White-matter abnormalities in Tourette syndrome extend beyond motor pathways
White-matter abnormalities in Tourette syndrome extend beyond motor pathways
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DOI：
10.1016/j.neuroimage.2010.02.049
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发表时间：
2010-07-01
期刊：
影响因子：
5.7
通讯作者：
Shah, N. Jon
中科院分区：
文献类型：
--
作者：
Neuner, Irene;Kupriyanova, Yuliya;Shah, N. Jon
多发性抽动症是一种以运动和声带痉挛为主要症状的神经精神障碍。抽搐通常伴随着强迫症、注意力缺陷多动障碍或抑郁症等共病。研究主要集中在皮质-纹状体-丘脑环路，但临床症状和最近的神经成像研究报告的静息网络连接改变表明，抽动症患者存在主要运动环路以外的异常。我们获得了符合DSM-IV-TR标准的19名成人患者和一名健康对照组的扩散加权数据。我们成人TS样本的扩散张量成像(DTI)分析显示，皮质脊髓束FA减少，放射状扩散率增加。内囊前肢和后肢有广泛的改变(FA减少，放射状扩散率增加)。此外，它还证实了先前发现的大脑半球间连通性的改变，这一发现表明，穹隆体内的FA减少。此外，我们的结果表明，TS不仅局限于运动通路，还影响到联合纤维，如额枕下束、上纵束和钩束。抽动是Tourette综合征的标志，因此皮质脊髓束的受累与临床症状相吻合。皮质区和边缘结构都参与了抽动的调节。我们的研究发现，长联结纤维束和胼胝体的改变是大脑半球间和跨大脑相互作用受阻的一个潜在来源。作为多发性抽动症的一个病理生理因素，放射状弥散率的改变指向髓鞘形成的缺陷。(C)2010年，由爱思唯尔公司出版。
Tourette syndrome is a neuropsychiatric disorder with the cardinal symptoms of motor and vocal tics. Often tics are accompanied by comorbidities such as obsessive-compulsive disorder, attention-deficit-hyperactivity disorder or depression. Research has mainly focused on the cortico-striato-thalamo circuit, but clinical symptoms and recent neuroimaging studies reporting altered resting network connectivity have suggested abnormalities in Tourette syndrome beyond the major motor circuits.We acquired diffusion-weighted data at 1.5 Tin nineteen adult patients fulfilling the DSM-IV-TR criteria for burette syndrome and in a healthy control group.Diffusion tensor imaging (DTI) analysis in our adult TS sample shows a decrease of FA and increase in radial diffusivity in the corticospinal tract. There are widespread changes (reduced FA and increased radial diffusivity) in the anterior and posterior limb of the internal capsule. Furthermore, it confirms prior findings of altered interhemispheric connectivity as indicated by a FA-decrease in the corpus callosum. In addition, our results indicate that TS is not restricted to motor pathways alone but affects association fibres such as the inferior fronto-occipitalis fascicle, the superior longitudinal fascicle and fascicle uncinatus as well.Tics are the hallmark of Tourette syndrome, so the involvement of the corticospinal tract fits in well with clinical symptoms. Cortical regions as well as limbic structures take part in the modulation of tics. Our findings of alterations in long association fibre tracts and the corpus callosum are a potential source for hindered interhemispheric and transhemispheric interaction. The change in radial diffusivity points toward a deficit in myelination as one pathophysiological factor in Tourette syndrome. (C) 2010 Published by Elsevier Inc.