Tobias Bäumer and Götz Thomalla contributed equally to the manuscript.
Interhemispheric motor networks are abnormal in patients with Gilles de la Tourette syndrome†
Article first published online: 19 OCT 2010
Copyright © 2010 Movement Disorder Society
Volume 25, Issue 16, pages 2828–2837, 15 December 2010
How to Cite
Bäumer, T., Thomalla, G., Kroeger, J., Jonas, M., Gerloff, C., Hummel, F. C., Müller-Vahl, K., Schnitzler, A., Siebner, H. R., Orth, M. and Münchau, A. (2010), Interhemispheric motor networks are abnormal in patients with Gilles de la Tourette syndrome. Mov. Disord., 25: 2828–2837. doi: 10.1002/mds.23418
Potential conflict of interest: Nothing to report.
- Issue published online: 16 DEC 2010
- Article first published online: 19 OCT 2010
- Manuscript Accepted: 2 AUG 2010
- Manuscript Revised: 1 JUL 2010
- Manuscript Received: 10 APR 2010
- Gilles de la Tourette syndrome;
- transcranial magnetic stimulation;
- interhemispheric inhibition;
- corpus callosum;
- diffusion tensor imaging;
- fractional anisotropy
Brain imaging has shown altered corpus callosum (CC) morphology in patients with Gilles de la Tourette syndrome (GTS). Yet it is unclear whether these morphological changes are associated with altered interhemispheric interactions. Here, we combined transcranial magnetic stimulation (TMS) with diffusion tensor magnetic resonance imaging (DTI) to explore functional and structural interhemispheric connections between the left and right motor hand areas. We studied 14 unmedicated GTS patients without psychiatric comorbidity (2 women, mean age 35.5 years) and 15 healthy volunteers (3 women, mean age 35 years). Left-to-right and right-to-left interhemispheric inhibitions (IHIs) were measured in hand muscles with TMS. In 13 GTS patients and all healthy controls, we measured fractional anisotropy (FA) with DTI to examine the relation between functional measures of interhemispheric connectivity as derived by TMS and structural properties of the CC region that carries fibers interconnecting both motor cortices. In GTS patients, left-to-right IHI was weaker than right-to-left IHI. Left-to-right IHI in GTS patients was also reduced compared with healthy controls. Voxel-based morphometric analysis revealed that FA in the motor region of the CC did not differ between groups. However, there was a significant interaction between groups and the relation between regional FA and left-to-right IHI in the motor region of the CC. A negative linear relation between FA and left-to-right IHI was present in control subjects but not in patients. Our combined TMS-DTI approach demonstrates abnormal functional interhemispheric connectivity in GTS accompanied by an altered structure–function relationship in the motor CC. © 2010 Movement Disorder Society.