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Whether similar WM patterns occur in early\u2010onset bipolar disorder (EOBD) remains unclear. This study investigated WM alterations in EOBD and their associations with psychiatric symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty\u2010seven individuals with EOBD and 57 healthy controls (HCs) underwent diffusion magnetic resonance imaging (dMRI) and psychiatric assessments. Whole\u2010brain WM changes between groups were examined using TractSeg and tract\u2010based spatial statistics. Partial correlations with multiple comparison corrections assessed associations between altered tracts and symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with HCs, EOBD showed widespread lower fractional anisotropy (FA) and altered other WM parameters, particularly in the CC and visual\u2010related tracts. Lower FA in the anterior midbody CC (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.307,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.038), right superior longitudinal fascicle I (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.305,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.038), thalamo\u2010parietal (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.315,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.038), and parieto\u2010occipital pontine tracts (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.329,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.038) correlated with greater depressive symptoms. Lower FA in the left inferior fronto\u2010occipital fascicle (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.371,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.030), left optic radiation (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.381,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.030), and left thalamo\u2010occipital tract (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.392,\n                      <jats:italic>q<\/jats:italic>\n                      \u2009=\u20090.030) were associated with greater positive symptoms. These visual\u2010related lower FAs were found more frequently in individuals with visual hallucinations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EOBD was associated with WM abnormalities in the CC and visual pathways linked to depressive symptoms and visual hallucinations, supporting its characterization as a neurodevelopmentally distinct subtype with persistent WM dysconnectivity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pcn.70023","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T11:50:18Z","timestamp":1768564218000},"page":"298-307","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["White matter alterations in the corpus callosum and visual cortical regions associated with depressive and psychotic symptoms in 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