Display options
Cite
Hawksley J, Cavanna AE, Nagai Y. The role of the autonomic nervous system in Tourette Syndrome. Front Neurosci. 2015;9:117doi: 10.3389/fnins.2015.00117.
Hawksley, J., Cavanna, A. E., & Nagai, Y. (2015). The role of the autonomic nervous system in Tourette Syndrome. Frontiers in neuroscience, 9117. https://doi.org/10.3389/fnins.2015.00117
Hawksley, Jack, et al. "The role of the autonomic nervous system in Tourette Syndrome." Frontiers in neuroscience vol. 9 (2015): 117. doi: https://doi.org/10.3389/fnins.2015.00117
Hawksley J, Cavanna AE, Nagai Y. The role of the autonomic nervous system in Tourette Syndrome. Front Neurosci. 2015 May 27;9:117. doi: 10.3389/fnins.2015.00117. eCollection 2015. PMID: 26074752; PMCID: PMC4444819.
Copy Download .nbib Format: NLM
Share it on

Front Neurosci. 2015 May 27;9:117. doi: 10.3389/fnins.2015.00117. eCollection 2015.

The role of the autonomic nervous system in Tourette Syndrome.

Frontiers in neuroscience

Jack Hawksley, Andrea E Cavanna, Yoko Nagai

Affiliations

  1. North Essex Partnership University NHS Foundation Trust Colchester, UK.
  2. Department of Neuropsychiatry, Birmingham and Solihull Mental Health NHS Trust and School of Clinical and Experimental Medicine, University of Birmingham Birmingham, UK.
  3. Department of Clinical Medicine, Clinical Imaging Sciences Center, Brighton and Sussex Medical School, University of Sussex Brighton, UK ; Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London London, UK.

PMID: 26074752 PMCID: PMC4444819 DOI: 10.3389/fnins.2015.00117

Abstract

Tourette Syndrome (TS) is a neurodevelopmental disorder, consisting of multiple involuntary movements (motor tics) and one or more vocal (phonic) tics. It affects up to one percent of children worldwide, of whom about one third continue to experience symptoms into adulthood. The central neural mechanisms of tic generation are not clearly understood, however recent neuroimaging investigations suggest impaired cortico-striato-thalamo-cortical activity during motor control. In the current manuscript, we will tackle the relatively under-investigated role of the peripheral autonomic nervous system, and its central influences, on tic activity. There is emerging evidence that both sympathetic and parasympathetic nervous activity influences tic expression. Pharmacological treatments which act on sympathetic tone are often helpful: for example, Clonidine (an alpha-2 adrenoreceptor agonist) is often used as first choice medication for treating TS in children due to its good tolerability profile and potential usefulness for co-morbid attention-deficit and hyperactivity disorder. Clonidine suppresses sympathetic activity, reducing the triggering of motor tics. A general elevation of sympathetic tone is reported in patients with TS compared to healthy people, however this observation may reflect transient responses coupled to tic activity. Thus, the presence of autonomic impairments in patients with TS remains unclear. Effect of autonomic afferent input to cortico-striato-thalamo-cortical circuit will be discussed schematically. We additionally review how TS is affected by modulation of central autonomic control through biofeedback and Vagus Nerve Stimulation (VNS). Biofeedback training can enable a patient to gain voluntary control over covert physiological responses by making these responses explicit. Electrodermal biofeedback training to elicit a reduction in sympathetic tone has a demonstrated association with reduced tic frequency. VNS, achieved through an implanted device that gives pulsatile electrical stimulation to the vagus nerve, directly modulates afferent interoceptive signals. The potential efficacy of biofeedback/VNS in TS and the implications for understanding the underlying neural mechanisms of tics will be discussed.

