Sensory symptoms in body-focused repetitive behaviors, restless legs syndrome, and Tourette syndrome: An overlap?

Research output: Contribution to journalReview articlepeer-review

Authors

Colleges, School and Institutes

External organisations

  • Department of Neuropsychiatry, BSMHFT and University of Birmingham, Birmingham, UK.
  • Department of Neuropsychiatry, The Barberry, Birmingham, UK
  • School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom.
  • Aston University
  • Department of Clinical and Movement Neuroscience, Queen Square Institute of Neurology, University College London, London, UK.

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.

Details

Original languageEnglish
Pages (from-to)320-332
Number of pages13
JournalNeuroscience and biobehavioral reviews
Volume119
Publication statusPublished - Dec 2020