Finger tapping-related activation differences in treatment-naïve pediatric Tourette syndrome: a comparison of the preferred and nonpreferred hand

Authors

  • Veit Roessner,

    1. Department of Child and Adolescent Psychiatry, University Medical Center, Goettingen, Germany
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    • Both authors contributed equally to this work.

    • Present address: Department of Child and Adolescent Psychiatry, University Medical Center, Dresden, Germany

  • Matthias Wittfoth,

    1. Department of Neurology, Hannover Medical School, Hannover, Germany
    2. NeuroImaging and Clinical Applications (NICA), Hannover, Germany
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    • Both authors contributed equally to this work.

  • Julia M. August,

    1. Department of Child and Adolescent Psychiatry, University Medical Center, Goettingen, Germany
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  • Aribert Rothenberger,

    1. Department of Child and Adolescent Psychiatry, University Medical Center, Goettingen, Germany
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  • Jürgen Baudewig,

    1. MR-Research in Neurology and Psychiatry, University Medical Center, Goettingen, Germany
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    • Present address: Dahlem Institute for Neuroimaging of Emotion, Cluster of Excellence “Languages of Emotion”, Freie Universitaet Berlin, Germany

  • Peter Dechent

    1. MR-Research in Neurology and Psychiatry, University Medical Center, Goettingen, Germany
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  • Conflict of interest statement: Professor Rothenberger reports having received research and travel support, as well as an educational grant from Shire (German Research Society, Schwaabe). He is in the advisory board and speakers’ bureau of Lilly, Shire, Medice, and Novartis. He disclosed consulting fees from UCB/Shire, and Lilly. Professor Roessner reported honoraria for lectures from Lilly, Medice, Novartis, and Shire. He is in the advisory board of Lilly and Norvartis. Mrs. August, Dr. Wittfoth, Dr. Dechent, and Dr. Baudewig reported no financial relationships with commercial interests.

Abstract

Background:  Disturbances of motor circuitry are commonly encountered in Tourette syndrome (TS). The aim of this study was to investigate simple motor performance differences between boys with TS and healthy controls.

Methods:  We attempted to provide insight into motor network alterations by studying a group of treatment-naïve patients suffering from ‘pure’ TS, i.e., without comorbid symptomatology at an early stage of disease. We used functional MRI to compare activation patterns during right (preferred) and left (nonpreferred) index finger tapping between 22 TS boys (12.6 ± 1.7 years) and 22 age-matched healthy control boys.

Results:  Boys with TS revealed altered motor network recruitment for right (dominant) and left (nondominant) index finger tapping. Brain activation patterns in response to index finger tapping of the nonpreferred left hand reflected the most prominent differences, including activation decrease in contralateral sensorimotor cortex while recruiting premotor and prefrontal regions along with the left inferior parietal lobule to a greater extent.

Conclusions:  This study demonstrates clear functional differences of simple index finger tapping in early-stage TS. We suggest that this reflects the requirement for additional brain networks to keep a normal performance level during the actual task and adaptive mechanisms due to continuous tic suppression and performance in TS.

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