Echoes from childhood—imitation in Gilles de la Tourette Syndrome§

Authors

  • Jennifer Finis PhD,

    1. Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany
    2. Department of Neurology, Movement Disorders and Neuromodulation, University Hospital Düsseldorf, Düsseldorf, Germany
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  • Agnes Moczydlowski,

    1. Department of Neurology, University Hospital Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Bettina Pollok PhD,

    1. Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany
    2. Department of Neurology, Movement Disorders and Neuromodulation, University Hospital Düsseldorf, Düsseldorf, Germany
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  • Katja Biermann-Ruben PhD,

    1. Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany
    2. Department of Neurology, Movement Disorders and Neuromodulation, University Hospital Düsseldorf, Düsseldorf, Germany
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  • Götz Thomalla MD,

    1. Department of Neurology, University Hospital Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Martin Heil MD,

    1. Heinrich-Heine University, Düsseldorf, Germany
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  • Holger Krause MD,

    1. Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany
    2. Department of Neurology, Movement Disorders and Neuromodulation, University Hospital Düsseldorf, Düsseldorf, Germany
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  • Melanie Jonas PhD,

    1. Department of Psychology, University of Hamburg, Hamburg, Germany
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  • Alfons Schnitzler MD,

    1. Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine University, Düsseldorf, Germany
    2. Department of Neurology, Movement Disorders and Neuromodulation, University Hospital Düsseldorf, Düsseldorf, Germany
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  • Alexander Münchau MD

    Corresponding author
    1. Department of Neurology, University Hospital Medical Center Hamburg-Eppendorf, Hamburg, Germany
    • Department of Neurology, University Hospital Medical Center Hamburg Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany

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  • Funding agencies: This work was supported by the Deutsche Forschungsgemeinschaft DFG (grant numbers SCH592/1-2 [to A.S.] and MU1692/2-1 [to A.M.]).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Background:

Tourette syndrome patients are reported to show automatic imitation (echopraxia), but this has not yet been proven experimentally.

Methods:

Video clips showing either tics of other Tourette patients or spontaneous movements of healthy subjects were presented to Tourette patients and healthy subjects. Participants' responses were assessed using blinded review of video recordings by 2 independent raters and related to stimuli presented.

Results:

Both raters detected more echoes in patients. In a permutation analysis, no healthy subject had echoes above chance level. In contrast, 6 and 5 patients were classified as echoers according to rater 1 and rater 2, respectively, in 1 analysis, and 9 patients were so classified in a second analysis (according to rater 2 only). Concordance between raters was high. Patients echoed both following stimuli showing tics and following stimuli showing spontaneous movements. Most echoes were part of patients' individual tic repertoire.

Conclusions:

Echopraxia is a hallmark of Tourette syndrome. © 2012 Movement Disorder Society

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