Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome

Brandt, Valerie; Beck, Christian; Sajin, Valeria; Baaske, Magdalena K.; Bäumer, Tobias; Beste, Christian; Anders, Silke; Münchau, Alexander

doi:10.1016/j.cortex.2016.01.008

Cited by 107 publications

(109 citation statements)

References 52 publications

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“…According to the theory of event coding, tics should then also activate sensory codes associated with urges. This is in line with a recent study showing that urge intensity increases during bouts of tics until the end of a bout and only then decreases …”

Section: Discussionsupporting

confidence: 93%

Tics as a model of over‐learned behavior—imitation and inhibition of facial tics

et al. 2016

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Section: Discussionsupporting

confidence: 93%

Tics as a model of over‐learned behavior—imitation and inhibition of facial tics

et al. 2016

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“…In a subsequent larger study of 135 patients with TS aged 8–71 years, 92% indicated that their tics were either fully or partially a voluntary response to their premonitory urges {54}. Consistent with Bliss’ account, 84% referred to unpleasant somatic phenomena that “build-up” prior to the tic (or upon attempts to resist ticcing) and are momentarily alleviated by tic expression {54,55}. Tics involving the head, neck, shoulders, or the midline abdomen tend to be most frequently preceded by urges, whereas simple tics which are more brisk in nature, such as eye blinking and mouth movements, are less likely to be preceded by urges.…”

Section: Clinical Phenomenology Of the Premonitory Urge To Ticmentioning

confidence: 84%

Neurobiology of the Premonitory Urge in Tourette’s Syndrome: Pathophysiology and Treatment Implications

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Hallett

et al. 2017

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Motor and vocal tics are relatively common motor manifestations identified as the core features of Tourette syndrome. Although traditional descriptions have focused on objective phenomenological observations, such as anatomical location, number and frequency of tics, patients’ first-person accounts have consistently reported characteristic subjective correlates. These sensory phenomena are often described as a feeling of mounting inner tension or urge to move (“premonitory urge”), which is transiently relieved by tic expression. This paper reviews the existing literature on the clinical and neurobiological aspects of the premonitory urge in patients with Tourette syndrome, with focus on its pathophysiology and possible treatment implications.

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“…Results of these studies showed that tics can be suppressed for brief periods and that PMU strength increased during reinforced tic suppression and decreased during breaks from suppression. Furthermore, a recent study found that PMU strength increases prior to ticcing and decreases after ticcing (Brandt, Beck, Sajin, Baske, et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

Investigating Habituation to Premonitory Urges in Behavior Therapy for Tic Disorders

et al. 2017

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Behavior therapy is effective for Persistent Tic Disorders (PTDs), but behavioral processes facilitating tic reduction are not well understood. One process, habituation, is thought to create tic reduction through decreases in premonitory urge severity. The current study tested whether premonitory urges decreased in youth with PTDs (N = 126) and adults with PTDs (N = 122) who participated in parallel randomized clinical trials comparing behavior therapy to psychoeducation and supportive therapy (PST). Trends in premonitory urges, tic severity, and treatment outcome were analyzed according to the predictions of a habituation model, whereby urge severity would be expected to decrease in those who responded to behavior therapy. Although adults who responded to behavior therapy showed a significant trend of declining premonitory urge severity across treatment, results failed to demonstrate that behavior therapy specifically caused changes in premonitory urge severity. In addition, reductions in premonitory urge severity in those who responded to behavior therapy were significant greater than those who did not respond to behavior therapy but no different than those who responded or did not respond to PST. Children with PTDs failed to show any significant changes in premonitory urges. Reductions in premonitory urge severity did not mediate the relationship between treatment and outcome in either adults or children. These results cast doubt on the notion that habituation is the therapeutic process underlying the effectiveness of behavior therapy, which has immediate implications for the psychoeducation and therapeutic rationale presented in clinical practice. Moreover, there may be important developmental changes in premonitory urges in PTDs, and alternative models of therapeutic change warrant investigation.

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Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome

Cited by 107 publications

References 52 publications

Tics as a model of over‐learned behavior—imitation and inhibition of facial tics

Tics as a model of over‐learned behavior—imitation and inhibition of facial tics

Neurobiology of the Premonitory Urge in Tourette’s Syndrome: Pathophysiology and Treatment Implications

Investigating Habituation to Premonitory Urges in Behavior Therapy for Tic Disorders

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