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Regional Brain and Ventricular Volumes in Tourette Syndrome
Bradley S. Peterson, MD;
Lawrence Staib, PhD;
Lawrence Scahill, MSN, PhD;
Heping Zhang, PhD;
Carol Anderson, PhD;
James F. Leckman, MD;
Donald J. Cohen, MD;
John C. Gore, PhD;
John Albert, BA;
Rebecca Webster, BS
Arch Gen Psychiatry. 2001;58:427-440.
Background The pathophysiology of Tourette syndrome (TS) is thought to involve
disturbances in cortico-striato-thalamo-cortical circuitry. The morphological
characteristics of the cortical and associated white matter portions of these
circuits have not been previously examined in TS subjects.
Methods High-resolution anatomical magnetic resonance images were acquired in
155 TS and 131 healthy children and adults. The cerebrums and ventricles were
isolated and then parcellated into subregions using standard anatomical landmarks.
Results For analyses that included both children and adults, TS subjects were
found to have larger volumes in dorsal prefrontal regions, larger volumes
in parieto-occipital regions, and smaller inferior occipital volumes. Significant
inverse associations of cerebral volumes with age were seen in TS subjects
that were not seen in healthy controls. Sex differences in the parieto-occipital
regions of healthy subjects were diminished in the TS group. The age-related
findings were most prominent in TS children, whereas the diminished sex differences
were most prominent in TS adults. Group differences in regional ventricular
volumes were less prominent than in the cerebrum. Regional cerebral volumes
were significantly associated with the severity of tic symptoms in orbitofrontal,
midtemporal, and parieto-occipital regions.
Conclusions Broadly distributed cortical systems are involved in the pathophysiology
of TS. Developmental processes, sexual dimorphisms, and compensatory responses
in these cortical regions may help to modulate the course and severity of
tic symptoms.
From the Yale Child Study Center, the Department of Diagnostic Radiology,
and the Department of Epidemiology and Public Health, Yale School of Medicine,
New Haven, Conn.
Reprints: Bradley S. Peterson, MD, Yale Child Study Center, 230 South
Frontage Rd, New Haven, CT 06520 (e-mail: bradley.peterson{at}yale.edu).
RELATED ARTICLE
Neuroimaging of Pediatric Neuropsychiatric Disorders: Is a Picture Really Worth a Thousand Words?
Jay N. Giedd
Arch Gen Psychiatry. 2001;58(5):443-444.
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