Brain perfusion abnormalities in Gilles de la Tourette's syndrome.
BACKGROUND
Functional brain imaging with technetium-99m d,l-hexamethyl propyleneamine oxime (HMPAO) Single Photon Emission Tomography (SPET) allows us to explore the cerebral pathophysiology of Gilles de la Tourette's Syndrome (GTS).


METHODS
Fifty patients and 20 controls were examined. Patients were rated for tic severity and mood. Scans were analysed quantitatively using internal ratios to the occipital cortex.


RESULTS
Patients different from controls on measures of relative blood flow to the left caudate, anterior cingulate cortex and the left dorsolateral prefrontal cortex. Severity of tics was related to hypoperfusion of the left caudate and cingulate and a left medial temporal region. Hypoperfusion in the left dorsolateral prefrontal region was related to mood.


CONCLUSIONS
The areas found to be hypoperfused in this study are consistent with known functions of fronto-striatal circuits. A wide range of perfusion patterns is seen, however, and no characteristic patterns for behavioural subgroups has been documented with this technique.
Moriarty
J
J
Raymond-Way Neuropsychiatry Group, Institute of Neurology, London.
Costa
D C
DC
Schmitz
B
B
Trimble
M R
MR
Ell
P J
PJ
Robertson
M M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply*; D001931:Brain Mapping; D002421:Caudate Nucleus / Q000098:blood supply; D002648:Child; D003866:Depressive Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000523:psychology; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D006179:Gyrus Cinguli / Q000098:blood supply; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D017397:Prefrontal Cortex / Q000098:blood supply; D012039:Regional Blood Flow / Q000502:physiology; D019690:Technetium Tc 99m Exametazime; D013702:Temporal Lobe / Q000098:blood supply; D015899:Tomography, Emission-Computed, Single-Photon; D005879:Tourette Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000523:psychology
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime