Premonitory urge in tic disorders - a scoping review

Area of Science:

• Neuroscience
• Psychiatry
• Clinical Psychology

Background:

• Premonitory urges are prevalent and bothersome sensations preceding tics in tic disorders.
• They are increasingly recognized as a key feature of tic disorder phenotypes.
• Understanding premonitory urges is crucial for effective intervention development.

Purpose of the Study:

• To systematically review and consolidate existing knowledge on premonitory urges in primary tic disorders.
• To identify current knowledge gaps concerning the assessment, characteristics, and mechanisms of premonitory urges.
• To inform future research and clinical practice for tic disorders.

Main Methods:

• A comprehensive scoping review was conducted.
• Searches were performed across five databases and five relevant journals.
• 155 articles were included after screening by two independent reviewers.

Main Results:

• Various assessment methods for premonitory urges exist, each with limitations.
• Urge quality varies, with "not just right" sensations more common in those with comorbid OCD.
• Awareness of urges develops years after tic onset; urges and tics are temporally linked but not consistently correlated in severity.
• The insula and supplementary motor area are implicated in urge generation.
• Limited data exist on treatment response, but promising interventions were noted.

Conclusions:

• Significant advancements have been made in understanding premonitory urges, including their characteristics and neural basis.
• Key knowledge gaps persist in their measurement, mechanistic understanding, and developmental trajectory.
• Addressing these gaps is essential for developing targeted and effective treatments for premonitory urges in tic disorders.