Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
Department of Psychology, Northwestern University, Evanston, Illinois; Department of Neuroscience, Northwestern University, Evanston, Illinois.
Biol Psychiatry. 2020 Jan 15;87(2):164-173. doi: 10.1016/j.biopsych.2019.06.021. Epub 2019 Jul 2.
Tourette syndrome (TS) is a neuropsychiatric disorder with symptomatology that typically changes over development. Whether and how brain function in TS also differs across development has been largely understudied. Here, we used functional connectivity magnetic resonance imaging to examine whole-brain functional networks in children and adults with TS.
Multivariate classification methods were used to find patterns among functional connections that distinguish individuals with TS from control subjects separately for children and adults (N = 202). We tested whether the patterns of connections that classify diagnosis in one age group (e.g., children) could classify diagnosis in another age group (e.g., adults). We also tested whether the developmental trajectory of these connections was altered in TS.
Diagnostic classification was successful in children and adults separately but expressly did not generalize across age groups, suggesting that the patterns of functional connections that best distinguished individuals with TS from control subjects were age specific. Developmental patterns among these functional connections used for diagnostic classification deviated from typical development. Brain networks in childhood TS appeared "older" and brain networks in adulthood TS appeared "younger" in comparison with typically developing individuals.
Our results demonstrate that brain networks are differentially altered in children and adults with TS. The observed developmental trajectory of affected connections is consistent with theories of accelerated and/or delayed maturation, but may also involve anomalous developmental pathways. These findings further our understanding of neurodevelopmental trajectories in TS and carry implications for future applications aimed at predicting the clinical course of TS in individuals over development.
妥瑞氏症（TS）是一种神经精神疾病，其症状表现通常会随着发育而改变。TS 患者的大脑功能是否以及如何在整个发育过程中存在差异，在很大程度上仍未得到充分研究。在这里，我们使用功能连接磁共振成像来检查 TS 儿童和成人的全脑功能网络。
使用多元分类方法来寻找功能连接中的模式，这些模式可将 TS 患者与对照组个体区分开来，分别针对儿童和成人（N=202）。我们测试了在一个年龄组（例如，儿童）中分类诊断的连接模式是否可以在另一个年龄组（例如，成人）中进行分类诊断。我们还测试了这些连接的发育轨迹在 TS 中是否发生改变。
诊断分类在儿童和成人中分别是成功的，但并未明确跨越年龄组，这表明可以将 TS 患者与对照组个体区分开来的最佳功能连接模式是特定于年龄的。用于诊断分类的这些功能连接的发育模式与典型发育不同。与正常发育的个体相比，童年 TS 的大脑网络显得“更成熟”，成年 TS 的大脑网络显得“更不成熟”。
我们的结果表明，TS 儿童和成人的大脑网络存在差异。受影响连接的观察到的发育轨迹与加速和/或延迟成熟的理论一致，但也可能涉及异常的发育途径。这些发现进一步了解了 TS 中的神经发育轨迹，并对未来旨在预测个体在发育过程中 TS 临床病程的应用具有启示意义。
