A developmental fMRI study of self-regulatory control in Tourette's syndrome
A developmental fMRI study of self-regulatory control in Tourette's syndrome
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DOI：
10.1176/appi.ajp.164.6.955
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发表时间：
2007-06-01
影响因子：
17.7
通讯作者：
Peterson, Bradley S.
中科院分区：
文献类型：
--
作者：
Marsh, Rachel;Zhu, Hongtu;Peterson, Bradley S.
目的：介导自我调节过程的神经系统成熟障碍可能通过释放调节控制的运动和发声抽搐而导致Tourette综合征的发展。本研究的目的是探讨儿童和成人抽动秽语综合征患者自我调节神经回路功能活动的年龄相关性。在Stroop干扰任务的执行过程中，作者比较了Tourette综合征患者与健康对照受试者的功能性磁共振成像（fMRI）血氧水平依赖性反应。Stroop相关激活的一般线性模型用于比较年龄和行为表现对两个诊断组之间自我调节控制变化的差异影响。虽然在抽动秽语综合征患者和健康对照受试者之间，年龄与Stroop任务行为表现的相关性相似，这两组人在年龄与任务期间局部大脑激活幅度的相关性方面存在显着差异。在腹侧前额叶（布罗德曼区10和24）和后扣带皮层（布罗德曼区31）检测到年龄与诊断的相互作用，事后分析表明，抽动秽语综合征患者随着年龄的增长，这些区域的失活减少。双侧额纹状体区激活程度更高（Brodmann区域9/46，45/46;豆状核;和丘脑）伴随着较差的性能在患者组，这-在Stroop任务的正常行为表现的存在下-表明额纹状体系统的更大激活有助于维持任务表现在个体与Tourette综合征。图雷特综合征患者额纹状体回路活动的规范性发育相关性受到干扰，有助于自我调节控制。这些异常的发育相关性可能是Tourette综合征成年人这些回路中更大的解剖和功能障碍的结果，这导致抽动行为的调节受损。图雷特综合征患者腹侧前额叶和后扣带皮层的默认模式处理减少，表明当摆脱更具挑战性的认知任务时，参与心理过程变得活跃的难度更大。然而，患有妥瑞氏综合征的个体似乎在自我调节控制中辅助年龄相关的改善的电路中选择正常的发育过程，同时可能努力保持足够的任务表现。
Objective: Disturbances in the maturation of neural systems that mediate self-regulatory processes may contribute to the development of Tourette's syndrome by releasing motor and vocal tics from regulatory control. The purpose of this study was to examine the age correlates of functional activity in neural circuits that subserve self-regulatory control in children and adults with Tourette's syndrome.Method: The participants were 136 children and adults, which included 66 Tourette's syndrome patients and 70 healthy comparison subjects. During performance of the Stroop interference task, the authors compared the functional magnetic resonance imaging (fMRI) bloodoxygen-level dependent response in patients with Tourette's syndrome with that of healthy comparison subjects. General linear modeling of Stroop-related activations was used to compare the differential effects of age and behavioral performance on changes in self-regulatory control between the two diagnostic groups.Results: Although the correlations of age with behavioral performance on the Stroop task were similar between patients with Tourette's syndrome and healthy comparison subjects, the two groups differed significantly in their correlations of age with the magnitude of regional brain activation during the task. Interactions of age with diagnosis were detected in the ventral prefrontal (Brodmann's areas 10 and 24) and posterior cingulate cortices (Brodmann's area 31), and post hoc analyses indicated that subjects with Tourette's syndrome deactivated these regions less with advancing age. Greater activation of bilateral frontostriatal regions (Brodmann's areas 9/46, 45/46; lenticular nucleus; and thalamus) accompanied poorer performance in the patient group, which-in the presence of normal behavioral performance on the Stroop task-suggests that greater activation of the frontostriatal systems helps to maintain task performance in individuals with Tourette's syndrome.Conclusions: Normative developmental correlates of activity in frontostriatal circuits that subserve self-regulatory control are disturbed in persons with Tourette's syndrome. These aberrant developmental correlates are likely a consequence of greater anatomical and functional disturbances in these circuits in adults with Tourette's syndrome, which leads to impaired regulation of tic behaviors. Reduced default-mode processing in ventral prefrontal and posterior cingulate cortices in adults with Tourette's syndrome suggests the presence of greater difficulty in engaging mental processes that become active when freed from the demands of more challenging cognitive tasks. However, individuals with Tourette's syndrome appear to co-opt normal developmental processes in circuits that subserve age-related improvement in self-regulatory control while presumably struggling to maintain adequate task performance.