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Tourette's syndrome: a disorder of cingulate and orbitofrontal function?
R A Weeks1, N Turjanski, D J Brooks
1MRC Cyclotron Unit, Hammersmith Hospital, London, UK.
Summary
Tourette's syndrome (TS) may stem from dysfunction in the cingulate and orbitofrontal cortex. Treatments targeting dopamine and opioid systems show promise for managing TS symptoms.
Area of Science:
- Neuroscience
- Clinical Neurology
- Psychiatry
Background:
- Tourette's syndrome (TS) is a neurological disorder characterized by involuntary motor and vocal tics.
- Understanding the underlying pathophysiology of TS is crucial for developing effective treatments.
Purpose of the Study:
- To review the clinical characteristics and treatment options for Tourette's syndrome.
- To propose a pathophysiological hypothesis for TS based on neuroimaging data.
Main Methods:
- Review of published pathophysiological and Positron Emission Tomography (PET) data.
- Analysis of a recent PET study on opioid receptor binding in TS.
Main Results:
- Hypothesized dysfunction in the cingulate and orbitofrontal cortex as a cause of TS.
- Suggested mechanisms for the efficacy of dopamine receptor antagonists and dopamine-depleting agents via basal ganglia-thalamofrontal circuits.
- Proposed direct action of opioid agents on the cingulate cortex.
Conclusions:
- The cingulate and orbitofrontal cortex are implicated in the pathophysiology of Tourette's syndrome.
- Dopamine and opioid pathways offer potential therapeutic targets for TS management.