Developmental Trajectories of Sensorimotor and Cognitive Control in Gilles de la Tourette Syndrome
Abstract
Abstract. The relationship between tics and preceding urges in Tourette syndrome suggests that abnormal internal monitoring is reflected in abnormal perceptual, attentional, and response selection. This article uses the theory of event coding to conceptualize Tourette syndrome as a disorder of the integration of perception and action. Given that Tourette syndrome is a prototypical neurodevelopmental disorder with a characteristic clinical course in childhood and early adolescence, we focus on reviewing developmental trajectories of perception-action binding and their neural correlates in Tourette and healthy controls with a view toward the dopaminergic system. Future cross-sectional and longitudinal research systematically comparing typical development and Tourette-related alterations of neurophysiological correlates underlying perception-action binding may shed light on individual differences in the clinical course in adolescence and adulthood.
Zusammenfassung. Die „Theory of Event Coding“ bietet sich als konzeptueller Rahmen an, um neuronale Mechanismen zu beleuchten, die der Integration von Wahrnehmung und Handlung beim Gilles de la Tourette Syndrom (GTS) zugrunde liegen und hierdurch Einblicke in die neuronalen Grundlagen von Tics und hiermit assoziierten Dranggefühlen zu gewinnen. Die besonderen Beziehungen zwischen Tics und Dranggefühlen deuten auf veränderte perzeptuelle Prozesse und die starke Aufmerksamkeitsabhängigkeit der Tic-Ausprägung auf Störungen in Aufmerksamkeits- und Handlungsauswahlprozessen hin. Das Tourette Syndrom ist eine klassische Entwicklungsstörung mit Symptombeginn in der Kindheit und Remission in der Adoleszenz in der Mehrzahl der Fälle. Allerdings ist bislang ungeklärt, wie individuelle Unterschiede des klinischen Verlaufs mit zugrunde liegenden neuronalen Prozessen zusammenhängen. Dieser Frage widmet sich dieser Übersichtsartikel mit besonderem Augenmerk auf das dopaminerge System. Es fehlen crosssektionale und longitudinale Studien, die systematisch Unterschiede im klinischen Verlauf und deren neurophysiologische Grundlagen, insbesondere in Hinblick auf Integration von Wahrnehmung und Handlung, adressieren. Derartige Studien könnten zu einem besseren Verständnis unterschiedlicher klinischer Verläufe des Tourette Syndroms im Jugend- und Erwachsenenalter beitragen.
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