2-Minute Neuroscience: Tourette Syndrome

In this video, I discuss what is hypothesized to occur in the brain to cause Tourette syndrome, a disorder characterized by recurrent involuntary movements or sounds called tics.

TRANSCRIPT:

Tourette syndrome is characterized by recurrent involuntary movements or sounds called tics. Tics can be classified as simple or complex. Simple tics usually involve only one group of muscles, and might consist of actions like eye blinking or throat clearing. Complex tics are more elaborate, and might involve actions like reaching out to touch something or the involuntary use of obscene language, which is known as coprolalia. It’s worth noting that coprolalia, while often associated with Tourette syndrome, is actually thought to occur in less than 20% of cases.

The neuroscience of Tourette syndrome is still poorly understood, but a number of studies suggest an important role for a group of structures known as the basal ganglia, which includes the: caudate, putamen, globus pallidus, substantia nigra, and subthalamic nucleus. The basal ganglia are involved in diverse brain functions, but they are especially relevant to Tourette syndrome for their hypothesized role in suppressing unwanted actions.

According to this perspective, one function of basal ganglia circuitry is to inhibit neurons in the thalamus and prevent them from sending undesired movement-related signals to the motor cortex. In Tourette syndrome, it’s thought that faulty inhibitory mechanisms in the basal ganglia may fail to stop unwanted signals from reaching the cortex. This causes the execution of an action that the patient might prefer to suppress, forming the basis for tics. The failed inhibition in the basal ganglia is thought to be coupled with increased activity in motor pathways that generate movements. Thus, patients with Tourette’s might experience a problematic combination of high motor activity that generates habitual patterns of behavior, along with abnormally low inhibitory activity that would normally keep those behaviors from being acted out. More research needs to be done, however, to fully elucidate the neural circuitry underlying the disorder.

REFERENCES:

Jahanshahi M, Obeso I, Rothwell JC, Obeso JA. A fronto-striato-subthalamic-pallidal network for goal-directed and habitual inhibition. Nat Rev Neurosci. 2015 Dec;16(12):719-32. doi: 10.1038/nrn4038. Epub 2015 Nov 4.

McNaught KS, Mink JW. Advances in understanding and treatment of Tourette syndrome. Nat Rev Neurol. 2011 Nov 8;7(12):667-76. doi: 10.1038/nrneurol.2011.167.

Robertson MM, Eapen V, Singer HS, Martino D, Scharf JM, Paschou P, Roessner V, Woods DW, Hariz M, Mathews CA, Črnčec R, Leckman JF. Gilles de la Tourette syndrome. Nat Rev Dis Primers. 2017 Feb 2;3:16097. doi: 10.1038/nrdp.2016.97.

[JELLEx]

This channel was literally mentioned in my college textbook. The website was linked. That's pretty awesome.

[brennamcilvain]

As someone who has been developing simple tics it already has become something I’m so self conscious about, I get constant headaches from them, sometime I can suppress them sometimes I can’t. I hope we can learn more about the syndrome but videos just like this help even in the slightest bit

[houstonevangelicalministries]

Thank you. I have Tourette’s and science had little to information on the “why” up until the last decade or two. You learn to live with it, but it’s so so so so much more than some “tics.” Thanks.

[dailydoseofmedicinee]

The tic can emerge at any age, but it most commonly appears between the ages of 6 and 18 years. During adolescence and early adulthood, the tics will normally become less severe, but In 10 to 15 percent of cases, Tourette's can become worse as the person moves into adulthood.👍

[MarkWendland]

I was born in 1968 and began having OCD-like symptoms around 7-8 years of age. Gradually, it morphed into mostly simply ticks that would give me headaches daily and alienated other children. I check the internet once very 5 years or so now to see what we know, looking for what help I might get. Sadly, the answer is always-- very little.

[mppp]

Love this. I started ticcing last January (2022), starting oh so simple, and now they can be very complex. I’ve always wondered why I tic and this makes much more sense. Thanks for this video!

[alex.x_x.]

Every time one of these videos comes out, I shed a tear of joy :’)
They’re so helpful with my Intro to Neuro students!! Thank you :)

[shrawastilavanya]

Hey, thank you a million times for this!
It would be a lot to ask if I requested videos on Neurodevelopmental disorders, but if possible, please do add them to your list. Forever grateful to your channel!

[anastasia..]

Hi, I really love your channel!
What about restless legs syndrome? It would be really nice to have a 2-minute video about that brain disorder as well. Cheers!

