Study on characteristic changes of brain function in children with Tourette syndrome based on resting state functional magnetic resonance imaging

This study investigated the characteristic changes of brain function in children with Tourette syndrome (TS) based on resting-state functional MRI (rs-fMRI) and their correlation with the Yale Global Tic Severity Scale (YGTSS) scores. A total of 19 children diagnosed as TS at the Department of Pediatrics in China-Japan Friendship Hospital from October 2021 to April 2023 were enrolled prospectively as the TS group, and 20 healthy children matched for age and gender were field recruited from the community as the control group. All participants underwent head rs-fMRI scans, and regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) values were calculated. YGTSS scores were assessed for the TS group. Pearson correlation analysis and Spearman correlation analysis were used to evaluate the correlation between ReHo, ALFF and YGTSS scores. Receiver operating characteristic (ROC) curves were plotted and area under the curve (AUC) was calculated to evaluate the efficacy of brain function parameters related to YGTSS score in diagnosing TS. The TS group included 19 patients, and aged (8.5±2.6) years, including 13 males (68.4%). The control group included 20 children, and aged (5.5±1.8) years, including 7 males (35.0%). In the TS group, the ReHo values in the left lentiform nucleus gray matter, left occipital lobe fusiform gyrus, right occipital lobe medial gyrus, and right frontal lobe paracentral lobule white matter were lower than those in the control group. The ReHo values in the pons and right cerebellar tonsil region, as well as the ALFF values in the right lingual gyrus, were higher than those in the control group (all P<0.01). The ReHo values in the right frontal lobe paracentral lobule, right occipital lobe medial gyrus, and left occipital lobe fusiform gyrus were positively correlated with vocal frequency (r=0.466, 0.576, 0.491) and intensity (r=0.498, 0.593, 0.609); the ReHo values in the right occipital lobe medial gyruss (r=0.615) and left occipital lobe fusiform gyrus (r=0.661) were positively correlated with the number of vocal tics (all P<0.05). The AUC (95%CI) for discriminating TS based on the ReHo values in the right frontal lobe paracentral lobule, right occipital lobe medial gyrus, and left occipital lobe fusiform gyrus were 0.890 (0.774-1.000), 0.863 (0.745-0.982), and 0.858 (0.760-0.988), respectively, with no statistically significant differences in the efficacy of these 3 ReHo values for discriminating TS (all P>0.05). Children with TS have characteristic brain function changes, and there is a correlation between the characteristic brain regions of MRI brain function changes and vocal tic symptoms.