I have gear with both and I'm not so "Princess and the Pea" to be able to really tell any practical, realistic difference between them. The rhetorical question I ask is "what did musicians do before the TUSQ was invented? What problem were they trying to solve, and was it such a widespread problem in the first place?"
I can't remember which necks I have with the TUSQ and without. That alone speaks volumes about how much it doesn't really matter and I should save the $5 for other features.