Premonitory sensory phenomenon in Tourette's syndrome

  title={Premonitory sensory phenomenon in Tourette's syndrome},
  author={Carolyn Kwak and Kevin Dat Vuong and Joseph Jankovic},
  journal={Movement Disorders},
We administered a questionnaire designed to probe for premonitory sensations associated with motor tics to 50 patients with Tourette's syndrome (TS). Premonitory sensations were reported by 46 (92%) patients, and the most common sensation was an urge to move and an impulse to tic (“had to do it”). Intensification of premonitory sensations, if prevented from performing a motor tic, was reported also in 37 patients (74%), 36 patients (72%) reported relief of premonitory sensations after… 
Tourette Syndrome and Consciousness of Action
The simultaneous presence of both voluntary and involuntary aspects in the expression of tic symptoms by patients with TS is consistent with the hypothesis that tics can have the same neurophysiologic substrate as voluntary acts, even though they are misperceived as being involuntary.
Neurobiology of the Premonitory Urge in Tourette's Syndrome: Pathophysiology and Treatment Implications.
This article reviews the existing literature on the clinical and neurobiological aspects of the premonitory urge in patients with TS, with focus on its pathophysiology and possible treatment implications.
Clinical Aspects of Premonitory Urges in Patients with Tourette’s Disorder
  • S. Nam, Juhyun Park, T. Park
  • Psychology, Medicine
    Soa--ch'ongsonyon chongsin uihak = Journal of child & adolescent psychiatry
  • 2019
Based on the concept that the premonitory urge induces tics, behavioral treatments such as Exposure and Response Prevention and Habit Reversal Therapy have been developed, but it is still unclear whether habituation, the main mechanism of these therapies, is directly related to their effectiveness.
Sensory sensitivity to external stimuli in Tourette syndrome patients
It is indicated that patients' perceived sensitivity derives from altered central processing rather than enhanced peripheral detection, and one aspect of processing: the perception of intensity.
Premonitory Urges and Sensorimotor Processing in Tourette Syndrome
A systematic literature review of the published studies addressing the pathophysiological mechanisms of premonitory urges identified some preliminary evidence for specific alterations in sensorimotor processing at both cortical and subcortical levels.
Premonitory Urges in Patients with Gilles de la Tourette Syndrome: An Italian Translation and a 7-Year Follow-up.
The results suggest the the Italian translation of the PUTS has good psychometric properties, and a statistical significant correlation between PUTs score and obsessive-compulsive symptoms (OCS) at both interviews.
Physiological Awareness Is Negatively Related to Inhibitory Functioning in Tourette Syndrome
Patients with TS exhibit increased PBC in addition to inhibitory deficits and complex interplay between neuropsychological and neurophysiological mechanisms could determine tic severity and the success of behavioral treatments.
Quantitative Sensory Testing in adults with Tourette syndrome.


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The results suggest that premonitory urges may be commonplace in adolescent and adult subjects with tic disorders and challenge the conventional wisdom that tic behaviors are wholly involuntary in character.
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  • Psychology
    Archives of general psychiatry
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A patient with a 62-year history of Gilles de la Tourette syndrome describes 35 years of self-observation of the subjective events that precede, accompany, and follow the occurrence of symptomatic
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The results suggest that "just right" perceptions may be commonplace in adolescent and adult subjects with both obsessive-compulsive disorder and tic disorders.
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Findings are consistent with the hypothesis that tics in Tourette's disorder originate either from a primarily subcortical disorder affecting the motor cortex through disinhibited afferent signals or from impaired inhibition directly at the level of the Motor cortex or both.
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Botulinum toxin A injections are an effective and well-tolerated treatment of tics in patients with Tourette syndrome and also provides relief of premonitory sensations.
Simple motor tics may be preceded by a premotor potential.
Spontaneous tics in Tourette's syndrome were not associated with premotor potentials, which were present when patients mimicked their tics voluntarily, suggesting that spontaneous tics were not generated in the same manner as voluntary movements.
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Findings are congruent with the hypothesis that Tourette’s syndrome and obsessive–compulsive disorder (OCD) are analogous disorders with overlapping dysfunction in corticobasal circuits.
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