Che Tiffanie, Kim Soyoung, Greene Deanna J, Heywood Ashley, Ding Jimin, Hershey Tamara, Schlaggar Bradley L, Black Kevin J, Wang Lei
Department of Psychiatry and Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA.
Departments of Psychiatry and Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
CNS Spectr. 2024 Dec;29(6):652-664. doi: 10.1017/S1092852924002190. Epub 2024 Nov 28.
This study examined children at the onset of tic disorder (tics for less than 9 months: NT group), a population on which little research exists. Here, we investigate relationships between the baseline shape and volume of subcortical nuclei, diagnosis, and tic symptom outcomes.
187 children were assessed at baseline and a 12-month follow-up: 88 with NT, 60 tic-free healthy controls (HC), and 39 with chronic tic disorder/Tourette syndrome (TS), using T1-weighted MRI and total tic scores (TTS) from the Yale Global Tic Severity Scale to evaluate symptom change. Subcortical surface maps were generated using FreeSurfer-initialized large deformation diffeomorphic metric mapping. Linear regression models correlated baseline structural shapes with follow-up TTS while accounting for covariates, with relationships mapped onto structure surfaces.
We found that the NT group had a larger right hippocampus compared to HC. Surface maps illustrate distinct patterns of inward deformation in the putamen and outward deformation in the thalamus for NT compared to controls. We also found patterns of outward deformation in almost all studied structures when comparing the TS group to controls. The NT group also showed consistent outward deformation compared to TS in the caudate, accumbens, putamen, and thalamus. Subsequent analyses including clinical symptoms revealed that a larger pallidum and thalamus at baseline correlated with less improvement of tic symptoms at follow-up.
These observations constitute some of the first prognostic biomarkers for tic disorders and suggest that these subregional shape and volume differences may be associated with the outcome of tic disorders.
本研究对抽动障碍发病初期（抽动症状持续时间少于9个月：NT组）的儿童进行了检查，这是一个研究较少的群体。在此，我们研究皮质下核团的基线形状和体积、诊断与抽动症状结果之间的关系。
对187名儿童进行了基线评估和为期12个月的随访：88名NT组儿童、60名无抽动症状的健康对照（HC组）和39名患有慢性抽动障碍/图雷特综合征（TS组）的儿童，使用T1加权磁共振成像和耶鲁综合抽动严重程度量表的总抽动评分（TTS）来评估症状变化。使用基于FreeSurfer初始化的大变形微分同胚度量映射生成皮质下表面图谱。线性回归模型在考虑协变量的情况下，将基线结构形状与随访TTS相关联，并将关系映射到结构表面。
我们发现，与HC组相比，NT组右侧海马体更大。表面图谱显示，与对照组相比，NT组壳核有向内变形的独特模式，丘脑有向外变形的独特模式。在将TS组与对照组进行比较时，我们还发现几乎所有研究结构都有向外变形的模式。与TS组相比，NT组在尾状核、伏隔核、壳核和丘脑中也表现出一致的向外变形。随后包括临床症状的分析表明，基线时苍白球和丘脑较大与随访时抽动症状改善较少相关。
这些观察结果构成了抽动障碍的一些首批预后生物标志物，并表明这些亚区域形状和体积差异可能与抽动障碍的结果有关。
