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抽动秽语综合征患者大脑皮质沟回结构改变:对大脑发育异常的进一步支持。

Altered structure of cortical sulci in gilles de la Tourette syndrome: Further support for abnormal brain development.

作者信息

Muellner Julia, Delmaire Christine, Valabrégue Romain, Schüpbach Michael, Mangin Jean-François, Vidailhet Marie, Lehéricy Stéphane, Hartmann Andreas, Worbe Yulia

机构信息

Assistance Publique Hôpitaux de Paris (APHP), INSERM, ICM, Centre d'Investigation Clinique Pitié Neurosciences, CIC-1422, Département des Maladies du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland.

出版信息

Mov Disord. 2015 Apr 15;30(5):655-61. doi: 10.1002/mds.26207. Epub 2015 Mar 26.

Abstract

Gilles de la Tourette syndrome is a neurodevelopmental disorder characterized by the presence of motor and vocal tics. We hypothesized that patients with this syndrome would present an aberrant pattern of cortical formation, which could potentially reflect global alterations of brain development. Using 3 Tesla structural neuroimaging, we compared sulcal depth, opening, and length and thickness of sulcal gray matter in 52 adult patients and 52 matched controls. Cortical sulci were automatically reconstructed and identified over the whole brain, using BrainVisa software. We focused on frontal, parietal, and temporal cortical regions, in which abnormal structure and functional activity were identified in previous neuroimaging studies. Partial correlation analysis with age, sex, and treatment as covariables of noninterest was performed amongst relevant clinical and neuroimaging variables in patients. Patients with Gilles de la Tourette syndrome showed lower depth and reduced thickness of gray matter in the pre- and post-central as well as superior, inferior, and internal frontal sulci. In patients with associated obsessive-compulsive disorder, additional structural changes were found in temporal, insular, and olfactory sulci. Crucially, severity of tics and of obsessive-compulsive disorder measured by Yale Global Tic severity scale and Yale-Brown Obsessive-Compulsive scale, respectively, correlated with structural sulcal changes in sensorimotor, temporal, dorsolateral prefrontal, and middle cingulate cortical areas. Patients with Gilles de la Tourette syndrome displayed an abnormal structural pattern of cortical sulci, which correlated with severity of clinical symptoms. Our results provide further evidence of abnormal brain development in GTS.

摘要

抽动秽语综合征是一种神经发育障碍,其特征为存在运动性和发声性抽动。我们推测,该综合征患者会呈现出异常的皮质形成模式,这可能潜在地反映大脑发育的整体改变。我们使用3特斯拉结构神经成像技术,比较了52例成年患者和52例匹配对照者的脑沟深度、开口以及脑沟灰质的长度和厚度。使用BrainVisa软件在全脑自动重建并识别皮质脑沟。我们重点关注额叶、顶叶和颞叶皮质区域,在先前的神经成像研究中已确定这些区域存在结构和功能活动异常。在患者的相关临床和神经成像变量之间进行偏相关分析,将年龄、性别和治疗作为非感兴趣的协变量。抽动秽语综合征患者在中央前回和中央后回以及额上沟、额下沟和额内沟的灰质深度较低且厚度减小。在伴有强迫症的患者中,在颞叶、岛叶和嗅沟发现了额外的结构变化。至关重要的是,分别通过耶鲁综合抽动严重程度量表和耶鲁-布朗强迫症量表测量的抽动严重程度和强迫症严重程度,与感觉运动、颞叶、背外侧前额叶和扣带回中部皮质区域的脑沟结构变化相关。抽动秽语综合征患者表现出皮质脑沟的异常结构模式,这与临床症状的严重程度相关。我们的结果为抽动秽语综合征中大脑发育异常提供了进一步的证据。

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