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Titolo:
Neuropsychiatric assessment of Gilles de la Tourette patients: Comparativestudy with other hyperkinetic and hypokinetic movement disorders
Autore:
Kulisevsky, J; Litvan, I; Berthier, ML; Pascual-Sedano, B; Paulsen, JS; Cummings, JL;
Indirizzi:
Autonomous Univ Barcelona, St Pau Hosp, Dept Neurol, Movement Disorders Unit, Barcelona 08025, Spain Autonomous Univ Barcelona Barcelona Spain 08025 , Barcelona 08025, Spain Henry M Jackson Fdn, Def & Vet Head Injury Program, Cognit Neuropharmacol Unit, Bethesda, MD USA Henry M Jackson Fdn Bethesda MD USA europharmacol Unit, Bethesda, MD USA Univ Malaga, Neurol & Dermatol Dept, E-29071 Malaga, Spain Univ Malaga Malaga Spain E-29071 & Dermatol Dept, E-29071 Malaga, Spain Univ Iowa, Dept Psychiat, Iowa City, IA 52242 USA Univ Iowa Iowa City IA USA 52242 , Dept Psychiat, Iowa City, IA 52242 USA Univ Iowa, Dept Neurol, Iowa City, IA 52242 USA Univ Iowa Iowa City IA USA 52242 wa, Dept Neurol, Iowa City, IA 52242 USA Univ Calif Los Angeles, Sch Med, Dept Neurol, Los Angeles, CA 90024 USA Univ Calif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA Univ Calif Los Angeles, Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA Univ Calif Los Angeles Los Angeles CA USA 90024 Los Angeles, CA 90024 USA
Titolo Testata:
MOVEMENT DISORDERS
fascicolo: 6, volume: 16, anno: 2001,
pagine: 1098 - 1104
SICI:
0885-3185(200111)16:6<1098:NAOGDL>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROGRESSIVE SUPRANUCLEAR PALSY; OBSESSIVE-COMPULSIVE DISORDER; POSITRON EMISSION TOMOGRAPHY; FRONTAL-SUBCORTICAL CIRCUITS; BASAL GANGLIA CALCIFICATION; BIOGENIC-AMINE METABOLISM; HUNTINGTONS-DISEASE; FUNCTIONAL NEUROANATOMY; GLUCOSE-METABOLISM; FDG-PET;
Keywords:
Gilles de la Tourette syndrome; basal ganglia; neuropsychiatric symptoms;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
65
Recensione:
Indirizzi per estratti:
Indirizzo: Kulisevsky, J Autonomous Univ Barcelona, St Pau Hosp, Dept Neurol, Movement Disorders Unit, St Antoni M Claret 167, Barcelona 08025, Spain AutonomousUniv Barcelona St Antoni M Claret 167 Barcelona Spain 08025
Citazione:
J. Kulisevsky et al., "Neuropsychiatric assessment of Gilles de la Tourette patients: Comparativestudy with other hyperkinetic and hypokinetic movement disorders", MOVEMENT D, 16(6), 2001, pp. 1098-1104

Abstract

The role of the basal ganglia in conditions with co-occurring movement disorders and neuropsychiatric symptoms is not well known. It has been hypothesized that hyperkinesia -disinhibited behaviors and hypokinesia-inhibited behaviors result from an imbalance between the direct and indirect striatal output pathways, and that differential involvement of these pathways could account for the concurrent abnormalities in movement and behavior observed in these disorders. This study aimed to evaluate whether the pattern and the extent of the neuropsychiatric manifestations of patients with GTS, a hyperkinetic movement disorder of basal ganglia origin, differs from that of patients with other basal ganglia hyperkinetic (e.g., HD) or hypokinetic (e.g., PSP) movement disorders, and to determine whether patients with GTS show a greater frequency of hyperactive behaviors (e.g., agitation, irritability, euphoria, or anxiety) than PSP patients, and are comparable to patients with HD. The Neuropsychiatric Inventory (NPI), a scale with established validity and reliability, was administered to 26 patients with GTS (mean age, 30.2 +/-2.2 years), and the results were compared with that of 29 patients with HD(mean age, 43.8 +/- 2 years) and 34 with PSP (mean S.D. age, 66.6 +/- 1.2 years). There was no difference between the groups in the total NPI scores: However, there was a double dissociation in behaviors: patients with hyperkineticdisorders (HD and GTS) exhibited significantly more agitation, irritability, anxiety, euphoria, and hyperkinesia, whereas hypokinetic patients (PSP) exhibited more apathy. Patients with GTS showed greater scores than HD patients in all those scores differentiating HD and GTS from PSP patients (e.g., agitation, irritability, anxiety and euphoria), and were differentiated in a logistic regression analysis from both HD and PSP patients in having significantly snore anxiety. We found that patients with GTS manifested predominantly hyperactive behaviors similar but more pronounced than those presented by patients with HD, while those with PSP manifested hypoactive behaviors. Based on our findings and the proposed models of basal ganglia dysfunctionin these disorders, we suggest that the hyperactive behaviors in GTS are comparable to those observed in HD, being both secondary to an excitatory subcortical output through the medial and orbitofrontal cortical circuits, while in PSP the hypoactive behaviors are secondary to hypostimulation of these circuits. Abnormalities of other brain structures (e.g., amygdala, brainstem nuclei) may account for the significantly higher anxiety scores differentiating GTS froth HD patients. (C) 2001 Movement Disorder Society.

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Documento generato il 23/01/20 alle ore 03:20:36