scholarly journals A Process-Oriented View of Procedural Memory Can Help Better Understand Tourette’s Syndrome

2021 ◽  
Vol 15 ◽  
Author(s):  
Bence Cs. Farkas ◽  
Eszter Tóth-Fáber ◽  
Karolina Janacsek ◽  
Dezso Nemeth

Tourette’s syndrome (TS) is a neurodevelopmental disorder characterized by repetitive movements and vocalizations, also known as tics. The phenomenology of tics and the underlying neurobiology of the disorder have suggested that the altered functioning of the procedural memory system might contribute to its etiology. However, contrary to the robust findings of impaired procedural memory in neurodevelopmental disorders of language, results from TS have been somewhat mixed. We review the previous studies in the field and note that they have reported normal, impaired, and even enhanced procedural performance. These mixed findings may be at least partially be explained by the diversity of the samples in both age and tic severity, the vast array of tasks used, the low sample sizes, and the possible confounding effects of other cognitive functions, such as executive functions, working memory or attention. However, we propose that another often overlooked factor could also contribute to the mixed findings, namely the multiprocess nature of the procedural system itself. We propose that a process-oriented view of procedural memory functions could serve as a theoretical framework to help integrate these varied findings. We discuss evidence suggesting heterogeneity in the neural regions and their functional contributions to procedural memory. Our process-oriented framework can help to deepen our understanding of the complex profile of procedural functioning in TS and atypical development in general.

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S245-S246
Author(s):  
Francesca Conti ◽  
Himanshu Tyagi

AimsChanges in the severity of tics in Tourette's syndrome (TS), as seen with variations in the intensity or frequency of tics, can be moderated by a variety of independent factors such as external or internal stimuli. Identifying such moderators has important clinical implications as it can aid clinicians in adjusting interventions. Hence, based on our previous review of tic-severity moderators, we developed a clinical inventory of moderating variables for motor and vocal tics for inclusion in the new version of the Queen Square Proforma for Tourette's Syndrome to aid initial assessments in the National Tourette Syndrome Service's Outpatient Clinic for Adults.MethodA review of tic-severity moderators was previously carried out by the authors to investigate the kinds of moderators and their worsening, improving or neutral effects on tic severity. Based on this a semantic thematic analysis of the identified moderators was carried out and themes were developed based on appropriate and relevant MeSH terms in order to create the categories and items of the clinical inventory.ResultSeventy-three different tic severity moderators were identified, the most common being exercise, sleep, peer victimisation, psychosocial stress, watching TV, academic activities and distraction. Twenty-nine themes emerged from the thematic analysis which were then used to update the clinical inventory of tic severity moderators. The review also highlighted the subjectivity of these moderators’ effects on tic severity as some moderators were tic-worsening in some individuals and tic-improving or neutral in others, which is contrary to the current dichotomous understanding.ConclusionThe updated clinical inventory of tic severity moderators invites researchers and clinicians to be more aware of the existence, variability and subjective effects of these tic severity moderators in individuals with TS, as these have been previously looked in a dichotomous way. By better identifying tic-severity moderators and their worsening, improving or neutral effects on tic severity this clinician rated inventory will have potentially important, direct implications for the management and treatment of tics.


2003 ◽  
Vol 18 (11) ◽  
pp. 1392-1395 ◽  
Author(s):  
Beatrice L. Wood ◽  
Kendra Klebba ◽  
Olufowbi Gbadebo ◽  
David Lichter ◽  
Roger Kurlan ◽  
...  

1997 ◽  
Vol 27 (2) ◽  
pp. 483-487 ◽  
Author(s):  
SERDAR M. DURSUN ◽  
MICHAEL A. REVELEY

Background. The treatment of Tourette's syndrome (TS) is often unsatisfactory. However, there is some evidence that transdermal nicotine patch (TNP) application may improve tics of non-smoking TS patients who are refractory to haloperidol treatment.Methods. In this open study we applied two 10 mg TNP for 2 consecutive days to four TS patients whose symptoms were not controlled by haloperidol and to a never-medicated TS patient, all of whom are non-smokers. The Yale Global Tic Severity Scale (YGTSS) and a quantified video-taped micro-structured analysis of tics (head-shake tics, eye-blinks, vocal tics, facial grimace and other body tics) were both carried out to assess the change after the application of TNP.Results. TNP application significantly reduced the YGTSS by an average of 50%, with no reported side-effects, for up to 4 weeks but not 16 weeks, as compared with TNP-free period. Consistent with these results, the total counts of tics also showed a significant decrease for up to 4 weeks after the TNP application.Conclusion. TNP application differentially affected individually quantified tics, which may suggest a differential role of nicotinic receptors in the generation of different tics.


