Basal ganglia volumes in patients with Gilles de la Tourette syndrome
Basal ganglia volumes in patients with Gilles de la Tourette syndrome
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DOI：
10.1001/archpsyc.60.4.415
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发表时间：
2003-04-01
影响因子：
--
通讯作者：
Staib, L
中科院分区：
文献类型：
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作者：
Peterson, BS;Thomas, P;Staib, L
背景：尽管有强有力的间接证据表明，妥瑞氏综合征（TS）的病理生理涉及基底节区结构和功能紊乱，但相对较小的体内TS成像研究结果不一致，支持了基底节区异常解剖特征在TS病理生理中的作用的相互矛盾的结论。研究人员对154名患有TS的儿童和成人以及130名健康对照者的基底神经节体积进行了高分辨率磁共振成像测量。重复测量分析检验了有关TS受试者基底神经节区域特异性、年龄效应和异常不对称性的假设。先前接触过抗精神病药物的受试者基底神经节体积更大，因此被排除在进一步的统计分析之外。结果：患有TS的儿童和成人的尾状核体积显著小于（P = 0.008），患有TS的成人和诊断为共病强迫症的TS儿童的透镜状核体积也较小。区域解剖不对称在各组间无差异。区域容量与抽动、强迫症或注意力缺陷/多动障碍症状的严重程度无显著相关性。结论：尾状核体积减小可能是一种有效的治疗方法。是TS患者基底神经节结构特征异常的一个很好的候选标记物。较小的荚状核体积可能是存在共病强迫症和抽动症状持续到成年的另一个标记物。除基底节区以外的脑区在确定抽动症状的严重程度方面可能具有更大的临床相关性。
Background: Despite strong circumstantial evidence that the pathophysiology of Gilles de la Tourette syndrome (TS) involves structural and functional disturbances of the basal ganglia, inconsistent findings from relatively small in vivo TS imaging studies have supported contradictory conclusions concerning the role of abnormal anatomical characteristics of the basal ganglia in the pathophysiology of TS.Methods: Basal ganglia volumes were measured on high-resolution magnetic resonance images acquired for 154 children and adults with TS and 130 healthy control subjects. Repeated-measures analyses tested hypotheses concerning regional specificity, age effects, and abnormal asymmetries in the basal ganglia of subjects with TS. Subjects with prior neuroleptic exposure had larger basal ganglia volumes and were excluded from further statistical analyses.Results: Caudate nucleus volumes were significantly (P = .008) smaller in-children and adults with TS. Lenticular nucleus volumes also were smaller in adults with TS and in children with TS who were diagnosed as having comorbid obsessive-compulsive disorder. Regional anatomical asymmetries did not differ across groups. Regional volumes did not correlate significantly with the severity of tic, obessive-compulsive disorder, or attention-deficit/hyperactivity disorder symptoms.Conclusions: Reduced caudate nucleus volumes may be. a good candidate marker for a trait abnormality in the structure of the basal ganglia in persons with TS. Smaller lenticular nucleus volumes may be an additional marker for the presence of comorbid obsessive-compulsive disorder and for the persistence of tic symptoms into adulthood. Brain regions other than the basal ganglia may have greater clinical relevance in determining the severity of tic symptoms.