Altered pattern of motor cortical activation-inhibition during voluntary movements in Tourette syndrome.

In patients with Gilles de la Tourette syndrome (GTS) alterations of motor cortex (M1) excitability at rest have been evidenced. In contrast, there has so far been little research into changes of motor cortical reactivity during the time course of voluntary movements in GTS patients. The present study investigates neuromagnetic event-related desynchronization (ERD) and event-related synchronization (ERS) of bilateral M1 in 11 GTS patients and 11 healthy control subjects. ERD represents motor cortical activation, whereas ERS most likely indicates its inhibition. Subjects performed a self-paced finger movement task while magnetoencephalography was used to record neuromagnetic activity. In GTS patients, ERD at beta frequency was significantly increased in the contralateral hemisphere before and during movements, whereas ERS following movement termination was increased in M1 ipsilateral. Ipsilateral ERS was inversely correlated with tic severity as determined by the Yale Global Tic Severity Rating Scale. The data of the present study support the hypothesis that during voluntary movements, motor cortical reactivity is pathologically altered in GTS patients. The observed pattern of increased activation (ERD) prior to and during movement execution followed by increased inhibition (ERS) after movement termination at beta frequency suggests abnormally increased motor cortical activation, possibly driving stronger inhibition. The stronger this inhibition is, the better symptoms appear to be controlled.

MR imaging of claustrophobic patients in an open 1.0T scanner: motion artifacts and patient acceptability compared with closed bore magnets.

OBJECTIVE: To evaluate motion artifacts and patient acceptability of MR imaging of claustrophobic patients in an open 1.0T scanner. SUBJECTS AND METHODS: Thirty six claustrophobic patients were enrolled prospectively, 34 of which had previous MR examinations in closed bore magnets. Anxiety and pain during MR examination in an open 1.0T scanner were evaluated by visual analogue scales and various tests. Influence of motion artifacts on image quality was evaluated by two radiologists independently using a five-point scale. Additionally, 36 non-claustrophobic patients delivered a reference value of a non-claustrophobic population for the visual analogue anxiety scale. RESULTS: Termination rate of MR imaging of highly claustrophobic patients decreased from 58.3% (n=21) in closed bore magnets to 8.3% (n=3) in the open scanner (p

Motor-cortical interaction in Gilles de la Tourette syndrome.

BACKGROUND: In Gilles de la Tourette syndrome (GTS) increased activation of the primary motor cortex (M1) before and during movement execution followed by increased inhibition after movement termination was reported. The present study aimed at investigating, whether this activation pattern is due to altered functional interaction between motor cortical areas. METHODOLOGY/PRINCIPAL FINDINGS: 10 GTS-patients and 10 control subjects performed a self-paced finger movement task while neuromagnetic brain activity was recorded using Magnetoencephalography (MEG). Cerebro-cerebral coherence as a measure of functional interaction was calculated. During movement preparation and execution coherence between contralateral M1 and supplementary motor area (SMA) was significantly increased at beta-frequency in GTS-patients. After movement termination no significant differences between groups were evident. CONCLUSIONS/SIGNIFICANCE: The present data suggest that increased M1 activation in GTS-patients might be due to increased functional interaction between SMA and M1 most likely reflecting a pathophysiological marker of GTS. The data extend previous findings of motor-cortical alterations in GTS by showing that local activation changes are associated with alterations of functional networks between premotor and primary motor areas. Interestingly enough, alterations were evident during preparation and execution of voluntary movements, which implies a general theme of increased motor-cortical interaction in GTS.