framework of neuropsychiatric disorders, with a greater focus on endophenotypes and quantitative indices, rather than qualitative descriptors. Given the complex and multifactorial nature of TS and other tic disorders, the selection of animal models that can appropriately capture specific symptomatic aspects of these conditions can pose significant theoretical and methodological challenges. In this article, we will review the state of the art on the available animal models of tic disorders, based on genetic mutations, environmental interventions as well as pharmacological manipulations. Furthermore, we will outline emerging lines of translational research showing how some of these experimental preparations have led to significant progress in the identification of novel therapeutic targets for tic disorders.
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Affiliation(s)
- Sean C Godar
- Department of Pharmacology and Toxicology, School of Pharmacy; University of Kansas, Lawrence, KS, USA
| | - Laura J Mosher
- Department of Pharmacology and Toxicology, School of Pharmacy; University of Kansas, Lawrence, KS, USA
| | - Giuseppe Di Giovanni
- Department of Physiology and Biochemistry, University of Malta, Msida, Malta; School of Biosciences, Cardiff University, Cardiff, UK
| | - Marco Bortolato
- Department of Pharmacology and Toxicology, School of Pharmacy; University of Kansas, Lawrence, KS, USA; Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, Lawrence, KS, USA.
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27
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Houghton DC, Capriotti MR, Conelea CA, Woods DW. Sensory Phenomena in Tourette Syndrome: Their Role in Symptom Formation and Treatment. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2014; 1:245-251. [PMID: 25844305 DOI: 10.1007/s40474-014-0026-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The primary symptoms of Tourette Syndrome (TS) are motor and vocal tics, but increasingly, researchers have examined the role of sensory phenomena in biobehavioral models of the disorder. These sensory phenomena involve tic-related premonitory urge sensations as well as potential abnormalities in the perceptual and behavioral experiences associated with external sensory input. As such, dysfunctional sensorimotor integration might represent a key facet of TS pathology. The current paper reviews the literature on sensory phenomena in tic disorders and highlights possible connections to TS symptoms and directions for future research.
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Affiliation(s)
- David C Houghton
- Department of Psychology, Texas A&M University, 4235 TAMU, College Station, TX 77843
| | - Matthew R Capriotti
- Department of Psychology, University of Wisconsin-Milwaukee, 224 Garland Hall, 2441 E. Hartford Ave, Milwaukee, WI, 53211
| | - Christine A Conelea
- Bradley Hasbro Children's Research Center, Alpert Medical School of Brown University, One Hoppin Street, Providence, RI, 02903
| | - Douglas W Woods
- Department of Psychology, Texas A&M University, 4235 TAMU, College Station, TX, 77843
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28
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Araki T, Hirata M, Sugata H, Yanagisawa T, Onishi M, Watanabe Y, Omura K, Honda C, Hayakawa K, Yorifuji S. Genetic and environmental influences on motor function: a magnetoencephalographic study of twins. Front Hum Neurosci 2014; 8:455. [PMID: 24994981 PMCID: PMC4063293 DOI: 10.3389/fnhum.2014.00455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 06/03/2014] [Indexed: 11/18/2022] Open
Abstract
To investigate the effect of genetic and environmental influences on cerebral motor function, we determined similarities and differences of movement-related cortical fields (MRCFs) in middle-aged and elderly monozygotic (MZ) twins. MRCFs were measured using a 160-channel magnetoencephalogram system when MZ twins were instructed to repeat lifting of the right index finger. We compared latency, amplitude, dipole location, and dipole intensity of movement-evoked field 1 (MEF1) between 16 MZ twins and 16 pairs of genetically unrelated pairs. Differences in latency and dipole location between MZ twins were significantly less than those between unrelated age-matched pairs. However, amplitude and dipole intensity were not significantly different. These results suggest that the latency and dipole location of MEF1 are determined early in life by genetic and early common environmental factors, whereas amplitude and dipole intensity are influenced by long-term environmental factors. Improved understanding of genetic and environmental factors that influence cerebral motor function may contribute to evaluation and improvement for individual motor function.
