Sheppard D M, Bradshaw J L, Purcell R, Pantelis C
Psychology Department, Monash University, Clayton, Victoria, Australia.
Clin Psychol Rev. 1999 Aug;19(5):531-52. doi: 10.1016/s0272-7358(98)00059-2.
Tourette's syndrome (TS), a neuropsychiatric movement disorder that manifests itself in childhood, is often associated with comorbid symptomatology, such as obsessions, compulsions, hyperactivity, distractibility, and impulsivity. Epidemiological studies suggest that a substantial number of TS patients develop clinical levels of obsessive-compulsive disorder (OCD) and/or attention deficit hyperactivity disorder (ADHD). This review aims to provide an integrated account of the three disorders in terms of their comorbidity. Neuroimaging studies suggest that all three disorders involve neuropathology of the basal-ganglia thalamocortical (BGTC) pathways: TS in the sensorimotor and limbic BGTC circuits; OCD in the prefrontal and limbic BGTC pathways; and ADHD in the sensorimotor, orbitofrontal, and limbic BGTC circuits. The pattern of comorbidity and other evidence indicates that the TS gene(s) may be responsible for a spectrum of disorders, including OCD and ADHD, but also that the disorders OCD and ADHD can exist in their own right with their own etiologies.
抽动秽语综合征（TS）是一种在儿童期出现的神经精神性运动障碍，常伴有共病症状，如强迫观念、强迫行为、多动、注意力不集中和冲动。流行病学研究表明，相当数量的TS患者会发展出临床水平的强迫症（OCD）和/或注意力缺陷多动障碍（ADHD）。本综述旨在综合阐述这三种疾病的共病情况。神经影像学研究表明，这三种疾病均涉及基底神经节 - 丘脑皮质（BGTC）通路的神经病理学改变：TS涉及感觉运动和边缘BGTC回路；OCD涉及前额叶和边缘BGTC通路；ADHD涉及感觉运动、眶额和边缘BGTC回路。共病模式及其他证据表明，TS基因可能导致一系列疾病，包括OCD和ADHD，但OCD和ADHD这两种疾病本身也可能有各自独立的病因。
