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Prefrontal and anterior cingulate cortex abnormalities in Tourette Syndrome: evidence from voxel-based morphometry and magnetization transfer imaging.

Müller-Vahl KR, Kaufmann J, Grosskreutz J, Dengler R, Emrich HM, Peschel T - BMC Neurosci (2009)

Bottom Line: Using VBM, TS patients showed significant decreases in gray matter volumes in prefrontal areas, the anterior cingulate gyrus, sensorimotor areas, left caudate nucleus and left postcentral gyrus.Increases were found in the left middle frontal gyrus and left sensorimotor areas.In MTI, white matter reductions were seen in the right medial frontal gyrus, the inferior frontal gyrus bilaterally and the right cingulate gyrus.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany. mueller-vahl.kirsten@mh-hannover.de

ABSTRACT

Background: Pathophysiological evidence suggests an involvement of fronto-striatal circuits in Tourette syndrome (TS). To identify TS related abnormalities in gray and white matter we used optimized voxel-based morphometry (VBM) and magnetization transfer imaging (MTI) which are more sensitive to tissue alterations than conventional MRI and provide a quantitative measure of macrostructural integrity.

Methods: Volumetric high-resolution anatomical T1-weighted MRI and MTI were acquired in 19 adult, unmedicated male TS patients without co-morbidities and 20 age- and sex-matched controls on a 1.5 Tesla neuro-optimized GE scanner. Images were pre-processed and analyzed using an optimized version of VBM in SPM2.

Results: Using VBM, TS patients showed significant decreases in gray matter volumes in prefrontal areas, the anterior cingulate gyrus, sensorimotor areas, left caudate nucleus and left postcentral gyrus. Decreases in white matter volumes were detected in the right inferior frontal gyrus, the left superior frontal gyrus and the anterior corpus callosum. Increases were found in the left middle frontal gyrus and left sensorimotor areas. In MTI, white matter reductions were seen in the right medial frontal gyrus, the inferior frontal gyrus bilaterally and the right cingulate gyrus. Tic severity was negatively correlated with orbitofrontal structures, the right cingulate gyrus and parts of the parietal-temporal-occipital association cortex bilaterally.

Conclusion: Our MRI in vivo neuropathological findings using two sensitive and unbiased techniques support the hypothesis that alterations in frontostriatal circuitries underlie TS pathology. We suggest that anomalous frontal lobe association and projection fiber bundles cause disinhibition of the cingulate gyrus and abnormal basal ganglia function.

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Areas with negative correlation between MTR maps and YGTSS score in TS patients. Areas with negative correlation between MTR maps and YGTSS score in TS patients. The same conventions apply as for figure 4. Significant voxels for MTR map reductions with higher YGTSS scores were found in right anterior cingulate gyrus, parietal-temporal-occipital association cortex, and superior frontal gyrus bilaterally (corrected P < .05). Note that changes in temporal areas, which were not significant according to our hypothesis, are also displayed. MTR = magnetization transfer ratio, YGTSS = Yale global tic severity scale, TS = Tourette syndrome.
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Figure 6: Areas with negative correlation between MTR maps and YGTSS score in TS patients. Areas with negative correlation between MTR maps and YGTSS score in TS patients. The same conventions apply as for figure 4. Significant voxels for MTR map reductions with higher YGTSS scores were found in right anterior cingulate gyrus, parietal-temporal-occipital association cortex, and superior frontal gyrus bilaterally (corrected P < .05). Note that changes in temporal areas, which were not significant according to our hypothesis, are also displayed. MTR = magnetization transfer ratio, YGTSS = Yale global tic severity scale, TS = Tourette syndrome.

Mentions: YGTSS scores correlated negatively with MTR maps in the superior frontal gyrus bilaterally and the left inferior frontal lobe. In addition, negative correlations were found in the right ACC and parts of the parietal-temporal-occipital association cortex (Figure 6, Table 4).


