Wed. Apr 17th, 2024

The Tourette syndrome (ST) is a neurodevelopmental disorder, that is, of a neurobiological type, and whose main characteristic is that it is based on the appearance of motor and phonic tics (simple and complex). This syndrome is more common in men than in women and does not present remarkable physical characteristics. The aforementioned tics are involuntary, oscillating in type and intensity, although they are usually preceded by a premonitory sensation. This syndrome can lead to the person presents difficulties at a social, academic or work level, since the person many times you cannot control these recurring vocalizations or movements and in addition there are still today many myths and false beliefs about this symptomatology.

A little history

Although the current name of the syndrome is due to the French neurologist Gilles de la Tourette who successfully described the disease at the end of the 19th century, the first descriptions date back to approximately 200 AD

Neurobiological basis

The latest studies highlight an interrelation between the frontal cortex, the basal ganglia and the thalamus, a deregulation of the cortical and subcortical motor circuits, which is known as cortico-thalamus-striatal circuits that they are responsible for the motor and cognitive processes in the face of any voluntary response and that when they fail, symptoms such as anxiety, hyperactivity, impulsivity, obsessions or tics can arise. Also involved in this syndrome are basal ganglia where in this syndrome there is also a significant dysfunction in the dopaminergic system.

comorbidity

TS also usually occurs together with other disorders, the most frequent being ADHD and OCD. In addition, most people with this disorder have a related family history.

Diagnostic criteria

The diagnostic criteria are mainly based on the DMS-V manual. Within the various tic disorders, we have Tourette’s. TS is characterized in that it has an onset prior to 18 years of age. Another characteristic is that throughout the disease there have been different motor and vocal tics, although not necessarily simultaneously. In addition, these tics appear several times a day over a period of more than 1 year and the alteration is not due to the direct physiological effects of a substance or to a disease.

Pharmacological and psychological approach to TS

The approach is usually pharmacological and psychological. At the pharmacological level, it is treated according to the symptoms. The most common in pharmacotherapy it is the use of classic or atypical antipsychotics, and at a psychotherapeutic level, the individualized therapy with which patients respond best is cognitive-behavioral therapy and that will also depend on the associated symptoms. Thus, among other techniques, psychoeducation, reeducation, exposure and response prevention, or training in habit reversal have given rise in recent years to an enormous increase in the quality of life of people affected by TS.
Bibliography
Tourette’s disorder throughout history. C. Carmona Fernandez; J. Artigas Pallares. Rev. Asoc. Esp. Neuropsiq. 2016; 36(130):347-362 Neuropsychology of Tourette’s disorder: cognition, neuroimaging and creativity. R. Espert, M. Gadea, M. AliƱo, J. Oltra-Cucarella. Rev Neurol 2017;64 (Suppl. 1):S0-S72 https://tourette.org/about-tourette/overview/espanol/ (Tourette Syndrome Association)
TAGS Tourette’s syndrome, neurodevelopmental, neurobiological, pharmacological and psychological approach.

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