The metabolic anatomy of Tourette's syndrome
The metabolic anatomy of Tourette's syndrome
复制标题
DOI：
10.1212/wnl.48.4.927
复制
发表时间：
1997-04-01
期刊：
影响因子：
9.9
通讯作者：
Feigin, A
中科院分区：
文献类型：
--
作者：
Eidelberg, D;Moeller, JR;Feigin, A
抽动秽语综合征（TS）的临床表现背后的脑功能网络目前尚不清楚。为了确定这些网络，我们研究了TS患者和正常受试者的F-18-氟脱氧葡萄糖（FDG）和PET采用区域代谢协变的统计模型。我们研究了10例TS患者（平均年龄41.5 ± 12.7岁），他们要么是药物初治，要么是至少2年的药物自由。10名正常志愿者（平均年龄42.5 ± 11.5）作为对照。我们使用定量FDG/PET来计算所有受试者的整体、局部和标准化葡萄糖代谢率（GMR、rCMRGlc和rCMRGlc/GMR）。比例子剖面模型（SSM）被用来确定与TS相关的区域代谢协变的特定模式。我们发现，全球和区域的代谢率是正常的TS。SSM分析确定了两个TS相关的大脑网络。一种模式（15.8%的方差占，VAF）的特点是协变量双侧代谢增加的外侧运动前区和补充运动联合皮质和中脑。在TS组中，这种模式的个体患者表达（受试者评分）异常增加（p < 0.01）。第二种模式（10.5% VAF）的特征是尾状核和丘脑代谢的协变量降低，与豆状核和海马代谢活性的较小降低相关。该模式的受试者评分与抽动秽语综合征总体量表（TSGS）总体评分相关（r = 0.85，p < 0.005）。我们的结论是代谢景观TS的特点是一个非特异性的模式，增加运动皮层活动在其他多动症。TS还与一个特定的大脑网络有关，其特征在于边缘基底神经节-丘脑皮质投射系统的活动减少。
The functional brain networks underlying the clinical manifestations of Gilles de la Tourette's syndrome (TS) are currently unknown. To identify these networks, we studied TS patients and normal subjects with F-18-fluorodeoxyglucose (FDG) and PET employing a statistical model of regional metabolic covariation. We studied 10 TS patients (mean age, 41.5 +/- 12.7 years) who were either drug naive or medication free for at least 2 years. Ten normal volunteers (mean age, 42.5 +/- 11.5) served as controls. We used quantitative FDG/PET to calculate global, regional, and normalized rates of glucose metabolism (GMR, rCMRGlc, and rCMRGlc/GMR) in all subjects. The Scaled Subprofile Model (SSM) was used to identify specific patterns of regional metabolic covariation associated with TS. We found that global and regional metabolic rates were normal in TS. SSM analysis identified two TS-related brain networks. One pattern (15.8% variance accounted for, VAF) was characterized by covariate bilateral metabolic increases in lateral premotor and supplementary motor association cortices and in the midbrain. Individual patient expression of this pattern (subject score) was abnormally increased in the TS group (p < 0.01). A second pattern (10.5% VAF) was characterized by covariate decreases in caudate and thalamic metabolism associated with smaller reductions in lentiform and hippocampal metabolic activity. Subject scores for this pattern correlated with Tourette Syndrome Global Scale (TSGS) global ratings (r = 0.85, p < 0.005). We conclude that the metabolic landscape of TS is characterized by a nonspecific pattern of increased motor cortical activity identified in other hyperkinetic disorders. TS is also associated with a specific brain network characterized by a reduction in the activity of limbic basal ganglia-thalamocortical projection systems.