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Sensory hypersensitivity in Tourette syndrome: A review
Brain and Development ( IF 1.7 ) Pub Date : 2020-10-01 , DOI: 10.1016/j.braindev.2020.06.003
David Isaacs 1 , Heather Riordan 2
Affiliation  

Tourette syndrome (TS) is a neurodevelopmental disorder defined by tics, but most patients also experience bothersome sensory phenomena, in the form of premonitory urges and/or sensory hypersensitivity. Whereas premonitory urges are temporally paired with tics, sensory hypersensitivity is a constant, heightened awareness of external and/or internal stimuli. The intensity of sensory hypersensitivity does not strongly correlate with the severity of tics or premonitory urges, suggesting it is a dissociable clinical phenomenon. At least 80% of TS patients report subjectively enhanced perception of various sensory stimuli. These same patients demonstrate normal static detection thresholds. However, individuals with TS habituate abnormally to repetitive stimuli, indicating incapacity to appropriately filter redundant sensory input, i.e. impaired sensory gating. Physiologic support for this hypothesis is provided by abnormal pre-pulse inhibition (PPI) and event-related potential (ERP) investigations. Preclinical data implicates parvalbumin-positive (PV+) interneuron dysfunction in altered sensory gating in TS and other neurodevelopment disorders. Studies probing TS sensory hypersensitivity must methodically account for comorbid psychiatric conditions, namely obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), as these entities appear to involve pathophysiologic processes shared with TS. The presence of psychiatric comorbidities in TS is associated with even more profound sensory processing dysfunction. A deepened understanding of TS sensory hypersensitivity will afford novel insights into disease mechanisms, clinical phenotype, and therapeutic management.

中文翻译:

图雷特综合征的感觉超敏反应:综述

抽动秽语综合征 (TS) 是一种由抽动定义的神经发育障碍,但大多数患者也会以先兆性冲动和/或感觉超敏反应的形式出现令人烦恼的感觉现象。尽管先兆冲动在时间上与抽搐相伴,但感觉超敏反应是对外部和/或内部刺激的持续的、高度的意识。感觉过敏的强度与抽动或先兆性冲动的严重程度没有强相关性,表明它是一种可分离的临床现象。至少 80% 的 TS 患者报告对各种感官刺激的主观感知增强。这些相同的患者表现出正常的静态检测阈值。然而,患有 TS 的个体异常习惯于重复刺激,表明无法适当过滤多余的感官输入,即 感觉门控受损。异常前脉冲抑制 (PPI) 和事件相关电位 (ERP) 研究为这一假设提供了生理学支持。临床前数据表明小清蛋白阳性 (PV+) 中间神经元功能障碍与 TS 和其他神经发育障碍的感觉门控改变有关。探索 TS 感觉超敏反应的研究必须有条不紊地考虑共病精神疾病,即强迫症 (OCD)、注意力缺陷多动障碍 (ADHD) 和自闭症谱系障碍 (ASD),因为这些实体似乎涉及与 TS 共有的病理生理过程。TS 中精神共病的存在与更严重的感觉处理功能障碍有关。对 TS 感觉超敏反应的深入理解将提供对疾病机制的新见解,
更新日期:2020-10-01
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