Enlargement of thalamic nuclei in Tourette syndrome.
BACKGROUND
The basal ganglia and thalamus together connect in parallel closed-loop circuits with the cortex. Previous imaging studies have shown modifications of the basal ganglia and cortical targets in individuals with Tourette syndrome (TS), but less is known regarding the role of the thalamus in TS pathogenesis.


OBJECTIVE
To study the morphological features of the thalamus in children and adults with TS.


METHODS
A cross-sectional, case-control study using anatomical magnetic resonance imaging.


METHODS
University research center.


METHODS
The 283 participants included 149 with TS and 134 normal control individuals aged 6 to 63 years.


METHODS
Conventional volumes and measures of surface morphology of the thalamus.


RESULTS
Analyses of conventional volumes and surface morphology were consistent in demonstrating an enlargement in TS-affected thalami. Overall volumes were 5% larger in the group composed of children and adults with TS. Statistical maps of surface contour demonstrated enlargement over the lateral thalamus. Post hoc testing indicated that differences in IQ, comorbid illnesses, and medication use did not account for these findings.


CONCLUSIONS
Morphological abnormalities in the thalamus, together with the disturbances reported in the sensorimotor cortex, striatum, and globus pallidus, support the hypothesis of a circuitwide disorder within motor pathways in TS. The connectivity and function of the numerous and diverse thalamic nuclei within cortical-subcortical circuits constitute an anatomical crossroad wherein enlargement of motor nuclei may represent activity-dependent hypertrophy within this component of cortical-subcortical motor circuits, or an adaptive response within a larger putative compensatory system that could thereby directly modulate activity in motor circuits to attenuate the severity of tics.
Miller
Ann M
AM
Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA.
Bansal
Ravi
R
Hao
Xuejun
X
Sanchez-Pena
Juan Pablo
JP
Sobel
Loren J
LJ
Liu
Jun
J
Xu
Dongrong
D
Zhu
Hongtu
H
Chakravarty
M Mallar
MM
Durkin
Kathleen
K
Ivanov
Iliyan
I
Plessen
Kerstin J
KJ
Kellendonk
Christoph B
CB
Peterson
Bradley S
BS
D000328:Adult; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology; D009434:Neural Pathways / Q000473:pathology; D013787:Thalamic Nuclei / Q000473:pathology*; D013788:Thalamus / Q000473:pathology; D005879:Tourette Syndrome / Q000473:pathology*
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