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Flashcards in Tourette's Syndrome Deck (17):

What are tics?

Sudden, involuntary, repetitive movements or vocalisations


What are the 2 kinds of motor tics + definition?

Simple motor tics = sudden, fleeting or fragmentary movements

Complex motor tics = several simple motor tics occuring in an orchestrated sequence or semi-purposeful movements


What are the 2 kinds of phonic tics + definitions?

Simple phonis tics = simple, unarticulated sounds

Complex phonic tics = out of context syllables, words, phrases or paroxysmal changes in prosody


Give some examples of complex tics

- Copropraxia = socially inappropriate gestures
- Copralalia = socially inappropriate utterances
- Echolalia = repeating other's words
- Echopraxia = reapeating other's gestures
- Self injurous such as cheeck chewing


What are premonitory urges?

Uncomfortable or aversive bodily sensations occuring prior to tics.


What is the prevalence rate of TS?

3-8 in 1000


At what age do symptoms peak at severity and when is there a stabilisation of symptoms (no sustained worsening or improvement)?

Peak in symptom severity = 9-12 years
Stabilisation = after 30s


Which npsy. test battery administered to children with TS is the best predictor of tic severity and global psychosocial functioning 7,5 years later, and what does it measure?

The Purdue Pegboard; test of fine motor skills


What is the etiology of TS?

- strong (polygenetic) component
- increased activity of DA and other neurotransmitters (e.g. serotonin)
- disinhibition of several circuits in the cortico-striatal-thalamic areas


What is the development of TS (neurologically)?

Abnormality in basal ganglia output systems and impairment in frontal inhibition of this output
-> information that ordinarily would be inhibited from reaching other areas of the brain is unfiltered


What disorders have high comorbidity with TS?

ADHD, OCD and behavioral/impulse problems


What are rage attacks?

Premonitory feelings of tension -> followed by relief -> followed by remorse
Studies suggest they are positively correlated with a triad of TS, ADHD and OCD


What are the prevalences and onset of comorbid ADHD and OCD with TS?

ADHD: 55%, often precede the onset of tic symptoms
OCD: 20-40%, symptoms present after tics have reached their peak severity
-> comorbid psychiatric disorders are more likely to persist into adulthood


Name two treatmens of TS

Habit Reversal Therapy = teachting the patient to become aware of the premonitory urge and develop a competing response incompatible with performing the tic

Pharmacotherapy = effective treatment, recommended if the tics are causing significant distress or functional impairment (examples: neuroleptics, benzodiazepines)


Name 3 areas of the frontostriatal cortex circuit that might be involved in processing of cognition?

1) Dorsolateral prefrontal cortex
-> cognitive flexibility, memory and attention
2) Orbitofrontal cortex
-> reinforcement (reward) and reversal learning, inhibition
3) Anterior cingulate cortex
-> conflict monitoring and resolution, inhibition


Is the hypothesis 'impairments of executive functioning in TS' true?

No: TS is not associated with consistent executive impairments (only robust evidence: inhibition impairment)


What are weaknesses of neuropsychological research of TS? (5)

- small samples
- often no control for comorbidities
- no control groups for typically developing children
- no control of medication use
- conscious tic supression may influence cognitive functioning