Basal ganglia dysfunction in Tourette's syndrome: A new hypothesis

Tourette's syndrome is a neuropsychiatric syndrome with onset in childhood that is characterized by chronic multiple ties. The cause of Tourette's syn drome is unknown, but the pathophysiology most likely involves basal gangli a and frontocortical circuits. A useful scheme of basal ganglia dysfunction should be able to account for the features that make Tourette's syndrome u nique, in addition to the features that Tourette's syndrome shares with oth er disorders. Recent advances in knowledge of basal ganglia functional anat omy and physiology make it possible to hypothesize how specific neural mech anisms relate to specific clinical manifestations of Tourette's syndrome. A model of selection and suppression of competing behaviors by the basal gan glia is presented. The functional anatomy of basal ganglia circuits and new information on dopamine modulation of those circuits provide the basis for hypotheses of basal ganglia dysfunction in Tourette's syndrome. (C) 2001 b y Elsevier Science Inc. All rights reserved.