Neural correlates of tic severity and cognitive control in children with Tourette syndrome
Neural correlates of tic severity and cognitive control in children with Tourette syndrome
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DOI：
10.1093/brain/awm278
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发表时间：
2008-01-01
期刊：
影响因子：
14.5
通讯作者：
Bunge, S. A.
中科院分区：
文献类型：
--
作者：
Baym, C. L.;Corbett, B. A.;Bunge, S. A.
多发性抽动症(TS)是一种以不自主运动和发音为特征的神经发育障碍。据推测，过量的多巴胺导致通过基底节的通路不平衡，导致通过丘脑去抑制而不受抑制的运动。目前尚不清楚TS是否与认知控制缺陷以及单纯的运动控制缺陷有关，或者认知缺陷是否与并存条件的存在有关。此外，在药物对大脑功能产生长期影响之前，人们对儿童TS的神经基础知之甚少。在这里，患有TS的儿童和典型的发育中儿童在事件相关fMRI数据获取过程中执行认知控制任务。这项研究包括18名以英语为母语的713岁TS儿童(M=10.42；15名男性)和19名健康的、年龄匹配的以英语为母语的志愿者(M=10.33；11名男性)。这项任务涉及三种不同的认知控制操作。在行为上，抽搐的严重性越高，在最苛刻的任务条件下，任务表现越慢。在神经方面，抽动的严重程度与直接通路中的多巴胺能核(黑质/腹侧被盖区)以及皮质、纹状体和丘脑区的激活增强有关。抽搐的严重程度也与丘脑底核区域的更多接触有关，这暗示了一种代偿机制。总体而言，在任务执行过程中，患者对左侧前额叶皮质的投入程度高于典型患者。这些数据表明，713岁未服用TS药物的儿童表现出通过基底节的直接通路的激活增加，以及前额叶皮质和丘脑底核的代偿激活增加。
Tourette syndrome (TS) is a neurodevelopmental disorder characterized by involuntary motor and phonic tics. It is hypothesized that excess dopamine leads to an imbalance in the pathways through the basal ganglia, resulting in unchecked movements via thalamic disinhibition. It has been unclear whether TS is associated with cognitive control deficits as well as pure motor control deficits, or whether cognitive deficits are associated with the presence of comorbid conditions. Furthermore, little is known about the neural underpinnings of TS in childhood, prior to the long-term effects of medication on brain function. Here, children with TS and typically developing children performed a cognitive control task during event-related fMRI data acquisition. The study included 18 native English-speaking 713-year-old children with TS (M = 10.42; 15 males), and 19 healthy, age-matched native English-speaking volunteers (M = 10.33; 11 males). The task involved three separate manipulations of cognitive control. Behaviourally, higher tic severity was correlated with slower task performance on the most demanding task conditions. Neurally, higher tic severity was associated with enhanced activation of dopaminergic nuclei (substantia nigra/ventral tegmental area) and cortical, striatal and thalamic regions in the direct pathway. Heightened tic severity was also associated with greater engagement of the subthalamic nucleus area, suggestive of a compensatory mechanism. Overall, patients engaged left prefrontal cortex more strongly than typicals during task performance. These data suggest that children aged 713 unmedicated for TS exhibit increased activation in the direct pathway through the basal ganglia, as well as increased compensatory activation in prefrontal cortex and the subthalamic nucleus.