[laurao]

It’s such a hard condition because to others it can look so extra or fake
It’s hard to believe it’s real
But so sad that it is and some cases are so extreme

[memesoon]

You guys helped me a lot with my neurology assignment. Thank you very much!

[Strawberrimiilk]

I have tourettes syndrome and this actually helped me understand myself and my condition much better! :)

[mathewhastings]

If they had a will to body program, I would donate my body for the study of this disease. I have a very rare case, because my Tourette’s was caused by a birth defect in the womb. It does not run in my family and I’m the only one that has it. I’ve had multiple tests done by neurologist and this was their conclusion as to how I got it.

[aternias]

Had it since I was 9, 23 now. It is a blessing and a curse.

[juretandara]

My dad is over 90 years old and has a tendency to spit, which is more frequent when he is nervous and for which no one in the family knows the cause. We all thought he was doing it on purpose, but he wasn't. He never wanted to talk about it. A couple of years ago, I watched a UK documentary on TV and realized for the first time that my dad has Tourent's syndrome. Although there is no mention of drooling in the literature as Tourent's disorder, I am sure it is. Fortunately, dad had a good life and this syndrome did not limit him in any way.

[ash-ton]

i started ticing at around age 5/6. the doctors said it was just sensory because i experienced Premonitory urges which weren't as common.

After the sudden passing of a close friend by anxiety went sky high and my adhd meds stopped supressing my tics. i now experience: Echolalia, Premonitory urges, Copropraxia, Coprolalia, Echopraxia, Echophenomenon, Palilalia, Palipraxia and Sensory phenomena. im only 16 and i've had a Tourette syndrome diagnosis for about 10 months, it gets worse daily and im now having to work out to strengthen my muscles to put up with my violent motor tics.

i know a lot of neuro students watch these so if you want to ask someone with Tourette syndrome a question i'll happily answer when i can. if i cant answer ill ask any of my friends with tourettes to try and answer if needed


Update: I'm now 18 and driving (yes I can drive safely) and I now experience non epileptic episodes with 4 variations. It's not easy to deal with but it's a byproduct of tourettes so not much I can do. I'm still perfectly fine answering comments as I know when I started ticing tourettes wasn't my first thought due to stigma as the obscene tics didn't start til about 7 months in by which I was already getting monitored ready for diagnosis so if I can help stop the stigma and get 1 more person to seek aid and advice early enough to avoid the level of uncertainty me and my family experienced then it will be worth it

[Anonymous-ngwc]

Another symptom I think a lot of people with TS have is poor impulse control. Obviously this is displayed with the tics, but it happens with other things too. Eating, sexual desires, and intrusive thoughts (throwing something valuable, hurting yourself, etc.)

There was an episode of The Good Doctor where a patient cheated on her husband and started having tics. It was later discovered that she had a brain tumor that made her unable to suppress her impulses (hence the cheating and tics). I think the same part of the brain that had the tumor is defective in people with TS.

There was also a podcast - I believe it’s called This Past Weekend - where Marc Elliot was a guest and he shared his story with TS. He mentioned how he felt compelled to do these tics, and how he also indulged in every desire he had because his brain was not capable to suppressing them.

The more I think about it, the more I believe that TS is actually a disorder of impulse.

[theshermantanker]

An important distinction to make is that we don't know if it's fully involuntary or semi voluntary (Patient doesn't want to do it but the runaway urge to do so is too great, much like scratching an itch) yet

[Lafue]

Seriously, after all these years they still cant really tell why. If you're struggling with tourettes, I would look into finding a naturopath experienced with tics and diet, and striving to go toxic free (and i'm not just only talking about buying organic produce). Anyone with a neurological condition should not be aggravating their system with stuff like MSG, VOC's, lead, and glyphosate; nor should you be offending your system with a low level allergy. Took a kid who started ticcing at age 5 and was on the normal progression to peaking at 12, both vocal and motor tics up to (40/minute) and completely eliminated tics by finding out she was allergic to dairy and really sensitive to MSG.

It is really sad to see doctors and neurologists make patients hopeless because they dont have any answers and their only tool is medication.

[denryu]

I suffer constant movements like blinking, arms, shoulder, neck, back movements sometimes its retracing my writings, seing everyone's face around me, blowing my hand, and etc. It's irritating as each actions last for months and i always suffer pains and aches with those actions while some are really annoying and embarrassing. What's more the more you stop doing it the stronger the urge to do it. It's hard to stop the urge but for some reason im confident and very good at stoping my urge to hurt someone i wonder if i ever hurt someone intentionally physically and i also has strong control not to speak mean and bad words, more like it's filtered out whenever i speak.