Influence of OCD and ADHD on Novel MRI Techniques (VBM, TI and DTI) in Patients with and without TS

Grant Type
Clinical
Grant Year
2005-2006
Institution Location
Foreign
Institution Organization Name
Medical School of Hannover Germany
Investigators Name
Muller-Vahl, Kirsten, MD

Recent MRI studies have demonstrated conflicting results in patients with TS. Most report abnormalities in the basal ganglia nuclei and frontal and corpus callosum regions. However, MRI scans are influenced by age, sex, and medication, as well as comorbidities such as ADHD and OCD. In a recent study, we used three sophisticated MRI techniques: voxel-based-morphometry (VBM), magnetization transfer imaging (MTI), and diffusion- tensor imaging (DTI) to investigate both the macro- and micro-structural integrity of white matter pathways, tissue integrity, and differences in gray and white matter volumes in patients with “TS only” (=TS without comorbidities). VBM is an objective, whole-brain method that uses an unbiased approach without the need for manually drawn regions of interest. MTI is an MRI technique which is more sensitive to neuropathological changes than conventional MRI, while DTI is suited to studying the micro-structural integrity of white matter pathways and tissue integrity. In this carefully selected TS group consisting of 19 unmedicated adult male patients, we found a reduction of frontal, anterior corpus callosum, cingulate gyrus white matter as well as alterations of the putamen, and reduced gray matter volume of the left caudate nucleus compared with normal controls (n=20). Due to this study’s design, influences from comorbid ADHD and OCD, gender, medication, and age were excluded. Our aim is to investigate the influence of OCD and ADHD on these MRI results because both are common TS comorbidities. Four patient groups, each made up of 20 adult, unmedicated males will be included: 1) TS+OCD, 2) TS+ADHD, 3) “pure” OCD, and 4) “pure” ADHD. Results will be compared with data from 40 unaffected, age- and sex-matched people. We believe that these new MRI techniques will demonstrate differences in patients with tics, OCD, and ADHD alone or in combination. Kirsten Müller-Vahl, M.D., Thomas Peschel, M.D. Medical School of Hannover, Hannover, Germany Award: $68,800 Tourette Association of America Inc. – Research Grant Award 2005-2006