Choroid Plexus Volume and Permeability at Brain MRI within the                     Alzheimer Disease Clinical Spectrum

Choi, Jong Duck; Moon, Yeonsil; Kim, Hee‐Jin; Yim, Younghee; Lee, Subin; Moon, Won-Jin

doi:10.1148/radiol.212400

Cited by 80 publications

(118 citation statements)

References 41 publications

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“…Intriguingly, enlargement of the CP has also been reported in other neurological conditions including stroke (Egorova et al 2019), psychosis (Lizano et al 2019), schizophrenia(Y. F. Zhou et al 2020), depression (Althubaity et al 2022), Alzheimer disease (Choi et al 2022) and complex regional pain syndrome(G. Zhou et al 2015). Therefore, enlargement of the CP is not MSspecific, but instead is likely to be associated with general increase of neuroinflammation (Althubaity et al 2022) (Choi et al 2022). Indeed, functional dysregulation of the CP may reflect a common underlying mechanism in the pathophysiology of the chronic stage of neurodegenerative diseases (Schwartz and Cahalon 2022).…”

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 92%

“…In addition, there is transient enlargement of the CP in association with appearance on new brain lesions. Similar to other neurodegenerative diseases, it remains to be seen as to whether enlargement of the CP is a cause or an effect of CNS neuroinflammation(Gião et al 2022) (Choi et al 2022) (Y. F. Zhou et al 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Zhou et al 2015). Therefore, enlargement of the CP is not MS-specific but instead is likely to be associated with general increase of neuroinflammation or neuronal/axonal degeneration (Althubaity et al 2022) (Choi et al 2022). Indeed, functional dysregulation of the CP may reflect yet unknown common underlying mechanisms in the pathophysiology of neurodegenerative diseases (Schwartz and Cahalon 2022).…”

Section: Discussionmentioning

confidence: 99%

“…Diffusion weighted MRI data (dMRI) were pre-processed using tools provided by the software suites MRtrix3 [1], FSL [2], and ANTs [3, 4]. Specifically, dMRI data were first denoised [5], then potential Gibbs-ringing artefacts were removed [6].…”

Section: Supplementary Materialsmentioning

confidence: 99%

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Choroid plexus volume is enlarged in clinically isolated syndrome patients with optic neuritis

Klistorner

Walt

Barnett

et al. 2022

Preprint

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Objectives: People with Multiple Sclerosis (MS) have a larger choroid plexus (CP) volume than healthy controls. We investigated CP volume in early MS by quantitatively assessing brain MRI scans in patients presenting with optic neuritis (ON) as a clinically isolated syndrome (CIS), compared to a cohort with established Relapsing Remitting Multiple Sclerosis (RRMS) and healthy controls. Methods: Pre- and post-gadolinium 3D-T1, 3D FLAIR and diffusion tensor images were acquired from 44 CIS ON patients at baseline, 1, 3, 6 and 12 months after the onset of ON. Fifty RRMS patients and 50 healthy controls were also included for comparison. Results: ANOVA revealed significantly larger CP volumes in both ON CIS and RRMS groups compared to healthy controls (p<0.001 for both), but no difference between ON CIS and RRMS patients (p=0.9) Twenty-three ON CIS patients who converted to CDMS during 10 years of follow-up demonstrated CP volume similar to RRMS patients, but significantly larger compared to healthy controls (p<0.001). Increased CP volume was identified even in a sub-group of patients without MS-like lesions at baseline (p<0.001). A significant (~6%) transient increase of CP volume was observed following a new bout of inflammation, which, however, returned to pre-inflammatory state few months later. CP volume was not associated with the severity of acute inflammation of the optic nerve or long-term optic nerve axonal loss, not with brain lesion load or severity of tissue damage within lesions. Interpretation: Our data demonstrate that enlarged CP can be observe very early in a disease, transiently reacts to acute inflammation, but not associated with the degree of tissue destruction.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Supplementary Materialsmentioning

confidence: 99%

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Choroid plexus volume is enlarged in clinically isolated syndrome patients with optic neuritis

