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Desai I, Kumar N, Goyal V. An Update on the Diagnosis and Management of Tic Disorders. Ann Indian Acad Neurol 2023; 26:858-870. [PMID: 38229610 PMCID: PMC10789408 DOI: 10.4103/aian.aian_724_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/14/2023] [Accepted: 10/06/2023] [Indexed: 01/18/2024] Open
Abstract
Tic disorders (TDs) are a group of common neuropsychiatric disorders of childhood and adolescence. TDs may impact the physical, emotional, and social well-being of the affected person. In this review, we present an update on the clinical manifestations, pathophysiology, diagnosis, and treatment of TDs. We searched the PubMed database for articles on tics and Tourette syndrome. More than 400 articles were reviewed, of which 141 are included in this review. TDs are more prevalent in children than in adults and in males than in females. It may result from a complex interaction between various genetic, environmental, and immunological factors. Dysregulation in the cortico-striato-pallido-thalamo-cortical network is the most plausible pathophysiology resulting in tics. TD is a clinical diagnosis based on clinical features and findings on neurological examination, especially the identification of tic phenomenology. In addition to tics, TD patients may have sensory features, including premonitory urge; enhanced and persistent sensitivity to non-noxious external or internal stimuli; and behavioral manifestations, including attention deficit hyperactivity disorders, obsessive-compulsive disorders, and autism spectrum disorders. Clinical findings of hyperkinetic movements that usually mimic tics have been compared and contrasted with those of TD. Patients with TD may not require specific treatment if tics are not distressing. Psychoeducation and supportive therapy can help reduce tics when combined with medication. Dispelling myths and promoting acceptance are important to improve patient outcomes. Using European, Canadian, and American guidelines, the treatment of TD, including behavioral therapy, medical therapy, and emerging/experimental therapy, has been discussed.
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Affiliation(s)
- Ishita Desai
- Department of Neurology, Teerthankar Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Niraj Kumar
- Department of Neurology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Vinay Goyal
- Department of Neurology, Institute of Neurosciences, Medanta, Gurugram, Haryana, India
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Rusheen AE, Rojas-Cabrera J, Goyal A, Shin H, Yuen J, Jang DP, Bennet KE, Blaha CD, Lee KH, Oh Y. Deep brain stimulation alleviates tics in Tourette syndrome via striatal dopamine transmission. Brain 2023; 146:4174-4190. [PMID: 37141283 PMCID: PMC10545518 DOI: 10.1093/brain/awad142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/24/2023] [Accepted: 04/14/2023] [Indexed: 05/05/2023] Open
Abstract
Tourette syndrome is a childhood-onset neuropsychiatric disorder characterized by intrusive motor and vocal tics that can lead to self-injury and deleterious mental health complications. While dysfunction in striatal dopamine neurotransmission has been proposed to underlie tic behaviour, evidence is scarce and inconclusive. Deep brain stimulation (DBS) of the thalamic centromedian parafascicular complex (CMPf), an approved surgical interventive treatment for medical refractory Tourette syndrome, may reduce tics by affecting striatal dopamine release. Here, we use electrophysiology, electrochemistry, optogenetics, pharmacological treatments and behavioural measurements to mechanistically examine how thalamic DBS modulates synaptic and tonic dopamine activity in the dorsomedial striatum. Previous studies demonstrated focal disruption of GABAergic transmission in the dorsolateral striatum of rats led to repetitive motor tics recapitulating the major symptom of Tourette syndrome. We employed this model under light anaesthesia and found CMPf DBS evoked synaptic dopamine release and elevated tonic dopamine levels via striatal cholinergic interneurons while concomitantly reducing motor tic behaviour. The improvement in tic behaviour was found to be mediated by D2 receptor activation as blocking this receptor prevented the therapeutic response. Our results demonstrate that release of striatal dopamine mediates the therapeutic effects of CMPf DBS and points to striatal dopamine dysfunction as a driver for motor tics in the pathoneurophysiology of Tourette syndrome.
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Affiliation(s)
- Aaron E Rusheen
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN 55902, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
| | - Juan Rojas-Cabrera
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN 55902, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
| | - Abhinav Goyal
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN 55902, USA
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
| | - Hojin Shin
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN 55902, USA
| | - Jason Yuen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
- IMPACT—the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, VIC 3216, Australia
| | - Dong-Pyo Jang
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, South Korea
| | - Keven E Bennet
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
- Division of Engineering, Mayo Clinic, Rochester, MN 55902, USA
| | - Charles D Blaha
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
| | - Kendall H Lee
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN 55902, USA
| | - Yoonbae Oh
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55902, USA
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN 55902, USA
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Fujimoto H, Hasegawa T. Reversible inhibition of the basal ganglia prolongs repetitive vocalization but only weakly affects sequencing at branch points in songbirds. Cereb Cortex Commun 2023; 4:tgad016. [PMID: 37675437 PMCID: PMC10477706 DOI: 10.1093/texcom/tgad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Although vocal signals, including languages and songbird syllables, are composed of a finite number of acoustic elements, diverse vocal sequences are composed of a combination of these elements, which are linked together by syntactic rules. However, the neural basis of syntactic vocalization generation remains poorly understood. Here, we report that inhibition using tetrodotoxin (TTX) and manipulations of gamma-aminobutyric acid (GABA) receptors within the basal ganglia Area X or lateral magnocellular nucleus of the anterior neostriatum (LMAN) alter and prolong repetitive vocalization in Bengalese finches (Lonchura striata var. domestica). These results suggest that repetitive vocalizations are modulated by the basal ganglia and not solely by higher motor cortical neurons. These data highlight the importance of neural circuits, including the basal ganglia, in the production of stereotyped repetitive vocalizations and demonstrate that dynamic disturbances within the basal ganglia circuitry can differentially affect the repetitive temporal features of songs.
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Affiliation(s)
- Hisataka Fujimoto
- Department of Anatomy, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Taku Hasegawa
- Laboratory for Imagination and Executive functions, RIKEN Center for Brain Science, 2-1 Hirosawa, Wakoshi, Saitama 351-0198, Japan
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Lamanna J, Ferro M, Spadini S, Racchetti G, Malgaroli A. The Dysfunctional Mechanisms Throwing Tics: Structural and Functional Changes in Tourette Syndrome. Behav Sci (Basel) 2023; 13:668. [PMID: 37622808 PMCID: PMC10451670 DOI: 10.3390/bs13080668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/31/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023] Open
Abstract
Tourette Syndrome (TS) is a high-incidence multifactorial neuropsychiatric disorder characterized by motor and vocal tics co-occurring with several diverse comorbidities, including obsessive-compulsive disorder and attention-deficit hyperactivity disorder. The origin of TS is multifactorial, with strong genetic, perinatal, and immunological influences. Although almost all neurotransmettitorial systems have been implicated in TS pathophysiology, a comprehensive neurophysiological model explaining the dynamics of expression and inhibition of tics is still lacking. The genesis and maintenance of motor and non-motor aspects of TS are thought to arise from functional and/or structural modifications of the basal ganglia and related circuitry. This complex wiring involves several cortical and subcortical structures whose concerted activity controls the selection of the most appropriate reflexive and habitual motor, cognitive and emotional actions. Importantly, striatal circuits exhibit bidirectional forms of synaptic plasticity that differ in many respects from hippocampal and neocortical plasticity, including sensitivity to metaplastic molecules such as dopamine. Here, we review the available evidence about structural and functional anomalies in neural circuits which have been found in TS patients. Finally, considering what is known in the field of striatal plasticity, we discuss the role of exuberant plasticity in TS, including the prospect of future pharmacological and neuromodulation avenues.
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Affiliation(s)
- Jacopo Lamanna
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, 20132 Milan, Italy
- Faculty of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Mattia Ferro
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Psychology, Sigmund Freud University, 20143 Milan, Italy
| | - Sara Spadini
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, 20132 Milan, Italy
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, 20132 Milan, Italy
| | - Gabriella Racchetti
- Division of Neuroscience, Scientific Institute Ospedale San Raffaele, 20132 Milan, Italy
| | - Antonio Malgaroli
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, 20132 Milan, Italy
- Faculty of Psychology, Vita-Salute San Raffaele University, 20132 Milan, Italy
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Colautti L, Magenes S, Rago S, Camerin S, Zanaboni Dina C, Antonietti A, Cancer A. Creative thinking in Tourette's syndrome: A comparative study of patients and healthy controls. J Clin Exp Neuropsychol 2023; 45:482-497. [PMID: 37667639 DOI: 10.1080/13803395.2023.2251644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Tourette's syndrome is a neurological disorder characterized by tics, that may interfere with patients' everyday life. Research suggested that creative thinking (namely, divergent and convergent thinking) could help patients cope with their symptoms, and therefore it can be a resource in non-pharmacological interventions. The present study aimed at investigating (i) possible differences in creative thinking between Tourette's syndrome patients and healthy controls and (ii) whether creative thinking can support patients in coping with their symptomatology. METHODS A group of 25 Tourette's syndrome patients and 25 matched healthy controls underwent an assessment of creative thinking, fluid intelligence, and depressive symptoms. Creative thinking was compared between patients and healthy controls after controlling for fluid intelligence and depressive symptoms. Moreover, the moderating role of divergent and convergent thinking on the subjective impact of tics was tested in a group of 30 patients. RESULTS Tourette's syndrome patients outperformed healthy controls in convergent thinking. Moreover, divergent thinking was found as a significant moderator of the relationship between tics severity and the subjective impact in Tourette's syndrome patients. CONCLUSIONS Findings highlighted the specific impact of convergent and divergent thinking on Tourette's syndrome patients. Considering the supportive role of creative thinking in Tourette's syndrome, our results confirm that higher levels of divergent thinking may reduce the tic-related discomfort. These findings suggest the potential positive implications of creative thinking in non-pharmacological interventions for Tourette's syndrome.
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Affiliation(s)
- Laura Colautti
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Sara Magenes
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Fraternità e Amicizia Società Cooperativa Sociale ONLUS, Milan, Italy
| | - Sabrina Rago
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Stefania Camerin
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Carlotta Zanaboni Dina
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Tourette Syndrome Centre, IRCCS, San Raffaele,Milan, Italy
| | | | - Alice Cancer
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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Zito GA, Hartmann A, Béranger B, Weber S, Aybek S, Faouzi J, Roze E, Vidailhet M, Worbe Y. Multivariate classification provides a neural signature of Tourette disorder. Psychol Med 2023; 53:2361-2369. [PMID: 35135638 DOI: 10.1017/s0033291721004232] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Tourette disorder (TD), hallmarks of which are motor and vocal tics, has been related to functional abnormalities in large-scale brain networks. Using a fully data driven approach in a prospective, case-control study, we tested the hypothesis that functional connectivity of these networks carries a neural signature of TD. Our aim was to investigate (i) the brain networks that distinguish adult patients with TD from controls, and (ii) the effects of antipsychotic medication on these networks. METHODS Using a multivariate analysis based on support vector machine (SVM), we developed a predictive model of resting state functional connectivity in 48 patients and 51 controls, and identified brain networks that were most affected by disease and pharmacological treatments. We also performed standard univariate analyses to identify differences in specific connections across groups. RESULTS SVM was able to identify TD with 67% accuracy (p = 0.004), based on the connectivity in widespread networks involving the striatum, fronto-parietal cortical areas and the cerebellum. Medicated and unmedicated patients were discriminated with 69% accuracy (p = 0.019), based on the connectivity among striatum, insular and cerebellar networks. Univariate approaches revealed differences in functional connectivity within the striatum in patients v. controls, and between the caudate and insular cortex in medicated v. unmedicated TD. CONCLUSIONS SVM was able to identify a neuronal network that distinguishes patients with TD from control, as well as medicated and unmedicated patients with TD, holding a promise to identify imaging-based biomarkers of TD for clinical use and evaluation of the effects of treatment.
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Affiliation(s)
- Giuseppe A Zito
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, Paris, France
- Support Centre for Advanced Neuroimaging (SCAN), University Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland
| | - Andreas Hartmann
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, Paris, France
- National Reference Center for Tourette Syndrome, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Benoît Béranger
- Center for NeuroImaging Research (CENIR), Paris Brain Institute, Sorbonne University, UPMC Univ Paris 06, Inserm U1127, CNRS UMR, 7225, Paris, France
| | - Samantha Weber
- Psychosomatics Unit of the Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland
| | - Selma Aybek
- Psychosomatics Unit of the Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, Bern CH-3010, Switzerland
| | - Johann Faouzi
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, ICM, Inria Paris, Aramis project-team, Paris, France
| | - Emmanuel Roze
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, Paris, France
| | - Marie Vidailhet
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, Paris, France
| | - Yulia Worbe
- Sorbonne University, Inserm U1127, CNRS UMR7225, UM75, Paris Brain Institute, Movement Investigation and Therapeutics Team, Paris, France
- National Reference Center for Tourette Syndrome, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Department of Neurophysiology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Codianni MG, Rubin JE. A spiking computational model for striatal cholinergic interneurons. Brain Struct Funct 2023; 228:589-611. [PMID: 36653544 DOI: 10.1007/s00429-022-02604-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 12/14/2022] [Indexed: 01/19/2023]
Abstract
Cholinergic interneurons in the striatum, also known as tonically active interneurons or TANs, are thought to have a strong effect on corticostriatal plasticity and on striatal activity and outputs, which in turn play a critical role in modulating downstream basal ganglia activity and movement. Striatal TANs can exhibit a variety of firing patterns and responses to synaptic inputs; furthermore, they have been found to display various surges and pauses in activity associated with sensory cues and reward delivery in learning as well as with motor tic production. To help explain the factors that contribute to TAN activity patterns and to provide a resource for future studies, we present a novel conductance-based computational model of a striatal TAN. We show that this model produces the various characteristic firing patterns observed in recordings of TANs. With a single baseline tuning associated with tonic firing, the model also captures a wide range of TAN behaviors found in previous experiments involving a variety of manipulations. In addition to demonstrating these results, we explain how various ionic currents in the model contribute to them. Finally, we use this model to explore the contributions of the acetylcholine released by TANs to the production of surges and pauses in TAN activity in response to strong excitatory inputs. These results provide predictions for future experimental testing that may help with efforts to advance our understanding of the role of TANs in reinforcement learning and in motor disorders such as Tourette's syndrome.
