Tourette Syndrome (TS) is a neuropsychiatric disorder thought to involve a reduction of basal ganglia (BG) interneurons and malfunctioning of the BG circuitry. However, whether interneurons fail to develop or are lost postnatally remains unknown. To investigate the pathophysiology of early development in TS, induced pluripotent stem cell (iPSC)-derived BG organoids from TS patients and healthy controls were compared on multiple levels of measurement and analysis. BG organoids from TS individuals manifested an impaired medial ganglionic eminence fate and a decreased differentiation of cholinergic and GABAergic interneurons. Transcriptome analyses revealed organoid mispatterning in TS, with a preference for dorsolateral at the expense of ventromedial fates. Our results point to altered expression of GLI transcription factors downstream of the Sonic Hedgehog signaling pathway with cilia disruption at the earliest stages of BG organoid differentiation as a potential mechanism for the BG mispatterning in TS. This study uncovers early neurodevelopmental underpinnings of TS neuropathological deficits using organoids as a model system.
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We wish to thank the participants who donated samples and time to our study. We want to thank Jeremy Schreiner and Livia Tomasini for technical assistance and Scott Norton for guidance in performing the transcriptome analyses. We thank Michael Higley and Riccardo Parra for use of the dual photon microscope. We are grateful to Drs. Christopher Pittenger and Nenad Sestan for comments and suggestions on an earlier version of this work. We acknowledge the Yale Center for Clinical Investigation for clinical support in obtaining the biopsy specimens, the Yale Stem Cell Center for the generation of the iPSC lines, and the Yale Center for Genome Analysis for library preparation and sequencing. We thank Dr. Pamela Ventola, Dr. Katarzyna Chawarska and Dr. Kevin Pelphrey for help with recruitment of control subjects.
The recruitment and production of iPSC lines for control subjects were supported by the following grants: MH087879, MH089176, and MH109648 from the National Institutes of Health, and by the Simons Foundation. The recruitment and production of iPSC lines for TS subjects were supported by MH118453 from the National Institutes of Health, by the NARSAD- Brain and Behavior Research Fund and by the Tourette Association of America.
The authors declare no competing interests.
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Brady, M.V., Mariani, J., Koca, Y. et al. Mispatterning and interneuron deficit in Tourette Syndrome basal ganglia organoids. Mol Psychiatry 27, 5007–5019 (2022). https://doi.org/10.1038/s41380-022-01880-5