Patients with Tourette Syndrome often state that their sensitivity to sensations is equally or more disruptive than are motor tics. However, their sensory sensitivity is not addressed by standard clinical assessments nor is it a focus of research. This lapse likely results from our limited awareness and understanding of the symptom. In this study we 1) defined the patients’ experience of sensitivity to external stimuli in detail, and 2) tested two hypotheses regarding its origin. First, we administered a lengthy questionnaire and in-depth interviews to adult Tourette patients (n=19) and age-matched healthy volunteers (n=19). Eighty percent of patients described a heightened sensitivity to external stimuli, with examples among all 5 sensory modalities. Bothersome stimuli were characterized as faint, repetitive or constant, and non-salient, whereas intense stimuli were well-tolerated. We then determined whether the sensitivity could be due to an increased ability to detect faint stimuli. After measuring the threshold of detection for olfactory and tactile stimuli among the patients and healthy volunteers, we found no significant difference for either sensory modality. These results indicate that patients’ perceived sensitivity derives from altered central processing rather than from enhanced peripheral detection. Lastly, we assessed one aspect of processing: the perception of intensity. When subjects rated the intensity of near-threshold tactile and olfactory stimuli, there was a surprising difference: Tourette patients more frequently used the lowest range of the scale compared with healthy volunteers. Future research is necessary to define the anatomical and physiological basis of the patients’ experience of heightened sensitivity.
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