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Sensory Hypersensitivity Severity and Association with Obsessive-Compulsive Symptoms in Adults with Tic Disorder

Authors Isaacs D, Key AP, Cascio CJ, Conley AC, Walker HC, Wallace MT, Claassen DO

Received 28 July 2020

Accepted for publication 3 October 2020

Published 2 November 2020 Volume 2020:16 Pages 2591—2601


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Roger Pinder

David Isaacs,1 Alexandra P Key,2– 4 Carissa J Cascio,4– 6 Alexander C Conley,2,6 Harrison C Walker,7 Mark T Wallace,3,5,6,8,9 Daniel O Claassen1

1Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA; 2Center for Cognitive Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; 3Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN, USA; 4Vanderbilt Kennedy Center, Vanderbilt University, Nashville, TN, USA; 5Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, USA; 6Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA; 7Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; 8Department of Pharmacology, Vanderbilt University, Nashville, TN, USA; 9Department of Psychology, Vanderbilt University, Nashville, TN, USA

Correspondence: David Isaacs
Department of Neurology, Vanderbilt University Medical Center, A-0118 Medical Center North, Nashville, TN 37232, USA
Tel +1 615 936-0060
Fax +1 615 936-1229

Background: 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).
Objective: 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.
Methods: 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.
Results: SGI and SPQ scores strongly correlated (rs = − 0.73, p < 0.0001) within patients. SGI total score was significantly higher in patients versus controls (119.0 vs 67.6, U =− 5.3, p < 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 (p = 0.044) to 1.41 (p = 0.001). A simple linear regression model with DOCS as the independent variable accounted for 31.9% of SGI score variance.
Conclusion: Sensory hypersensitivity is prominent in adults with tic disorder and is independently associated with obsessive-compulsive symptom severity.

Keywords: Tourette syndrome, tic disorder, sensory hypersensitivity, sensory sensitivity, obsessive-compulsive symptoms

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