Articlegreen2011

Sensory sensitivity to external stimuli in Tourette syndrome patients

Beth A. Belluscio · Lily L. Jin · Veronica Watters · Mark Hallett

149 citations0/0 files storedMovement Disorders

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Obsessive-Compulsive Spectrum Disorders Psychosomatic Disorders and Their Treatments Neurological disorders and treatments

Abstract

Patients with Tourette Syndrome often state that their sensitivity to sensations is equally or more disruptive than are motor tics. However, their sensory sensitivity is not addressed by standard clinical assessments nor is it a focus of research. This lapse likely results from our limited awareness and understanding of the symptom. In this study (1) we defined the patients' experience of sensitivity to external stimuli in detail, and (2) we tested 2 hypotheses regarding its origin. First, we interviewed in depth and administered a lengthy questionnaire to adult Tourette patients (n = 19) and age-matched healthy volunteers (n = 19). Eighty percent of patients described heightened sensitivity to external stimuli, with examples among all 5 sensory modalities. Bothersome stimuli were characterized as faint, repetitive or constant, and nonsalient, whereas intense stimuli were well tolerated. We then determined whether the sensitivity could be the result of an increased ability to detect faint stimuli. After measuring the threshold of detection for olfactory and tactile stimuli among the patients and healthy volunteers, we found no significant differences between them for either sensory modality. These results indicate that patients' perceived sensitivity derives from altered central processing rather than enhanced peripheral detection. Last, we assessed one aspect of processing: the perception of intensity. When subjects rated the intensity of near-threshold tactile and olfactory stimuli, there was a surprising difference: Tourette patients more frequently used the lowest range of the scale than did healthy volunteers. Future research is necessary to define the anatomical and physiological basis of the patients' experience of heightened sensitivity. © 2011 Movement Disorder Society.

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References

1965SEQUENTIAL ESTIMATION OF POINTS ON A PSYCHOMETRIC FUNCTION 1993Premonitory urges in Tourette's syndrome 2005Premonitory Urge for Tics Scale (PUTS)1996Sensorimotor gating in boys with Tourette's syndrome and ADHD: Preliminary results 2001Basal ganglia dysfunction in Tourette’s syndrome: a new hypothesis 2005Caudate volumes in childhood predict symptom severity in adults with Tourette syndrome 2003Premonitory sensory phenomenon in Tourette's syndrome 1980Sensory Experiences of Gilles de la Tourette Syndrome

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