Objective: To investigate cerebral structure in Tourette's syndrome (TS).
Methods: Voxel-based morphometry study of high-resolution MRIs in 31 TS patients compared with 31 controls.
Results: Increased gray matter mainly in the left mesencephalon in 31 TS patients.
Interpretation: This result constitutes strong and direct evidence supporting Devinsky's hypothesis (Devinsky O. Neuroanatomy of Gilles de la Tourette's syndrome. Possible midbrain involvement. Arch Neurol 1983;40:508-514) according to which midbrain disturbances play an important pathogenic role in TS.