Sensory symptoms in body-focused repetitive behaviors, restless legs syndrome, and Tourette syndrome: An overlap?. (December 2020)

• Record Type: Journal Article
• Authors: Badenoch, James; Searle, Tamara; Watson, Iona; Cavanna, Andrea E.
• Is Part Of: Neuroscience and biobehavioral reviews. Volume 119(2020)
• Page Start: 320
• Page End: 332
• Publication Date: 2020-12
• Subjects: Body-focused repetitive behaviors -- Premonitory urges -- Restless legs syndrome -- Sensory symptoms -- Tics -- Tourette syndrome -- Trichotillomania; Psychophysiology -- Periodicals; Human behavior -- Periodicals; Animal behavior -- Periodicals; Neurology -- Periodicals; Behavior -- Periodicals; Ethology -- Periodicals; Neurology -- Periodicals; Psychophysiologie -- Périodiques; Comportement humain -- Périodiques; Animaux -- Mœurs et comportement -- Périodiques; Neurologie -- Périodiques; Animal behavior; Human behavior; Neurology; Psychophysiology; Periodicals; Electronic journals; 573.8
• DOI: 10.1016/j.neubiorev.2020.10.008
• Languages: English
• ISSNs: 0149-7634

Abstract

Highlights: In Tourette syndrome (TS), most patients report premonitory urges to tic. Sensory symptoms are documented in most body focused repetitive behaviors (BFRBs). Patients with restless legs syndrome (RLS) have sensory urges to move their legs. Repetitive behaviors in TS, BFRBs, and RLS have overlapping clinical features. The sensory component of repetitive behaviors might have a shared pathophysiology. Abstract: Tourette syndrome (TS) is a neurodevelopmental condition characterized by multiple tics. Sensory symptoms play a key role in the clinical phenomenology and pathophysiology of TS, as most patients report premonitory urges driving tic expression. Interestingly, sensory symptoms have also been reported in other conditions characterized by repeated behaviors. This review explores the nature of sensory symptoms reported by patients with body focused repetitive behaviors (BFRBs, especially trichotillomania and skin picking disorder) and restless legs syndrome (RLS) in comparison to TS. A sense of mounting inner tension and reinforcement mechanisms driven by gratification and relief on expression of the tic or repetitive behavior appear to be implicated across all conditions. Subjective urges can be temporarily suppressed by patients with TS and selected BFRBs, whereas patients with RLS tend to report dysesthesia more frequently than a suppressible urge to move. The observed similarities in the phenomenology of sensory symptoms across these conditions raise the possibility of a comparable underlying pathophysiology. Preliminary findings suggest an overlap of neural pathways encompassing the insula, basal ganglia (putamen), and posterior cingulate cortex.