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Affiliation(s)
- Marcello G Codianni
- Department of Mathematics, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Jonathan E Rubin
- Department of Mathematics, University of Pittsburgh, Pittsburgh, PA, 15260, USA. .,Center for the Neural Basis of Cognition, Pittsburgh, PA, 15260, USA.
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Wang N, Wu X, Yang Q, Wang D, Wu Z, Wei Y, Cui J, Hong L, Xiong L, Qin D. Qinglong Zhidong Decoction Alleviated Tourette Syndrome in Mice via Modulating the Level of Neurotransmitters and the Composition of Gut Microbiota. Front Pharmacol 2022; 13:819872. [PMID: 35392572 PMCID: PMC8981146 DOI: 10.3389/fphar.2022.819872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/07/2022] [Indexed: 02/05/2023] Open
Abstract
Qinglong Zhidong Decoction (QLZDD), a traditional Chinese medicine (TCM) prescription, has been effectively used to alleviate Tourette syndrome (TS) in children. However, the therapeutic mechanism of QLZDD on TS has not been evaluated. The present study aims to elucidate the therapeutic effect and the possible therapeutic mechanism of QLZDD on TS in mouse model. A 3,3-iminodipropionitrile (IDPN, 350 mg/kg)-induced-TS mouse model was established. The mice were randomly divided into the control group, the model group, the haloperidol group (14 mg/kg), the low-, middle-, or high-QLZDD-dose groups (6.83 g/kg, 13.65 g/kg, 27.3 g/kg). QLZDD was administrated orally once a day for 4 weeks. The tic-like behavior was recorded weekly. Then, neurotransmitters and neurotransmitter receptors were analyzed by ELISA, immunohistochemistry (IHC), and quantitative reverse transcription PCR in striatum. Further, the alteration to intestinal flora was monitored by 16s rRNA sequencing, and the role of gut microbiota in the alleviation of TS by QLZDD was investigated. QLZDD ameliorated the tic-like behavior, and decreased the level of excitatory neurotransmitters such as Glu and DA and increased the level of the inhibitory neurotransmitter GABA significantly. Moreover, QLZDD significantly blocked the mRNA expression and the protein expression of D1R and D2R in the striatum, while activated the levels of DAT and GABAR. Interestingly, QLZDD mediated the composition of gut microbiota by increasing the abundance of Lactobacillus and Bacteroides but decreasing the abundance of Alloprevotella and Akkermansia. Taken together, QLZDD ameliorated the tic-like behavior in TS mouse, its mechanism of action may be associated with restoring the balance of gut microbiota and neurotransmitters. The study indicated a promising role of QLZDD in alleviating TS and a therapeutic strategy for fighting TS in clinical settings.
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Affiliation(s)
- Na Wang
- Yunnan University of Chinese Medicine, Kunming, China.,Huanghe S & T University, Zhengzhou, China.,Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinchen Wu
- Yunnan University of Chinese Medicine, Kunming, China
| | - Qi Yang
- Yunnan University of Chinese Medicine, Kunming, China
| | - Dingyue Wang
- Yunnan University of Chinese Medicine, Kunming, China
| | - Zhao Wu
- Yunnan University of Chinese Medicine, Kunming, China
| | - Yuanyuan Wei
- Yunnan University of Chinese Medicine, Kunming, China
| | - Jieqiong Cui
- Yunnan University of Chinese Medicine, Kunming, China
| | - Li Hong
- Yunnan University of Chinese Medicine, Kunming, China
| | - Lei Xiong
- Yunnan University of Chinese Medicine, Kunming, China
| | - Dongdong Qin
- Yunnan University of Chinese Medicine, Kunming, China
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He JL, Mikkelsen M, Huddleston DA, Crocetti D, Cecil KM, Singer HS, Edden RA, Gilbert DL, Mostofsky SH, Puts NA. Frequency and Intensity of Premonitory Urges-to-Tic in Tourette Syndrome Is Associated With Supplementary Motor Area GABA+ Levels. Mov Disord 2022; 37:563-573. [PMID: 34854494 PMCID: PMC9014425 DOI: 10.1002/mds.28868] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/05/2021] [Accepted: 10/26/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Individuals with Tourette syndrome (TS) often report that they express tics as a means of alleviating the experience of unpleasant sensations. These sensations are perceived as an urge to act and are referred to as premonitory urges. Premonitory urges have been the focus of recent efforts to develop interventions to reduce tic expression in those with TS. OBJECTIVE The aim of this study was to examine the contribution of brain γ-aminobutyric acid (GABA) and glutamate levels of the right primary sensorimotor cortex (SM1), supplementary motor area (SMA), and insular cortex (insula) to tic and urge severity in children with TS. METHODS Edited magnetic resonance spectroscopy was used to assess GABA+ (GABA + macromolecules) and Glx (glutamate + glutamine) of the right SM1, SMA, and insula in 68 children with TS (MAge = 10.59, SDAge = 1.33) and 41 typically developing control subjects (MAge = 10.26, SDAge = 2.21). We first compared GABA+ and Glx levels of these brain regions between groups. We then explored the association between regional GABA+ and Glx levels with urge and tic severity. RESULTS GABA+ and Glx of the right SM1, SMA, and insula were comparable between the children with TS and typically developing control subjects. In children with TS, lower levels of SMA GABA+ were associated with more severe and more frequent premonitory urges. Neither GABA+ nor Glx levels were associated with tic severity. CONCLUSIONS These results broadly support the role of GABAergic neurotransmission within the SMA in the experience of premonitory urges in children with TS. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jason L. He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom
| | - Mark Mikkelsen
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - David A. Huddleston
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Deana Crocetti
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Kim M. Cecil
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Harvey S. Singer
- Department of Neurology, Kennedy Krieger Institute, Baltimore, Maryland, USA,Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Richard A.E. Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,F. M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
| | - Donald L. Gilbert
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio, USA
| | - Stewart H. Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, Maryland, USA,Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nicolaas A.J. Puts
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, United Kingdom,MRC Centre for Neurodevelopmental Disorders, King’s College London, London, United Kingdom,Correspondence to: Dr. Nicolaas Puts, Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, 16 De Crespigny Park, London SE5 8AB, London, United Kingdom;
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10
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Bortolato M, Coffey BJ, Gabbay V, Scheggi S. Allopregnanolone: The missing link to explain the effects of stress on tic exacerbation? J Neuroendocrinol 2022; 34:e13022. [PMID: 34423500 PMCID: PMC8800948 DOI: 10.1111/jne.13022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 12/13/2022]
Abstract
The neurosteroid allopregnanolone (3α-hydroxy-5α-pregnan-20-one; AP) elicits pleiotropic effects in the central nervous system, ranging from neuroprotective and anti-inflammatory functions to the regulation of mood and emotional responses. Several lines of research show that the brain rapidly produces AP in response to acute stress to reduce the allostatic load and enhance coping. These effects not only are likely mediated by GABAA receptor activation but also result from the contributions of other mechanisms, such as the stimulation of membrane progesterone receptors. In keeping with this evidence, AP has been shown to exert rapid, potent antidepressant properties and has been recently approved for the therapy of moderate-to-severe postpartum depression. In addition to depression, emerging evidence points to the potential of AP as a therapy for other neuropsychiatric disorders, including anxiety, seizures, post-traumatic stress disorder and cognitive problems. Although this evidence has spurred interest in further therapeutic applications of AP, some investigations suggest that this neurosteroid may also be associated with adverse events in specific disorders. For example, our group has recently documented that AP increases tic-like manifestations in several animal models of tic disorders; furthermore, our results indicate that inhibiting AP synthesis and signalling reduces the exacerbation of tic severity associated with acute stress. Although the specific mechanisms of these effects remain partially elusive, our findings point to the possibility that the GABAergic activation by AP may also lead to disinhibitory effects, which could interfere with the ability of patients to suppress their tics. Future studies will be necessary to verify whether these mechanisms may apply to other externalising manifestations, such as impulse-control problems and manic symptoms.
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Affiliation(s)
- Marco Bortolato
- Department of Pharmacology and ToxicologyCollege of PharmacyUniversity of UtahSalt Lake CityUTUSA
- Research Consortium on NeuroEndocrine Causes of Tics (ReConNECT)
| | - Barbara J. Coffey
- Research Consortium on NeuroEndocrine Causes of Tics (ReConNECT)
- Department of Psychiatry and Behavioral ScienceMiller School of MedicineUniversity of MiamiMiamiFLUSA
| | - Vilma Gabbay
- Research Consortium on NeuroEndocrine Causes of Tics (ReConNECT)
- Department of Psychiatry and Behavioral SciencesAlbert Einstein College of MedicineBronxNYUSA
| | - Simona Scheggi
- Department of Molecular and Developmental MedicineSchool of MedicineUniversity of SienaSienaItaly
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11
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Clinical Practice Patterns in Tic Disorders Among Movement Disorder Society Members. Tremor Other Hyperkinet Mov (N Y) 2021; 11:43. [PMID: 34754602 PMCID: PMC8555622 DOI: 10.5334/tohm.656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/24/2021] [Indexed: 12/26/2022] Open
Abstract
Background Tic disorders belong to the broad spectrum of pediatric and adult movement disorders. The wide variability in clinical presentations, applied assessment tools, and treatments are poorly understood. Objectives To map practices and knowledge base of movement disorder clinicians concerning clinical features, pathophysiology, and treatment approaches in tic disorders. Methods A 33-item survey was developed by the Tic Disorders and Tourette syndrome Study Group members of the Movement Disorder Society. The survey was distributed to the complete society membership and included responses from 346 members, 314 of whom reported treating tic disorders. Results Approximately one third of survey respondents (35%) frequently evaluated patients with tics. The data revealed widespread use of existing guidelines (about 70%) and screening for comorbid disorders (>90%). The most common investigations used to rule out secondary causes of tics were imaging (92%), laboratory tests (66%) and neurophysiology (38%). Functional tics were the second most common tic etiology following primary tics. Only 27% of respondents reported confidence in knowledge about tic pathogenesis. Top rated interventions to treat tics were psychoeducation, cognitive behavioral intervention for tics (CBIT) and treatment for neuropsychiatric comorbidities. Antipsychotics were ranked as the most effective pharmacologic tic intervention. Conclusions The majority of movement disorders specialists do not frequently encounter tics. There was sparse knowledge about tic pathophysiology. Psychoeducation, CBIT, the treatment of neuropsychiatric comorbidities and use of antipsychotics emerged as the most common interventions to treat tics. These results provide insight into what will be needed to improve the diagnosis and treatment of tic disorders.
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12
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Gray matter abnormalities in Tourette Syndrome: a meta-analysis of voxel-based morphometry studies. Transl Psychiatry 2021; 11:287. [PMID: 33990537 PMCID: PMC8121885 DOI: 10.1038/s41398-021-01394-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 04/14/2021] [Accepted: 04/21/2021] [Indexed: 02/05/2023] Open
Abstract
Tourette syndrome (TS) is a neurobehavioral disorder for which the neurological mechanism has not been elucidated. Voxel-based morphometry (VBM) studies have revealed abnormalities in gray matter volume (GMV) in patients with TS; however, consistent results have not been obtained. The current study attempted to provide a voxel wise meta-analysis of gray matter changes using seed-based d mapping (SDM). We identified ten relevant studies that investigated gray matter alterations in TS patients and performed a meta-analysis using the SDM method to quantitatively estimate regional gray matter abnormalities. Next, we examined the relationships between GMV abnormalities and demographic and clinical characteristics. Our results demonstrated that TS patients had smaller GMV in the bilateral inferior frontal gyri and greater GMV in the cerebellum, right striatum (putamen), and bilateral thalami (pulvinar nucleus) than healthy controls. A meta-regression analysis did not identify correlations between GMV changes and demographic or clinical variables. This meta-analysis confirmed significant and consistent GMV changes in several brain regions of TS patients, primarily in the cortico-striato-thalamo-cortical network.
