Department of Anatomy, Histology, Forensic Medicine & Orthopedics, Sapienza University, Rome, Italy.
Department of Human Neuroscience, Sapienza University, Rome, Italy.
Mov Disord. 2018 Jul;33(6):950-959. doi: 10.1002/mds.27406. Epub 2018 May 21.
Impaired inhibitory control is thought to be a core deficit in psychiatric disorders where patients exhibit problems with controlling urges. These problems include the urge to perform movements typical of Tourette syndrome and the urge to execute compulsive actions typical of obsessive-compulsive disorder. However, the picture emerging from studies that address this issue is controversial. Furthermore, most studies have only focused on reactive control (the ability of subjects to react to a stop signal), but not on proactive control (the ability of patients to shape their response strategies in anticipation of known task demands).
We assessed reactive and proactive inhibitory control in drug naïve children/adolescents affected by Tourette syndrome, obsessive-compulsive disorder, and in those in which the 2 disorders co-occur.
Reaching version of the stop signal task and of a simple reaction time task were given to 37 unmedicated patients (mean age ± SD, 11.0 ± 2.3) and to 37 healthy age- and gender-matched controls (mean age ± SD, 10.8 ± 1.6).
Both reactive and proactive inhibition scaled with the severity of obsessive-compulsive symptoms, but not with those of tic symptoms (ie, inhibitory control in uncomplicated Tourette patients was comparable with that of healthy controls).
We suggest that the cognitive mechanisms underlying tics and compulsions controls are likely to be different. Possibly the preserved ability to suppress actions in uncomplicated Tourette patients allows them to experience a greater feeling of self-control, and this fact might play a key role in evolution of the disorder beyond adolescence. © 2018 International Parkinson and Movement Disorder Society.
抑制控制受损被认为是精神障碍的核心缺陷，患者表现出控制冲动的问题。这些问题包括表现出图雷特综合征典型运动的冲动和执行强迫症典型强迫行为的冲动。然而，解决这个问题的研究得出的结果存在争议。此外，大多数研究仅关注反应性控制（受试者对停止信号做出反应的能力），而不关注前摄性控制（患者在预期已知任务要求的情况下塑造其反应策略的能力）。
我们评估了未经药物治疗的图雷特综合征、强迫症和这两种疾病共病的儿童和青少年的反应性和前摄性抑制控制。
对 37 名未接受药物治疗的患者（平均年龄 ± 标准差，11.0 ± 2.3 岁）和 37 名年龄和性别匹配的健康对照者（平均年龄 ± 标准差，10.8 ± 1.6 岁）进行了伸手版停止信号任务和简单反应时间任务。
反应性和前摄性抑制均与强迫症症状的严重程度相关，但与抽搐症状无关（即，单纯性图雷特患者的抑制控制与健康对照者相当）。
我们认为，抽搐和强迫控制的认知机制可能不同。可能是未经治疗的图雷特患者抑制动作的能力得以保留，使他们体验到更大的自我控制感，而这一事实可能在青春期后疾病的发展中起着关键作用。© 2018 国际帕金森病和运动障碍协会。
