Neurobiology of the Premonitory Urge in Tourette's Syndrome: Pathophysiology and Treatment Implications

Abstract

Motor and vocal tics are relatively common motor manifestations identified as the core features of Tourette's syndrome (TS). Although traditional descriptions have focused on objective phenomenological observations, such as anatomical location, number and frequency of tics, patients' first-person accounts have consistently reported characteristic subjective correlates. These sensory phenomena are often described as a feeling of mounting inner tension or urge to move ("premonitory urge"), which is transiently relieved by tic expression. This article reviews the existing literature on the clinical and neurobiological aspects of the premonitory urge in patients with TS, with focus on its pathophysiology and possible treatment implications.

Keywords: Basal Ganglia Disorders; Brain Development and Maturation; Cerebral Disorders; Motor Disorders; Neurology.

Conflict of interest statement

Competing interests

None.

Figures

Figure 1

Brain structures thought to be involved in the generation of the urge to tic.

Figure 2

Sense of volition and suppressibility associated with different types of movements.