Microstructural abnormalities of striatum and thalamus in children with Tourette syndrome

We applied diffusion‐tensor MRI (DT‐MRI) to investigate directly the water diffusivity within subcortical gray matter structures comprising the fronto‐striato‐thalamic (FST) circuit, which is implicated in the pathophysiology of Tourette syndrome (TS). We investigated the structural integrity of basal ganglia and thalamus in 23 children with TS and 35 age‐matched healthy controls (NC), and examined the association of DT‐MRI measures to tic severity and comorbid symptoms. We measured parallel (λ1) and perpendicular (λ23) diffusivity, mean diffusivity (MD), and fractional anisotropy (FA) in both hemispheres. Compared with NC, the TS group showed a significant increase in λ1 (P = 0.003) and MD (P = 0.027) in the bilateral putamen, an increase in λ23 in right thalamus (P = 0.008), and a reversed asymmetry of FA (P = 0.03) in the thalamus. There was a significant positive correlation between λ23 in right thalamus and tic severity. TS patients showed significantly lower left caudate volume (P = 0.011) and bilateral thalamic volumes (left, P = 0.035, right P = 0.006) compared with NC. These findings support the notion that microstructural dysfunction measured by DT‐MRI in component regions of the FST circuit contribute to the pathophysiology in TS. © 2008 Movement Disorder Society

[1]  A. Anderson,et al.  A functional magnetic resonance imaging study of tic suppression in Tourette syndrome. , 1998, Archives of general psychiatry.

[2]  D. Cohen,et al.  Tourette's Syndrome -- Tics, Obsessions, Compulsions: Developmental Psychopathology and Clinical Care , 1998 .

[3]  Alfredo Berardelli,et al.  Pathophysiology of tics and Tourette syndrome , 2003, Journal of Neurology.

[4]  W. Goodman,et al.  Children's Yale-Brown Obsessive Compulsive Scale: reliability and validity. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[5]  Bradley S. Peterson,et al.  Abnormal magnetic resonance imaging T2 relaxation time asymmetries in Tourette's syndrome , 1994, Psychiatry Research: Neuroimaging.

[6]  A Rothenberger,et al.  Decreased motor inhibition in Tourette's disorder: evidence from transcranial magnetic stimulation. , 1997, The American journal of psychiatry.

[7]  S. Dursun,et al.  Antisaccade eye movement abnormalities in Tourette syndrome: evidence for cortico-striatal network dysfunction? , 2000, Journal of psychopharmacology.

[8]  Heping Zhang,et al.  Basal Ganglia volumes in patients with Gilles de la Tourette syndrome. , 2003, Archives of general psychiatry.

[9]  Alexander Leemans,et al.  Microstructural maturation of the human brain from childhood to adulthood , 2008, NeuroImage.

[10]  J. Garbern.  Pelizaeus-Merzbacher disease: Genetic and cellular pathogenesis , 2006, Cellular and Molecular Life Sciences.

[11]  Derek K. Jones,et al.  The effect of gradient sampling schemes on measures derived from diffusion tensor MRI: A Monte Carlo study † , 2004, Magnetic resonance in medicine.

[12]  B S Peterson,et al.  Human basal ganglia volume asymmetries on magnetic resonance images. , 1993, Magnetic resonance imaging.

[13]  C. Beaulieu,et al.  The basis of anisotropic water diffusion in the nervous system – a technical review , 2002, NMR in biomedicine.

[14]  S. Dursun,et al.  Neuroanatomy of coprolalia in Tourette syndrome using functional magnetic resonance imaging , 2004, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[15]  A. Auchus,et al.  Diffusion Tensor Imaging of Normal-Appearing White Matter in Mild Cognitive Impairment and Early Alzheimer Disease: Preliminary Evidence of Axonal Degeneration in the Temporal Lobe , 2007, American Journal of Neuroradiology.

[16]  Richard S. J. Frackowiak,et al.  Anti-basal ganglia antibodies and Tourette’s syndrome: a voxel-based morphometry and diffusion tensor imaging study in an adult population , 2008, Journal of Neurology, Neurosurgery, and Psychiatry.

