Correlates and Clinical Implications of Tic Suppressibility

Abstract

Purpose of review: Tic disorders are common in the pediatric population and are differentiated from other movement disorders by tic suppressibility. Understanding the mechanism of tic suppression may provide new insights to the pathophysiology of tic disorders. This article highlights clinical phenomenology and neuronal correlates of tic suppressibility. Recent findings:Recent studies suggest that tic suppressibility exists in children shortly after onset of their tics. Moreover, those who are better able to suppress their tics have better tic outcomes. Interoceptive awareness and automatic action inhibition may be involved in tic suppression. Summary:We illustrate a possible underlying mechanism of tic suppressibility and its clinical correlations and implications. New concepts such as interoceptive awareness and action inhibition may help explain tic disorders. Further study will be useful to fill remaining knowledge gaps.

Non-invasive brain stimulation as therapy: systematic review and recommendations with a focus on the treatment of Tourette syndrome

“…Relating to the first and second point made above, tic suppression has been shown to cause transient alterations in motor cortical excitability as measured by TMS (Ganos et al 2018) and several lines of converging evidence suggest that tic suppression influences multiple neural circuits (Ueda et al 2021). Yet, controlling for this is challenging, and is often not discussed in NIBS-focused papers.…”

A Comprehensive Review of Tic Disorders in Children

“…Over 90% of adolescents and adults with TS [ 33 , 34 , 35 ] and 37% of children with TS from age 8 to 19 years [ 36 ] reportedly experience premonitory urges to some extent. Unlike other movement disorders, tics may be voluntarily suppressed for variable periods, which is known as tic suppressibility [ 11 , 37 , 38 ].…”

Recent progress on Tourette syndrome

“…Tourette syndrome (TS) indicates the presence of multiple motor and vocal tics spanning a period of more than 1 year, and onset is before the age of 18 years. The cardinal features of tics are a premonitory urge (an unpleasant sensation preceding tics) 2 , suppressibility (the ability to voluntarily suppress tics for variable periods) 3 , and suggestibility (more likely to experience a tic when it is mentioned) 4 . Tics can be associated with various psychiatric comorbidities, which can complicate the clinical picture.…”