Tourette's syndrome is characterized by involuntary tics and, although the
underlying pathogenesis and pathophysiology of Tourette's syndrome remains
unclear, it is suspected that basal ganglia structures are involved. The ba
sal ganglia also play an important role in the control of saccadic eye move
ments and we therefore hypothesize that Tourette's syndrome patients have a
bnormal control of saccadic eye movements. In this study, 10 subjects with
Tourette's syndrome and 10 age- and sex-matched controls performed four dif
ferent oculomotor paradigms requiring the execution and/or suppression of r
eflexive and/or voluntary saccades. In the immediate saccade tasks, subject
s were required to look either toward (pro-saccade task) or away from (anti
-saccade task) a peripheral target as soon as it appeared. In the delayed s
accade tasks, subjects were instructed to wait for a central fixation point
to disappear before initiating eye movements. Among Tourette's syndrome su
bjects, saccadic reaction times were longer in all tasks. Saccadic amplitud
es were smaller in Tourette's syndrome subjects, and they made more saccade
s to reach the eccentric target. The occurrence of direction errors (i.e. r
eflexive pro-saccades on anti-saccade trials) was normal in the immediate a
nti-saccade task, suggesting that the ability to inhibit reflexive saccades
towards novel stimuli was not impaired in Tourette's syndrome. Timing erro
rs (i.e. eye movements made prior to disappearance of the central fixation
point in delayed saccade tasks) were significantly greater among Tourette's
syndrome subjects. Moreover, these errors were predominantly made towards
the first target of the remembered sequence in a delayed memory-guided sequ
ential saccade task. These results indicate that the ability to inhibit or
delay planned motor programmes is significantly impaired in Tourette's synd
rome. We hypothesize that altered cortical-basal ganglia circuitry leads to
reduced cortical inhibition making it harder for Tourette's syndrome subje
cts to withhold the execution of planned motor programmes.