Alterations in structural connectivity may contribute both to the occurrence of tics in Gilles de la Tourette syndrome and to their subsequent control

This scientific commentary refers to ‘Altered structural connectivity of cortico-striato-pallido-thalamic networks in Gilles de la Tourette syndrome’ by Worbe et al. (doi:10.1093/brain/awu311). Tourette syndrome is a developmental disorder of childhood onset characterized by the presence of involuntary, recurring movements and utterances known as tics. It is more prevalent in boys than in girls (∼4:1) and typically follows a developmental time course in which, in the majority of individuals, tics are either absent or mild by early adulthood. Adults with Tourette syndrome can thus be viewed as unrepresentative of the more general Tourette population (i.e. children and adolescents with the disorder), but nevertheless constitute an important group in which the clinical phenotype is stable and the compensatory plastic changes thought to bring about increased control over tic severity during adolescence (Jackson et al. , 2011) have either failed to occur or have been ineffective.While the neurobiology of Tourette syndrome is unclear, it is thought to involve disinhibition of cortico-striato-thalamo-cortical (CSTC) circuits, which are a connected set of brain structures involved in the planning and execution of movements (Albin and Mink, 2006) and in the formation …