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Linking socioeconomic context to functional brain network abnormalities and clinical severity in children with
Zhongyi Liu1, 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; Beijing Key Laboratory of Research and Application of Intelligent Diagnosis and Treatment System for Pediatric Neurodevelopmental Disorders, China.
Background:
Tourette syndrome (TS) shows substantial clinical heterogeneity, but the factors contributing to this variability remain unclear. Socioeconomic status (SES) may influence brain functional connectivity (FC) and symptom expression, yet its role in pediatric TS is still not well understood.
Objective:
To clarify the role of SES in modulating brain-behavior relationships in TS.
Methods:
Resting-state fMRI data were acquired from 67 children and adolescents with TS and 49 matched controls. FC was computed within and between seven predefined brain networks. We identified group differences in FC, examined associations between SES and clinical measures, and tested whether SES indicators (family income, parental education, and residential location) moderated FC-symptom relationships.
Results:
Compared with controls, children with TS showed significant alterations in FC, mainly characterized by increased connectivity involving somatomotor, frontoparietal control, default mode, attention, and limbic networks, and decreased connectivity within the right frontoparietal control network. Within the TS group, higher parental education was associated with greater premonitory urge severity. Moderation analyses showed that family income, parental education, and residential location moderated FC-premonitory urge associations; higher family income and parental education strengthened these associations, whereas rural residence weakened them.
Conclusions:
Socioeconomic context may contribute to variability in brain-symptom relationships in pediatric TS, particularly for premonitory urges rather than clinician-rated tic severity. These findings highlight the importance of considering socioeconomic context when interpreting neuroclinical heterogeneity in TS and may inform more context-sensitive clinical assessment and interpretation.
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