Abstract：
Functional neuroimaging studies demonstrate disinhibition of the cortico-striatal-thalamo-cortical circuit. However, structural imaging studies revealed conflicting results, some suggesting smaller volumes of the caudate nucleus (CN) in children with Gilles de la Tourette syndrome (TS). Here we wanted to find out whether transcranial sonography (TCS) detects alterations of raphe nuclei, substantia nigra, lenticular nucleus (LN), or CN in children with Tic disorder or TS (TIC/TS).The study included 25 treatment-naive children (age: 12.2 ± 2.5 years) with a DSM-V based diagnosis of Tic disorder or TS (10 subjects), without other psychiatric or neurologic diagnosis, and 25 healthy controls (age: 12.17 ± 2.57 years), matched for age and sex. Parental rating of behavioral, emotional abnormalities, somatic complaints and social competencies of the participants were assessed using the Child Behavior Check List (CBCL/4-18R). TCS of deep brain structures was conducted through the preauricular acoustic bone windows using a 2.5-MHz phased-array ultrasound system. Fisher\'s exact test and Mann-Whitney-U test were used for comparisons between TIC/TS patients and healthy volunteers. The number of participants with hyperechogenic area of left CN in the TIC/TS sample was increased, compared to the healthy control group. TIC/TS patients with hyperechogenic CN showed an increased occurrence of thought- and obsessive-compulsive problems. This TCS study revealed pathologic structural changes in CN, its higher occurrence in TIC/TS compared to healthy controls and the relation to comorbidity of thought problems. Further research should focus on the molecular cause of these alterations, probably the disturbed iron metabolism.
摘要：
功能神经影像学研究表明皮质-纹状体-丘脑-皮质回路的抑制作用。然而,结构成像研究揭示了相互矛盾的结果，一些提示GillesdelaTourette综合征（TS）儿童的尾状核（CN）体积较小。在这里，我们想找出经颅超声检查（TCS）是否检测到中缝核的改变，黑质,豆状核(LN),或CN在儿童抽动障碍或TS（TIC/TS）。该研究包括25名接受过治疗的儿童（年龄：12.2±2.5岁），其诊断为基于DSM-V的抽动障碍或TS（10名受试者），没有其他精神或神经诊断，和25名健康对照（年龄：12.17±2.57岁），年龄和性别相匹配。父母的行为评级，情绪异常,使用儿童行为检查表(CBCL/4-18R)评估参与者的躯体投诉和社交能力.使用2.5MHz相控阵超声系统通过耳前声学骨窗进行深部脑结构的TCS。Fisher精确检验和Mann-Whitney-U检验用于TIC/TS患者和健康志愿者之间的比较。TIC/TS样本中左CN高回声区的参与者数量增加，与健康对照组相比。高回声CN的TIC/TS患者的思想和强迫问题发生率增加。这项TCS研究揭示了CN的病理结构变化，与健康对照组相比，其在TIC/TS中的发生率更高，并且与思维问题的合并症有关。进一步的研究应该集中在这些改变的分子原因上，可能是铁代谢紊乱.
