Controversies Surrounding the Pathophysiology of Tics. (November 2019)

• Record Type: Journal Article
• Authors: Singer, Harvey S.; Augustine, Farhan
• Is Part Of: Journal of child neurology. Volume 34:Number 13(2019)
• Page Start: 851
• Page End: 862
• Publication Date: 2019-11
• Subjects: tics -- premonitory urge -- pathophysiology -- voluntary or involuntary -- excitatory or inhibitory -- CBGTC circuits -- anatomic localization -- neurotransmitters; Nervous system -- Diseases -- Periodicals; 618.928
• DOI: 10.1177/0883073819862121
• Languages: English
• ISSNs: 0883-0738

Abstract

Tics are sudden, rapid, recurrent, nonrhythmic motor movements or vocalizations (phonic productions) that are commonly present in children and are required symptoms for the diagnosis of Tourette syndrome. Despite their frequency, the underlying pathophysiology of tics/Tourette syndrome remains unknown. In this review, we discuss a variety of controversies surrounding the pathophysiology of tics, including the following: Are tics voluntary or involuntary? What is the role of the premonitory urge? Are tics due to excess excitatory or deficient inhibition? Is it time to adopt the contemporary version of the cortico-basal ganglia-thalamocortical (CBGTC) circuit? and Do we know the primary abnormal neurotransmitter in Tourette syndrome? Data from convergent clinical and animal model studies support complex interactions among the various CBGTC sites and neurotransmitters. Advances are being made; however, numerous pathophysiologic questions persist.