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Research paper
Are premonitory urges a prerequisite of tic inhibition in Gilles de la Tourette syndrome?
  1. Christos Ganos1,
  2. Ursula Kahl1,
  3. Odette Schunke2,
  4. Simone Kühn2,
  5. Patrick Haggard3,
  6. Christian Gerloff1,
  7. Veit Roessner4,
  8. Götz Thomalla1,
  9. Alexander Münchau3
  1. 1Department of Neurology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
  2. 2Centre for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
  3. 3Institute of Cognitive Neuroscience, University College London, London, UK
  4. 4Department of Child and Adolescent Psychiatry, University of Dresden Medical School, Dresden, Germany
  1. Correspondence to Dr C Ganos, Movement Disorders Research Group, Department of Neurology, University Medical Centre Hamburg-Eppendorf, Martinistr 52, 20246 Hamburg, Germany; cganos{at}gmail.com

Abstract

Background Despite the common notion that premonitory urges facilitate tic inhibition, no studies have investigated this question systematically. We examined the relation of the trait of premonitory urges with tics and tic suppression. We hypothesised that patients with more urges would be more efficient at inhibiting tics.

Methods 15 adult (14 men, mean age 32.2±7.9 years) pure Gilles de la Tourette syndrome patients participated. Tic severity was evaluated using the modified Rush Video Scale and by employing the Yale Global Tic Severity Scale. Tic suppressibility was assessed from videos of additional periods where patients were instructed to maximally suppress their tics. Rush score based inhibition potency was synthesised by combining the scores in the two conditions. A measure of pure motor tic inhibition potency was also generated based on the number of motor tics alone. Premonitory urges were assessed by the Premonitory Urge for Tics Scale.

Results All participants reported urges preceding their tics and were able to voluntarily suppress their tics. However, there was no correlation between urge scores and the Rush score based inhibition potency or the pure motor tic inhibition potency. Scores of the Premonitory Urge for Tics Scale correlated with the interference subscale item of the Yale Global Tic Severity Scale.

Conclusions Urges and tic inhibition are not directly related. There seem to exist at least two distinct neurophysiological systems of urge/tic generation and tic control in adult Gilles de la Tourette syndrome patients.

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Footnotes

  • Funding This research received support from the Deutsche Forschungsgemeinschaft (MU1692/2-1) and the European Science Foundation.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Hamburg local ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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