Structural Abnormalities in Early Tourette Syndrome Children: A Combined Voxel-Based Morphometry and Tract-Based Spatial Statistics Study

Yue Liu,Jieqiong Wang,Yun Peng,Guangheng Yin,Chuankai Lv,Tong Yu,Peiyi Gao,Zhiying Ji,Huiguang He,Liping Zhang,Wen Miao,B A Sabel,Hao Huang

doi:10.1371/journal.pone.0076105

Abstract

Tourette Syndrome (TS) is characterized with chronic motor and vocal tics beginning in childhood. Abnormality of both gray (GM) and white matter (WM) has been observed in cortico-striato-thalamo-cortical circuits and sensory-motor cortex of adult TS patient. It is not clear if these morphological changes are also present in TS children and if there are any microstructural changes of WM. To understand the developmental cause of such changes, we investigated volumetric changes of GM and WM using VBM and microstructural changes of WM using DTI, and correlated these changes with tic severity and duration. T1 images and Diffusion Tensor Images (DTI) from 21 TS children were compared with 20 age and gender matched health control children using a 1.5T Philips scanner. All of the 21 TS children met the DSM-IV-TR criteria. T1 images were analyzed using DARTEL-VBM in conjunction with statistical parametric mapping (SPM). Diffusion tensor imaging (DTI) analysis was performed using Tract-Based Spatial Statistics (TBSS). Brain volume changes were found in left superior temporal gyrus, left and right paracentral gyrus, right precuneous cortex, right pre- and post- central gyrus, left temporal occipital fusiform cortex, right frontal pole, and left lingual gyrus. Significant axial diffusivity (AD) and mean diffusivity (MD) increases were found in anterior thalamic radiation, right cingulum bundle projecting to the cingulate gurus and forceps minor. Decreases in white matter volume (WMV) in the right frontal pole were inversely related with tic severity (YGTSS), and increases in AD and MD were positively correlated with tic severity and duration, respectively. These changes in TS children can be interpreted as signs of neural plasticity in response to the experiential demand. Our findings may suggest that the morphological and microstructural measurements from structural MRI and DTI can potentially be used as a biomarker of the pathophysiologic pattern of early TS children.

Highlights

Tourette syndrome (TS) is a developmental neuropsychiatric disorder with the cardinal symptoms of motor and vocal tics which begin in childhood and fluctuate in severity in later years
TS is frequently concomitant with obsessive-compulsive disorder (OCD), attention-deficit hyperactivity disorder (ADHD), and other social and behavioral disturbances [2]
white matter volume (WMV) was decreased in right precuneous cortex, right precentral gyrus, left temporal occipital fusiform cortex, right frontal lobe, right postcentral gyrus and left lingual gyrus (Figure 1 C)

Summary

Introduction

Tourette syndrome (TS) is a developmental neuropsychiatric disorder with the cardinal symptoms of motor and vocal tics which begin in childhood and fluctuate in severity in later years. Many patients may experience attenuation or remission of tic symptoms during adolescence. This may be due to drug intervention and/or patients’ improvement in their capacity for self-regulation of behavior [1]. The incidence of TS is much higher than previously estimated [3], accounting for about 1% of children between the age 5–17 years [4,5] About 0.6% of the children show symptoms of distress and impairment caused by their tics [6]

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Discussion

Conclusion