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Implicit sequence learning in young people with Tourette syndrome with and without co-occurring attention-deficit/hyperactivity disorder (ADHD)

Shephard, Elizabeth; Groom, Madeleine J.; Jackson, Georgina M.

Authors

Elizabeth Shephard

GEORGINA JACKSON GEORGINA.JACKSON@NOTTINGHAM.AC.UK
Professor of Cognitive Neuropsychology



Abstract

Impaired habit-learning has been proposed to underlie the tic symptoms of Tourette syndrome (TS). However, accounts differ in terms of how habit-learning is altered in TS, with some authors proposing habit-formation is impaired due to a deficient “chunking” mechanism, and others proposing habit-learning is over-active and tics reflect hyper-learned behaviours. Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with TS and is known to affect cognitive function in young people with co-occurring TS and ADHD (TS+ADHD). It is unclear, however, how co-occurring ADHD symptoms affect habit-learning in TS. In this study, we investigated whether young people with TS would show deficient or hyper-active habit-learning, and assessed the effects of co-occurring ADHD symptoms on habit-learning in TS. Participants aged 9-17 years with TS (n = 18), TS+ADHD (n = 17), ADHD (n = 13) and typical development (n = 20) completed a motor sequence-learning task to assess habit-learning. We used a 2 (TS-yes, TS-no) x 2 (ADHD-yes, ADHD-no) factorial analysis to test the effects of TS, ADHD, and their interaction on accuracy and reaction time indices of sequence-learning. TS was associated with intact sequence-learning, but a tendency for difficulty transitioning from sequenced to non-sequenced performance was suggestive of hyper-learning. ADHD was associated with significantly poorer accuracy during acquisition of the sequence, indicative of impaired habit-learning. There were no interactions between the TS and ADHD factors, indicating young people with TS+ADHD showed both TS- and ADHD-related atypicalities in habit-learning.

Journal Article Type Article
Publication Date 2019-09
Journal Journal of Neuropsychology
Print ISSN 1748-6645
Electronic ISSN 1748-6653
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 13
Issue 3
Pages 529-549
APA6 Citation Shephard, E., Groom, M. J., & Jackson, G. M. (2019). Implicit sequence learning in young people with Tourette syndrome with and without co-occurring attention-deficit/hyperactivity disorder (ADHD). Journal of Neuropsychology, 13(3), 529-549. https://doi.org/10.1111/jnp.12167
DOI https://doi.org/10.1111/jnp.12167
Keywords habit-learning, Tourette syndrome, ADHD, sequence learning, tics, comorbidity
Publisher URL https://onlinelibrary.wiley.com/doi/abs/10.1111/jnp.12167
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
Additional Information This is the peer reviewed version of the following article,, which has been published in final form at https://onlinelibrary.w.../abs/10.1111/jnp.12167. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

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Shephard et al. Sequence learning in children with TS and ADHD.pdf (1.1 Mb)
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Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





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