Abstract
Gilles de la Tourette syndrome is a neurodevelopmental disorder characterized by tics. Abnormal neuronal circuits in a wide-spread structural and functional network involved in planning, execution and control of motor functions are thought to represent the underlying pathology. We therefore studied changes of structural brain networks in 13 adult GTS patients reconstructed by diffusion tensor imaging and probabilistic tractography. Structural connectivity and network topology were characterized by graph theoretical measures and compared to 13 age-matched controls. In GTS patients, significantly reduced connectivity was detected in right hemispheric networks. These were furthermore characterized by significantly reduced local graph parameters (local clustering, efficiency and strength) indicating decreased structural segregation of local subnetworks. Contrasting these results, whole brain and right hemispheric networks of GTS patients showed significantly increased normalized global efficiency indicating an overall increase of structural integration among distributed areas. Higher global efficiency was associated with tic severity (R = 0.63, p = 0.022) suggesting the clinical relevance of altered network topology. Our findings reflect an imbalance between structural integration and segregation in right hemispheric structural connectome of patients with GTS. These changes might be related to an underlying pathology of impaired neuronal development, but could also indicate potential adaptive plasticity.
Highlights
Gilles de la Tourette (GTS) syndrome is a complex developmental neuropsychiatric disorder with childhood onset[1]
Alterations in network organization detected by functional MRI in healthy GTS patients that resembled the topology of brain networks in younger healthy individuals point in a similar direction[20]
We hypothesised that distinctive changes in the topology of global white-matter networks could be detected in patients with GTS, reflecting primary, neurodevelopmental pathology as well as potential adaptive plasticity of the structural brain network architecture
Summary
Gilles de la Tourette (GTS) syndrome is a complex developmental neuropsychiatric disorder with childhood onset[1]. GTS represents a model disorder characterized by abnormal structural and functional networks involved in planning, execution and control of motor actions Due to their inherent complexity, brain networks are difficult to compare between individuals or groups. Alterations in network organization detected by functional MRI in healthy GTS patients that resembled the topology of brain networks in younger healthy individuals point in a similar direction[20]. Taken together, these findings lend support to the concept of GTS as a prototype neurodevelopmental disorder of brain immaturity leading to disturbed motor and behavioural control. We hypothesised that distinctive changes in the topology of global white-matter networks could be detected in patients with GTS, reflecting primary, neurodevelopmental pathology as well as potential adaptive plasticity of the structural brain network architecture
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