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

Jirui Wang1,2, Xianbin Wang1,2, Wenyan Zhang1,2

  • 1Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.

Japanese Journal of Radiology
|June 5, 2026
PubMed
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Children with Tourette syndrome (TS) show altered white matter microstructure, impacting neural pathways. These microstructural changes are linked to tic severity and reduced quality of life, suggesting integrated treatment approaches.

Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Medical Imaging

Background:

  • Tourette syndrome (TS) is a complex neurodevelopmental disorder.
  • Understanding the underlying neurobiology of TS is crucial for effective treatment.
  • White matter microstructure alterations have been implicated in various neurological conditions.

Purpose of the Study:

  • To investigate white matter microstructure changes in children with TS.
  • To explore the relationship between these alterations and the pathophysiology of TS.
  • To examine the association between white matter integrity, tic severity, and quality of life (QOL).

Main Methods:

  • Diffusion tensor imaging (DTI) was used to analyze white matter integrity in 53 children with TS and 91 controls.
  • Key DTI metrics including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were assessed.
Keywords:
DTIMediation analysisQuality of lifeTBSSTourette syndromeWhite matter

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  • Correlations between white matter metrics, tic severity, and QOL were analyzed, with mediation analysis exploring the role of motor tic severity.

    • Main Results:

    • Children with TS displayed widespread white matter alterations, including lower FA in the right anterior corona radiata (ACR_R) and left anterior limb of the internal capsule.
    • Significant correlations were found between FA values in ACR_R, motor tic severity, and the physical/activities of daily living (ADL) subscale of QOL.
    • Motor tic severity partially mediated the association between ACR_R FA and physical/ADL QOL scores.

    Conclusions:

    • Impaired white matter microstructure is associated with the pathophysiology of Tourette syndrome.
    • Findings suggest that interventions targeting both neural circuit integrity and symptom management may benefit individuals with TS.
    • This study highlights the importance of neuroimaging in understanding TS and guiding therapeutic strategies.