Affiliations: Altrecht Academic Anxiety Center, Utrecht, The
Netherlands | Department of Clinical and Health Psychology, Utrecht
University, Utrecht, The Netherlands
Note: [] Corresponding author: Prof. Marcel van den Hout, Department of
Clinical and Health Psychology, Utrecht University, PO Box 80140, 3508 TC
Utrecht, The Netherlands. Tel.: +31 30 253 9216; Fax: +31 30 253 7482; E-mail:
m.vandenhout@uu.nl
Abstract: Tics in Tourette Syndrome (TS) are often preceded by 'premonitory
urges': annoying feelings or bodily sensations. We hypothesized that, by
reducing annoyance of premonitory urges, tic behaviour may be reinforced. In a
2X2 experimental design in healthy participants, we studied the effects of
premonitory urges (operationalized as air puffs on the eye) and tic behaviour
(deliberate eye blinking after a puff or a sound) on changes in subjective
evaluation of air puffs, and EMG responses on the m. orbicularis oculi. The
experimental group with air puffs+ blinking experienced a decrease in
subjective annoyance of the air puff, but habituation of the EMG response was
blocked and length of EMG response increased. In the control groups (air puffs
without instruction to blink, no air puffs), these effects were absent. When
extrapolating to the situation in TS patients, these findings suggest that
performance of tics is reinforced by reducing the subjective annoyance of
premonitory urges, while simultaneously preventing habituation or even inducing
sensitisation of the physiological motor response.
Keywords: Tourette syndrome, tics, eye blink, experimental model, human model
