White matter microstructural abnormalities in children with Tourette syndrome using tract-based spatial statistics analysis.

OBJECTIVES

This study aimed to investigate alterations in white matter microstructure in children with Tourette syndrome (TS) and to explore its potential role in pathophysiology.

METHODS

Diffusion tensor imaging data were collected from 53 children with TS and 91 typically developing controls. White matter integrity was assessed and analyzed using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Correlations with tic severity and quality of life (QOL) were examined, followed by mediation analysis to assess whether motor tic severity mediated the relationship between FA values in the right anterior corona radiata (ACR_R) and QOL.

RESULTS

Children with TS exhibited widespread white matter alterations, lower FA in ACR_R and left anterior limb of the internal capsule, lower MD in the inferior fronto-occipital fasciculus, and lower AD in ACR_R, alongside higher MD in the genu of the corpus callosum, higher AD in the inferior fronto-occipital fasciculus, and higher RD in ACR_R. The FA values in ACR_R showed a significant negative correlation with motor tic severity (r = - 0.302, P = 0.031) and a significant negative correlation with physical/activities of daily living (ADL) subscale of QOL (r = - 0.468, P < 0.001). Motor tic severity was positively correlated with physical/ADL subscale of QOL (r = 0.430, P = 0.008). Motor tic severity partially mediated the relationship between FA values in ACR_R and physical/ADL scores (β = - 0.091, 95% CI [- 0.208, - 0.016]).

CONCLUSIONS

These findings suggest that impaired white matter microstructure may be associated with the pathophysiology of TS, and that future interventions may benefit from simultaneously addressing neural circuit integrity and symptom management.