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13
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Vinner Harduf E, Matzner A, Belelovsky K, Bar-Gad I. Dissociation of tic generation from tic expression during the sleep-wake cycle. iScience 2021; 24:102380. [PMID: 33981969 PMCID: PMC8081921 DOI: 10.1016/j.isci.2021.102380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 10/26/2022] Open
Abstract
Motor tics, the hallmark of Tourette syndrome (TS), are modulated by different behavioral and environmental factors. A major modulating factor is the sleep-wake cycle in which tics are attenuated to a large extent during sleep. This study demonstrates a similar reduction in tic expression during sleep in an animal model of chronic tic disorders and investigates the underlying neural mechanism. We recorded the neuronal activity during spontaneous sleep-wake cycles throughout continuous GABAA antagonist infusion into the striatum. Analysis of video streams and concurrent kinematic assessments indicated tic reduction during sleep in both frequency and intensity. Extracellular recordings in the striatum revealed a state-dependent dissociation between motor tic expression and their macro-level neural correlates ("LFP spikes") during the sleep-wake cycle. Local field potential (LFP) spikes, which are highly correlated with tic expression during wakefulness, persisted during tic-free sleep and did not change their properties despite the reduced behavioral expression. Local, micro-level, activity near the infusion site was time-locked to the LFP spikes during wakefulness, but this locking decreased significantly during sleep. These results suggest that whereas LFP spikes encode motor tic generation and feasibility, the behavioral expression of tics requires local striatal neural activity entrained to the LFP spikes, leading to the propagation of the activity to downstream targets and consequently their motor expression. These findings point to a possible mechanism for the modulation of tic expression in patients with TS during sleep and potentially during other behavioral states.
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Affiliation(s)
- Esther Vinner Harduf
- The Leslie & Susan Goldschmied (Gonda) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Ayala Matzner
- The Leslie & Susan Goldschmied (Gonda) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Katya Belelovsky
- The Leslie & Susan Goldschmied (Gonda) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
| | - Izhar Bar-Gad
- The Leslie & Susan Goldschmied (Gonda) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan 52900, Israel
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14
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Poppi LA, Ho-Nguyen KT, Shi A, Daut CT, Tischfield MA. Recurrent Implication of Striatal Cholinergic Interneurons in a Range of Neurodevelopmental, Neurodegenerative, and Neuropsychiatric Disorders. Cells 2021; 10:907. [PMID: 33920757 PMCID: PMC8071147 DOI: 10.3390/cells10040907] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/03/2021] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
Cholinergic interneurons are "gatekeepers" for striatal circuitry and play pivotal roles in attention, goal-directed actions, habit formation, and behavioral flexibility. Accordingly, perturbations to striatal cholinergic interneurons have been associated with many neurodevelopmental, neurodegenerative, and neuropsychiatric disorders. The role of acetylcholine in many of these disorders is well known, but the use of drugs targeting cholinergic systems fell out of favor due to adverse side effects and the introduction of other broadly acting compounds. However, in response to recent findings, re-examining the mechanisms of cholinergic interneuron dysfunction may reveal key insights into underlying pathogeneses. Here, we provide an update on striatal cholinergic interneuron function, connectivity, and their putative involvement in several disorders. In doing so, we aim to spotlight recurring physiological themes, circuits, and mechanisms that can be investigated in future studies using new tools and approaches.
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Affiliation(s)
- Lauren A. Poppi
- Human Genetics Institute of New Jersey, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA;
- Child Health Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA; (K.T.H.-N.); (A.S.); (C.T.D.)
- Tourette International Collaborative (TIC) Genetics Study, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Khue Tu Ho-Nguyen
- Child Health Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA; (K.T.H.-N.); (A.S.); (C.T.D.)
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Anna Shi
- Child Health Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA; (K.T.H.-N.); (A.S.); (C.T.D.)
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Cynthia T. Daut
- Child Health Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA; (K.T.H.-N.); (A.S.); (C.T.D.)
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
| | - Max A. Tischfield
- Child Health Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA; (K.T.H.-N.); (A.S.); (C.T.D.)
- Tourette International Collaborative (TIC) Genetics Study, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
- Department of Cell Biology and Neuroscience, Rutgers, The State University of New Jersey, Piscataway, NJ 08854, USA
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15
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Peixoto RT, Chantranupong L, Hakim R, Levasseur J, Wang W, Merchant T, Gorman K, Budnik B, Sabatini BL. Abnormal Striatal Development Underlies the Early Onset of Behavioral Deficits in Shank3B -/- Mice. Cell Rep 2020; 29:2016-2027.e4. [PMID: 31722214 PMCID: PMC6889826 DOI: 10.1016/j.celrep.2019.10.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 07/12/2019] [Accepted: 10/04/2019] [Indexed: 11/17/2022] Open
Abstract
The neural substrates and pathophysiological mechanisms underlying the onset of cognitive and motor deficits in autism spectrum disorders (ASDs) remain unclear. Mutations in ASD-associated SHANK3 in mice (Shank3B−/−) result in the accelerated maturation of corticostriatal circuits during the second and third postnatal weeks. Here, we show that during this period, there is extensive remodeling of the striatal synaptic proteome and a developmental switch in glutamatergic synaptic plasticity induced by cortical hyperactivity in striatal spiny projection neurons (SPNs). Behavioral abnormalities in Shank3B−/− mice emerge during this stage and are ameliorated by normalizing excitatory synapse connectivity in medial striatal regions by the downregulation of PKA activity. These results suggest that the abnormal postnatal development of striatal circuits is implicated in the onset of behavioral deficits in Shank3B−/− mice and that modulation of postsynaptic PKA activity can be used to regulate corticostriatal drive in developing SPNs of mouse models of ASDs and other neurodevelopmental disorders. Peixoto et al. show that the onset of behavioral deficits in Shank3B−/− mice occurs during early postnatal development and that these can be ameliorated by reducing the glutamatergic synaptic drive in medial regions of the striatum by the downregulation of PKA activity.
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Affiliation(s)
- Rui Tiago Peixoto
- Department of Psychiatry, University of Pittsburgh, 450 Technology Dr, Pittsburgh, PA 15219, USA; Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, 220 Longwood Ave., Boston, MA 02115, USA.
| | - Lynne Chantranupong
- Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, 220 Longwood Ave., Boston, MA 02115, USA
| | - Richard Hakim
- Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, 220 Longwood Ave., Boston, MA 02115, USA
| | - James Levasseur
- Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, 220 Longwood Ave., Boston, MA 02115, USA
| | - Wengang Wang
- Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, 220 Longwood Ave., Boston, MA 02115, USA
| | - Tasha Merchant
- Department of Psychiatry, University of Pittsburgh, 450 Technology Dr, Pittsburgh, PA 15219, USA; Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, 220 Longwood Ave., Boston, MA 02115, USA
| | - Kelly Gorman
- Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, 220 Longwood Ave., Boston, MA 02115, USA
| | - Bogdan Budnik
- Mass Spectrometry and Proteomic Laboratory, FAS Division of Science, Harvard University, 52 Oxford Street, Cambridge, MA 02138, USA
| | - Bernardo Luis Sabatini
- Howard Hughes Medical Institute, Department of Neurobiology, Harvard Medical School, 220 Longwood Ave., Boston, MA 02115, USA
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16
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Abstract
Background:Tics, defined as quick, rapid, sudden, recurrent, non-rhythmic motor movements or vocalizations are required components of Tourette Syndrome (TS) - a complex disorder characterized by the presence of fluctuating, chronic motor and vocal tics, and the presence of co-existing neuropsychological problems. Despite many advances, the underlying pathophysiology of tics/TS remains unknown.Objective:To address a variety of controversies surrounding the pathophysiology of TS. More specifically: 1) the configuration of circuits likely involved; 2) the role of inhibitory influences on motor control; 3) the classification of tics as either goal-directed or habitual behaviors; 4) the potential anatomical site of origin, e.g. cortex, striatum, thalamus, cerebellum, or other(s); and 5) the role of specific neurotransmitters (dopamine, glutamate, GABA, and others) as possible mechanisms (Abstract figure).Methods:Existing evidence from current clinical, basic science, and animal model studies are reviewed to provide: 1) an expanded understanding of individual components and the complex integration of the Cortico-Basal Ganglia-Thalamo-Cortical (CBGTC) circuit - the pathway involved with motor control; and 2) scientific data directly addressing each of the aforementioned controversies regarding pathways, inhibition, classification, anatomy, and neurotransmitters.Conclusion:Until a definitive pathophysiological mechanism is identified, one functional approach is to consider that a disruption anywhere within CBGTC circuitry, or a brain region inputting to the motor circuit, can lead to an aberrant message arriving at the primary motor cortex and enabling a tic. Pharmacologic modulation may be therapeutically beneficial, even though it might not be directed toward the primary abnormality.
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Affiliation(s)
- Harvey S. Singer
- Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, United States
| | - Farhan Augustine
- Department of Neurology, Johns Hopkins Hospital, Baltimore, MD, United States
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17
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Kurvits L, Martino D, Ganos C. Clinical Features That Evoke the Concept of Disinhibition in Tourette Syndrome. Front Psychiatry 2020; 11:21. [PMID: 32161555 PMCID: PMC7053490 DOI: 10.3389/fpsyt.2020.00021] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 01/09/2020] [Indexed: 01/14/2023] Open
Abstract
The capacity to efficiently control motor output, by either refraining from prepotent actions or disengaging from ongoing motor behaviors, is necessary for our ability to thrive in a stimulus-rich and socially complex environment. Failure to engage in successful inhibitory motor control could lead to aberrant behaviors typified by an excess of motor performance. In tic disorders and Tourette syndrome (TS) - the most common tic disorder encountered in clinics - surplus motor output is rarely the only relevant clinical sign. A range of abnormal behaviors is often encountered which are historically viewed as "disinhibition phenomena". Here, we present the different clinical features of TS from distinct categorical domains (motor, sensory, complex behavioral) that evoke the concept of disinhibition and discuss their associations. We also present evidence for their consideration as phenomena of inhibitory dysfunction and provide an overview of studies on TS pathophysiology which support this view. We then critically dissect the concept of disinhibition in TS and illuminate other salient aspects, which should be considered in a unitary pathophysiological approach. We briefly touch upon the dangers of oversimplification and emphasize the necessity of conceptual diversity in the scientific exploration of TS, from disinhibition and beyond.
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Affiliation(s)
- Lille Kurvits
- Department of Neurology, Charité University Hospital, Berlin, Germany
| | - Davide Martino
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Christos Ganos
- Department of Neurology, Charité University Hospital, Berlin, Germany
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18
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Herrmann K, Sprenger A, Baumung L, Alvarez-Fischer D, Münchau A, Brandt V. Help or hurt? How attention modulates tics under different conditions. Cortex 2019; 120:471-482. [DOI: 10.1016/j.cortex.2019.06.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/16/2019] [Accepted: 06/11/2019] [Indexed: 01/10/2023]
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19
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Mainka T, Balint B, Gövert F, Kurvits L, van Riesen C, Kühn AA, Tijssen MAJ, Lees AJ, Müller-Vahl K, Bhatia KP, Ganos C. The spectrum of involuntary vocalizations in humans: A video atlas. Mov Disord 2019; 34:1774-1791. [PMID: 31651053 DOI: 10.1002/mds.27855] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/22/2019] [Accepted: 08/21/2019] [Indexed: 12/11/2022] Open
Abstract
In clinical practice, involuntary vocalizing behaviors are typically associated with Tourette syndrome and other tic disorders. However, they may also be encountered throughout the entire tenor of neuropsychiatry, movement disorders, and neurodevelopmental syndromes. Importantly, involuntary vocalizing behaviors may often constitute a predominant clinical sign, and, therefore, their early recognition and appropriate classification are necessary to guide diagnosis and treatment. Clinical literature and video-documented cases on the topic are surprisingly scarce. Here, we pooled data from 5 expert centers of movement disorders, with instructive video material to cover the entire range of involuntary vocalizations in humans. Medical literature was also reviewed to document the range of possible etiologies associated with the different types of vocalizing behaviors and to explore treatment options. We propose a phenomenological classification of involuntary vocalizations within different categorical domains, including (1) tics and tic-like vocalizations, (2) vocalizations as part of stereotypies, (3) vocalizations as part of dystonia or chorea, (4) continuous vocalizing behaviors such as groaning or grunting, (5) pathological laughter and crying, (6) vocalizations resembling physiological reflexes, and (7) other vocalizations, for example, those associated with exaggerated startle responses, as part of epilepsy and sleep-related phenomena. We provide comprehensive lists of their associated etiologies, including neurodevelopmental, neurodegenerative, neuroimmunological, and structural causes and clinical clues. We then expand on the pathophysiology of the different vocalizing behaviors and comment on available treatment options. Finally, we present an algorithmic approach that covers the wide range of involuntary vocalizations in humans, with the ultimate goal of improving diagnostic accuracy and guiding appropriate treatment. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Tina Mainka
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK.,Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Felix Gövert
- Department of Neurology, University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany
| | - Lille Kurvits
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Christoph van Riesen
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany.,Department of Neurology, University Medicine Göttingen, Göttingen, Germany
| | - Andrea A Kühn
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
| | - Marina A J Tijssen
- Department of Neurology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, UCL, Institute of Neurology, London, UK
| | - Kirsten Müller-Vahl
- Clinic of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, Queen Square Institute of Neurology, University College London, London, UK
| | - Christos Ganos
- Department of Neurology, Charité University Medicine Berlin, Berlin, Germany
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20
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Vissani M, Cordella R, Micera S, Eleopra R, Romito LM, Mazzoni A. Spatio-temporal structure of single neuron subthalamic activity identifies DBS target for anesthetized Tourette syndrome patients. J Neural Eng 2019; 16:066011. [PMID: 31370042 DOI: 10.1088/1741-2552/ab37b4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Deep brain stimulation (DBS) of basal ganglia effectively tackles motor symptoms of movement disorders such as Tourette syndrome (TS). The precise location of target stimulation site determines the range of clinical outcome in DBS patients, and the occurrence of side-effects of DBS. DBS implant procedures currently localize stimulation target relying on a combination of pre-surgical imaging, standardized brain atlases and on-the-spot clinical tests. Here we show that temporal structure of single unit activity in subthalamic nucleus (STN) of patients affected by pure TS can contribute to identify the optimal target location of DBS. APPROACH Neural activity was recorded at different depths within STN with microelectrodes during DBS implant surgery. Depth specific neural features were extracted and correlated with the optimal depth for tic control. MAIN RESULTS We describe for the first time temporal spike patterns of single neurons from sensorimotor STN of anesthetized TS patients. A large fraction of units (31.2%) displayed intense bursting in the delta band (<4 Hz). The highest firing irregularity and hence the higher density of bursting units (42%) were found at the optimal spot for tic control. Discharge patterns irregularity and dominant oscillations frequency (but not firing rate) carried significant information on optimal target. SIGNIFICANCE We found single unit activity features in the STN of TS patients reliably associated to optimal DBS target site for tic control. In future works measures of firing irregularity could be integrated with current target localization methods leading to a more effective and safer DBS for TS patients.
