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Brain Perfusion Abnormalities in Gilles de la Tourette's Syndrome

Published online by Cambridge University Press:  02 January 2018

John Moriarty*
Affiliation:
Raymond-Way Neuropsychiatry Group, Institute of Neurology, London
Durval Campos Costa
Affiliation:
Institute of Nuclear Medicine, London
Bettina Schmitz
Affiliation:
Raymond-Way Neuropsychiatry Group, Institute of Neurology, London
Michael R. Trimble
Affiliation:
Raymond-Way Neuropsychiatry Group, Institute of Neurology, London
Peter J. Ell
Affiliation:
Institute of Nuclear Medicine, London
Mary M. Robertson
Affiliation:
Raymond-Way Neuropsychiatry Group, Institute of Neurology, London
*
Dr J. Moriarty, Institute of Neurology, Queen Square, London WC1N 3BG. Fax: (0171) 278 8772.

Abstract

Background

Functional brain imaging with technetium-99m d,l-hexamethyl propyleneamine oxime (HMPAO) Single Photon Emission Tomography (SPET) allows us to explore the cerebral pathophysiology of Gilles de la Tourette's Syndrome (GTS).

Method

Fifty patients and 20 controls were examined. Patients were rated for tic severity and mood. Scans were analysed quantitatively using internal ratios to the occipital cortex.

Results

Patients differed from controls on measures of relative blood flow to the left caudate, anterior cingulate cortex and the left dorsolateral prefrontal cortex. Severity of tics was related to hypoperfusion of the left caudate and cingulate and a left medial temporal region. Hypoperfusion in the left dorsolateral prefrontal region was related to mood.

Conclusions

The areas found to be hypoperfused in this study are consistent with known functions of fronto-striatal circuits. A wide range of perfusion patterns is seen, however, and no characteristic patterns for behavioural subgroups has been documented with this technique.

Type
Papers
Copyright
Copyright © 1995 The Royal College of Psychiatrists 

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References

Alexander, G. E., DeLong, M. R. & Strick, P. L. (1986) Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annual Review of Neuroscience, 9, 357381.Google Scholar
American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, rev) (DSM–III–R). Washington, DC: American Psychiatric Press.Google Scholar
Beck, A. T., Ward, C. H., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.CrossRefGoogle ScholarPubMed
Bench, C. J., Friston, K. J., Brown, R. G., et al (1992) The anatomy of melancholia – focal abnormalities of cerebral blood flow in major depression. Psychological Medicine, 22, 607615.Google Scholar
Costa, D. C., Ell, P. J., Burns, A., et al (1988) CBF tomograms with 99mTc-HMPAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease – initial results. Journal of Cerebral Blood Flow and Metabolism, 8, S109S115.Google Scholar
Cummings, J. L. (1993) Frontal-subcortical circuits and human behaviour. Archives of Neurology, 50, 873880.Google Scholar
Decety, J., Sjöholm, H., Ryping, E., et al (1990) The cerebellum participates in mental activity: tomographic measurements of regional cerebral blood flow. Brain Research, 535, 313317.CrossRefGoogle ScholarPubMed
Dimitsopulos, T., Klieger, P. & Kurlan, R. (1993) Asymmetry of basal ganglia perfusion in Tourette's syndrome shown by Single Photon Emission Tomography. Movement Disorders, 8, 415416 (abstract).Google Scholar
George, M. S., Trimble, M. R., Costa, D. C., et al (1992) Elevated frontal cerebral blood flow in Gilles de la Tourette syndrome: A 99Tcm-HMPAO SPECT study: Psychiatry Research: Neuroimaging, 45, 143151.Google Scholar
George, M. S., Trimble, M. R., Ring, H. A., et al (1993) Obsessions in obsessive–compulsive disorder with and without Gilles de la Tourette's syndrome. American Journal of Psychiatry, 150, 9397.Google ScholarPubMed
Jadresic, D. (1992). The role of the amygdaloid complex in Gilles de la Tourette's syndrome. British Journal of Psychiatry, 161, 532534.CrossRefGoogle ScholarPubMed
Jurgens, U. (1976) Reinforcing concomitants of electrically elicited vocalisations. Experimental Brain Research, 26, 203214.Google Scholar
Kouris, K., Jarritt, P. H., Costa, D. C., et al (1992) Physical assessment of the GE/CGR Neurocam and comparison with a single rotating gamma-camera. European Journal of Nuclear Medicine, 19, 236242.Google Scholar
Leckman, J. F., Knorr, A. M., Rasmusson, A. M., et al (1991) Basal ganglia research and Tourette's syndrome. TINS 14, 94.Google Scholar
Montgomery, E. B. & Buchholz, S. R. (1991) The striatum and motor cortex in motor initiation and execution. Brain Research, 549, 222229.CrossRefGoogle ScholarPubMed
Peterson, B., Riddle, M. A., Cohen, D. J., et al (1993) Reduced basal ganglia volumes in Tourette's syndrome using three-dimensional reconstruction techniques from magnetic resonance images. Neurology, 43, 941949.CrossRefGoogle ScholarPubMed
Riddle, M. A., Rasmusson, A. M., Woods, S. W., et al (1992) SPECT imaging of cerebral blood flow in Tourette syndrome. Advances in Neurology, 58, 207211.Google Scholar
Robertson, M. (1989) The Gilles de la Tourette syndrome: the current status. British Journal of Psychiatry, 154, 147169.Google Scholar
Singer, H. S., Reiss, A. L., Brown, J. E., et al (1993) Volumetric MRI changes in basal ganglia of children with Tourette's syndrome. Neurology, 43, 950956.Google Scholar
Starkstein, S. E., Robinson, R. G., Berthier, M. L., et al (1988) Differential mood changes following basal ganglia vs thalamic lesions. Archives of Neurology, 45, 725730.CrossRefGoogle ScholarPubMed
Stoetter, B., Braun, A. R., Randolph, C., et al (1992) Functional neuroanatomy of Tourette syndrome. Limbic–motor interactions studied with FDG PET. Advances in Neurology, 58, 213226.Google Scholar
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