Longitudinal Magnetic Resonance Imaging (MRI) Analysis of the Developmental Changes of Tourette Syndrome Reveal Reduced Diffusion in the Cortico-Striato-Thalamo-Cortical Pathways

Abstract

There is evidence that cortico-striato-thalamo-cortical pathways are involved in Tourette syndrome. We performed a longitudinal imaging study in 22 patients and 21 healthy controls in order to examine the development of tics and its correlation with magnetic resonance imaging (MRI) findings. Patients were divided in a group with persisting and a group with remission of tics. We found a decrease in volume of left putamen in controls, but not in patients. We found changes in mean diffusivity between patients and controls in right caudate nucleus, thalamus, and frontal lobe. In contrast to controls, parallel and perpendicular diffusivity decreased in patients and were most pronounced in the patients with persisting tics compared to those with remission. The findings suggest that the development of the brain in patients with remission resembles the normal development more than in patients with persistent tics. This could reflect a change in brain structure or compensatory mechanisms in the brain.

Deep Brain Stimulation for Tourette’s Syndrome: The Case for Targeting the Thalamic Centromedian–Parafascicular Complex

“…In this conception, TS and comorbidities are considered diseases deriving from a failure in the mechanisms responsible for sensory and motor gating (19). In support of the role of BG dysfunction in TS, a recent diffusion-weighted imaging study confirmed that delayed or altered development in the CSTC networks is a possible factor leading to TS manifestations and its normalization is associated with remission of tics (20). …”

Evidence for Thalamocortical Circuit Abnormalities and Associated Cognitive Dysfunctions in Underweight Individuals with Anorexia Nervosa

“…Implicating thalamic dysfunction in AN adds to the growing literature suggesting CSTC loop dysfunction as an endophenotype of several disease states, including schizophrenia, ADHD, obsessive-compulsive disorder, and Tourette syndrome (Debes et al, 2014;Mitelman et al, 2005;Nigg and Casey, 2005;Posner et al, 2014a, b). Since alterations in thalamo-frontal connectivity might indicate general CSTC loop dysfunction, future studies could investigate whether other components of CTSC circuitry show alterations in AN.…”

Functional neuroimaging in Tourette syndrome: recent perspectives

“…The adults included in cross-sectional studies who still have symptoms might represent another phenotypic variant of TS with another pathophysiologic mechanism compared with patients with remission of symptoms. 80 To our knowledge, there has been only one longitudinal neuroimaging study on TS. 80 A longitudinal study gives the opportunity to investigate the changes over time in the same patients from childhood into adulthood, and it can help examine the development of tics and comorbidity and correlate these to the neuroimaging findings.…”

“…80 To our knowledge, there has been only one longitudinal neuroimaging study on TS. 80 A longitudinal study gives the opportunity to investigate the changes over time in the same patients from childhood into adulthood, and it can help examine the development of tics and comorbidity and correlate these to the neuroimaging findings. More longitudinal studies are warranted in the future in order to further examine the pathophysiological mechanisms of TS and the neuroplasticity that might be involved in TS.…”