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;40:508514) according to which midbrain disturbances play an important pathogenic role in TS.
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