title: Altered fronto-striato-thalamic connectivity in children with Tourette syndrome assessed with diffusion tensor MRI and probabilistic fiber tracking.
abstract: The aim of the study was to determine whether abnormal connectivity of the fronto-striato-thalamic circuit underlies the morphological changes in subcortical structures of patients with Tourette syndrome and to correlate these changes with neurobehavioral measures. A total of 18 children with Tourette syndrome and 12 age-matched healthy controls underwent diffusion tensor magnetic resonance imaging. Tractography of the fronto-striato-thalamic circuit was achieved using probability distribution function of individual voxels. The Tourette syndrome group had significantly lower probability of connection between caudate nucleus and anterior-dorsolateral-frontal cortex on the left (P = .038). Obsessive-compulsive behavior was negatively associated with connectivity score of the left caudate and anterior dorsolateral frontal cortex (P = .01) and was positively associated with connectivity score for the subcallosal gyrus (P = .009) and for the lentiform nucleus (P = .008). The abnormal connectivity among components of the fronto-striato-thalamic circuit bilaterally (ie, seeds on the caudate and thalamus) in patients with Tourette syndrome provides direct evidence for the involvement of these circuits in the pathophysiology.
authors.affiliation: Department of Radiology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan 48201, USA.
authors.forename: Malek I
authors.initials: MI
authors.lastname: Makki
authors.forename: Rajkumar Munian
authors.initials: RM
authors.lastname: Govindan
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Wilson
authors.forename: Michael E
authors.initials: ME
authors.lastname: Behen
authors.forename: Harry T
authors.initials: HT
authors.lastname: Chugani
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology; D002421:Caudate Nucleus / Q000473:pathology*; D002648:Child; D038524:Diffusion Magnetic Resonance Imaging; D005625:Frontal Lobe / Q000473:pathology*; D007839:Functional Laterality; D006801:Humans; D015999:Multivariate Analysis; D009434:Neural Pathways / Q000473:pathology; D009483:Neuropsychological Tests; D009770:Obsessive Behavior / Q000150:complications / Q000473:pathology; D009929:Organ Size; D011336:Probability; D013788:Thalamus / Q000473:pathology*; D005879:Tourette Syndrome / Q000150:complications / Q000473:pathology*