Symptoms of Tourette’s Gilles Syndrome vary widely among individuals. The main element of this condition are tics, motors and sound. These are almost always accompanied by psychiatric manifestations. Patient tics are uncontrollable and often occur intensely and repeatedly. Not all types of tics are present in a person at the same time, they may appear and then disappear to give way to another type of tics.
Symptoms of Tourette’s Gilles Syndrome improve or disappear spontaneously in adulthood in 3/4 of patients, although it is not yet clear why. Unfortunately, in 25% of cases, the symptoms persist or get worse.
It is important to note that motor tics and sound tics may be temporarily suppressed by intense exertion of the patient's will and may decrease during activities requiring high concentration. Also, tics are usually preceded by a premonitory sensation. These characteristics are important criteria for the diagnosis of Tourette’s syndrome.
Engine tics
The motor tics manifest themselves in sudden, involuntary and repeated muscle contractions and movements, and are almost permanent. First, they touch the upper body, the face as a grimace, the head and the shoulders/arms. Climbing the eyes, shaking the head, moving the arm or shoulders, each tic remains fairly localized. More complex movements may also represent tics such as jumping, looking back, touching or grabbing an object.
These tics may also be more complex with a tendency to repeat movements observed in others, echopraxia or a propensity to make obscene gestures, copropraxia.
Sound tics
Sound tics are the most well known in the public mind, especially coprolalie, the tendency to make repeated and uncontrolled insults. However, it affects only a very small number of patients but constitutes a social stigma that is very difficult for patients to live with. In the majority of cases, sound tics take the form of simple noises such as sniffing, throat-scraping or touching. More complex sounds, as in the case of coprolalia, may still exist but most often consist of the repetition of syllables or words, palilalia, without connotations of coarse language or the repetition of other people’s words, echolalia.
Factors conducive to the manifestation of tics
Several factors may be involved in the frequency and intensity of tics. Stress and fatigue tend to favour them, while calmness and concentration help to reduce them.
Associated psychiatric symptoms
Gilles de la Tourette’s syndrome is in the majority of cases associated with psychiatric and behavioural symptoms or pathologies. First, attention deficit disorders, whether or not associated with hyperactivity, are present in a large proportion of patients. Obsessive Compulsive Disorder (OCD) is also encountered and manifests itself in the presence of pervasive obsessions. To relieve the anxiety, the person performs invasive rituals that have a considerable impact on daily life. Patients may also develop concurrent oppositional defiant disorders, anxiety terrain, depressive syndrome or autism spectrum disorder.
At Paris Brain Institute
In a study published in the journal Cortex, Cyril Atkinson-Clément and Yulia Worbe (Sorbonne University/APHP) in the team “Mov’it: movement, investigations, therapeutics. Experimental pathophysiology and Therapeutics" at Paris Brain Institute, show that, contrary to what we might think, the control of motor impulsivity, the trait that characterizes the ability to inhibit a movement or action already begun, is not correlated with tics in patients with Gilles de la Tourette syndrome.
The team of Eric Burgière (CNRS) at Paris Brain Institute is interested in the brain mechanisms underlying the generation of repetitive behaviours such as those present in obsessive compulsive disorders and Gilles de la Tourette syndrome.