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Affiliation(s)
- Matteo Vissani
- The Biorobotics Institute, Scuola Superiore Sant'Anna, 56025 Pisa, Italy
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21
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Lin L, Yu L, Xiang H, Hu X, Yuan X, Zhu H, Li H, Zhang H, Hou T, Cao J, Wu S, Su W, Li M. Effects of Acupuncture on Behavioral Stereotypies and Brain Dopamine System in Mice as a Model of Tourette Syndrome. Front Behav Neurosci 2019; 13:239. [PMID: 31680895 PMCID: PMC6803462 DOI: 10.3389/fnbeh.2019.00239] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/23/2019] [Indexed: 12/23/2022] Open
Abstract
Tourette syndrome (TS), a developmental neurobehavioral disorder, is characterized by involuntary behavioral stereotypies. Clinical studies have confirmed the positive effect of acupuncture on treating TS, but the underlying mechanisms are not fully understood. In the present study, we used behavioral tests, Western blotting, double-immunofluorescence labeling, and fluorescence spectrophotometry to investigate whether acupuncture performed at acupoints "Baihui" (GV20) and "Yintang" (GV29) affected behavioral stereotypies and regulated the dopamine (DA) system in three different brain regions in Balb/c mice injected with 3,3'-iminodipropionitrile (IDPN) as a model for TS. We found that acupuncture alleviated behavioral stereotypies, down-regulated the expression of D1R and D2R in the striatum (STR) and substantia nigra pars compacta (SNpc), and decreased the concentration of DA in the STR, SNpc, and prefrontal cortex (PFC) as well. Moreover, acupuncture reduced the expression of tyrosine hydroxylase (TH) in the SNpc. Conclusively, acupuncture ameliorated behavioral stereotypies by regulating the DA system in the STR, SNpc, and PFC. Our findings provide novel evidence for the therapeutic effect of acupuncture on TS.
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Affiliation(s)
- Lixue Lin
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lingling Yu
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongchun Xiang
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xuefei Hu
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaocui Yuan
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - He Zhu
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongping Li
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Zhang
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tengfei Hou
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jie Cao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuang Wu
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen Su
- Department of Pediatrics, Wuhan No. 1 Hospital, Wuhan, China
| | - Man Li
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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22
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Ganos C, Martino D, Espay AJ, Lang AE, Bhatia KP, Edwards MJ. Tics and functional tic-like movements: Can we tell them apart? Neurology 2019; 93:750-758. [PMID: 31551261 DOI: 10.1212/wnl.0000000000008372] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/31/2019] [Indexed: 11/15/2022] Open
Abstract
Within the broad spectrum of movement disorders, tics and functional tic-like movements belong to a particular clinical category. Both types of movements are within the range of normal movement kinematics and muscle synergies, but appear repetitive and without appropriate context embedment. Historically, there have been many attempts to separate the 2 types of movements, but because of their phenomenological overlap, clinical distinction may be prone to error, and misdiagnoses may often occur. Most importantly, the 2 types of movement may coexist. Here, we review the available literature on the 2 types of motor phenomena and demonstrate some of the difficulties in distinguishing tics from functional tic-like movements on clinical grounds. We also highlight similarities and differences in pathophysiologic characteristics, documenting the significance of action monitoring, attentional allocation, and behavioral reinforcement in both types of movements, as well as in their risk factors. We discuss the overlap of current behavioral treatments for tics and functional tic-like movements and emphasize implications of diagnostic mislabeling. Such implications include the need to tailor behavioral treatment approaches to individual phenomenological profiles and guiding decision making for severe patients requiring invasive interventions, such as deep brain stimulation. A deeper insight from clinicians with respect to persisting challenges in classifying and differentiating these motor phenomena could accelerate the development of reliable clinical and physiologic markers (i.e., next generation phenotyping) and a neurobiology-driven therapeutic approach for these motor phenomena.
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Affiliation(s)
- Christos Ganos
- From the Department of Neurology (C.G.), Charité University Medicine Berlin, Germany; Department of Clinical Neurosciences (D.M.), Cumming School of Medicine, University of Calgary and Hotchkiss Brain Institute, AB, Canada; Department of Neurology (A.J.E.), James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, OH; Division of Neurology (A.E.L.), Edmond J. Safra Program in Parkinson's Disease Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, University of Toronto, ON, Canada; Department of Clinical and Movement Neurosciences (K.P.B.), Queen Square Institute of Neurology, University College London; and Neurosciences Research Centre (M.E.), Molecular and Clinical Sciences Institute, St George's University of London.
| | - Davide Martino
- From the Department of Neurology (C.G.), Charité University Medicine Berlin, Germany; Department of Clinical Neurosciences (D.M.), Cumming School of Medicine, University of Calgary and Hotchkiss Brain Institute, AB, Canada; Department of Neurology (A.J.E.), James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, OH; Division of Neurology (A.E.L.), Edmond J. Safra Program in Parkinson's Disease Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, University of Toronto, ON, Canada; Department of Clinical and Movement Neurosciences (K.P.B.), Queen Square Institute of Neurology, University College London; and Neurosciences Research Centre (M.E.), Molecular and Clinical Sciences Institute, St George's University of London
| | - Alberto J Espay
- From the Department of Neurology (C.G.), Charité University Medicine Berlin, Germany; Department of Clinical Neurosciences (D.M.), Cumming School of Medicine, University of Calgary and Hotchkiss Brain Institute, AB, Canada; Department of Neurology (A.J.E.), James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, OH; Division of Neurology (A.E.L.), Edmond J. Safra Program in Parkinson's Disease Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, University of Toronto, ON, Canada; Department of Clinical and Movement Neurosciences (K.P.B.), Queen Square Institute of Neurology, University College London; and Neurosciences Research Centre (M.E.), Molecular and Clinical Sciences Institute, St George's University of London
| | - Anthony E Lang
- From the Department of Neurology (C.G.), Charité University Medicine Berlin, Germany; Department of Clinical Neurosciences (D.M.), Cumming School of Medicine, University of Calgary and Hotchkiss Brain Institute, AB, Canada; Department of Neurology (A.J.E.), James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, OH; Division of Neurology (A.E.L.), Edmond J. Safra Program in Parkinson's Disease Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, University of Toronto, ON, Canada; Department of Clinical and Movement Neurosciences (K.P.B.), Queen Square Institute of Neurology, University College London; and Neurosciences Research Centre (M.E.), Molecular and Clinical Sciences Institute, St George's University of London
| | - Kailash P Bhatia
- From the Department of Neurology (C.G.), Charité University Medicine Berlin, Germany; Department of Clinical Neurosciences (D.M.), Cumming School of Medicine, University of Calgary and Hotchkiss Brain Institute, AB, Canada; Department of Neurology (A.J.E.), James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, OH; Division of Neurology (A.E.L.), Edmond J. Safra Program in Parkinson's Disease Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, University of Toronto, ON, Canada; Department of Clinical and Movement Neurosciences (K.P.B.), Queen Square Institute of Neurology, University College London; and Neurosciences Research Centre (M.E.), Molecular and Clinical Sciences Institute, St George's University of London
| | - Mark J Edwards
- From the Department of Neurology (C.G.), Charité University Medicine Berlin, Germany; Department of Clinical Neurosciences (D.M.), Cumming School of Medicine, University of Calgary and Hotchkiss Brain Institute, AB, Canada; Department of Neurology (A.J.E.), James J. and Joan A. Gardner Family Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, OH; Division of Neurology (A.E.L.), Edmond J. Safra Program in Parkinson's Disease Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital-UHN, University of Toronto, ON, Canada; Department of Clinical and Movement Neurosciences (K.P.B.), Queen Square Institute of Neurology, University College London; and Neurosciences Research Centre (M.E.), Molecular and Clinical Sciences Institute, St George's University of London
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Disinhibition of the Nucleus Accumbens Leads to Macro-Scale Hyperactivity Consisting of Micro-Scale Behavioral Segments Encoded by Striatal Activity. J Neurosci 2019; 39:5897-5909. [PMID: 31126998 DOI: 10.1523/jneurosci.3120-18.2019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 12/14/2022] Open
Abstract
The striatum comprises of multiple functional territories involved with multilevel control of behavior. Disinhibition of different functional territories leads to territory-specific hyperkinetic and hyperbehavioral symptoms. The ventromedial striatum, including the nucleus accumbens (NAc) core, is typically associated with limbic input but was historically linked to high-level motor control. In this study, performed in female Long-Evans rats, we show that the NAc core directly controls motor behavior on multiple timescales. On the macro-scale, following NAc disinhibition, the animals manifested prolonged hyperactivity, expressed as excessive normal behavior, whereas on the micro-scale multiple behavior transitions occurred, generating short movement segments. The underlying striatal network displayed population-based local field potential transient deflections (LFP spikes) whose rate determined the magnitude of the hyperactivity and whose timing corresponded to unitary behavioral transition events. Individual striatal neurons preserved normal baseline activity and network interactions following the disinhibition, maintaining the normal encoding of behavioral primitives and forming a sparse link between the LFP spikes and single neuron activity. Disinhibition of this classically limbic territory leads to profound motor changes resembling hyperactivity and attention deficit. These behavioral and neuronal results highlight the direct interplay on multiple timescales between different striatal territories during normal and pathological conditions.SIGNIFICANCE STATEMENT The nucleus accumbens (NAc) is a key part of the striatal limbic territory. In the current study we show that this classically limbic area directly controls motor behavior on multiple timescales. Focal disinhibition of the NAc core in freely behaving rats led to macro-scale hyperactivity and micro-scale behavioral transitions, symptoms typically associated with attention deficit hyperactivity disorder. The behavioral changes were encoded by the striatal LFP signal and single-unit spiking activity in line with the neuronal changes observed during tic expression following disinhibition of the striatal motor territory. These results point to the need to extend the existing parallel functional pathway concept of basal ganglia function to include the study of limbic-motor cross-territory interactions in both health and disease.
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Abstract
Novel pharmacological treatments are needed for Tourette syndrome. Our goal was to examine the current evidence base and biological rationale for the use of cannabis-derived medications or medications that act on the cannabinoid system in Tourette syndrome. We conducted a comprehensive literature search of PubMed for randomized controlled trials or clinical trials of cannabis-derived medications in Tourette syndrome. Data regarding the population, intervention, safety profile, and outcomes for each trial were extracted and reported and the evidence supporting use of individual cannabis-derived medications was critiqued. There is a strong biological rationale regarding how cannabis-derived medications could affect tic severity. Anecdotal case reports and series have noted that many patients report that their tics improve after using cannabis. However, only two small randomized, placebo-controlled trials of Δ9-tetrahydrocannabinol have been published; these suggested possible benefits of cannabis-derived agents for the treatment of tics. Trials examining other agents active on the cannabinoid system for tic disorders are currently ongoing. Cannabinoid-based treatments are a promising avenue of new research for medications that may help the Tourette syndrome population. However, given the limited research available, the overall efficacy and safety of cannabinoid-based treatments is largely unknown. Further trials are needed to examine dosing, active ingredients, and optimal mode of administration of cannabis-derived compounds, assuming initial trials suggest efficacy. Clinical use for refractory patients should at the very least be restricted to adult populations, given the uncertain efficacy and risk of developmental adverse effects that cannabinoids may have in children. Even in adult populations, cannabis-derived medications are associated with significant issues such as the effects they have on driving safety and the fact that they cause positive urine drug screens that can affect employment.
