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Premonitory urges in Tourette's syndrome
J F Leckman1, D E Walker, D J Cohen
1Child Study Center, Yale University School of Medicine, New Haven, CT 06510.
The American Journal of Psychiatry
|January 1, 1993
Summary
Most people with tic disorders experience premonitory urges before tics. These urges often lead to a voluntary tic response, challenging the view of Tourette syndrome as purely involuntary.
Area of Science:
- Neuroscience
- Psychiatry
- Movement Disorders
Background:
- Tourette's syndrome is traditionally classified as a hyperkinetic movement disorder.
- Many patients report premonitory urges preceding their tics, suggesting a voluntary component.
Purpose of the Study:
- To investigate the prevalence and characteristics of premonitory urges in individuals with tic disorders.
- To evaluate the voluntary nature of tic responses to premonitory urges.
Main Methods:
- Cross-sectional study involving 135 subjects (aged 8-71) with tic disorders.
- Utilized a questionnaire to assess current and past tic symptoms and premonitory urges.
- Employed the Yale Global Tic Severity Scale to measure tic severity.
Main Results:
- 93% of subjects reported experiencing premonitory urges.
- The most common urge locations included palms, shoulders, abdomen, and throat.
- 84% reported relief after tics, and 92% considered tics a voluntary response to urges.
Conclusions:
- Premonitory urges are common in tic disorders, challenging the notion of wholly involuntary tics.
- Findings suggest sensorimotor processing regions may be implicated in the pathophysiology of tic disorders.
- Highlights the need to incorporate premonitory urges into future epidemiological studies of tic disorders.