[17]  David Bonekamp,et al.  Diffusion tensor imaging in children and adolescents: Reproducibility, hemispheric, and age-related differences , 2007, NeuroImage.

[18]  Peter Herscovitch,et al.  The Functional Neuroanatomy of Tourette's Syndrome: An FDG PET Study III: Functional Coupling of Regional Cerebral Metabolic Rates , 2002, Neuropsychopharmacology.

[19]  J. Yelnik.  Functional anatomy of the basal ganglia , 2002, Movement disorders : official journal of the Movement Disorder Society.

[20]  V. Visser-Vandewalle,et al.  Deep brain stimulation in Tourette's syndrome: Two targets? , 2006, Movement disorders : official journal of the Movement Disorder Society.

[21]  James F. Leckman,et al.  Tourette's syndrome and tic disorders : clinical understanding and treatment , 1988 .

[22]  S. Yoo,et al.  Abnormal thalamic volume in treatment‐naïve boys with Tourette syndrome , 2006, Acta psychiatrica Scandinavica.

[23]  Khader M Hasan,et al.  Diffusion tensor metrics, T2 relaxation, and volumetry of the naturally aging human caudate nuclei in healthy young and middle‐aged adults: Possible implications for the neurobiology of human brain aging and disease , 2008, Magnetic resonance in medicine.

[24]  John Russell,et al.  Dysmyelination Revealed through MRI as Increased Radial (but Unchanged Axial) Diffusion of Water , 2002, NeuroImage.

[25]  Hongtu Zhu,et al.  Caudate volumes in childhood predict symptom severity in adults with Tourette syndrome , 2005, Neurology.

[26]  D. Barch,et al.  Cognitive-pharmacologic functional magnetic resonance imaging in tourette syndrome: a pilot study , 2004, Biological Psychiatry.

[27]  M Rovaris,et al.  Improving interobserver variation in reporting gadolinium-enhanced MRI lesions in multiple sclerosis , 1997, Neurology.

[28]  David S Tuch,et al.  Diffusion tensor imaging in presymptomatic and early Huntington's disease: Selective white matter pathology and its relationship to clinical measures , 2006, Movement disorders : official journal of the Movement Disorder Society.

[29]  Christian Beaulieu,et al.  Diffusion tensor imaging of neurodevelopment in children and young adults , 2005, NeuroImage.

[30]  Karl J. Friston,et al.  Cerebral Asymmetry and the Effects of Sex and Handedness on Brain Structure: A Voxel-Based Morphometric Analysis of 465 Normal Adult Human Brains , 2001, NeuroImage.

[31]  B. Peterson,et al.  Developmental processes and brain imaging studies in Tourette syndrome. , 2003, Journal of Psychosomatic Research.

[32]  H. Singer,et al.  Neurobiology of Tourette's syndrome: concepts of neuroanatomic localization and neurochemical abnormalities , 2003, Brain and Development.

[33]  A. Parent,et al.  Functional anatomy of the basal ganglia. I. The cortico-basal ganglia-thalamo-cortical loop , 1995, Brain Research Reviews.

[34]  Jean-Luc Anton,et al.  Region of interest analysis using an SPM toolbox , 2010 .

[35]  Carol L. Baym,et al.  Neural correlates of tic severity and cognitive control in children with Tourette syndrome. , 2008, Brain : a journal of neurology.

[36]  Hangyi Jiang,et al.  DtiStudio: Resource program for diffusion tensor computation and fiber bundle tracking , 2006, Comput. Methods Programs Biomed..

[37]  B. Peterson,et al.  Contents of Advances in Psychiatric Treatment , 2006, British Journal of Psychiatry.

[38]  E. Chee,et al.  Volumetric MRI changes in basal ganglia of children with Tourette's syndrome , 1993, Neurology.

[39]  M. Robertson,et al.  Tourette syndrome, associated conditions and the complexities of treatment. , 2000, Brain : a journal of neurology.

[40]  Bradley S. Peterson,et al.  Course of Tic Severity in Tourette Syndrome: The First Two Decades , 1998, Pediatrics.

[41]  Tore Wentzel-Larsen,et al.  Reduced white matter connectivity in the corpus callosum of children with Tourette syndrome. , 2006, Journal of child psychology and psychiatry, and allied disciplines.