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Affiliation(s)
- Bekir B Artukoglu
- Yale University, Yale Child Study Center, PO Box 207900, New Haven, CT, 06520, USA.
| | - Michael H Bloch
- Department of Psychiatry, Yale University, Yale Child Study Center, New Haven, CT, USA
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25
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Pittenger C. The histidine decarboxylase model of tic pathophysiology: a new focus on the histamine H 3 receptor. Br J Pharmacol 2019; 177:570-579. [PMID: 30714121 DOI: 10.1111/bph.14606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/12/2018] [Accepted: 01/07/2019] [Indexed: 12/16/2022] Open
Abstract
Histamine dysregulation was implicated as a rare cause of Tourette syndrome and other tic disorders a decade ago by a landmark genetic study in a high density family pedigree, which implicated a hypomorphic mutation in the histidine decarboxylase (Hdc) gene as a rare but high penetrance genetic cause. Studies in Hdc knockout (KO) mice have confirmed that this mutation causes tic-relevant behavioural and neurochemical abnormalities that parallel what is seen in patients and thus validate the KO as a potentially informative model of tic pathophysiology. Recent studies have focused on the potential role of the histamine H3 receptor in this model, and by association in tic disorders and related neuropsychiatric conditions. The H3 receptor is up-regulated in the striatum in Hdc KO mice. As the H3 receptor has constitutive activity in the absence of ligand, this receptor up-regulation may have significant cellular effects despite the absence of neurotransmitter histamine in these mice. Activation in vivo of H3 receptors in wild type mice regulates signalling in striatal medium spiny neurons (MSNs) that interacts non-linearly with dopamine receptor signalling. Baseline signalling alterations in MSNs in Hdc KO mice resemble those seen after H3 receptor agonist treatment in wild type animals. H3 receptor agonist treatment in the KOs further accentuates most of these signalling abnormalities and produces behavioural stereotypy. Together, these data suggest the intriguing hypothesis that constitutive signalling by up-regulated H3 receptors explains many of the molecular and behavioural abnormalities seen in these animals. LINKED ARTICLES: This article is part of a themed section on New Uses for 21st Century. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.3/issuetoc.
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26
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Tics and stereotypies: A comparative clinical review. Parkinsonism Relat Disord 2019; 59:117-124. [DOI: 10.1016/j.parkreldis.2019.02.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/28/2018] [Accepted: 02/03/2019] [Indexed: 01/07/2023]
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27
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Augustine F, Singer HS. Merging the Pathophysiology and Pharmacotherapy of Tics. Tremor Other Hyperkinet Mov (N Y) 2019; 8:595. [PMID: 30643668 PMCID: PMC6329776 DOI: 10.7916/d8h14jtx] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/28/2018] [Indexed: 12/14/2022] Open
Abstract
Background Anatomically, cortical-basal ganglia-thalamo-cortical (CBGTC) circuits have an essential role in the expression of tics. At the biochemical level, the proper conveyance of messages through these circuits requires several functionally integrated neurotransmitter systems. In this manuscript, evidence supporting proposed pathophysiological abnormalities, both anatomical and chemical is reviewed. In addition, the results of standard and emerging tic-suppressing therapies affecting nine separate neurotransmitter systems are discussed. The goal of this review is to integrate our current understanding of the pathophysiology of Tourette syndrome (TS) with present and proposed pharmacotherapies for tic suppression. Methods For this manuscript, literature searches were conducted for both current basic science and clinical information in PubMed, Google-Scholar, and other scholarly journals to September 2018. Results The precise primary site of abnormality for tics remains undetermined. Although many pathophysiologic hypotheses favor a specific abnormality of the cortex, striatum, or globus pallidus, others recognize essential influences from regions such as the thalamus, cerebellum, brainstem, and ventral striatum. Some prefer an alteration within direct and indirect pathways, whereas others believe this fails to recognize the multiple interactions within and between CBGTC circuits. Although research and clinical evidence supports involvement of the dopaminergic system, additional data emphasizes the potential roles for several other neurotransmitter systems. Discussion A greater understanding of the primary neurochemical defect in TS would be extremely valuable for the development of new tic-suppressing therapies. Nevertheless, recognizing the varied and complex interactions that exist in a multi-neurotransmitter system, successful therapy may not require direct targeting of the primary abnormality.
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Affiliation(s)
- Farhan Augustine
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Harvey S. Singer
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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28
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Li HH, Xu ZD, Wang B, Feng JY, Dong HY, Jia FY. Clinical improvement following vitamin D3 supplementation in children with chronic tic disorders. Neuropsychiatr Dis Treat 2019; 15:2443-2450. [PMID: 31933522 PMCID: PMC6716592 DOI: 10.2147/ndt.s212322] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/12/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Vitamin D deficiency has been found in children with chronic tic disorders (CTDs). Our previous data showed that serum 25-hydroxyvitamin D [25(OH)D] level in children with CTDs was lower than that of the healthy controls and lower serum 25(OH)D level was associated with increased severity of the tic disorder. Thus, we intend to further verify this phenomenon and examine the effect of vitamin D3 on CTDs. PATIENTS AND METHODS In total, 120 children with CTDs and 140 normal controls were enrolled in this study, with 36/120 of those in the CTD group receiving vitamin D3 treatment for 3 months. The Yale Global Tic Severity Scale (YGTSS) and Clinical Global Impression of Severity of Illness (CGI-SI) were, respectively, used to evaluate the tic severity. High-performance liquid chromatography and tandem mass spectrometry were used to measure serum 25(OH)D level. RESULTS Those children with CTDs exhibited significantly lower 25(OH)D levels than did healthy controls, and these reduced 25(OH)D levels were linked to increasing severity of tic symptoms. After treatment with supplemental vitamin D3, serum 25(OH)D level and scores of YGTSS total, motor tics, phonic tics, total tic, impairment, and CGI-SI improved significantly in children with CTDs without any adverse reactions. CONCLUSION Supplementation vitamin D3, given its low cost and excellent safety, may be an effective means of improving symptoms in certain children with CTDs.
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Affiliation(s)
- Hong-Hua Li
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People's Republic of China
| | - Zhi-Da Xu
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People's Republic of China.,Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bing Wang
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People's Republic of China
| | - Jun-Yan Feng
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People's Republic of China
| | - Han-Yu Dong
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People's Republic of China
| | - Fei-Yong Jia
- Department of Developmental and Behavioral Pediatrics, The First Hospital of Jilin University, Changchun, Jilin 130021, People's Republic of China.,Neurological Research Center of the First Hospital of Jilin University, Changchun, People's Republic of China
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29
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Abudukeyoumu N, Hernandez-Flores T, Garcia-Munoz M, Arbuthnott GW. Cholinergic modulation of striatal microcircuits. Eur J Neurosci 2018; 49:604-622. [PMID: 29797362 PMCID: PMC6587740 DOI: 10.1111/ejn.13949] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/30/2018] [Accepted: 04/04/2018] [Indexed: 12/15/2022]
Abstract
The purpose of this review is to bridge the gap between earlier literature on striatal cholinergic interneurons and mechanisms of microcircuit interaction demonstrated with the use of newly available tools. It is well known that the main source of the high level of acetylcholine in the striatum, compared to other brain regions, is the cholinergic interneurons. These interneurons provide an extensive local innervation that suggests they may be a key modulator of striatal microcircuits. Supporting this idea requires the consideration of functional properties of these interneurons, their influence on medium spiny neurons, other interneurons, and interactions with other synaptic regulators. Here, we underline the effects of intrastriatal and extrastriatal afferents onto cholinergic interneurons and discuss the activation of pre‐ and postsynaptic muscarinic and nicotinic receptors that participate in the modulation of intrastriatal neuronal interactions. We further address recent findings about corelease of other transmitters in cholinergic interneurons and actions of these interneurons in striosome and matrix compartments. In addition, we summarize recent evidence on acetylcholine‐mediated striatal synaptic plasticity and propose roles for cholinergic interneurons in normal striatal physiology. A short examination of their role in neurological disorders such as Parkinson's, Huntington's, and Tourette's pathologies and dystonia is also included.
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Affiliation(s)
| | | | | | - Gordon W Arbuthnott
- Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan
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30
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Li HH, Shan L, Wang B, Du L, Xu ZD, Jia FY. Serum 25-hyroxyvitamin D levels and tic severity in Chinese children with tic disorders. Psychiatry Res 2018; 267:80-84. [PMID: 29885558 DOI: 10.1016/j.psychres.2018.05.066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 05/04/2018] [Accepted: 05/25/2018] [Indexed: 10/14/2022]
Abstract
The aim of this study is to evaluate serum 25-hydroxyvitamin D[25(OH)D] levels in children with tic disorders and to explore the relationship between serum 25(OH)D level and tic severity. Children (n = 179, 31 females, 148 males, mean age at diagnosis: 8.0 ± 2.7 years old, age ranged from 3 to 14.5 years old) who were diagnosed with a tic disorder were enrolled as case group, 189 healthy children were recruited as control group. Serum level of 25(OH)D of each child was measured by high performance liquid chromatography and tandem mass spectrometry (HPLC-MS/MS). Yale Global Tic Severity Scale (YGTSS) was used to assess tic severity. Mean serum level of 25(OH)D in the case group was significantly lower than that of the control group. The serum 25(OH)D level was significantly associated with tic severity after adjusting for age and body mass index (BMI). This study identified a high prevalence of vitamin D insufficiency or deficiency in children with tic disorders, and there was a negative correlation between the serum 25(OH)D level and tic severity. In the future, large sample size studies are urgently needed to further clarify this correlation.
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Affiliation(s)
- Hong-Hua Li
- Department of Developmental and Behavioral Pediatrics, the First Hospital of Jilin University, Changchun, China
| | - Ling Shan
- Department of Developmental and Behavioral Pediatrics, the First Hospital of Jilin University, Changchun, China
| | - Bing Wang
- Department of Developmental and Behavioral Pediatrics, the First Hospital of Jilin University, Changchun, China
| | - Lin Du
- Department of Developmental and Behavioral Pediatrics, the First Hospital of Jilin University, Changchun, China
| | - Zhi-Da Xu
- Department of Developmental and Behavioral Pediatrics, the First Hospital of Jilin University, Changchun, China; Department of psychiatry, University Medical Center Utrecht, Utrecht, Netherlands
| | - Fei-Yong Jia
- Department of Developmental and Behavioral Pediatrics, the First Hospital of Jilin University, Changchun, China; Neurological Research Center, the First Hospital of Jilin University, Changchun, China.
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31
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Nespoli E, Rizzo F, Boeckers T, Schulze U, Hengerer B. Altered dopaminergic regulation of the dorsal striatum is able to induce tic-like movements in juvenile rats. PLoS One 2018; 13:e0196515. [PMID: 29698507 PMCID: PMC5919623 DOI: 10.1371/journal.pone.0196515] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/13/2018] [Indexed: 01/01/2023] Open
Abstract
Motor tics are sudden, repetitive, involuntary movements representing the hallmark behaviors of the neurodevelopmental disease Tourette’s syndrome (TS). The primary cause of TS remains unclear. The initial observation that dopaminergic antagonists alleviate tics led to the development of a dopaminergic theory of TS etiology which is supported by post mortem and in vivo studies indicating that non-physiological activation of the striatum could generate tics. The striatum controls movement execution through the balanced activity of dopamine receptor D1 and D2-expressing medium spiny neurons of the direct and indirect pathway, respectively. Different neurotransmitters can activate or repress striatal activity and among them, dopamine plays a major role. In this study we introduced a chronic dopaminergic alteration in juvenile rats, in order to modify the delicate balance between direct and indirect pathway. This manipulation was done in the dorsal striatum, that had been associated with tic-like movements generation in animal models. The results were movements resembling tics, which were categorized and scored according to a newly developed rating scale and were reduced by clonidine and riluzole treatment. Finally, post mortem analyses revealed altered RNA expression of dopaminergic receptors D1 and D2, suggesting an imbalanced dopaminergic regulation of medium spiny neuron activity as being causally related to the observed phenotype.
