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Altered Fronto-Striato-Thalamic Connectivity in Children with Tourette Syndrome Assessed with Diffusion Tensor MRI and Probabilistic Fiber Tracking

Department of Radiology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, Department of Neurology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan

Rajkumar Munian Govindan, MD

Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan

Benjamin J. Wilson, BA

Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan

Michael E. Behen, PhD

Department of Neurology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan

Harry T. Chugani, MD

Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, Department of Neurology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Michigan, hchugani{at}pet.wayne.edu

The aim of the study was to determine whether abnormal connectivity of the fronto-striato-thalamic circuit underlies the morphological changes in subcortical structures of patients with Tourette syndrome and to correlate these changes with neurobehavioral measures. A total of 18 children with Tourette syndrome and 12 age-matched healthy controls underwent diffusion tensor magnetic resonance imaging. Tractography of the fronto-striato-thalamic circuit was achieved using probability distribution function of individual voxels. The Tourette syndrome group had significantly lower probability of connection between caudate nucleus and anterior-dorsolateral-frontal cortex on the left (P = .038). Obsessive-compulsive behavior was negatively associated with connectivity score of the left caudate and anterior dorsolateral frontal cortex (P = .01) and was positively associated with connectivity score for the subcallosal gyrus (P = .009) and for the lentiform nucleus (P = .008). The abnormal connectivity among components of the fronto-striato-thalamic circuit bilaterally (ie, seeds on the caudate and thalamus) in patients with Tourette syndrome provides direct evidence for the involvement of these circuits in the pathophysiology.

Key Words: Tourette syndrome • fiber tracking • fronto-striato-thalamic pathway

Journal of Child Neurology, Vol. 24, No. 6, 669-678 (2009)
DOI: 10.1177/0883073808327838


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