Isaacs David, Key Alexandra P, Cascio Carissa J, Conley Alexander C, Walker Harrison C, Wallace Mark T, Claassen Daniel O
Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Neuropsychiatr Dis Treat. 2020 Nov 2;16:2591-2601. doi: 10.2147/NDT.S274165. eCollection 2020.
Sensory hypersensitivity, defined as heightened awareness of and reactivity to external stimuli, is a bothersome symptom that affects up to 80% of adults with Tourette syndrome (TS). Such widespread prevalence suggests sensory hypersensitivity is a core feature of the disorder, but its severity and association with other clinical features of TS remain largely unexplored. Complicating matters, sensory hypersensitivity has been observed in two neurodevelopmental disorders commonly comorbid with TS: obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD).
We sought to measure sensory hypersensitivity in TS patients relative to healthy controls and to investigate the relationship of sensory hypersensitivity with OCD and ADHD symptoms in the context of TS.
We recruited 34 adults with TS or chronic tic disorder to undergo evaluation with the Yale Global Tic Severity Scale (YGTSS) and a battery of validated self-report instruments assessing sensory hypersensitivity (Sensory Gating Inventory, SGI; Sensory Perception Quotient, SPQ), premonitory urge (Premonitory Urge to Tic Scale, PUTS), OCD (Dimensional Obsessive-Compulsive Scale, DOCS), and ADHD (Adult ADHD Self-Report Screening Scale for DSM-5, ASRS-V). Age- and sex-matched healthy controls were recruited to complete SGI and psychiatric measures.
SGI and SPQ scores strongly correlated ( = -0.73, < 0.0001) within patients. SGI total score was significantly higher in patients versus controls (119.0 vs 67.6, =-5.3, < 0.0001), indicating greater sensory hypersensitivity in the tic disorder group. SGI score correlated modestly with PUTS, DOCS, and ASRS-V scores but not with YGTSS total tic score. Hierarchical linear regression analysis revealed that, of the tested variables, only DOCS score contributed significantly to mean SGI score, with β ranging from 1.03 ( = 0.044) to 1.41 ( = 0.001). A simple linear regression model with DOCS as the independent variable accounted for 31.9% of SGI score variance.
Sensory hypersensitivity is prominent in adults with tic disorder and is independently associated with obsessive-compulsive symptom severity.
感觉超敏反应被定义为对外部刺激的意识增强和反应性增强，是一种令人烦恼的症状，影响高达80%的抽动秽语综合征（TS）成人患者。如此广泛的患病率表明感觉超敏反应是该疾病的一个核心特征，但其严重程度以及与TS其他临床特征的关联在很大程度上仍未得到探索。使情况复杂化的是，在两种通常与TS共病的神经发育障碍中也观察到了感觉超敏反应：强迫症（OCD）和注意力缺陷多动障碍（ADHD）。
我们试图测量TS患者相对于健康对照者的感觉超敏反应，并在TS的背景下研究感觉超敏反应与OCD和ADHD症状之间的关系。
我们招募了34名患有TS或慢性抽动障碍的成人，用耶鲁全球抽动严重程度量表（YGTSS）以及一系列经过验证的自我报告工具进行评估，这些工具评估感觉超敏反应（感觉门控量表，SGI；感觉知觉商数，SPQ）、预感冲动（抽动预感量表，PUTS）、OCD（维度强迫症量表，DOCS）和ADHD（DSM-5成人ADHD自我报告筛查量表，ASRS-V）。招募年龄和性别匹配的健康对照者来完成SGI和精神科测量。
患者内部的SGI和SPQ分数高度相关（r = -0.73，P < 0.0001）。患者的SGI总分显著高于对照组（119.0对67.6，t = -5.3，P < 0.0001），表明抽动障碍组的感觉超敏反应更强。SGI分数与PUTS、DOCS和ASRS-V分数有适度相关性，但与YGTSS总抽动分数无关。分层线性回归分析显示，在测试变量中，只有DOCS分数对平均SGI分数有显著贡献，β值范围从1.03（P = 0.044）到1.41（P = 0.001）。以DOCS为自变量的简单线性回归模型解释了SGI分数方差的31.9%。
感觉超敏反应在患有抽动障碍的成人中很突出，并且与强迫症状严重程度独立相关。
