Amygdala hypersensitivity in response to emotional faces in Tourette's patients.
OBJECTIVE
Tourette's syndrome is characterised by motor and vocal tics as well as a high level of impulsivity and emotional dysregulation. Neuroimaging studies point to structural changes of the basal ganglia, prefrontal cortex and parts of the limbic system. However, there is no link between behavioural symptoms and the structural changes in the amygdala. One aspect of daily social interaction is the perception of emotional facial expressions, closely linked to amgydala function.


METHODS
We therefore investigated via fMRI the implicit discrimination of six emotional facial expressions in 19 adult Tourette's patients.


RESULTS
In comparison to healthy control group, Tourette's patients showed significantly higher amygdala activation, especially pronounced for fearful, angry and neutral expressions. The BOLD-activity of the left amygdala correlated negatively with the personality trait extraversion.


CONCLUSIONS
We will discuss these findings as a result of either deficient frontal inhibition due to structural changes or a desynchronization in the interaction of the cortico-striato-thalamo-cortical network within structures of the limbic system. Our data show an altered pattern of implicit emotion discrimination and emphasize the need to consider motor and non-motor symptoms in Tourette's syndrome in the choice of both behavioural and pharmacological treatment.
Neuner
Irene
I
Department of Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany. ineuner@ukaachen.de
Kellermann
Thilo
T
Stöcker
Tony
T
Kircher
Tilo
T
Habel
Ute
U
Shah
Jon N
JN
Schneider
Frank
F
D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000503:physiopathology*; D000786:Anger / Q000502:physiology; D001143:Arousal / Q000502:physiology; D002540:Cerebral Cortex / Q000503:physiopathology; D004292:Dominance, Cerebral / Q000502:physiology; D004644:Emotions / Q000502:physiology*; D005120:Extraversion, Psychological; D005239:Fear / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007398:Interpersonal Relations; D008032:Limbic System / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology; D009433:Neural Inhibition / Q000502:physiology; D010100:Oxygen / Q000097:blood*; D010364:Pattern Recognition, Visual / Q000502:physiology*; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D012938:Social Perception; D005879:Tourette Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
D010100:Oxygen