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Affiliation(s)
- Toshihiko Araki
- Division of Functional Diagnostic Science, Osaka University Medical School , Suita , Japan
| | - Masayuki Hirata
- Division of Functional Diagnostic Science, Osaka University Medical School , Suita , Japan ; Department of Neurosurgery, Osaka University Medical School , Suita , Japan
| | - Hisato Sugata
- Department of Neurosurgery, Osaka University Medical School , Suita , Japan
| | - Takufumi Yanagisawa
- Division of Functional Diagnostic Science, Osaka University Medical School , Suita , Japan ; Department of Neurosurgery, Osaka University Medical School , Suita , Japan
| | - Mai Onishi
- Division of Functional Diagnostic Science, Osaka University Medical School , Suita , Japan
| | - Yoshiyuki Watanabe
- Department of Diagnostic and Interventional Radiology, Osaka University Medical School , Suita , Japan
| | - Kayoko Omura
- Center for Twin Research, Osaka University Medical School , Suita , Japan
| | - Chika Honda
- Center for Twin Research, Osaka University Medical School , Suita , Japan
| | - Kazuo Hayakawa
- Center for Twin Research, Osaka University Medical School , Suita , Japan
| | - Shiro Yorifuji
- Division of Functional Diagnostic Science, Osaka University Medical School , Suita , Japan
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Abstract
PURPOSE OF REVIEW Primary tic disorders are complex, multifactorial disorders in which tics are accompanied by other sensory features and an array of comorbid behavioral disorders. Secondary tics are proportionally much less frequent, but their etiology is diverse. This review aims to guide clinicians in the recognition of the phenomenology, pathophysiology, and treatment of these disorders. RECENT FINDINGS Advances include greater phenomenologic insights, particularly of nonmotor (sensory) features; increased knowledge of disease mechanisms, particularly coming from neuropsychological, functional imaging, pathologic, and animal model studies; growing evidence on the efficacy of alpha-2 agonists and the newer generation of dopamine-modulating agents; and recent strides in the evaluation of cognitive-behavioral therapy and deep brain stimulation surgery. SUMMARY The correct diagnostic approach to tic disorders requires accurate historical gathering, a thorough neurologic examination, and detailed definition of the patient's psychopathologic profile. Treatment should always begin with individualized psychoeducational strategies. Although pharmacologic treatments remain beneficial for most patients, cognitive-behavioral treatments have thus far shown promising efficacy. Deep brain stimulation surgery should still be limited to adult patients refractory to pharmacotherapy and cognitive-behavioral therapy.
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Abstract
Movement disorders, which include disorders such as Parkinson's disease, dystonia, Tourette's syndrome, restless legs syndrome, and akathisia, have traditionally been considered to be disorders of impaired motor control resulting predominantly from dysfunction of the basal ganglia. This notion has been revised largely because of increasing recognition of associated behavioural, psychiatric, autonomic, and other non-motor symptoms. The sensory aspects of movement disorders include intrinsic sensory abnormalities and the effects of external sensory input on the underlying motor abnormality. The basal ganglia, cerebellum, thalamus, and their connections, coupled with altered sensory input, seem to play a key part in abnormal sensorimotor integration. However, more investigation into the phenomenology and physiological basis of sensory abnormalities, and about the role of the basal ganglia, cerebellum, and related structures in somatosensory processing, and its effect on motor control, is needed.
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Affiliation(s)
- Neepa Patel
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
| | - Mark Hallett
- Human Motor Control Section, NINDS, National Institutes of Health, Bethesda, MD, USA
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31
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Abstract
AbstractSomatosensory pathways and cortices contribute to the control of human movement. In humans, non-invasive transcranial magnetic stimulation techniques to promote plasticity within somatosensory pathways and cortices have revealed potent effects on the neurophysiology within motor cortices. In this mini-review, we present evidence to indicate that somatosensory cortex is positioned to influence motor cortical circuits and as such, is an ideal target for plasticity approaches that aim to alter motor physiology and behavior in clinical populations.
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32
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Klepp A, Weissler H, Niccolai V, Terhalle A, Geisler H, Schnitzler A, Biermann-Ruben K. Neuromagnetic hand and foot motor sources recruited during action verb processing. BRAIN AND LANGUAGE 2014; 128:41-52. [PMID: 24412808 DOI: 10.1016/j.bandl.2013.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 09/19/2013] [Accepted: 12/02/2013] [Indexed: 06/03/2023]
Abstract
The current study investigated sensorimotor involvement in the processing of verbs describing actions performed with the hands, feet, or no body part. Actual movements were used to identify neuromagnetic sources for hand and foot actions. These sources constrained the analysis of verb processing. While hand and foot sources picked up activation in all three verb conditions, peak amplitudes showed an interaction of source and verb condition at 200 ms after word onset, thereby reflecting effector-specificity. Specifically, hand verbs elicited significantly higher peak amplitudes than foot verbs in hand sources. Our results are in line with theories of embodied cognition that assume an involvement of sensorimotor areas in early stages of lexico-semantic processing, even for single words without a semantic or motor task.
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Affiliation(s)
- Anne Klepp
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany.
| | - Hannah Weissler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Valentina Niccolai
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Anselm Terhalle
- Department of Romance Languages and Literatures, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Hans Geisler
- Department of Romance Languages and Literatures, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
| | - Katja Biermann-Ruben
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Universitätsstr. 1, 40225 Düsseldorf, Germany
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33
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Martino D, Madhusudan N, Zis P, Cavanna AE. An Introduction to the Clinical Phenomenology of Tourette Syndrome. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2013; 112:1-33. [DOI: 10.1016/b978-0-12-411546-0.00001-9] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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