An introduction to the clinical phenomenology of Tourette syndrome

Davide Martino*, Namrata Madhusudan, Panagiotis Zis, Andrea E. Cavanna

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter (peer-reviewed)

Abstract

Tourette syndrome (TS) is the primary tic disorder that reaches most commonly medical attention and monitoring, with an estimated prevalence close to 1% between 5 and 18 years of age. Motor and phonic tics are the core features of TS. In addition to their well-characterized phenomenology, tics display a peculiar variability over time, which is strongly influenced by a variety of contextual factors. The sensory phenomena of TS are increasingly recognized as another crucial symptom of TS and consist of premonitory urges and somatic hypersensitivity. A relevant proportion of patients with TS display complex, tic-like, repetitive behaviors that include echophenomena, coprophenomena, and nonobscene socially inappropriate behaviors (NOSIBs). The burden of behavioral comorbidities is very important in determining the degree of disability of TS patients. Only a small minority of TS patients presents exclusively with a tic disorder. Obsessive-compulsive symptoms and related disorder (OCD) are common in TS, and the clinical distinction between compulsions and complex tics may be difficult in some cases. Probably, the presence of comorbid attention deficit hyperactivity disorder (ADHD) is the main determinant of cognitive dysfunction in TS patients and influences heavily also the risk of developing disruptive behaviors. Affective disorders, impulse control disorders, autism spectrum disorders, and personality disorders complete the wide psychopathological spectrum of this condition, but have been less investigated than OCD and ADHD. The complexity of the Tourette spectrum has been confirmed by cluster and factor analytical approaches, and is likely to inform the study of the genetic basis of this disorder, as well as future reappraisal of its nosography, with the development of novel clinical subtypes.

Original languageEnglish
Title of host publicationAdvances in the neurochemistry and neuropharmacology of Tourette syndrome
EditorsDavide Martino, Andrea E. Cavanna
Place of PublicationLondon (UK)
PublisherAcademic Press
Pages1-33
Number of pages33
ISBN (Print)978-0-12-411546-0
DOIs
Publication statusPublished - 3 Dec 2013

Publication series

NameInternational review of neurobiology
PublisherElsevier
Volume112
ISSN (Print)0074-7742

Fingerprint

Tourette Syndrome
Tics
Tic Disorders
Attention Deficit Disorder with Hyperactivity
Disruptive, Impulse Control, and Conduct Disorders
Inborn Genetic Diseases
Personality Disorders
Mood Disorders
Comorbidity
Hypersensitivity

Keywords

  • attention deficit
  • compulsions
  • coprophenomena
  • echophenomena
  • hyperactivity
  • iImpulse control disorders
  • tics
  • Tourette syndrome

Cite this

Martino, D., Madhusudan, N., Zis, P., & Cavanna, A. E. (2013). An introduction to the clinical phenomenology of Tourette syndrome. In D. Martino, & A. E. Cavanna (Eds.), Advances in the neurochemistry and neuropharmacology of Tourette syndrome (pp. 1-33). (International review of neurobiology; Vol. 112). London (UK): Academic Press. https://doi.org/10.1016/B978-0-12-411546-0.00001-9
Martino, Davide ; Madhusudan, Namrata ; Zis, Panagiotis ; Cavanna, Andrea E. / An introduction to the clinical phenomenology of Tourette syndrome. Advances in the neurochemistry and neuropharmacology of Tourette syndrome. editor / Davide Martino ; Andrea E. Cavanna. London (UK) : Academic Press, 2013. pp. 1-33 (International review of neurobiology).
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Martino, D, Madhusudan, N, Zis, P & Cavanna, AE 2013, An introduction to the clinical phenomenology of Tourette syndrome. in D Martino & AE Cavanna (eds), Advances in the neurochemistry and neuropharmacology of Tourette syndrome. International review of neurobiology, vol. 112, Academic Press, London (UK), pp. 1-33. https://doi.org/10.1016/B978-0-12-411546-0.00001-9

An introduction to the clinical phenomenology of Tourette syndrome. / Martino, Davide; Madhusudan, Namrata; Zis, Panagiotis; Cavanna, Andrea E.

