title: Three cases of symptom change in Tourette's syndrome and obsessive-compulsive disorder associated with paediatric cerebral malignancies.
abstract: OBJECTIVE
  To correlate behaviour manifestations with tumour location in three children who had Gilles de la Tourette's syndrome (GTS), obsessive-compulsive disorder (OCD), and primary cerebral malignancies.
  
  
  METHODS
  Cases were ascertained from a chart review in a GTS and OCD specialty clinic. For each case the temporal progression of change in neuropsychiatric symptoms was qualitatively correlated with radiographic documentation of tumour progression.
  
  
  RESULTS
  The change in symptom severities during tumour progression and treatment, together with prior neurobiological studies of GTS, suggest that the ventral striatum, corpus callosum, thalamus, and midbrain are potentially important neural substrates in the formation or modulation of tic symptoms. The limbic system, including the hypothalamus and cingulate, and the caudate nucleus, seem to be important in the neurobiology of OCD. All structures are neuroanatomically and functionally related to the corticostriato-thalamocortical circuitry that is thought to subserve symptom generation in both GTS and OCD.
  
  
  CONCLUSIONS
  Although the malignancies were not likely to have caused the tic and OCD symptoms in these children, the locations of these intracranial lesions provide important clues in identifying brain regions that may contribute to the determination of tic and OCD severities.
authors.affiliation: Yale Child Study Center, New Haven, CT, USA.
authors.forename: B S
authors.initials: BS
authors.lastname: Peterson
authors.forename: R A
authors.initials: RA
authors.lastname: Bronen
authors.forename: C C
authors.initials: CC
authors.lastname: Duncan
mesh_terms: D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000209:etiology*; D011859:Radiography; D012720:Severity of Illness Index; D005879:Tourette Syndrome / Q000209:etiology*; D016896:Treatment Outcome