Dimitrios G. Gkotsoulias | Pathophysiology of Tourette Syndrome - Multimodal Assessment of Metabolic Alterations

Gilles-de-la-Tourette syndrome (GTS) is a congenital neuropsychiatric disorder characterised by sudden motor and vocal tics, occurring after commonly reported premonitory urges. State-of-the-art supports the hypothesis of a dysregulated dopaminergic system, in particular dysfunctions of the tonic/phasic dopamine release or a dopaminergic hyperinnervation. In view of the complex interaction of different neurotransmitters, especially in the basal ganglia, it can also be assumed that an abnormal dopaminergic transmission also affects other transmitter systems, e.g. glutamate (Glu), glutamine (Gln) or gamma-Aminobutyric acid (GABA). Recent studies indicating abnormalities in subcortical iron disposition in GTS, iron’s accumulation in dopamine vesicles and it’s role in dopamine synthesis also support the hypothesis of disturbed iron homeostasis in GTS. In this study, we combine methods of magnetic resonance tomography (MRI), magnetic resonance spectroscopy (MRS) and positron emission tomography (PET), in order to compare the following parameters in patients with GTS and a control cohort: (i) the binding potential of D1-dopamine receptors (ii) the concentrations of Glu, Glutamine and GABA in the corpus striatum and in the cortex cingularis anterior (iii) the subcortical iron concentration.