Premonitory urges and tics in Tourette syndrome: computational mechanisms and neural correlates

Publication date: October 2017
Source:Current Opinion in Neurobiology, Volume 46
Author(s): Vasco A Conceição, Ângelo Dias, Ana C Farinha, Tiago V Maia
Tourette syndrome is characterized by open motor behaviors — tics — but another crucial aspect of the disorder is the presence of premonitory urges: uncomfortable sensations that typically precede tics and are temporarily alleviated by tics. We review the evidence implicating the somatosensory cortices and the insula in premonitory urges and the motor cortico-basal ganglia-thalamo-cortical loop in tics. We consider how these regions interact during tic execution, suggesting that the insula plays an important role as a nexus linking the sensory and emotional character of premonitory urges with their translation into tics. We also consider how these regions interact during tic learning, integrating the neural evidence with a computational perspective on how premonitory-urge alleviation reinforces tics.



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