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Assessment of Glymphatic System Function in Children With Tourette Syndrome Using Diffusion Tensor Image Analysis
Jirui Wang1, Tianyuan Lei1, Xianbin Wang1
1Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China; Laboratory for Clinical Medicine, Capital Medical University, Beijing, China.
Biological Psychiatry. Cognitive Neuroscience and Neuroimaging
|October 1, 2025
Summary
Children with Tourette syndrome (TS) show impaired glymphatic system function, linked to increased tic severity and reduced quality of life. This suggests glymphatic dysfunction may play a role in TS.
Area of Science:
- Neuroscience
- Radiology
- Pediatrics
Background:
- Tourette syndrome (TS) pathophysiology remains incompletely understood.
- The glymphatic system, responsible for waste clearance in the brain, is a potential factor in neurological disorders.
Purpose of the Study:
- To evaluate glymphatic system function in children with TS using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS).
- To explore the association between glymphatic function and TS clinical manifestations, including tic severity and quality of life.
Main Methods:
- DTI scans were performed on 76 children with TS and 82 typically developing controls.
- Glymphatic function was quantified using the ALPS index, derived from specific brain regions.
- Associations between the ALPS index and clinical measures (YGTSS, GTS-QOL) were analyzed, including mediation analysis.
Main Results:
- Children with TS exhibited a significantly reduced ALPS index compared to controls.
- The ALPS index negatively correlated with tic severity (motor, total, global) and GTS-QOL subscales (physical/ADL, obsessive-compulsive).
- Motor tic severity partially mediated the relationship between ALPS index and physical/ADL scores.
Conclusions:
- Altered glymphatic function is evident in children with TS.
- Glymphatic dysfunction is associated with increased tic severity and diminished quality of life in TS.
- These findings implicate glymphatic system impairment in the neurobiological basis of Tourette syndrome.
