Premonitory urges in Tourette's syndrome.
Premonitory urges in Tourette's syndrome.
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DOI：
10.1176/ajp.150.1.98
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
J. Leckman;D. E. Walker;D. Cohen
中科院分区：
文献类型：
--
作者：
J. Leckman;D. E. Walker;D. Cohen
目的Tourette综合征传统上被认为是一种以不自主运动和语音抽动为特征的多动症。然而，许多患者将他们的抽搐描述为对先兆冲动的自愿反应。这项横断面研究评估了抽动障碍受试者的先兆冲动和相关现象。方法对135例8~71岁抽动障碍患者进行抽动症状问卷调查。受试者被要求描述并在可能的情况下定位他们的先兆冲动。采用耶鲁全球抽动严重度量表评估目前抽动的严重程度。发现病例的方法不提供先兆冲动的流行数据。结果93%的受试者有先兆冲动。冲动密度最大的解剖区域是手掌、肩膀、中线腹部和喉咙。84%的受试者报告说抽搐与一种解脱的感觉有关。绝大多数人(92%)还表示，他们的抽搐完全或部分是对先兆冲动的自愿反应。结论虽然抽动障碍的流行病学研究尚未纳入有关先兆冲动的问题，但这些结果表明，这种冲动在青少年和成年抽动障碍受试者中可能是常见的。这些结果挑战了传统观点，即抽动行为完全是非自愿的。它们还牵涉到抽动障碍的病理生物学中参与感觉运动信息处理的大脑区域。
OBJECTIVE Tourette's syndrome traditionally has been viewed as a hyperkinetic movement disorder characterized by involuntary motor and phonic tics. Many patients, however, describe their tics as a voluntary response to premonitory urges. This cross-sectional study evaluated premonitory urges and related phenomena in subjects with tic disorders. METHOD A total of 135 subjects with tic disorders, aged 8 to 71 years, completed a questionnaire concerning their current and past tic symptoms. Subjects were asked to describe and, if possible, localize their premonitory urges. The Yale Global Tic Severity Scale was used to assess current tic severity. The method of case finding does not provide prevalence data for premonitory urges. RESULTS Ninety-three percent of the subjects reported premonitory urges. Anatomical regions with the greatest density of urges were the palms, shoulders, midline abdomen, and throat. Eighty-four percent of the subjects reported that tics were associated with a feeling of relief. A substantial majority (92%) also indicated that their tics were either fully or partially a voluntary response to the premonitory urges. CONCLUSIONS While epidemiological studies of tic disorders have yet to incorporate questions concerning premonitory urges, these results suggest that such urges may be commonplace in adolescent and adult subjects with tic disorders. These results challenge the conventional wisdom that tic behaviors are wholly involuntary in character. They also implicate brain regions involved in the processing of sensorimotor information in the pathobiology of tic disorders.