Abstract
Pathophysiological evidence suggests an involvement of frontostriatal circuits in Tourette syndrome (TS) and cognitive abnormalities have been detected in tasks sensitive to cognitive deficits associated with prefrontal damage (verbal fluency, planning, attention shifting, working memory, cognitive flexibility, and social reasoning). A disorder in counterfactual thinking (CFT), a behavioural executive process linked to the prefrontal cortex functioning, has not been investigated in TS. CFT refers to the generation of a mental simulation of alternatives to past factual events, actions, and outcomes. It is a pervasive cognitive feature in everyday life and it is closely related to decision-making, planning, problem-solving, and experience-driven learning—cognitive processes that involve wide neuronal networks in which prefrontal lobes play a fundamental role. Clinical observations in patients with focal prefrontal lobe damage or with neurological and psychiatric diseases related to frontal lobe dysfunction (e.g., Parkinson's disease, Huntington's disease, and schizophrenia) show counterfactual thinking impairments. In this work, we evaluate the performance of CFT in a group of patients with Tourette's syndrome compared with a group of healthy participants. Overall results showed no statistical differences in counterfactual thinking between TS patients and controls in the three counterfactual measures proposed. The possible explanations of this unexpected result are discussed below.
Highlights
Tourette’s syndrome (TS) is a neuropsychiatric disorder characterized by chronic multiple motor tics and one or more phonic/vocal tics, defined as semivoluntary, repetitive, and stereotyped movements and vocalization [1]
An important strand of current research relates to social cognition, as it is becoming evident that some aspects of social reasoning involved in decision-making are altered in TS [9]
There has been an accumulating body of evidence showing that counterfactual thinking (CFT) is sustained by a brain network in which a main role is played by the prefrontal cortex
Summary
Tourette’s syndrome (TS) is a neuropsychiatric disorder characterized by chronic multiple motor tics and one or more phonic/vocal tics, defined as semivoluntary, repetitive, and stereotyped movements and vocalization [1]. In the Diagnostic and Statistical Manual, in its fifth edition (DSM-5), TS is defined as a tic disorder characterized by an early onset before the age of 18 years and is not secondary to the administration of drugs known to cause motor side effects or to the presence of other disorders [2]. An important strand of current research relates to social cognition, as it is becoming evident that some aspects of social reasoning involved in decision-making are altered in TS [9]. These studies report that patients with TS exhibited significantly
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