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Question 42: My sister is 44 years old. She
has exhibited TS symptoms for decades....Most pronounced are her verbal
tics. While never profane, she has classic TS symptoms. On June 29,
my sister was diagnosed with a BRAIN TUMOUR, on her speech center,
left parietal lobe. Since then, her tics have become somewhat more
frequent and the variety of verbal tics has increased. My main question:
Have you ever seen a TS case where the person has developed a tumour
in the speech center? Is there any correlation, in your opinion? Thank
you for hearing me out. My sister....beyond the tics is a kind, generous
person. Blessings, H.G., ON, Canada.
Good
evening H:
My
answers are no and no, I'm sorry. As you describe in your (impressive)
email, though, stress is a factor that increases tics.......I would
postulate that the tumour might affect the TS symptoms through the increased
psychological and physical stress that a tumour would present. As to
whether the tumour more directly influences the vocal tics you are hearing,
that is a fascinating thought, but something that has not been explored
as your sister's situation is an enormously unique one (i.e. no one
has thought to research this connection, and even if anyone had there
hasn't been anyone out there to use as research participants).
One hot-off-the-press study that could suggest a possible connection
is the finding that increased volumes of parieto-occipital cortex are
significantly correlated with tic severity (that is, the larger the
cortex, the more severe the tics). Assumedly a tumour in the parieto-occipital
area would increase the cortical volume. While there IS no speech centre
in the parietal lobe, there is a centre for speech near the juncture
of the parietal, temporal, and occipital lobes -- in the general area
described both by you, and in the study. This is a receptive speech
centre though: it is the area where speech is comprehended rather than
expressed. Expressive speech is located more near the front of the brain
than where you describe your sister's tumour to be.
Bottom line: there is some early evidence that the parietal lobe may
have something to do with tic severity, but there is no research suggesting
direct connections between parietal tumours and TS. It is also unlikely
that the tumour, as you describe it, would be impacting any areas of
the brain involved in the production of speech. Whether some of her
treatments for the cancer may have impacted areas closer to the front
of the brain though, and therefore the expressive speech centre, is
another thing.
Thank you for your email -- it is always a pleasure to get an interesting
intellectual challenge thrown my way, and it is always a pleasure to
meet someone with a heart to match her intellect.
cheers,
Dr. Dunc.
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