Many people, you may have noticed, have babies ticsighs, clearing of the throat, shuffling of the shoulders, twisting of the head, coughing, repetition of a vowel or a word (often a swear word) in the middle of ordinary speech. Small gestures repeated in a rhythmic and obsessive way, absolutely involuntary, without the person being able to do anything regarding it. Among the youngest, these attitudes are often the object of ridicule by peers. His name is Tourette’s syndrome and that’s tic disease. The scientific name comes from the name of the French neurologist Gilles de la Tourette who identified it towards the end of the 19th century by describing a clinical picture. This problem affects regarding one percent of the population, so it is quite common; it usually begins to manifest at school age 6 to 9 years and is considered a neurodevelopmental disorder, such as autism. The good news is that in most cases it disappears with puberty.
What does it come from?
As reported by the site Verona Foundation, it is not known what it depends on, but the origins of this pathology have been studied by research from the Washington University School of Medicine in St. Louis, published in the journal Molecular Psychiatry. The brains of 103 children with Tourette syndrome and 103 other children with the same characteristics without the disorder were analyzed using magnetic resonance imaging. Scientists found significantly more gray matter in the thalamus, hypothalamus, and midbrain, remembering that gray matter is responsible for processing information. In contrast, subjects with Tourette syndrome have less white matter in the cortex above the eyes and in the medial prefrontal cortex. “White matter is kind of the wiring of the brain,” they explain. “It consists mainly of axons (extensions of neurons) covered with myelin and transmits signals to the gray matter. Less white matter might indicate less efficiency in transmitting sensations, while the excess gray matter might mean that nerve cells are sending an excess of signals.
These findings are just a starting point for further research: “Furthermore,” observes psychiatrist Kevin J. Black, who led the investigation, “the areas where we saw changes are related to sensations and treatments. sensory. Now, many people with Tourette’s syndrome explain that their tics mostly start in response to unusual sensations, like that part of the body that’s wrong. And they add that following the tic, they feel better”. Cristiano Termine, Professor of Child Neuropsychiatry at the University of Insubria, one of the few Italian Tourette’s syndrome researchers and therapists, comments: “The continuous activation that occurs in tics may justify the gray matter being more thick, as if the neurons were still under stimulation. Neurons can also grow, which cannot be done without consequences. For its part, the decrease in white matter might mean decreases in the conduction of stimuli, as if there were “threads” too small to be able to transmit”.
How to Manage Tourette’s Syndrome in Adulthood
A third of Tourette’s cases see permanent tics even into adulthood. How to deal with this problem? “Above all, phonatory tics are annoying: sighs, vowels, words repeated inappropriately,” continues Professor Termine, “In addition, in 15 to 20% of cases, they are swear words. They are said to be involuntary gestures, but I would define them as semi-involuntary, because the person wants and can block the tics for a while. It would be enough to see a medical examination with these subjects: often not even the shadow of a tic, which would also serve to better understand”. Termine continues: “This effort to hold back creates increasing discomfort, comparable to the effort to hold back a sneeze or to feel an itch and not be able to scratch. If the disorder is severe, social and professional life is very difficult. In Italy, this syndrome is very little known. You can intervene with cognitive-behavioral therapy sessions to “educate” to overcome tics or to live with them by implementing alternative strategies to “unload” the tic you have on another less troublesome tic. In very severe cases, drugs are used. There are symptomatic medications, capable of “lowering” the tic, which disappears, as long as you continue to take this medication. Admittedly, research still needs to take many steps in this direction.
Other associated syndromes
In Professor Termine’s experience, Gilles de la Tourette’s syndrome sometimes appears associated either with a hyperactivity disorder (HAD), or with Obsessive Compulsive Disorder (doc). “It is understood that the same brain structures are involved because even obsessive thoughts are uncontrollable and repetitive like tics,” notes Cristiano Termine. In all cases, it is important to consult a neuropsychiatrist to have a certain diagnosis and identify the most suitable path.
