Dimensions of interoception predict premonitory urges and tic severity in Tourette syndrome

Abstract

Dimensions of interoception predict premonitory urges and tic severity in Tourette syndrome.

Clinical Features That Evoke the Concept of Disinhibition in Tourette Syndrome

“…Despite the apparent straightforward relation between premonitory urges and tics (i.e., tics are the result of premonitory urges), the exact pathophysiological relevance of these phenomena remains unclear (37,38), and several models have been proposed to explain the presence of excessive bodily sensations (35,36,(39)(40)(41). According to one promising line of research, the capacity to perceive premonitory urges is related to the overall capacity to perceive interoceptive signals (41,42), possibly providing an explanatory framework to understand the associations of premonitory urges with other clinical symptoms, such as anxiety or obsessive-compulsive behaviors (25,(43)(44)(45)(46). Interestingly, patients with TS are less well able to perceive their own physiological interoceptive signals (41,42,47).…”

“…According to one promising line of research, the capacity to perceive premonitory urges is related to the overall capacity to perceive interoceptive signals (41,42), possibly providing an explanatory framework to understand the associations of premonitory urges with other clinical symptoms, such as anxiety or obsessive-compulsive behaviors (25,(43)(44)(45)(46). Interestingly, patients with TS are less well able to perceive their own physiological interoceptive signals (41,42,47).…”

Impact of cardiac interoception cues and confidence on voluntary decisions to make or withhold action in an intentional inhibition task

“…This raises the possibility that insight abilities follow a 'U-shaped' curve, although in our present dataset, we were limited in our ability to explore this by the much smaller group of participants (n = 5) who showed low accuracy and high confidence, combined with the fact that the magnitude of their discrepancy is much smaller (0 to 0.3) than those showing the opposite (up to 0.7). www.nature.com/scientificreports www.nature.com/scientificreports/ We did not observe effects between decisions to act and trait-level awareness of interoceptive ability, measured using trait interoceptive prediction error (TIPE), which indexes discrepancy between an individual's objective (accuracy) and belief-based subjective (sensibility) dimensions of interoception 28,29 . State-based (e.g.…”

“…Interestingly, in people with Tourette Syndrome, who experience uncomfortable bodily sensations preceding involuntary tics, sensitivity to bodily sensations predicts severity of their premonitory urges to move 29,58 . This is further evidence that interoceptive signals can cue motor behaviour, via signals to midline motor regions 12,59 .…”

Theoretical models of Obsessive-Compulsive Disorder (OCD)

“…Ganos et al 27 demonstrated that interoceptive perception is an important predictor of the severity of sensory phenomena measured by the Premonitory Urges for Tics Scale (PUTS) 28 in TS patients. Rae et al 29 demonstrated that the severity of sensory phenomena in their sample of TS patients correlated positively with interoceptive sensitivity, but not with interoceptive perception -which presented a significant positive correlation only with tics severity measured by the global severity scale (Yale Global Tic Severity Scale, YGTSS) 30 . Still, several functional neuroimaging studies show that areas involved in interoceptive processes activate just before the occurrence of tics; for example, conducted the first study to evaluate neurofunctional correlates of tics and reported that, during tic occurrence, there was significant hyperactivation as measured by positron emission tomography, insula, somatosensory cortex, and SMA.…”