Document Detail

Limbic and motor circuits involved in symmetry behavior in Tourette's syndrome.
MedLine Citation:
PMID:  23199522     Owner:  NLM     Status:  Publisher    
OBJECTIVE: The need for symmetry and ordering objects related to a "just right"-feeling is a common symptom in Tourette's syndrome (TS) and resembles symmetry behavior in obsessive-compulsive disorder, but its pathophysiology is unknown. We used a symptom provocation paradigm to investigate the neural correlates of symmetry behavior in TS and hypothesized the involvement of frontal-striatal and limbic brain areas. METHODS: Pictures of asymmetrically and symmetrically arranged objects were presented in randomized blocks (4 blocks of each condition) to 14 patients with TS and 10 matched healthy controls (HC). A H2 15O positron emission tomography scan was acquired during each stimulus block, resulting in 8 scans per subject. After each scan, state anxiety and symmetry behavior (the urge to rearrange objects) were measured using a visual analogue scale. RESULTS: During the asymmetry condition, TS patients showed increased regional cerebral blood flow (rCBF) in the anterior cingulate cortex, supplementary motor area, and inferior frontal cortex, whereas HC showed increased rCBF in the visual cortex, primary motor cortex, and dorsal prefrontal cortex. Symmetry ratings during provocation correlated positively with orbitofrontal activation in the TS group and sensorimotor activation in the HC group, and negatively with dorsal prefrontal activity in HC. CONCLUSIONS: Results suggest that both motor and limbic circuits are involved in symmetry behavior in TS. Motor activity may relate to an urge to move or perform tics, and limbic activation may indicate that asymmetry stimuli are salient for TS patients. In contrast, symmetry provocation in HC resulted in activation of brain regions implicated in sensorimotor function and cognitive control.
Froukje E de Vries; Odile A van den Heuvel; Danielle C Cath; Henk J Groenewegen; Anton J L M van Balkom; Ronald Boellaard; Adriaan A Lammertsma; Dick J Veltman
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-3
Journal Detail:
Title:  CNS spectrums     Volume:  -     ISSN:  1092-8529     ISO Abbreviation:  CNS Spectr     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9702877     Medline TA:  CNS Spectr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-9     Citation Subset:  -    
1 Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands.
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