No abstract

The cardinal characteristics of tic-related disorders are stereotyped motor movements and vocalizations. However, they may be accompanied by non-motor features that appear sequentially during the course of the disorder and can sometimes be more disabling than the tics themselves. This review presents our perspectives on several non-motor aspects of Tourette syndrome based on the long experience of the Neuropsychiatric Tourette Clinic of a tertiary pediatric medical center. The effect of premonitory urges, sensory modulation disorder, tic-related cognitions, and environmental conditions on the expression and intensity of tics is elaborated, with suggestions for treatment approaches to each. We also describe the mediatory effect of parental attachment style on the link between maternal stress and ticcing intensity and the need to adjust psychotherapy interventions to account for the importance of this factor in emotion regulation. This review is intended to direct attention to the non-motor aspects of Tourette syndrome. An in-depth understanding of this complex and debilitating disorder will facilitate the formulation of innovative therapeutic protocols.

The role of brain asymmetry in emotional processing in Asperger syndrome (AS) is still largely unknown. Although the valence hypothesis predicts that positive emotions are processed preferentially by the left hemisphere and negative emotions by the right hemisphere, reports concerning laterality of emotion point to a left hemisphere advantage for complex emotion versus a right hemisphere advantage for basic emotions (the "type hypothesis"). In this study, we investigated the lateralization of basic versus complex (negative and positive) eye expressions in adults with AS in 2 consecutive experiments: in the first experiment, the performance of AS and healthy controls were compared in a divided visual field task. In the second experiment, the ability of participants with AS to identify eye expressions varying in valence and type was compared with that of patients with localized lesions in either the right or the left hemispheres. Controls were better in recognizing negative emotions presented to the left visual field and positive emotions presented to the right visual field, whereas individuals with AS failed to show this interaction effect. Lateralization of basic versus complex emotions was less evident although indeed controls identified better basic emotions presented to the right visual field. Furthermore, participants with AS exhibited a similar pattern of recognition of negative versus positive emotions to that of patients with left hemisphere damage. It is suggested that the pattern of performance of individuals with AS resembles that of patients with left hemisphere dysfunction.

The present study used parent-report data to explore crosscultural similarities and differences in tic severity and reactions to tics across 223 children with Tourette's disorder (TD) from the United States, United Kingdom, and Netherlands/Norway. Psychometric properties of the TARS-PR and PTQ were also examined and results indicated that both measures may be suitable for assessing tic severity and the consequences of tics in these countries. No differences in parent-reported tic severity were found. However, parents of children with TD from the United Kingdom reported significantly more reactions to their child's tics than parents from the United States and Netherlands/Norway.