We investigated the differences in white matter pathology between children with autism spectrum disorder (ASD) and typically developing children using single-tensor diffusion tensor imaging (DTI) and bi-tensor free-water (FW) imaging. Tract-based spatial statistics analysis demonstrated significantly increased FW volume fraction in children with ASD compared with that in typically developing children. Increased FW volume fraction may reflect neuroinflammation in children with ASD as a result of inflammatory cytokine accumulation in the white matter. Furthermore, we showed that FW imaging is more sensitive and specific than single-tensor DTI in the evaluation of white matter in children with ASD.
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