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Related Experiment Video

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Cingulate role in Tourette syndrome.

Joseph O'Neill1, John C Piacentini1, Bradley S Peterson2

  • 1Division of Child & Adolescent Psychiatry, Jane & Terry Semel Institute for Neuroscience, UCLA Department of Psychiatry & Biobehavioral Sciences, Los Angeles, CA, United States.

Handbook of Clinical Neurology
|November 17, 2019
PubMed
Summary
This summary is machine-generated.

Neuroimaging reveals significant involvement of the cingulate gyrus in Gilles de la Tourette syndrome (TS), with structural and functional abnormalities correlating with tic severity. This suggests potential therapeutic targets involving GABAergic and glutamatergic systems.

Keywords:
Cingulate cortexNeuroimagingNeurostimulationNeurosurgeryTourette's disorder

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Area of Science:

  • Neuroscience
  • Neuroimaging
  • Genetics

Background:

  • Gilles de la Tourette syndrome (TS) is a complex neurological disorder characterized by motor and vocal tics.
  • The precise neurobiological underpinnings of TS remain incompletely understood, necessitating comprehensive reviews of existing evidence.

Purpose of the Study:

  • To comprehensively review neurosurgical, neurostimulatory, and neuroimaging evidence linking the cingulate gyrus to TS.
  • To identify specific subregions of the cingulate cortex implicated in TS pathophysiology and symptom severity.

Main Methods:

  • Systematic review of published literature.
  • Analysis of neuroimaging data including structural MRI, DTI, MRS, rsfMRI, task fMRI, and PET.
  • Correlation of neuroimaging findings with clinical TS symptoms and genetic data.

Main Results:

  • Six of eight cingulate subregions are implicated in TS, with MRI showing cortical thinning/volume loss in sACC, pACC, aMCC, and pMCC, correlating with tic severity.
  • DTI indicates white matter abnormalities near sACC, pACC, pMCC, and dPCC.
  • rsfMRI reveals abnormal functional connectivity of pACC and dPCC with the globus pallidus internus, a target for deep brain stimulation (DBS).
  • Task fMRI suggests pMCC involvement in premonitory urges and tic preparation.
  • Abnormalities in cingulate subregions are linked to tic severity, complexity, and suppression efforts.

Conclusions:

  • The cingulate gyrus, particularly specific subregions, plays a crucial role in TS pathophysiology.
  • Neuroimaging findings suggest excitotoxicity secondary to GABAergic inhibition deficits, supporting the development of GABAergic and glutamatergic pharmacotherapies.
  • Cortical thickness in specific cingulate subregions may serve as a biomarker for TS.
  • Future research should focus on longitudinal studies, treatment response prediction, and advanced neuroimaging techniques.