Does anyone have a good hypothesis that explains why the symptoms of Tourette’s often fade and intensify over time, for both short intervals of time and over the long-term?
And is Tourette’s caused by a structural problem in the brain, or is it just a bug in the “software”?
Fucked if I know.
It is structural. For stuff like this, the hardware/software distinction does not really apply to the brain. Even things like (long term) memories are (almost certainly) physically embodied as structural changes in the arrangement and strength of synapses: even more so for ongoing conditions like Tourette’s.
I do not know about the waxing and waning, but is it any different, in this respect, from regular personality traits, such as being bad tempered, for example? After all, even the most bad tempered people are not in a spitting rage the whole of the time, they are just more likely to be set off into a rage than better tempered people are.
The experts in the field mainly have a whole bunch of best guesses and mainly agree that is a complex disorder that involves brain regions and neurotransmitters and likely immunologic, hormonal, and/or environmental contributions. Structural? Software? Yes to both.
I would blame its waxing and waning on the fact that it manifests in a genetically prone individual based likely on some constantly shifting relative balance of neurotransmitters against some backdrop of confounding but not necessarily independent factors ranging from hormone levels to emotional stress to sleep debt status to immunologic triggers to possibly even nutritional influences like iron status.
What do consider differentiates software from hardware in OP?