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Translational Psychiatry：Tourette综合征的CSTC回路脑区灰质存在异常变化

2021-05-17 MedSci原创 MedSci原创

灰质体积Tourette综合征皮质-纹状体-丘脑-皮质网络
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TS患者IFG、纹状体、丘脑和小脑的GMV变化，其中大部分是皮质-纹状体-丘脑-皮质网络的关键节点。这些发现为TS患者可能的治疗靶点提供了新的见解。

Tourette综合症(TS)是一种以原发性运动和发声抽动为特征的神经系统疾病，常伴有强迫症(OCD)、注意缺陷多动障碍(ADHD)或其它社会和行为障碍。每1000人中有5人患有TS，倾向于家族遗传，通常影响男孩，高峰发病年龄为3-8岁。先前的研究表明，抽搐和共病的严重程度与年龄有关，并可能在青少年时期逐渐缓解，有共病障碍的TS患者比单纯的TS患者的自杀风险更高。TS临床症状复杂，治疗困难，对公共卫生和经济造成重大负担。

到目前为止，基于体素的形态测量学(Voxel-based morphometry, VBM)研究发现TS患者的灰质体积(GMV)异常;然而，尚未取得一致的结果。最近，华西医院龚启勇团队进行了相关研究，研究结果发表在Translational Psychiatry杂志。

该研究推测TS患者的部分脑功能区(如额叶皮质，丘脑，海马，基底神经节，中脑)可能受到影响而出现结构改变，GMV异常可能与某些临床因素有关。

在当前meta分析中考虑的纳入研究时使用的搜索策略

该研究对所有纳入的VBM研究进行了汇总荟萃分析，以确定TS患者中最显著和最一致的灰质变化。在这一过程中使用了基于种子点图(Seed-based mapping, SDM)软件，因为它可以控制单个研究的结果，并且该研究中包含的所有信息都可以在同一脑图中使用。还分析了主要研究结果的稳健性和异质性。接下来，采用多变量元回归分析来探讨GMV变化与临床和人口统计学特征之间的潜在关系。

与健康对照组相比，TS患者显示灰质体积改变的区域

 该研究试图利用SDM软件提供一种脑灰质变化的体素元分析。该研究确定了10项调查TS患者灰质改变的相关研究，并采用SDM方法进行meta分析，定量评估区域灰质异常。接下来，研究了GMV异常与人口统计学和临床特征之间的关系。

该研究汇总了10项VBM研究，包括331例TS患者和327例对照，以定义TS患者和对照组之间的GMV差异。观察到以下灰质改变:(1)TS患者双侧IFG GMV降低;(2) TS患者小脑、右侧纹状体、双侧丘脑GMV增加;(3)根据meta回归分析，临床或人口统计学特征与GMV变化不相关。

这项研究证实了TS患者IFG、纹状体、丘脑和小脑的GMV变化，其中大部分是皮质-纹状体-丘脑-皮质网络的关键节点。这些发现为TS患者可能的治疗靶点提供了新的见解。但还需要更多的研究来证实，GMV变化的机制以及GMV变化与临床症状的关系有待进一步阐明。

原文出处

Wan, X., Zhang, S., Wang, W. et al. Gray matter abnormalities in Tourette Syndrome: a meta-analysis of voxel-based morphometry studies. Transl Psychiatry 11, 287 (2021). https://doi.org/10.1038/s41398-021-01394-8

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    2021-09-22 12498561m32(暂无昵称)

    #translational#

    0

  4. 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createdBy=96d4340, createdName=ysjykql, createdTime=Thu Dec 16 19:51:14 CST 2021, time=2021-12-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1796040, encodeId=1c901e960400f, content=<a href='/topic/show?id=8c201e758e5' target=_blank style='color:#2F92EE;'>#translational#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17758, encryptionId=8c201e758e5, topicName=translational)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d81c2500028, createdName=12498561m32(暂无昵称), createdTime=Wed Sep 22 18:51:14 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2067555, encodeId=9a5e206e55562, content=<a href='/topic/show?id=d0841e75535' target=_blank style='color:#2F92EE;'>#Transl#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=18, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17755, encryptionId=d0841e75535, topicName=Transl)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Fri Sep 10 03:51:14 CST 2021, time=2021-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2016542, encodeId=ef082016542f8, content=<a href='/topic/show?id=3dab1e67924' target=_blank style='color:#2F92EE;'>#Tourette综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17679, encryptionId=3dab1e67924, topicName=Tourette综合征)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2fe4321, createdName=lifangping, createdTime=Sat Dec 04 13:51:14 CST 2021, time=2021-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1792239, encodeId=6a621e9223911, content=<a href='/topic/show?id=696a14818df' target=_blank style='color:#2F92EE;'>#Psychiatry#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14818, encryptionId=696a14818df, topicName=Psychiatry)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c192448, createdName=diushouji, createdTime=Sat Dec 18 07:51:14 CST 2021, time=2021-12-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1795917, encodeId=a5c61e95917e6, content=<a href='/topic/show?id=42211e757d7' target=_blank style='color:#2F92EE;'>#Translation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17757, encryptionId=42211e757d7, topicName=Translation)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Fri Jun 11 21:51:14 CST 2021, time=2021-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2038421, encodeId=51f32038421c5, content=<a href='/topic/show?id=f7c61e90472' target=_blank style='color:#2F92EE;'>#TTE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17904, encryptionId=f7c61e90472, topicName=TTE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Fri Jul 16 20:51:14 CST 2021, time=2021-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432059, encodeId=d1d614320590c, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 10:51:14 CST 2021, time=2021-05-19, status=1, ipAttribution=)]
    2021-09-10 ms3025846204744509

    #Transl#

    0

  5. 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createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Fri Jun 11 21:51:14 CST 2021, time=2021-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2038421, encodeId=51f32038421c5, content=<a href='/topic/show?id=f7c61e90472' target=_blank style='color:#2F92EE;'>#TTE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17904, encryptionId=f7c61e90472, topicName=TTE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=96f62500201, createdName=12498e67m28暂无昵称, createdTime=Fri Jul 16 20:51:14 CST 2021, time=2021-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432059, encodeId=d1d614320590c, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 10:51:14 CST 2021, time=2021-05-19, status=1, ipAttribution=)]
    2021-12-04 lifangping

    #Tourette综合征#

    0

  6. 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style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Wed May 19 10:51:14 CST 2021, time=2021-05-19, status=1, ipAttribution=)]
    2021-12-18 diushouji

    #Psychiatry#

    0

  7. 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    2021-06-11 ms8435843352634314

    #Translation#

    0

  8. 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    2021-07-16 12498e67m28暂无昵称

    #TTE#

    0

  9. 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    2021-05-19 zhouqu_8

    #综合征#

    0

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