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Affiliation(s)
- Ester Nespoli
- CNS Department, Boehringer Ingelheim Pharma GmbH& Co. KG, Biberach an der Riss, Germany
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
- * E-mail: (BH); (EN)
| | - Francesca Rizzo
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
- Institute of Anatomy and Cell Biology, University of Ulm, Ulm, Germany
| | - Tobias Boeckers
- Institute of Anatomy and Cell Biology, University of Ulm, Ulm, Germany
| | - Ulrike Schulze
- Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany
| | - Bastian Hengerer
- CNS Department, Boehringer Ingelheim Pharma GmbH& Co. KG, Biberach an der Riss, Germany
- * E-mail: (BH); (EN)
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32
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Mahone EM, Puts NA, Edden RAE, Ryan M, Singer HS. GABA and glutamate in children with Tourette syndrome: A 1H MR spectroscopy study at 7T. Psychiatry Res 2018; 273:46-53. [PMID: 29329743 PMCID: PMC5815927 DOI: 10.1016/j.pscychresns.2017.12.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/06/2017] [Accepted: 12/30/2017] [Indexed: 02/08/2023]
Abstract
Tourette syndrome (TS) is characterized by presence of chronic, fluctuating motor and phonic tics. The underlying neurobiological basis for these movements is hypothesized to involve cortical-striatal-thalamo-cortical (CSTC) pathways. Two major neurotransmitters within these circuits are γ-aminobutyric acid (GABA) and glutamate. Seventy-five participants (32 with TS, 43 controls) ages 5-12 years completed 1H MRS at 7T. GABA and glutamate were measured in dorsolateral prefrontal cortex (DLPFC), ventromedial prefrontal cortex (VMPFC), premotor cortex (PMC), and striatum, and metabolites quantified using LCModel. Participants also completed neuropsychological assessment emphasizing inhibitory control. Scans were well tolerated by participants. Across ROIs combined, glutamate was significantly higher in the TS group, compared to controls, with no significant group differences in GABA observed. ROI analyses revealed significantly increased PMC glutamate in the TS group. Among children with TS, increased PMC glutamate was associated with improved selective motor inhibition; however, no significant associations were identified between levels of glutamate or GABA and tic severity. The dopaminergic system has long been considered to have a dominant role in TS. Accumulating evidence, however, suggests involvement of other neurotransmitter systems. Data obtained using 1H MRS at 7T supports alteration of glutamate within habitual behavior-related CSTC pathways of children with TS.
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Affiliation(s)
- E Mark Mahone
- Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave., Baltimore, MD 21231, USA; Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, USA.
| | - Nicolaas A Puts
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205, USA
| | - Matthew Ryan
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, USA
| | - Harvey S Singer
- Department of Neurology, The Johns Hopkins University School of Medicine, 600 N Wolfe St., Baltimore, MD 21287, USA
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33
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Ganos C, Rothwell J, Haggard P. Voluntary inhibitory motor control over involuntary tic movements. Mov Disord 2018; 33:937-946. [DOI: 10.1002/mds.27346] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/18/2018] [Accepted: 01/21/2018] [Indexed: 12/12/2022] Open
Affiliation(s)
- Christos Ganos
- Department of Neurology, Charité; University Medicine; Berlin Germany
- Institute of Cognitive Neuroscience; University College London; London UK
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology; University College London; London UK
| | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, University College London Institute of Neurology; University College London; London UK
| | - Patrick Haggard
- Institute of Cognitive Neuroscience; University College London; London UK
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34
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Rizzo F, Nespoli E, Abaei A, Bar-Gad I, Deelchand DK, Fegert J, Rasche V, Hengerer B, Boeckers TM. Aripiprazole Selectively Reduces Motor Tics in a Young Animal Model for Tourette's Syndrome and Comorbid Attention Deficit and Hyperactivity Disorder. Front Neurol 2018; 9:59. [PMID: 29487562 PMCID: PMC5816975 DOI: 10.3389/fneur.2018.00059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 01/23/2018] [Indexed: 12/17/2022] Open
Abstract
Tourette’s syndrome (TS) is a neurodevelopmental disorder characterized primarily by motor and vocal tics. Comorbidities such as attention deficit and hyperactivity disorder (ADHD) are observed in over 50% of TS patients. We applied aripiprazole in a juvenile rat model that displays motor tics and hyperactivity. We additionally assessed the amount of ultrasonic vocalizations (USVs) as an indicator for the presence of vocal tics and evaluated the changes in the striatal neurometabolism using in vivo proton magnetic resonance spectroscopy (1H-MRS) at 11.7T. Thirty-one juvenile spontaneously hypertensive rats (SHRs) underwent bicuculline striatal microinjection and treatment with either aripiprazole or vehicle. Control groups were sham operated and sham injected. Behavior, USVs, and striatal neurochemical profile were analyzed at early, middle, and late adolescence (postnatal days 35 to 50). Bicuculline microinjections in the dorsolateral striatum induced motor tics in SHR juvenile rats. Acute aripiprazole administration selectively reduced both tic frequency and latency, whereas stereotypies, USVs, and hyperactivity remained unaltered. The striatal neurochemical profile was only moderately altered after tic-induction and was not affected by systemic drug treatment. When applied to a young rat model that provides high degrees of construct, face, and predictive validity for TS and comorbid ADHD, aripiprazole selectively reduces motor tics, revealing that tics and stereotypies are distinct phenomena in line with clinical treatment of patients. Finally, our 1H-MRS results suggest a critical revision of the striatal role in the hypothesized cortico-striatal dysregulation in TS pathophysiology.
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Affiliation(s)
- Francesca Rizzo
- Department for Child and Adolescent Psychiatry and Psychotherapy, Ulm University, Ulm, Germany.,Institute of Anatomy and Cell Biology, Ulm University, Ulm, Germany
| | - Ester Nespoli
- Boehringer Ingelheim Pharma GmbH & Co. KG, CNS Diseases, Biberach an der Riss, Germany
| | - Alireza Abaei
- Core Facility Small Animal Imaging, Ulm University, Ulm, Germany.,Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Izhar Bar-Gad
- Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Dinesh K Deelchand
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States
| | - Jörg Fegert
- Department for Child and Adolescent Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Volker Rasche
- Core Facility Small Animal Imaging, Ulm University, Ulm, Germany.,Department of Internal Medicine II, Ulm University Medical Center, Ulm, Germany
| | - Bastian Hengerer
- Boehringer Ingelheim Pharma GmbH & Co. KG, CNS Diseases, Biberach an der Riss, Germany
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Albin RL. Tourette syndrome: a disorder of the social decision-making network. Brain 2018; 141:332-347. [PMID: 29053770 PMCID: PMC5837580 DOI: 10.1093/brain/awx204] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 06/08/2017] [Accepted: 07/21/2017] [Indexed: 12/11/2022] Open
Abstract
Tourette syndrome is a common neurodevelopmental disorder defined by characteristic involuntary movements, tics, with both motor and phonic components. Tourette syndrome is usually conceptualized as a basal ganglia disorder, with an emphasis on striatal dysfunction. While considerable evidence is consistent with these concepts, imaging data suggest diffuse functional and structural abnormalities in Tourette syndrome brain. Tourette syndrome exhibits features that are difficult to explain solely based on basal ganglia circuit dysfunctions. These features include the natural history of tic expression, with typical onset of tics around ages 5 to 7 years and exacerbation during the peri-pubertal years, marked sex disparity with higher male prevalence, and the characteristic distribution of tics. The latter are usually repetitive, somewhat stereotyped involuntary eye, facial and head movements, and phonations. A major functional role of eye, face, and head movements is social signalling. Prior work in social neuroscience identified a phylogenetically conserved network of sexually dimorphic subcortical nuclei, the Social Behaviour Network, mediating many social behaviours. Social behaviour network function is modulated developmentally by gonadal steroids and social behaviour network outputs are stereotyped sex and species specific behaviours. In 2011 O'Connell and Hofmann proposed that the social behaviour network interdigitates with the basal ganglia to form a greater network, the social decision-making network. The social decision-making network may have two functionally complementary limbs: the basal ganglia component responsible for evaluation of socially relevant stimuli and actions with the social behaviour network component responsible for the performance of social acts. Social decision-making network dysfunction can explain major features of the neurobiology of Tourette syndrome. Tourette syndrome may be a disorder of social communication resulting from developmental abnormalities at several levels of the social decision-making network. The social decision-making network dysfunction hypothesis suggests new avenues for research in Tourette syndrome and new potential therapeutic targets.
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Affiliation(s)
- Roger L Albin
- Department of Neurology, University of Michigan, Ann Arbor, MI, 48109, USA
- Neurology Service and GRECC, VAAAHS, Ann Arbor, MI, 48105, USA
- University of Michigan Morris K. Udall Parkinson’s Disease Research Center, University of Michigan, Ann Arbor, MI 48109, USA
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Loss of Balance between Striatal Feedforward Inhibition and Corticostriatal Excitation Leads to Tremor. J Neurosci 2018; 38:1699-1710. [PMID: 29330326 DOI: 10.1523/jneurosci.2821-17.2018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/30/2017] [Accepted: 01/05/2018] [Indexed: 11/21/2022] Open
Abstract
Fast-spiking interneurons (FSIs) exert powerful inhibitory control over the striatum and are hypothesized to balance the massive excitatory cortical and thalamic input to this structure. We recorded neuronal activity in the dorsolateral striatum and globus pallidus (GP) concurrently with the detailed movement kinematics of freely behaving female rats before and after selective inhibition of FSI activity using IEM-1460 microinjections. The inhibition led to the appearance of episodic rest tremor in the body part that depended on the somatotopic location of the injection within the striatum. The tremor was accompanied by coherent oscillations in the local field potential (LFP). Individual neuron activity patterns became oscillatory and coherent in the tremor frequency. Striatal neurons, but not GP neurons, displayed additional temporal, nonoscillatory correlations. The subsequent reduction in the corticostriatal input following muscimol injection to the corresponding somatotopic location in the primary motor cortex led to disruption of the tremor and a reduction of the LFP oscillations and individual neuron's phase-locked activity. The breakdown of the normal balance of excitation and inhibition in the striatum has been shown previously to be related to different motor abnormalities. Our results further indicate that the balance between excitatory corticostriatal input and feedforward FSI inhibition is sufficient to break down the striatal decorrelation process and generate oscillations resulting in rest tremor typical of multiple basal ganglia disorders.SIGNIFICANCE STATEMENT Fast-spiking interneurons (FSIs) play a key role in normal striatal processing by exerting powerful inhibitory control over the network. FSI malfunctions have been associated with abnormal processing of information within the striatum that leads to multiple movement disorders. Here, we study the changes in neuronal activity and movement kinematics following selective inhibition of these neurons. The injections led to the appearance of episodic rest tremor, accompanied by coherent oscillations in neuronal activity, which was reversed following corticostriatal inhibition. These results suggest that the balance between corticostriatal excitation and feedforward FSI inhibition is crucial for maintaining the striatal decorrelation process, and that its breakdown leads to the formation of oscillations resulting in rest tremor typical of multiple basal ganglia disorders.
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Edemann-Callesen H, Habelt B, Wieske F, Jackson M, Khadka N, Mattei D, Bernhardt N, Heinz A, Liebetanz D, Bikson M, Padberg F, Hadar R, Nitsche MA, Winter C. Non-invasive modulation reduces repetitive behavior in a rat model through the sensorimotor cortico-striatal circuit. Transl Psychiatry 2018; 8:11. [PMID: 29317605 PMCID: PMC5802458 DOI: 10.1038/s41398-017-0059-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 09/26/2017] [Accepted: 10/01/2017] [Indexed: 01/19/2023] Open
Abstract
Involuntary movements as seen in repetitive disorders such as Tourette Syndrome (TS) results from cortical hyperexcitability that arise due to striato-thalamo-cortical circuit (STC) imbalance. Transcranial direct current stimulation (tDCS) is a stimulation procedure that changes cortical excitability, yet its relevance in repetitive disorders such as TS remains largely unexplored. Here, we employed the dopamine transporter-overexpressing (DAT-tg) rat model to investigate behavioral and neurobiological effects of frontal tDCS. The outcome of tDCS was pathology dependent, as anodal tDCS decreased repetitive behavior in the DAT-tg rats yet increased it in wild-type (wt) rats. Extensive deep brain stimulation (DBS) application and computational modeling assigned the response in DAT-tg rats to the sensorimotor pathway. Neurobiological assessment revealed cortical activity changes and increase in striatal inhibitory properties in the DAT-tg rats. Our findings show that tDCS reduces repetitive behavior in the DAT-tg rat through modulation of the sensorimotor STC circuit. This sets the stage for further investigating the usage of tDCS in repetitive disorders such as TS.
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Affiliation(s)
- Henriette Edemann-Callesen
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- International Graduate Program Medical Neurosciences, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Bettina Habelt
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Franziska Wieske
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Mark Jackson
- Department of Biomedical Engineering, The City College of The City University of New York, New York, NY, USA
| | - Niranjan Khadka
- Department of Biomedical Engineering, The City College of The City University of New York, New York, NY, USA
| | - Daniele Mattei
- Cellular Neuroscience, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
| | - Nadine Bernhardt
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - David Liebetanz
- Department of Clinical Neurophysiology, University Medical Center, Georg-August-University, Goettingen, Germany
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of The City University of New York, New York, NY, USA
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, Ludwig Maximillian University, Munich, Germany
| | - Ravit Hadar
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Christine Winter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany.