Klistorner

Walt

Barnett

et al. 2022

Preprint

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Pathogenesis of Alzheimer's disease: Involvement of the choroid plexus

Čarná

Onyango

Katina

et al. 2023

Alzheimer's & Dementia

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The choroid plexus (ChP) produces and is bathed in the cerebrospinal fluid (CSF), which in aging and Alzheimer's disease (AD) shows extensive proteomic alterations including evidence of inflammation. Considering inflammation hampers functions of the involved tissues, the CSF abnormalities reported in these conditions are suggestive of ChP injury. Indeed, several studies document ChP damage in aging and AD, which nevertheless remains to be systematically characterized. We here report that the changes elicited in the CSF by AD are consistent with a perturbed aging process and accompanied by aberrant accumulation of inflammatory signals and metabolically active proteins in the ChP. Magnetic resonance imaging (MRI) imaging shows that these molecular aberrancies correspond to significant remodeling of ChP in AD, which correlates with aging and cognitive decline. Collectively, our preliminary post‐mortem and in vivo findings reveal a repertoire of ChP pathologies indicative of its dysfunction and involvement in the pathogenesis of AD.Highlights Cerebrospinal fluid changes associated with aging are perturbed in Alzheimer's disease Paradoxically, in Alzheimer's disease, the choroid plexus exhibits increased cytokine levels without evidence of inflammatory activation or infiltrates In Alzheimer's disease, increased choroid plexus volumes correlate with age and cognitive performance

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Choroid Plexus Enlargement Exacerbates White Matter Hyperintensity Growth through Glymphatic Impairment

Zhou

Zhong

et al. 2023

Annals of Neurology

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Objective: Choroid plexus (CP) is a key regulator in cerebrospinal fluid production, but its contribution to glymphatic clearance function and association with white matter hyperintensity (WMH) remains unclear. Methods: This retrospective study included 2 prospective 3.0-T magnetic resonance imaging (MRI) cohorts. In cohort 1, patients with indications for lumbar puncture underwent 3-dimensional T1-weighted sequence (3D-T1) before and at 39 hours after intrathecal administration of contrast agent (glymphatic MRI). In cohort 2, patients with WMH were enrolled from the CIRCLE study and had a median follow-up time of 1.4 years. WMH and CP of the lateral ventricles were automatically segmented on T2 fluid-attenuated inversion recovery (FLAIR) and 3D-T1, respectively. CP volume was expressed as a ratio to intracranial volume. Glymphatic clearance was measured as signal percentage change from baseline to 39 hours at 8 brain locations based on glymphatic MRI in the first cohort, or as noninvasive diffusion tensor image analysis along the perivascular space (DTI-ALPS) index based on DTI in the second cohort. Results: In cohort 1, a total of 52 patients were included. Higher CP volume was correlated with slower glymphatic clearance rate in all brain locations. In cohort 2, a total of 197 patients were included. Baseline CP volume was positively associated with WMH volume and its growth. Furthermore, DTI-ALPS index partially mediated the association of CP with both WMH load and growth. Interpretations: Enlarged CP volume could be an indicator for larger growth of WMH, potentially involving impaired glymphatic clearance function. The exploration of CP may provide a novel perspective to clarify the mechanism of WMH pathogenesis, as well as other glymphatic-related disorders.

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Choroid Plexus Volume and Permeability at Brain MRI within the Alzheimer Disease Clinical Spectrum

Cited by 80 publications

References 41 publications

Choroid plexus volume is enlarged in clinically isolated syndrome patients with optic neuritis

Choroid plexus volume is enlarged in clinically isolated syndrome patients with optic neuritis

Pathogenesis of Alzheimer's disease: Involvement of the choroid plexus

Choroid Plexus Enlargement Exacerbates White Matter Hyperintensity Growth through Glymphatic Impairment

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