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Structural abnormalities in the substantia nigra and neighbouring nuclei in Tourette’s syndrome

  • Movement Disorders - Original Article
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Abstract

Although midbrain nuclei (substantia nigra, ventral tegmental area, and periaqueductal grey) are considered candidate loci of pathology in Tourette’s syndrome (TS), few imaging studies have examined midbrain structure. The objective of this study was to evaluate the presence of subtle structural abnormalities in the midbrain of patients with TS. High-field magnetic resonance imaging (MRI) (1.5- and 3-T) was used in 23 patients with TS and in 20 age- and sex-matched normal control subjects. Tics symptoms were rated using the Yale Global Tic Severity Scale and comorbid neuropsychiatric disorders were evaluated with standardised psychiatric rating scales. MRI scans revealed subtle structural abnormalities consistent with expanded perivascular spaces (EPVS) in the substantia nigra (compacta and reticulata) and neighbouring nuclei in 6 (26%) patients with TS, but in none of the normal control subjects (P = 0.045). Stereotyped movements were more frequent (P = 0.017) amongst TS patients with midbrain EPVS than in TS patients with normal MRI. Parkinsonism, posttraumatic stress disorder and autistic spectrum disorders exclusively occurred in TS patients with midbrain EPVS. There were no significant between-group differences in other comorbid neuropsychiatric disorders and in tics. Although EPVS are generally viewed as incidental findings, our results suggest that when EPVS are located in the midbrain they may be symptomatic. These abnormalities would reduce the actual number of neurons in specific midbrain nuclei (e.g., substantia nigra) and disrupt their connectivity with limbic, associative, and motor circuits.

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Acknowledgments

The authors thank Francisco Alfaro and Diego Lara for technical advice on MRI studies.

Conflict of interest statement

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Área de Psicobiología, Facultad de Psicología, Universidad de Málaga, Campus Teatinos, 29071, Málaga, Spain

    Guadalupe Dávila

  2. Centro de Investigaciones Médico-Sanitarias, University of Malaga, Málaga, Spain

    Guadalupe Dávila, Marcelo L. Berthier, Jorge Gómez & J. Pablo Lara

  3. Movement Disorder Unit, Department of Neurology, Sant Pau Hospital, Autonomous University of Barcelona, Barcelona, Spain

    Jaime Kulisevsky

  4. Neuroradiology Department, Carlos Haya University Hospital, Málaga, Spain

    Beatriz Asenjo

  5. Asociación Andaluza de Síndrome de Tourette y Trastornos Asociados, Córdoba, Spain

    Salud Jurado Chacón

  6. Neuroscience Department, Xanit Hospital Internacional, Málaga, Spain

    Víctor M. Campos

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  1. Guadalupe Dávila
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  2. Marcelo L. Berthier
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  3. Jaime Kulisevsky
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  4. Beatriz Asenjo
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  5. Jorge Gómez
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  6. J. Pablo Lara
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Correspondence to Guadalupe Dávila.

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Dávila, G., Berthier, M.L., Kulisevsky, J. et al. Structural abnormalities in the substantia nigra and neighbouring nuclei in Tourette’s syndrome. J Neural Transm 117, 481–488 (2010). https://doi.org/10.1007/s00702-010-0369-8

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  • DOI: https://doi.org/10.1007/s00702-010-0369-8

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