Advances in the neurochemistry and neuropharmacology of Tourette syndrome. ed. / Davide Martino; Andrea E. Cavanna. London (UK) : Academic Press, 2013. p. 1-33 (International review of neurobiology; Vol. 112).

Research output: Chapter in Book/Report/Conference proceedingChapter (peer-reviewed)

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N2 - Tourette syndrome (TS) is the primary tic disorder that reaches most commonly medical attention and monitoring, with an estimated prevalence close to 1% between 5 and 18 years of age. Motor and phonic tics are the core features of TS. In addition to their well-characterized phenomenology, tics display a peculiar variability over time, which is strongly influenced by a variety of contextual factors. The sensory phenomena of TS are increasingly recognized as another crucial symptom of TS and consist of premonitory urges and somatic hypersensitivity. A relevant proportion of patients with TS display complex, tic-like, repetitive behaviors that include echophenomena, coprophenomena, and nonobscene socially inappropriate behaviors (NOSIBs). The burden of behavioral comorbidities is very important in determining the degree of disability of TS patients. Only a small minority of TS patients presents exclusively with a tic disorder. Obsessive-compulsive symptoms and related disorder (OCD) are common in TS, and the clinical distinction between compulsions and complex tics may be difficult in some cases. Probably, the presence of comorbid attention deficit hyperactivity disorder (ADHD) is the main determinant of cognitive dysfunction in TS patients and influences heavily also the risk of developing disruptive behaviors. Affective disorders, impulse control disorders, autism spectrum disorders, and personality disorders complete the wide psychopathological spectrum of this condition, but have been less investigated than OCD and ADHD. The complexity of the Tourette spectrum has been confirmed by cluster and factor analytical approaches, and is likely to inform the study of the genetic basis of this disorder, as well as future reappraisal of its nosography, with the development of novel clinical subtypes.

AB - Tourette syndrome (TS) is the primary tic disorder that reaches most commonly medical attention and monitoring, with an estimated prevalence close to 1% between 5 and 18 years of age. Motor and phonic tics are the core features of TS. In addition to their well-characterized phenomenology, tics display a peculiar variability over time, which is strongly influenced by a variety of contextual factors. The sensory phenomena of TS are increasingly recognized as another crucial symptom of TS and consist of premonitory urges and somatic hypersensitivity. A relevant proportion of patients with TS display complex, tic-like, repetitive behaviors that include echophenomena, coprophenomena, and nonobscene socially inappropriate behaviors (NOSIBs). The burden of behavioral comorbidities is very important in determining the degree of disability of TS patients. Only a small minority of TS patients presents exclusively with a tic disorder. Obsessive-compulsive symptoms and related disorder (OCD) are common in TS, and the clinical distinction between compulsions and complex tics may be difficult in some cases. Probably, the presence of comorbid attention deficit hyperactivity disorder (ADHD) is the main determinant of cognitive dysfunction in TS patients and influences heavily also the risk of developing disruptive behaviors. Affective disorders, impulse control disorders, autism spectrum disorders, and personality disorders complete the wide psychopathological spectrum of this condition, but have been less investigated than OCD and ADHD. The complexity of the Tourette spectrum has been confirmed by cluster and factor analytical approaches, and is likely to inform the study of the genetic basis of this disorder, as well as future reappraisal of its nosography, with the development of novel clinical subtypes.

KW - attention deficit

KW - compulsions

KW - coprophenomena

KW - echophenomena

KW - hyperactivity

KW - iImpulse control disorders

KW - tics

KW - Tourette syndrome

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Martino D, Madhusudan N, Zis P, Cavanna AE. An introduction to the clinical phenomenology of Tourette syndrome. In Martino D, Cavanna AE, editors, Advances in the neurochemistry and neuropharmacology of Tourette syndrome. London (UK): Academic Press. 2013. p. 1-33. (International review of neurobiology). https://doi.org/10.1016/B978-0-12-411546-0.00001-9