Directed attention in Gilles de la Tourette syndrome

Gilles de la Tourette syndrome (TS) is a basal ganglia (BG) disorder, associated not only with hyperkinetic movements but also with attentional impairments. This experiment sought to ascertain whether overt direct visual attention would influence tactile attentional performance in TS, via the use of a vibrotactile choice reaction time procedure involving biased probabilities of event occurrence. Participants were required to look (i.e., direct gaze) either at the hand receiving the most (expected) vibrations, or the hand less often stimulated (the unexpected), for both crossed and uncrossed arm postures. Contrary to our predictions, gaze did not influence attentional performance in TS patients. Furthermore, patients were found not to be sensitive to distributions of event probability; that is, they did not demonstrate normal expectancy effects like controls. Attentional deficits in TS (as in Parkinson's disease, another BG disorder) may pertain more to difficulties in holding rather than in shifting the focus of attention. Moreover, directing attention towards the unexpected locus in the crossed arm posture improved overall performance in both patients and controls, suggesting that increased task demands (e.g., crossed arm posture), and/or unexpected stimulus location, may be alleviated by directed attention. These impairments may stem from dysfunction in the circuits linking the frontal lobes with the BG.     

The ability to orient attention in Gilles de la Tourette syndrome

Gilles de la Tourette syndrome is characterised by tics, although patients also commonly present with attentional problems. This experiment aimed to ascertain whether TS patients have problems in orienting attention, via the use of a vibrotactile choice reaction time task. Participants were required to push a button in response to a faint vibration delivered to the index finger. Prior to each stimulus vibration, a pre-cue (valid, neutral or invalid) was administered to the finger. The performance benefits and costs participants gained from valid and invalid precues were calculated. Contrary to our prediction TS patients did not show significantly different costs or benefits. Furthermore, both patients and controls showed an equal and increased benefit in the crossed arm posture, compared to the uncrossed. These results suggest TS patients do not generally have problems in orienting attention. In addition, in the tactile modality, both patients and controls may benefit from directed attention when difficulty levels are maximal.     

Gilles de la Tourette syndrome in India: two cases.

Two cases of Gilles de la Tourette syndrome from India are presented. The symptomatology of Tourette syndrome is the same as that documented in western populations which suggests biological factors in the aetiology of the syndrome.     

Dilemmas in diagnosis and treatment of Gilles de la Tourette syndrome.

Gilles de la Tourette syndrome (TS) is a neurological disorder which has an inordinate risk of being diagnosed as psychogenic in nature because of commonly shared behavioral symptomes with syndromes of psychological origin. An overview of TS is presented including its history, symptomatology, and treatment of choice. The problems and pitfalls inherent in the diagnostic process which lead to psychogenic misconceptions are discussed. Treatment considerations include the secondary emotional problems and the negative consequences of the medication for TS. The implications for training professionals are discussed, but the essential point is that without an adequate history of the onset of symptoms, the potential for misdiagnosis is dramatically increased.     

Ambulatory accelerometry to quantify involuntary movements and tics in the syndrome of Gilles de la Tourette

Gilles de la Tourette syndrome is a chronic neuropsychiatric disorder characterizedby recurrent and involuntary tics, in addition to complex behavioral symptoms. Objective quantification of the nonspecific movements in Tourette patients can contribute much to understanding the pathophysiology of this disease. We used three accelerometersto characterizehead movement patterns and to objectively quantify head motility in the lateral, sagittal, and transversal planes in 9 Tourette patients and 14 controls during periods of rest, conversation, and watching a videotape with an entertaining program. Characteristic head movement patterns can be documented by means of accelerometry. Head motility levels in the lateral, sagittal, and transversal planes were significantly higher in the patients than in the controls during all the procedures. The patients and the controls showed a similar significant increase in head motility during conversation, but not during video watching. This first study shows that for both standardized and ambulatory research, accelerometry may provide an objective tool by which to quantify the severity and temporal dynamics of tics or nonspecific movements.     

Cerebellar neurophysiology in Gilles de la Tourette syndrome and its role as a target for therapeutic intervention

Therapy resistance of approximately one‐third of patients with Gilles de la Tourette syndrome (GTS) requires consideration of alternative therapeutic interventions. The article demonstrates the role of the cerebellum in neuropsychiatric disorders and GTS in particular, specifically its role in functions relating to motor and cognitive symptoms. Certain circuits in the cerebellum have been shown to undergo learning‐induced changes during conditioning, with cells in the cortex of the cerebellum appearing to decrease their activity whilst those in deep nuclei seem to do the inverse. Evidence exists showing that abnormal excitability of the motor cortex via the cerebellum could be expected to participate in motor tics in GTS possibly due to aberrations in certain structures of involved circuits. The role of the cerebellum in learning and plasticity processes renders it a strategic and valuable structure to consider for brain stimulation when investigating potential treatment options for neuropsychiatric disorders such as GTS. This article puts forth the concept of using non‐invasive and invasive brain stimulation techniques as a novel platform for non‐pharmacological neuromodulation of GTS symptoms.     

Polygraphic therapy control in Gilles de la Tourette syndrome--a case report

In a female patient with Gilles-de-la Tourette syndrome (GTS) the clinical improvement during drug therapy of haloperidol and clomipramine was proved with the help of a polygraphic method (simultaneous recording of different electrophysiological and vegetative parameters). Before intensifying therapy symptoms of vegetative irritation, motoric discharge patterns with high amplitude in correlation with movements and permanent activity with low amplitude even in a state of external motoric rest were found. After intensifying therapy vegetative stabilization and ceasing of any electrical activity in the EMG could be demonstrated. It is concluded that the effects of therapy in GTS may be checked and quantified by means of polygraphic methods.     

Freud and Gilles de la Tourette. Speculations regarding the diagnosis of Mrs. Emmy von N

The author reviews the case of Emmy von N. and provides a historical overview of the Gilles-de-la-Tourette syndrome (tic convulsif) referring also to recent studies of this illness. She revises Freud's diagnosis of hysteria in favour of the Gilles-de-la-Tourette syndrome.     

Essai sur la logique de l'indeterminisme et la ramification de l'espace-temps

Sans résumé     

Relaciones de intimidad en la adolescencia: el papel de la expresividad y la instrumentalidad

Resumen

Numerosas investigación es señalan que las chicas adolescentes mantienen relaciones más próximas e íntimas en sus relaciones de amistad, que los chicos. En este trabajo se pretende conocer qué papel juegan algunos atributos personales, como la expresividad y la instrumentalidad, en esas diferencias.

La muestra fue de 602 estudiantes (279 chicos y 323 chicas) salmantinos, de edades comprendidas entre los 14 y 19 años. Se aplicó un cuestionario donde se recogía información sobre la red de amigos/as íntimos, el nivel de intimidad experimentado con el mejor amigo/a, y el grado de instrumentalidad y expresividad de los sujetos. Aunque en algunos aspectos de las relaciones de amistad se subraya la importancia de la instrumentalidad y la expresividad, más allá del sexo de los sujetos, en otros, y especialmente en lo referido al nivel de intimidad con el mejor amigo/a, estos atributos personales, no dan cuenta de las importantes diferencias halladas entre los chicos y chicas.     

L'objet de la Geometrie

Sans résuméConférence faite à Eindhoven le 14 Mars 1953, pour la Société Néerlandaise de logique et philosophie des Sciences positives en collaboration avec la Société Académique de Eindhoven. — L'auteur tient à remercier le P. François Russo à Paris, qui a bien voulu reviser la traduction française et a fait nombre de précieux retouchements.