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It involves alterations in the dopaminergic system within the cortico-basal ganglia-thalamo-cortical loops although several hypotheses from the literature implicate the glutamatergic system. Our objective was to study the activity of NMDA receptors (NMDARs) in vivo in patients with Tourette syndrome compared to healthy controls. PET imaging was used in patients with Tourette syndrome (n = 12) and healthy controls (n = 12) with a new radioligand, the [18F]-FNM, which binds to activated NMDARs. Clinical and behavioural assessments were also performed on patients to evaluate tics severity (YGTSS), obsessive\u2013compulsive disorder (Y-BOCS), impulsivity (BIS-11) and anxio-depressive state (HAD). PET activity was compared between groups in different ROIs. Correlations were made between PET activity and clinical\/behavioural scores in patients with Tourette syndrome. Significant differences in NMDAR activity were found between patients with Tourette syndrome and controls in the right and left ACC, the right caudate nucleus, the right olfactory cortex and the left paracentral lobule: patients with Tourette syndrome exhibited higher NMDAR activity in these ROIs. Moreover, this hyper-NMDAR activity in the ACC correlated positively and significantly with YGTSS scores in patients with Tourette syndrome. Patients with Tourette syndrome showed higher NMDAR activity in the ACC, caudate nucleus, paracentral lobule and olfactory cortex. This presumed hyper-glutamatergic activity may indicate a hyper-activation of the direct striatal pathway leading to the onset of tics, in addition to the supposed hypo-activation of the indirect striatal pathway related to hypo-GABAergic state reported in the literature. Tourette syndrome would therefore be associated with an imbalance between excitatory and inhibitory influences within the cortico-basal ganglia-thalamo-cortical circuit.<\/jats:p>","DOI":"10.1093\/braincomms\/fcag212","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:20:05Z","timestamp":1781612405000},"source":"Crossref","is-referenced-by-count":0,"title":["Tics severity in Tourette syndrome associated with higher glutamatergic activity in the anterior cingulate cortex"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3532-6743","authenticated-orcid":false,"given":"Mathilde","family":"Boussac","sequence":"first","affiliation":[{"name":"Toulouse Neuroimaging Centre (ToNIC), Inserm UMR1214, University of Toulouse III (UPS) , 31059 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Sophie","family":"Salabert","sequence":"additional","affiliation":[{"name":"Toulouse Neuroimaging Centre (ToNIC), Inserm UMR1214, University of Toulouse III (UPS) , 31059 Toulouse ,","place":["France"]},{"name":"Department of Radiopharmacy, Toulouse University Hospital , 31059 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estelle","family":"Harroch","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Neurosciences, Parkinson\u2019s Expert Centre, Toulouse University Hospital, NeuroToul COEN (Centre of Excellence in Neurodegeneration) , 31059 Toulouse ,","place":["France"]},{"name":"NS-PARK\/FCRIN Network ,","place":["France"]},{"name":"Clinical Investigation Centre (CIC 1436), Department of Clinical Pharmacology, Toulouse University Hospital , 31059 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Thalamas","sequence":"additional","affiliation":[{"name":"Clinical Investigation Centre (CIC 1436), Department of Clinical Pharmacology, Toulouse University Hospital , 31059 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Arbus","sequence":"additional","affiliation":[{"name":"Toulouse Neuroimaging Centre (ToNIC), Inserm UMR1214, University of Toulouse III (UPS) , 31059 Toulouse ,","place":["France"]},{"name":"Department of Psychiatry, Toulouse University Hospital, Purpan University Hospital Centre , 31059 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Chaix","sequence":"additional","affiliation":[{"name":"Toulouse Neuroimaging Centre (ToNIC), Inserm UMR1214, University of Toulouse III (UPS) , 31059 Toulouse ,","place":["France"]},{"name":"Department of Paediatric Neurology, Children's Hospital, Toulouse University Hospital , 31059 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Laure","family":"Toureille Pouget","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurology, Children's Hospital, Toulouse University Hospital , 31059 Toulouse ,","place":["France"]},{"name":"Midi-Pyr\u00e9n\u00e9es Autism Resource Centre , 31300 Toulouse ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Payoux","sequence":"additional","affiliation":[{"name":"Toulouse Neuroimaging Centre (ToNIC), Inserm UMR1214, University of Toulouse III (UPS) , 31059 Toulouse ,","place":["France"]},{"name":"Department of Nuclear Medicine, Toulouse University Hospital , Toulouse Cedex 31059 ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Brefel-Courbon","sequence":"additional","affiliation":[{"name":"Toulouse Neuroimaging Centre (ToNIC), Inserm UMR1214, University of Toulouse III (UPS) , 31059 Toulouse ,","place":["France"]},{"name":"Department of Clinical Pharmacology and Neurosciences, Parkinson\u2019s Expert Centre, Toulouse University Hospital, NeuroToul COEN (Centre of Excellence in Neurodegeneration) , 31059 Toulouse ,","place":["France"]},{"name":"NS-PARK\/FCRIN Network ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"issue":"42","key":"2026061913460228500_fcag212-B1","first-page":"158","article-title":"Etude d\u2032une affection nerveuse caracterisee par de l\u2032incoordination motorice accompagnee d\u2032echolalie et de coprolalie","volume":"9","author":"de la Tourette","year":"1885","journal-title":"Archives de Neurologie (Paris)"},{"issue":"4","key":"2026061913460228500_fcag212-B2","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/WCO.0000000000000575","article-title":"Tourette syndrome: Clinical spectrum, mechanisms and personalized treatments","volume":"31","author":"Hartmann","year":"2018","journal-title":"Curr Opin 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