Prefrontal and anterior cingulate cortex abnormalities in Tourette Syndrome: evidence from voxel-based morphometry and magnetization transfer imaging.

Müller-Vahl KR, Kaufmann J, Grosskreutz J, Dengler R, Emrich HM, Peschel T - BMC Neurosci (2009)

Areas with negative correlation between MTR maps and YGTSS score in TS patients. Areas with negative correlation between MTR maps and YGTSS score in TS patients. The same conventions apply as for figure 4. Significant voxels for MTR map reductions with higher YGTSS scores were found in right anterior cingulate gyrus, parietal-temporal-occipital association cortex, and superior frontal gyrus bilaterally (corrected P < .05). Note that changes in temporal areas, which were not significant according to our hypothesis, are also displayed. MTR = magnetization transfer ratio, YGTSS = Yale global tic severity scale, TS = Tourette syndrome.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2691409&req=5

Figure 6: Areas with negative correlation between MTR maps and YGTSS score in TS patients. Areas with negative correlation between MTR maps and YGTSS score in TS patients. The same conventions apply as for figure 4. Significant voxels for MTR map reductions with higher YGTSS scores were found in right anterior cingulate gyrus, parietal-temporal-occipital association cortex, and superior frontal gyrus bilaterally (corrected P < .05). Note that changes in temporal areas, which were not significant according to our hypothesis, are also displayed. MTR = magnetization transfer ratio, YGTSS = Yale global tic severity scale, TS = Tourette syndrome.
Mentions: YGTSS scores correlated negatively with MTR maps in the superior frontal gyrus bilaterally and the left inferior frontal lobe. In addition, negative correlations were found in the right ACC and parts of the parietal-temporal-occipital association cortex (Figure 6, Table 4).

Bottom Line: Using VBM, TS patients showed significant decreases in gray matter volumes in prefrontal areas, the anterior cingulate gyrus, sensorimotor areas, left caudate nucleus and left postcentral gyrus.Increases were found in the left middle frontal gyrus and left sensorimotor areas.In MTI, white matter reductions were seen in the right medial frontal gyrus, the inferior frontal gyrus bilaterally and the right cingulate gyrus.

View Article: PubMed Central - HTML - PubMed

Affiliation: Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany. mueller-vahl.kirsten@mh-hannover.de

ABSTRACT

Background: Pathophysiological evidence suggests an involvement of fronto-striatal circuits in Tourette syndrome (TS). To identify TS related abnormalities in gray and white matter we used optimized voxel-based morphometry (VBM) and magnetization transfer imaging (MTI) which are more sensitive to tissue alterations than conventional MRI and provide a quantitative measure of macrostructural integrity.

Methods: Volumetric high-resolution anatomical T1-weighted MRI and MTI were acquired in 19 adult, unmedicated male TS patients without co-morbidities and 20 age- and sex-matched controls on a 1.5 Tesla neuro-optimized GE scanner. Images were pre-processed and analyzed using an optimized version of VBM in SPM2.

Results: Using VBM, TS patients showed significant decreases in gray matter volumes in prefrontal areas, the anterior cingulate gyrus, sensorimotor areas, left caudate nucleus and left postcentral gyrus. Decreases in white matter volumes were detected in the right inferior frontal gyrus, the left superior frontal gyrus and the anterior corpus callosum. Increases were found in the left middle frontal gyrus and left sensorimotor areas. In MTI, white matter reductions were seen in the right medial frontal gyrus, the inferior frontal gyrus bilaterally and the right cingulate gyrus. Tic severity was negatively correlated with orbitofrontal structures, the right cingulate gyrus and parts of the parietal-temporal-occipital association cortex bilaterally.

Conclusion: Our MRI in vivo neuropathological findings using two sensitive and unbiased techniques support the hypothesis that alterations in frontostriatal circuitries underlie TS pathology. We suggest that anomalous frontal lobe association and projection fiber bundles cause disinhibition of the cingulate gyrus and abnormal basal ganglia function.

Show MeSH
Related in: MedlinePlus