Fronto-striatal glutamate in children with Tourette's disorder and attention-deficit/hyperactivity disorder.

OBJECTIVE: Both Tourette's disorder (TD) and attention-deficit/hyperactivity disorder (ADHD) have been related to abnormalities in glutamatergic neurochemistry in the fronto-striatal circuitry. TD and ADHD often co-occur and the neural underpinnings of this co-occurrence have been insufficiently investigated in prior studies.

METHOD: We used proton magnetic resonance spectroscopy (1H-MRS) in children between 8 and 12 years of age (TD n  = 15, ADHD n  = 39, TD + ADHD n  = 29, and healthy controls n  = 53) as an in vivo method of evaluating glutamate concentrations in the fronto-striatal circuit. Spectra were collected on a 3 Tesla Siemens scanner from two voxels in each participant: the anterior cingulate cortex (ACC) and the left dorsal striatum. LC-model was used to process spectra and generate glutamate concentrations in institutional units. A one-way analysis of variance was performed to determine significant effects of diagnostic group on glutamate concentrations.

RESULTS: We did not find any group differences in glutamate concentrations in either the ACC (F(3132)  = 0.97, p  = 0.41) or striatum (F(3121)  = 0.59, p  = 0.62). Furthermore, variation in glutamate concentration in these regions was unrelated to age, sex, medication use, IQ, tic, or ADHD severity. Obsessive-compulsive (OC) symptoms were positively correlated with ACC glutamate concentration within the participants with TD (rho = 0.35, p uncorrected  = 0.02).

CONCLUSION: We found no evidence for glutamatergic neuropathology in TD or ADHD within the fronto-striatal circuits. However, the correlation of OC-symptoms with ACC glutamate concentrations suggests that altered glutamatergic transmission is involved in OC-symptoms within TD, but this needs further investigation.