维生素水平与T淋巴细胞亚群和儿童抽动严重程度的关联：一项使用YGTSS的横断面研究

ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Adolescent and Young Adult Psychiatry

• Zhangjiagang City First People's Hospital, Zhangjiagang, China

Abstract

Background: Tic disorders (TDs) are common neurodevelopmental disorders in children, and increasing evidence suggests that immune dysfunction and nutritional factors may contribute to their pathophysiology. However, the relationships between vitamin status, T-lymphocyte subsets, and tic severity remain incompletely understood. This study aimed to investigate the associations of vitamin levels and T-lymphocyte subsets with tic severity in children with TDs. Methods: In this cross-sectional study, children diagnosed with TDs at Zhangjiagang Hospital Affiliated to Soochow University were enrolled. Tic severity was assessed using the Yale Global Tic Severity Scale (YGTSS) Global Severity Score. Serum levels of vitamin A, vitamin D, vitamin E, vitamin B12, and folate, as well as peripheral blood T-lymphocyte subsets, including CD3+, CD4+, CD8+, and CD4/CD8 ratio, were measured. Correlation analyses were performed to evaluate associations between biological markers and YGTSS scores. Subgroup analyses were conducted according to vitamin D status. Results: Serum vitamin D levels were inversely associated with YGTSS Global Severity Scores, indicating that lower vitamin D status was associated with greater tic severity. Among T-lymphocyte subsets, CD4+ T-cell counts demonstrated a significant association with tic severity, whereas CD4+ percentages showed no significant relationship. Children with vitamin D deficiency tended to have higher tic severity scores compared with those with sufficient vitamin D levels. No consistent associations were observed between tic severity and vitamin A, vitamin E, vitamin B12, folate, CD8+ T-cell counts, or CD4/CD8 ratio. Conclusions: Vitamin D status and CD4+ T-cell counts were associated with tic severity in children with TDs, suggesting that nutritional and immune factors may contribute to the clinical manifestations of tic disorders. These findings support a potential role of neuroimmune mechanisms in TDs and provide a basis for future longitudinal and mechanistic studies.

Keywords

CD4+ T lymphocytes, Pediatric Neuroimmunology, tic disorder, Tourette Syndrome, Vitamin D, Yale Global Tic Severity Scale

Received

08 June 2026

Accepted

01 September 2026

Copyright

© 2026 Zhu, Zhang, Kang, Gao, Zhang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence:

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