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
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Bortolato M, Pittenger C. Modeling tics in rodents: Conceptual challenges and paths forward. J Neurosci Methods 2017; 292:12-19. [PMID: 28237575 PMCID: PMC5568514 DOI: 10.1016/j.jneumeth.2017.02.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/17/2017] [Accepted: 02/21/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Recent advances in our understanding of the neurobiology of tics have led to the development of novel rodent models capturing different pathophysiological and phenotypic aspects of Tourette syndrome. The proliferation of these models, however, raises vexing questions on what standards should be adopted to assess their theoretical validity and empirical utility. Assessing the homology of a rodent motoric burst with a tic remains problematic, due to our incomplete knowledge of the underpinnings of tics, their high phenotypic complexity and variability, limitations in our ability test key aspects of tic phenomenology (such as premonitory sensory phenomena) in animals, and between-species differences in neuroanatomy and behavioral repertoire. These limitations underscore that any interpretation of behavioral output in an animal model cannot exclusively rely on the recognition of features that bear superficial resemblance with tics, but must be supported by other etiological and convergent phenomenological criteria. NEW METHOD Here, we discuss two complementary approaches for the study and validation of tic-like manifestations in rodents, based respectively on the use of contextual modulators and accompanying features of repetitive motor manifestations and on the reproduction of pathogenic factors. RESULTS Neither strategy can by itself provide convincing evidence that a model informatively recapitulates tic pathophysiology. Their combination holds promise to enhance the rigorous evaluation and translational relevance of rodent models of tic disorders. CONCLUSIONS This systematic consideration of different approaches to the validation and study of animal models of tic pathophysiology provides a framework for future work in this area.
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Affiliation(s)
- Marco Bortolato
- Department of Pharmacology and Toxicology, Interdepartmental Neuroscience Program, University of Utah, 30 S 2000 E, Skaggs Hall, Room 3916, Salt Lake City, UT, 84112, USA.
| | - Christopher Pittenger
- Department of Psychiatry, Department of Psychology, Child Study Center, Interdepartmental Neuroscience Program, Yale University, 34 Park Street, W315, New Haven, CT, 06519, USA.
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Li HH, Wang B, Shan L, Wang CX, Jia FY. [Serum levels of 25-hydroxyvitamin D in children with tic disorders]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:1165-1168. [PMID: 29132463 PMCID: PMC7389328 DOI: 10.7499/j.issn.1008-8830.2017.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 09/29/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To examine serum 25-hydroxyvitamin D levels in children with tic disorders (TD) and to explore the relationship between vitamin D level and TD. METHODS One hundred and thirty-two children who were diagnosed with TD between November 2016 and May 2017 were enrolled as the TD group, including 8 cases of Tourette syndrome, 32 cases of chronic TD, and 92 cases of transient TD. One hundred and forty-four healthy children served as the control group. Peripheral venous blood samples were collected from each child. Serum levels of 25-hydroxyvitamin D were measured using HPLC-MS/MS. The categories of vitamin D status based on serum 25-hydroxyvitamin D level included: normal (>30 ng/mL), insufficiency (10-30 ng/mL) and deficiency (<10 ng/mL). RESULTS Mean serum level of 25-hydroxyvitamin D in the TD group was significantly lower than that in the control group (P<0.01). The rate of vitamin D insufficiency or deficiency in the TD group was significantly higher than in the control group (P<0.01). Mean serum level of 25-hydroxyvitamin D in the transient tic group was higher than in the TS group (P<0.05). CONCLUSIONS Vitamin D insufficiency or deficiency might be associated with the development of TD, and the level of serum 25-hydroxyvitamin D might be related to the classification of TD.
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Affiliation(s)
- Hong-Hua Li
- Department of Developmental and Behavioral Pediatrics, First Hospital of Jilin University, Changchun 130021, China.
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Godar SC, Bortolato M. What makes you tic? Translational approaches to study the role of stress and contextual triggers in Tourette syndrome. Neurosci Biobehav Rev 2017; 76:123-133. [PMID: 27939782 PMCID: PMC5403589 DOI: 10.1016/j.neubiorev.2016.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/17/2016] [Accepted: 10/05/2016] [Indexed: 01/04/2023]
Abstract
Tourette syndrome (TS) is a neurodevelopmental condition characterized by multiple, recurring motor and phonic tics. Rich empirical evidence shows that the severity of tics and associated manifestations is increased by several stressors and contextual triggers; however, the neurobiological mechanisms responsible for symptom exacerbation in TS remain poorly understood. This conceptual gap partially reflects the high phenotypic variability in tics, as well as the existing difficulties in operationalizing and standardizing stress and its effects in a clinical setting. Animal models of TS may be highly informative tools to overcome some of these limitations; these experimental preparations have already provided critical insights on key aspects of TS pathophysiology, and may prove useful to identify the neurochemical alterations induced by different stressful contingencies. In particular, emerging knowledge on the role of contextual triggers in animal models of TS may inform the development of novel pharmacological interventions to reduce tic fluctuations in this disorder.
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Affiliation(s)
- Sean C Godar
- Dept. of Pharmacology and Toxicology, College of Pharmacy, United States; University of Utah, Salt Lake City, UT, United States
| | - Marco Bortolato
- Dept. of Pharmacology and Toxicology, College of Pharmacy, United States; University of Utah, Salt Lake City, UT, United States.
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Compulsive Social Behavior Emerges after Selective Ablation of Striatal Cholinergic Interneurons. J Neurosci 2017; 37:2849-2858. [PMID: 28193688 DOI: 10.1523/jneurosci.3460-16.2017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/23/2017] [Accepted: 01/27/2017] [Indexed: 12/14/2022] Open
Abstract
The mechanisms underlying social dysfunction in neuropsychiatric conditions such as obsessive-compulsive disorder and Tourette syndrome remain uncertain. However, it is known that dysfunctions in basal ganglia, including a reduced number of striatal cholinergic interneurons (SCIN), are involved in their pathophysiology. To explore the role of SCIN in relation to perseverative behaviors, we characterized a new transgenic mouse model in which inducible ablation of SCIN is achieved with high efficiency in a cell-type- and region-specific manner. Mice were subjected to extensive behavioral testing, including assessment of social behaviors, and corticostriatal functional connectivity was evaluated in vivo Selective SCIN ablation leads to altered social interactions together with exacerbated spontaneously emitted repetitive behaviors. Lesioned mice showed normal motor coordination, balance, and general locomotion. Interestingly, only environmentally driven, but not self-directed, repetitive behaviors were exacerbated in lesioned mice. Remarkably, in mice with SCIN ablation, the normal pattern of social exploration was replayed continuously. The emerging pattern of social interactions is highly predictable and invariant across time. In vivo electrophysiological recordings indicate that SCIN ablation results in an increase of the functional connectivity between different cortical areas and the motor, but not associative, region of the striatum. Our results identify a role of SCIN in suppressing perseverative behaviors, including socially related ones. In sum, SCIN ablation in mice leads to exacerbated ritualistic-like behaviors that affect social performance, providing a link between SCIN dysfunction and the social impairments present in psychiatric disorders.SIGNIFICANCE STATEMENT We sought to uncover the impact of striatal cholinergic interneuron (SCIN) degeneration on perseverative behaviors related to obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). We found that extensive SCIN ablation results in exacerbated social interactions, in which normal social contacts were replayed continuously in a highly stereotyped, ritualistic pattern. SCIN ablation also leads to an increase in other spontaneously emitted repetitive behaviors without alteration of motor coordination, balance, or locomotion. Moreover, we identify an increase of functional connectivity between frontal cortical areas and the motor region of the striatum as a putative substrate for the observed behavioral alterations. Therefore, perseveration induced by SCIN ablation extends to social performance as occurs in neuropsychiatric conditions such as OCD and TS.
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Abstract
Gilles de la Tourette syndrome (GTS) is a childhood-onset neurodevelopmental disorder that is characterized by several motor and phonic tics. Tics usually develop before 10 years of age, exhibit a waxing and waning course and typically improve with increasing age. A prevalence of approximately 1% is estimated in children and adolescents. The condition can result in considerable social stigma and poor quality of life, especially when tics are severe (for example, with coprolalia (swearing tics) and self-injurious behaviours) or when GTS is accompanied by attention-deficit/hyperactivity disorder, obsessive-compulsive disorder or another neuropsychiatric disorder. The aetiology is complex and multifactorial. GTS is considered to be polygenic, involving multiple common risk variants combined with rare, inherited or de novo mutations. These as well as non-genetic factors (such as perinatal events and immunological factors) are likely to contribute to the heterogeneity of the clinical phenotype, the structural and functional brain anomalies and the neural circuitry involvement. Management usually includes psychoeducation and reassurance, behavioural methods, pharmacotherapy and, rarely, functional neurosurgery. Future research that integrates clinical and neurobiological data, including neuroimaging and genetics, is expected to reveal the pathogenesis of GTS at the neural circuit level, which may lead to targeted interventions.
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Pittenger C. Histidine Decarboxylase Knockout Mice as a Model of the Pathophysiology of Tourette Syndrome and Related Conditions. Handb Exp Pharmacol 2017; 241:189-215. [PMID: 28233179 PMCID: PMC5538774 DOI: 10.1007/164_2016_127] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
While the normal functions of histamine (HA) in the central nervous system have gradually come into focus over the past 30 years, the relationship of abnormalities in neurotransmitter HA to human disease has been slower to emerge. New insight came with the 2010 description of a rare nonsense mutation in the biosynthetic enzyme histidine decarboxylase (Hdc) that was associated with Tourette syndrome (TS) and related conditions in a single family pedigree. Subsequent genetic work has provided further support for abnormalities of HA signaling in sporadic TS. As a result of this genetic work, Hdc knockout mice, which were generated more than 15 years ago, have been reexamined as a model of the pathophysiology of TS and related conditions. Parallel work in these KO mice and in human carriers of the Hdc mutation has revealed abnormalities in the basal ganglia system and its modulation by dopamine (DA) and has confirmed the etiologic, face, and predictive validity of the model. The Hdc-KO model thus serves as a unique platform to probe the pathophysiology of TS and related conditions, and to generate specific hypotheses for subsequent testing in humans. This chapter summarizes the development and validation of this model and recent and ongoing work using it to further investigate pathophysiological changes that may contribute to these disorders.
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Affiliation(s)
- Christopher Pittenger
- Departments of Psychiatry and Psychology, Yale Child Study Center, and Interdepartmental Neuroscience Program, Yale University School of Medicine, 34 Park Street, W315, New Haven, CT, 06519, USA.
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Klaus A, Plenz D. A Low-Correlation Resting State of the Striatum during Cortical Avalanches and Its Role in Movement Suppression. PLoS Biol 2016; 14:e1002582. [PMID: 27923040 PMCID: PMC5147796 DOI: 10.1371/journal.pbio.1002582] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 11/08/2016] [Indexed: 12/13/2022] Open
Abstract
During quiet resting behavior, involuntary movements are suppressed. Such movement control is attributed to cortico-basal ganglia loops, yet population dynamics within these loops during resting and their relation to involuntary movements are not well characterized. Here, we show by recording cortical and striatal ongoing population activity in awake rats during quiet resting that intrastriatal inhibition maintains a low-correlation striatal resting state in the presence of cortical neuronal avalanches. Involuntary movements arise from disturbed striatal resting activity through two different population dynamics. Nonselectively reducing intrastriatal γ-aminobutyric acid (GABA) receptor-A inhibition synchronizes striatal dynamics, leading to involuntary movements at low rate. In contrast, reducing striatal interneuron (IN)-mediated inhibition maintains decorrelation and induces intermittent involuntary movements at high rate. This latter scenario was highly effective in modulating cortical dynamics at a subsecond timescale. To distinguish intrastriatal processing from loop dynamics, cortex-striatum-midbrain cultures, which lack feedback to cortex, were used. Cortical avalanches in vitro were accompanied by low-correlated resting activity in the striatum and nonselective reduction in striatal inhibition synchronized striatal neurons similar to in vivo. Importantly, reduction of inhibition from striatal INs maintained low correlations in the striatum while reorganizing functional connectivities among striatal neurons. Our results demonstrate the importance of two major striatal microcircuits in distinctly regulating striatal and cortical resting state dynamics. These findings suggest that specific functional connectivities of the striatum that are maintained by local inhibition are important in movement control. Why don’t neuronal “avalanches” in resting-state cortex cause involuntary movements? This study shows that a low-correlation striatal resting state suppresses such movements and explores mechanisms that disrupt this inhibition. Even in the absence of apparent motor output, the brain produces a rich repertoire of neuronal activity patterns known as “resting state” activity. In the outer layer of the cortex, resting state patterns emerge as neuronal avalanches, precisely scale-invariant spatiotemporal bursts that often engage large populations of neurons. Little is known about how the brain suppresses involuntary movements during such activity. Here, we show that the striatum, which is part of the cortex-basal ganglia loop, maintains a low-correlation state during resting activity. By using a combination of in vivo and in vitro approaches with pharmacological manipulations, we demonstrate that the precise configuration of this low-correlation state effectively contributes to involuntary movements. Nonselective blockade of intra-striatal inhibition abolished the low-correlation striatal resting state, barely affected cortical avalanches, and led to involuntary movements at low rate. In contrast, selectively reducing striatal interneuron inhibition strongly affected cortical avalanches and triggered involuntary movements at high rate while maintaining a relatively decorrelated striatal resting state. Our results demonstrate the importance of different inhibitory striatal circuits in the suppression of involuntary movements and suggest that the precise spatiotemporal configuration of striatal activity plays an active role in the regulation of cortical resting state activity and motor control.
