Basal Ganglia volumes in patients with Gilles de la Tourette syndrome.
BACKGROUND
Despite strong circumstantial evidence that the pathophysiology of Gilles de la Tourette syndrome (TS) involves structural and functional disturbances of the basal ganglia, inconsistent findings from relatively small in vivo TS imaging studies have supported contradictory conclusions concerning the role of abnormal anatomical characteristics of the basal ganglia in the pathophysiology of TS.


METHODS
Basal ganglia volumes were measured on high-resolution magnetic resonance images acquired for 154 children and adults with TS and 130 healthy control subjects. Repeated-measures analyses tested hypotheses concerning regional specificity, age effects, and abnormal asymmetries in the basal ganglia of subjects with TS. Subjects with prior neuroleptic exposure had larger basal ganglia volumes and were excluded from further statistical analyses.


RESULTS
Caudate nucleus volumes were significantly (P =.008) smaller in children and adults with TS. Lenticular nucleus volumes also were smaller in adults with TS and in children with TS who were diagnosed as having comorbid obsessive-compulsive disorder. Regional anatomical asymmetries did not differ across groups. Regional volumes did not correlate significantly with the severity of tic, obsessive-compulsive disorder, or attention-deficit/hyperactivity disorder symptoms.


CONCLUSIONS
Reduced caudate nucleus volumes may be a good candidate marker for a trait abnormality in the structure of the basal ganglia in persons with TS. Smaller lenticular nucleus volumes may be an additional marker for the presence of comorbid obsessive-compulsive disorder and for the persistence of tic symptoms into adulthood. Brain regions other than the basal ganglia may have greater clinical relevance in determining the severity of tic symptoms.
Peterson
Bradley S
BS
Division of Child and Adolescent Psychiatry, the Department of Psychiatry, New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York 10032, USA. PetersoB@child.cpmc.columbia.edu
Thomas
Prakash
P
Kane
Michael J
MJ
Scahill
Lawrence
L
Zhang
Heping
H
Bronen
Richard
R
King
Robert A
RA
Leckman
James F
JF
Staib
Lawrence
L
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology; D001479:Basal Ganglia / Q000033:anatomy & histology*; D001921:Brain / Q000033:anatomy & histology; D002421:Caudate Nucleus / Q000033:anatomy & histology; D002648:Child; D015897:Comorbidity; D005260:Female; D005917:Globus Pallidus / Q000033:anatomy & histology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology; D011699:Putamen / Q000033:anatomy & histology; D005879:Tourette Syndrome / Q000175:diagnosis* / Q000453:epidemiology