2014 ◽  
Vol 36 (3) ◽  
pp. 123-133 ◽  
Author(s):  
Bárbara R. Ferreira ◽  
J. L. Pio-Abreu ◽  
Cristina Januário

Objective: To compile data on Tourette's syndrome (TS), tics and associated disorders.Methods: A systematic review of the literature was conducted using the 5S levels of organization of healthcare research evidence (systems, summaries, synopses, syntheses, studies), based on the model described by Haynes. The search keywords were Tourette, tics and comorbidity, which were cross-referenced. Studies provided by publishers and articles being processed on July 31, 2013, were also included.Results: Of all studies retrieved during the search, 64 were selected because they analyzed the epidemiology, clinical features and etiopathogenesis of TS and its comorbidities. TS is classified as a hyperkinetic movement disorder, and at least 90% of the patients have neuropsychiatric comorbidities, of which attention deficit hyperactivity and obsessive-compulsive disorders are the most common. The syndrome is clinically heterogeneous and has been associated with a dysfunction of cortico-striatal-thalamic-cortical circuits involving various neurotransmitters. Although its genetic etiology has been widely studied, other factors may be important to understand this syndrome and its associated disorders.Conclusions: TS is a neurodevelopmental disorder that results from the impact of stress factors on a vulnerable biological substrate during the critical periods of neurodevelopment. The study of TS and its comorbidities may contribute, at different levels, to the understanding of several neuropsychiatric disorders of clinical and therapeutic relevance.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053156
Author(s):  
Cynthia K Kahl ◽  
Rose Swansburg ◽  
Adam Kirton ◽  
Tamara Pringsheim ◽  
Gabrielle Wilcox ◽  
...  

IntroductionTourette’s syndrome (TS) affects approximately 1% of children. This study will determine the efficacy and safety of paired comprehensive behavioural intervention for tics (CBIT) plus repetitive transcranial magnetic stimulation (rTMS) treatment in children with Tourette’s syndrome. We hypothesise that CBIT and active rTMS to the supplementary motor area (SMA) will (1) decrease tic severity, and (2) be associated with changes indicative of enhanced neuroplasticity (eg, changes in in vivo metabolite concentrations and TMS neurophysiology measures).Methods and analysisThis study will recruit 50 youth with TS, aged 6–18 for a phase II, double-blind, block randomised, sham-controlled trial comparing active rTMS plus CBIT to sham rTMS plus CBIT in a 1:1 ratio. The CBIT protocol is eight sessions over 10 weeks, once a week for 6 weeks and then biweekly. The rTMS protocol is 20 sessions of functional MRI-guided, low-frequency (1 Hz) rTMS targeted to the bilateral SMA over 5 weeks (weeks 2–6). MRI, clinical and motor assessments and neurophysiological evaluations including motor mapping will be performed 1 week before CBIT start, 1 week after rTMS treatment and 1 week after CBIT completion. The primary outcome measure is Tourette’s symptom change from baseline to post-CBIT treatment, as measured by the Yale Global Tic Severity Scale. Secondary outcomes include changes in imaging, neurophysiological and behavioural markers.Ethics and disseminationEthical approval by the Conjoint Health Research Ethics Board (REB18-0220). The results of this study will be published in peer-reviewed scientific journals, on ClinicalTrials.gov and shared with the Tourette and OCD Alberta Network. The results will also be disseminated through the Alberta Addictions and Mental Health Research Hub.Trial registrationNCT03844919.


2008 ◽  
Vol 28 ◽  
pp. 170-190 ◽  
Author(s):  
Larry Burd ◽  
Trent Christensen ◽  
Jacob Kerbeshian

In this article we review the relationship between Tourette's syndrome (TS) and speech, language, and communication disorders. We consider TS to be a neurodevelopmental disorder with an increased rate of co-occurring (comorbid) disorders. We have organized the available research into topical areas for convenience of review. These areas are tic insertion into speech, learning disabilities, speech abnormalities, expressive and receptive language impairments, coprophenomena, writing and tics, signing and tic premonitory phenomena, and TS. We conclude with a discussion of the interplay between neurological function and mental factors on expression and outcome of this relationship. We offer discussion of a research agenda to advance the science in this area.


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