Keywords: Tourette Syndrome; autonomic modulation; autonomic nervous system; sympathetic activity; ticks

References

  1. J Psychosom Res. 2009 Dec;67(6):599-605 - PubMed
  2. Mov Disord. 1987;2(2):99-102 - PubMed
  3. J Neurol Neurosurg Psychiatry. 2011 Dec;82(12):1320-3 - PubMed
  4. Neurology. 1982 Nov;32(11):1315-7 - PubMed
  5. Pediatr Neurol. 1998 Feb;18(2):136-42 - PubMed
  6. Adv Neurol. 1982;35:391-401 - PubMed
  7. Behav Neurol. 2013;27(1):65-73 - PubMed
  8. Pediatr Neurosci. 1985-1986;12(2):71-4 - PubMed
  9. Neurosci Biobehav Rev. 2013 Jul;37(6):1008-15 - PubMed
  10. J Clin Psychiatry. 1992 Sep;53(9):319-23 - PubMed
  11. J Psychosom Res. 2008 Nov;65(5):473-86 - PubMed
  12. Adv Pharmacol. 2013;68:319-34 - PubMed
  13. Pediatr Neurol. 2009 Jun;40(6):420-5 - PubMed
  14. Am J Psychiatry. 1977 Mar;134(3):257-60 - PubMed
  15. Am J Psychiatry. 2011 Dec;168(12):1326-37 - PubMed
  16. J Neurol Neurosurg Psychiatry. 1985 Jun;48(6):535-44 - PubMed
  17. Br J Psychiatry. 2008 Jul;193(1):31-6 - PubMed
  18. Neuron. 2013 Feb 20;77(4):624-38 - PubMed
  19. J Psychosom Res. 2008 Nov;65(5):461-72 - PubMed
  20. Psychiatry Res. 2013 Dec 30;210(3):1198-204 - PubMed
  21. J Am Acad Child Psychiatry. 1986 Sep;25(5):645-52 - PubMed
  22. Brain Dev. 2014 Jan;36(1):45-50 - PubMed
  23. Behav Res Ther. 1988;26(4):347-51 - PubMed
  24. Trends Neurosci. 2006 Mar;29(3):175-82 - PubMed
  25. Eur Neuropsychopharmacol. 2007 Jul;17(8):523-6 - PubMed
  26. Psychol Rep. 1998 Oct;83(2):515-29 - PubMed
  27. Ann N Y Acad Sci. 2011 Jan;1216:86-98 - PubMed
  28. Mov Disord. 2006 Aug;21(8):1273-5 - PubMed
  29. Neurology. 1997 Feb;48(2):358-62 - PubMed
  30. Neurol Clin. 1997 May;15(2):267-75 - PubMed
  31. Adv Neurol. 1992;58:245-51 - PubMed
  32. Biol Psychiatry. 1994 Jul 1;36(1):35-43 - PubMed
  33. Clin Neuropharmacol. 2012 Nov-Dec;35(6):269-72 - PubMed
  34. J Psychosom Res. 2009 Dec;67(6):475-83 - PubMed
  35. Brain. 2000 Mar;123 Pt 3:425-62 - PubMed
  36. Adv Neurol. 2001;85:113-22 - PubMed
  37. Int Rev Neurobiol. 2013;112:239-79 - PubMed
  38. Mov Disord. 2003 Nov;18(11):1392-5 - PubMed
  39. Cogn Behav Neurol. 2014 Mar;27(1):17-24 - PubMed
  40. Funct Neurol. 2012 Jan-Mar;27(1):23-7 - PubMed
  41. J Clin Psychiatry. 1990 Nov;51(11):463-9 - PubMed
  42. Compr Psychiatry. 2013 Jul;54(5):462-6 - PubMed
  43. Arch Gen Psychiatry. 1980 Dec;37(12):1350-7 - PubMed
  44. Pharmacopsychiatry. 2008 May;41(3):117-8 - PubMed
  45. Arch Gen Psychiatry. 1991 Apr;48(4):324-8 - PubMed
  46. Clin Neurol Neurosurg. 1992;94(2):157-9 - PubMed
  47. Compr Psychiatry. 2013 Jul;54(5):467-73 - PubMed

Publication Types