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Affiliation(s)
- Andreas Klaus
- Section on Critical Brain Dynamics, National Institute of Mental Health, Bethesda, Maryland, United States of America
- * E-mail:
| | - Dietmar Plenz
- Section on Critical Brain Dynamics, National Institute of Mental Health, Bethesda, Maryland, United States of America
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Forde NJ, Kanaan AS, Widomska J, Padmanabhuni SS, Nespoli E, Alexander J, Rodriguez Arranz JI, Fan S, Houssari R, Nawaz MS, Rizzo F, Pagliaroli L, Zilhäo NR, Aranyi T, Barta C, Boeckers TM, Boomsma DI, Buisman WR, Buitelaar JK, Cath D, Dietrich A, Driessen N, Drineas P, Dunlap M, Gerasch S, Glennon J, Hengerer B, van den Heuvel OA, Jespersgaard C, Möller HE, Müller-Vahl KR, Openneer TJC, Poelmans G, Pouwels PJW, Scharf JM, Stefansson H, Tümer Z, Veltman DJ, van der Werf YD, Hoekstra PJ, Ludolph A, Paschou P. TS-EUROTRAIN: A European-Wide Investigation and Training Network on the Etiology and Pathophysiology of Gilles de la Tourette Syndrome. Front Neurosci 2016; 10:384. [PMID: 27601976 PMCID: PMC4994475 DOI: 10.3389/fnins.2016.00384] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/08/2016] [Indexed: 11/26/2022] Open
Abstract
Gilles de la Tourette Syndrome (GTS) is characterized by the presence of multiple motor and phonic tics with a fluctuating course of intensity, frequency, and severity. Up to 90% of patients with GTS present with comorbid conditions, most commonly attention-deficit/hyperactivity disorder (ADHD), and obsessive-compulsive disorder (OCD), thus providing an excellent model for the exploration of shared etiology across disorders. TS-EUROTRAIN (FP7-PEOPLE-2012-ITN, Grant Agr.No. 316978) is a Marie Curie Initial Training Network (http://ts-eurotrain.eu) that aims to elucidate the complex etiology of the onset and clinical course of GTS, investigate the neurobiological underpinnings of GTS and related disorders, translate research findings into clinical applications, and establish a pan-European infrastructure for the study of GTS. This includes the challenges of (i) assembling a large genetic database for the evaluation of the genetic architecture with high statistical power; (ii) exploring the role of gene-environment interactions including the effects of epigenetic phenomena; (iii) employing endophenotype-based approaches to understand the shared etiology between GTS, OCD, and ADHD; (iv) establishing a developmental animal model for GTS; (v) gaining new insights into the neurobiological mechanisms of GTS via cross-sectional and longitudinal neuroimaging studies; and (vi) partaking in outreach activities including the dissemination of scientific knowledge about GTS to the public. Fifteen partners from academia and industry and 12 PhD candidates pursue the project. Here, we aim to share the design of an interdisciplinary project, showcasing the potential of large-scale collaborative efforts in the field of GTS. Our ultimate aims are to elucidate the complex etiology and neurobiological underpinnings of GTS, translate research findings into clinical applications, and establish Pan-European infrastructure for the study of GTS and associated disorders.
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Affiliation(s)
- Natalie J Forde
- Department of Psychiatry, University of Groningen, University Medical Center GroningenGroningen, Netherlands; Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical CenterNijmegen, Netherlands
| | - Ahmad S Kanaan
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical SchoolHannover, Germany; Max Planck Institute for Human Cognitive and Brain SciencesLeipzig, Germany
| | - Joanna Widomska
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center Nijmegen, Netherlands
| | - Shanmukha S Padmanabhuni
- Department of Molecular Biology and Genetics, Democritus University of Thrace Alexandropoulos, Greece
| | - Ester Nespoli
- Boehringer Ingelheim Pharma GmbH & Co. KG, CNS ResearchBiberach an der Riss, Germany; Department of Child and Adolescent Psychiatry, University of UlmUlm, Germany
| | - John Alexander
- Department of Molecular Biology and Genetics, Democritus University of Thrace Alexandropoulos, Greece
| | - Juan I Rodriguez Arranz
- Department of Clinical Genetics, Applied Human Molecular Genetics, Kennedy Center, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Siyan Fan
- Department of Clinical and health Psychology, Utrecht UniversityUtrecht, Netherlands; Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands
| | - Rayan Houssari
- Department of Clinical Genetics, Applied Human Molecular Genetics, Kennedy Center, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Muhammad S Nawaz
- deCODE Genetics/AmgenReykjavik, Iceland; Faculty of Medicine, University of IcelandReykjavik, Iceland
| | - Francesca Rizzo
- Department of Child and Adolescent Psychiatry, University of UlmUlm, Germany; Institute for Anatomy and Cell Biology, Ulm UniversityUlm, Germany
| | - Luca Pagliaroli
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis UniversityBudapest, Hungary; Research Centre for Natural Sciences, Institute of Enzymology, Hungarian Academy of SciencesBudapest, Hungary
| | - Nuno R Zilhäo
- Department of Clinical and health Psychology, Utrecht UniversityUtrecht, Netherlands; Department of Biological Psychology, VU UniversityAmsterdam, Netherlands
| | - Tamas Aranyi
- Research Centre for Natural Sciences, Institute of Enzymology, Hungarian Academy of SciencesBudapest, Hungary; Université d'Angers, BNMI (Institut national de la santé et de la recherche médicale 1083 / Centre National de la Recherche Scientifique 6214)Angers, France
| | - Csaba Barta
- Institute of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University Budapest, Hungary
| | - Tobias M Boeckers
- Department of Biological Psychology, VU University Amsterdam, Netherlands
| | - Dorret I Boomsma
- Institute for Anatomy and Cell Biology, Ulm UniversityUlm, Germany; EMGO+ Institute for Health and Care Research, VU University Medical CentreAmsterdam, Netherlands
| | | | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical CenterNijmegen, Netherlands; Karakter Child and Adolescent Psychiatry, University CentreNijmegen, Netherlands
| | - Danielle Cath
- Department of Clinical and health Psychology, Utrecht University Utrecht, Netherlands
| | - Andrea Dietrich
- Department of Psychiatry, University of Groningen, University Medical Center Groningen Groningen, Netherlands
| | - Nicole Driessen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center Nijmegen, Netherlands
| | | | | | - Sarah Gerasch
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School Hannover, Germany
| | - Jeffrey Glennon
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center Nijmegen, Netherlands
| | - Bastian Hengerer
- Boehringer Ingelheim Pharma GmbH & Co. KG, CNS Research Biberach an der Riss, Germany
| | - Odile A van den Heuvel
- Department of Psychiatry, VU University Medical CenterAmsterdam, Netherlands; Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands
| | - Cathrine Jespersgaard
- Department of Clinical Genetics, Applied Human Molecular Genetics, Kennedy Center, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Harald E Möller
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Germany
| | - Kirsten R Müller-Vahl
- Clinic of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School Hannover, Germany
| | - Thaïra J C Openneer
- Department of Psychiatry, University of Groningen, University Medical Center Groningen Groningen, Netherlands
| | - Geert Poelmans
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical CenterNijmegen, Netherlands; Department of Human Genetics, Radboud University Medical CenterNijmegen, Netherlands; Department of Molecular Animal Physiology, Donders Institute for Brain, Cognition and Behaviour, Radboud Institute for Molecular Life Sciences, Radboud UniversityNijmegen, Netherlands
| | - Petra J W Pouwels
- Department of Physics and Medical Technology, VU University Medical Center Amsterdam, Netherlands
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Departments of Psychiatry and Neurology, Center for Human Genetic Research, Harvard Medical School, Massachusetts General Hospital Boston, MA, USA
| | | | - Zeynep Tümer
- Department of Clinical Genetics, Applied Human Molecular Genetics, Kennedy Center, Copenhagen University Hospital Rigshospitalet, Denmark
| | - Dick J Veltman
- Department of Psychiatry, VU University Medical Center Amsterdam, Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, VU University Medical CenterAmsterdam, Netherlands; Netherlands Institute for NeuroscienceAmsterdam, Netherlands
| | - Pieter J Hoekstra
- Department of Psychiatry, University of Groningen, University Medical Center Groningen Groningen, Netherlands
| | - Andrea Ludolph
- Department of Child and Adolescent Psychiatry, University of Ulm Ulm, Germany
| | - Peristera Paschou
- Department of Molecular Biology and Genetics, Democritus University of Thrace Alexandropoulos, Greece
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Bolam JP, Ellender TJ. Histamine and the striatum. Neuropharmacology 2016; 106:74-84. [PMID: 26275849 PMCID: PMC4917894 DOI: 10.1016/j.neuropharm.2015.08.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 07/30/2015] [Accepted: 08/06/2015] [Indexed: 12/25/2022]
Abstract
The neuromodulator histamine is released throughout the brain during periods of wakefulness. Combined with an abundant expression of histamine receptors, this suggests potential widespread histaminergic control of neural circuit activity. However, the effect of histamine on many of these circuits is unknown. In this review we will discuss recent evidence for histaminergic modulation of the basal ganglia circuitry, and specifically its main input nucleus; the striatum. Furthermore, we will discuss recent findings of histaminergic dysfunction in several basal ganglia disorders, including in Parkinson's disease and most prominently, in Tourette's syndrome, which has led to a resurgence of interest in this neuromodulator. Combined, these recent observations not only suggest a central role for histamine in modulating basal ganglia activity and behaviour, but also as a possible target in treating basal ganglia disorders. This article is part of the Special Issue entitled 'Histamine Receptors'.
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Affiliation(s)
- J Paul Bolam
- Department of Pharmacology, MRC Brain Network Dynamics Unit, Mansfield Road, OX1 3TH Oxford, United Kingdom
| | - Tommas J Ellender
- Department of Pharmacology, MRC Brain Network Dynamics Unit, Mansfield Road, OX1 3TH Oxford, United Kingdom.
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Ganos C, Rothwell J. The Motor Cortex Modulates the “When” of Tic Generation in the Rat Striatal Disinhibition Model. Mov Disord 2016; 31:637. [DOI: 10.1002/mds.26609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 02/06/2016] [Accepted: 02/12/2016] [Indexed: 11/10/2022] Open
Affiliation(s)
- Christos Ganos
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology; University College London; London UK
- Department of Neurology; University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology; University College London; London UK
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Brandt VC, Münchau A. Evidence of Different Neural Pathways for Motor and Vocal Tic-like Expressions in Monkeys. Mov Disord 2016; 31:971. [PMID: 27113644 DOI: 10.1002/mds.26640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 03/14/2016] [Accepted: 03/16/2016] [Indexed: 11/06/2022] Open
Affiliation(s)
- Valerie Cathérine Brandt
- Institute of Neurogenetics, University of Luebeck, Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Lübeck, Germany
| | - Alexander Münchau
- Institute of Neurogenetics, University of Luebeck, Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Lübeck, Germany
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Nespoli E, Rizzo F, Boeckers TM, Hengerer B, Ludolph AG. Addressing the Complexity of Tourette's Syndrome through the Use of Animal Models. Front Neurosci 2016; 10:133. [PMID: 27092043 PMCID: PMC4824761 DOI: 10.3389/fnins.2016.00133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/16/2016] [Indexed: 01/06/2023] Open
Abstract
Tourette's syndrome (TS) is a neurodevelopmental disorder characterized by fluctuating motor and vocal tics, usually preceded by sensory premonitions, called premonitory urges. Besides tics, the vast majority—up to 90%—of TS patients suffer from psychiatric comorbidities, mainly attention deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). The etiology of TS remains elusive. Genetics is believed to play an important role, but it is clear that other factors contribute to TS, possibly altering brain functioning and architecture during a sensitive phase of neural development. Clinical brain imaging and genetic studies have contributed to elucidate TS pathophysiology and disease mechanisms; however, TS disease etiology still is poorly understood. Findings from genetic studies led to the development of genetic animal models, but they poorly reflect the pathophysiology of TS. Addressing the role of neurotransmission, brain regions, and brain circuits in TS disease pathomechanisms is another focus area for preclinical TS model development. We are now in an interesting moment in time when numerous innovative animal models are continuously brought to the attention of the public. Due to the diverse and largely unknown etiology of TS, there is no single preclinical model featuring all different aspects of TS symptomatology. TS has been dissected into its key symptomst hat have been investigated separately, in line with the Research Domain Criteria concept. The different rationales used to develop the respective animal models are critically reviewed, to discuss the potential of the contribution of animal models to elucidate TS disease mechanisms.
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Affiliation(s)
- Ester Nespoli
- Competence in Neuro Spine Department, Boehringer Ingelheim Pharma GmbH & Co. KGBiberach an der Riss, Germany; Department of Child and Adolescence Psychiatry/Psychotherapy, University of UlmUlm, Germany
| | - Francesca Rizzo
- Department of Child and Adolescence Psychiatry/Psychotherapy, University of UlmUlm, Germany; Institute of Anatomy and Cell Biology, University of UlmUlm, Germany
| | - Tobias M Boeckers
- Institute of Anatomy and Cell Biology, University of Ulm Ulm, Germany
| | - Bastian Hengerer
- Competence in Neuro Spine Department, Boehringer Ingelheim Pharma GmbH & Co. KG Biberach an der Riss, Germany
| | - Andrea G Ludolph
- Department of Child and Adolescence Psychiatry/Psychotherapy, University of Ulm Ulm, Germany
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