Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal.
Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Portugal.
Curr Opin Neurobiol. 2017 Oct;46:187-199. doi: 10.1016/j.conb.2017.08.009. Epub 2017 Oct 7.
Tourette syndrome is characterized by open motor behaviors - tics - but another crucial aspect of the disorder is the presence of premonitory urges: uncomfortable sensations that typically precede tics and are temporarily alleviated by tics. We review the evidence implicating the somatosensory cortices and the insula in premonitory urges and the motor cortico-basal ganglia-thalamo-cortical loop in tics. We consider how these regions interact during tic execution, suggesting that the insula plays an important role as a nexus linking the sensory and emotional character of premonitory urges with their translation into tics. We also consider how these regions interact during tic learning, integrating the neural evidence with a computational perspective on how premonitory-urge alleviation reinforces tics.
妥瑞氏症的特征是开放性运动行为——抽搐，但这种疾病的另一个关键方面是存在预感冲动：在抽搐之前通常会出现不适感，而抽搐可以暂时缓解这种不适感。我们回顾了涉及体感皮层和脑岛的预感冲动的证据，以及涉及运动皮质-基底节-丘脑-皮质回路的抽搐。我们考虑了这些区域在抽搐执行过程中的相互作用，表明脑岛在将预感冲动的感觉和情绪特征转化为抽搐方面起着重要作用。我们还考虑了这些区域在抽搐学习过程中的相互作用，将神经证据与预感冲动缓解如何加强抽搐的计算观点相结合。
