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Functional imaging in Tourette's syndrome.

J R Adams1, A R Troiano, D B Calne

  • 1Pacific Parkinson's Research Centre, Vancouver, Canada.

Journal of Neural Transmission (Vienna, Austria : 1996)
|October 14, 2004
PubMed
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Tourette's syndrome (TS) causes are unknown, but metabolic changes in brain regions suggest it is both a motor and behavioral disorder. Future research should distinguish urge sensations from tic execution.

Area of Science:

  • Neuroscience
  • Neurology
  • Psychiatry

Background:

  • The etiology of Tourette's syndrome (TS) remains elusive.
  • Previous functional imaging studies on neurotransmitter systems have yielded inconclusive and contradictory results regarding tic pathogenesis.
  • Metabolic alterations in the basal ganglia, limbic system, and sensori-motor cortex align with TS as a complex motor and behavioral disorder.

Purpose of the Study:

  • To explore the underlying pathogenetic mechanisms of Tourette's syndrome.
  • To investigate the potential role of metabolic derangements in the basal ganglia, limbic system, and sensori-motor cortex in TS.
  • To re-evaluate the nature of tics in TS, considering the premonitory urge as a potential involuntary component.

Main Methods:

  • Review of functional imaging studies focusing on neurotransmitter systems and tic frequency/severity.

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  • Analysis of evidence for metabolic derangements in specific brain regions associated with TS.
  • Consideration of patient-reported premonitory sensations preceding tic manifestation.

    • Main Results:

    • Functional imaging results for neurotransmitter systems have been inconclusive.
    • Metabolic derangements are evident in the basal ganglia, limbic system, and sensori-motor cortex.
    • The premonitory urge, reported by patients, suggests a potential voluntary component in tic performance.

    Conclusions:

    • Tourette's syndrome involves metabolic changes in key brain areas, supporting its classification as a motor and behavioral disorder.
    • The premonitory urge may represent the involuntary aspect of TS, with tic execution being a voluntary response.
    • Further research is necessary to differentiate neural functions related to the urge versus the act of tic suppression.