Are premonitory urges a prerequisite of tic inhibition in Gilles de la Tourette syndrome?
Are premonitory urges a prerequisite of tic inhibition in Gilles de la Tourette syndrome?
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DOI：
10.1136/jnnp-2012-303033
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发表时间：
2012-10-01
影响因子：
11
通讯作者：
Muenchau, Alexander
中科院分区：
文献类型：
--
作者：
Ganos, Christos;Kahl, Ursula;Muenchau, Alexander
尽管普遍认为先兆冲动有助于抽动抑制，但没有研究系统地调查了这个问题。我们研究了抽动和抽动抑制与先兆冲动特征的关系。我们假设有更多冲动的患者在抑制抽搐方面更有效。方法对15例成人纯抽动秽语综合征患者（男性14例，平均年龄32.2±7.9岁）进行研究。抽搐严重程度采用改进的拉什视频量表和耶鲁全球抽搐严重程度量表进行评估。抽动抑制能力是通过另外一段时间的视频来评估的，在这段时间里，患者被指示最大限度地抑制他们的抽动。结合两种条件下的Rush分数，合成基于Rush分数的抑制效价。纯运动性抽动抑制效力的测量也仅基于运动性抽动的数量产生。先兆冲动采用抽搐先兆冲动量表进行评估。结果所有的参与者都报告了抽搐前的冲动，并能够自愿抑制抽搐。然而，冲动得分与基于Rush评分的抑制效价或纯运动抽搐抑制效价之间没有相关性。抽动前兆冲动量表得分与耶鲁全球抽动严重程度量表干扰子量表项相关。结论冲动与抽动抑制无直接关系。似乎存在至少两个不同的神经生理系统的冲动/抽动的产生和抽动控制在成人吉尔勒德拉图雷特综合征患者。
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.