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NEUROLOGY 2007;68:1979-1987
© 2007 American Academy of Neurology

Neuroimaging of neuronal circuits involved in tic generation in patients with Tourette syndrome

A. Lerner, MD, PhD, A. Bagic, MD, E. A. Boudreau, MD, PhD, T. Hanakawa, MD, PhD, F. Pagan, MD, Z. Mari, MD, W. Bara-Jimenez, MD, M. Aksu, MD, G. Garraux, MD, J. M. Simmons, MD, PhD, S. Sato, MD, D. L. Murphy, MD and M. Hallett, MD

From the Molecular Imaging Branch (A.L.), Laboratory of Neuropsychology (J.M.S.), and Laboratory of Clinical Science (D.L.M.), National Institute of Mental Health, and EEG Section (A.B., E.A.B., S.S.) and Human Motor Control Section (T.H., F.P., Z.M., W.B.-J., M.A., G.G., M.H.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.

Address correspondence and reprint requests to Dr. Alicja Lerner, Molecular Imaging Branch, National Institute of Mental Health, National Institutes of Health, 31 Center Drive MSC 2035, Bldg. 31, Room B2-B34, Bethesda, MD 20892-2035 lernera{at}mail.nih.gov

Objective: To identify brain regions generating tics in patients with Tourette syndrome using sleep as a baseline.

Methods: We used [15O]H2O PET to study nine patients with Tourette syndrome and nine matched control subjects. For patients, conditions included tic release states and sleep stage 2; and for control subjects, rest states and sleep stage 2.

Results: Our study showed robust activation of cerebellum, insula, thalamus, and putamen during tic release.

Conclusion: The network of structures involved in tics includes the activated regions and motor cortex. The prominent involvement of cerebellum and insula suggest their involvement in tic initiation and execution.

Supplemental data at www.neurology.org

Supported by the Intramural Research Programs of the National Institute of Neurological Disorders and Stroke and National Institute of Mental Health, NIH.

Disclosure: The authors report no conflicts of interest.

Received July 21, 2006. Accepted in final form February 5, 2007.




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