Enlarged choroid plexus related to iron rim lesions and deep gray matter atrophy in relapsing-remitting multiple sclerosis

Wang, Xiaohua; Zhu, Qiyuan; Zhang, Yan; Shi, Zhuowei; Xu, Yuhui; Liu, Yanbing; Li, Yongmei

doi:10.1016/j.msard.2023.104740

Cited by 16 publications

(15 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The latter may be more plausible since, in contrast with the deep grey matter, we found no association between CP enlargement and cortical volume. This finding is corroborated by recent research from Wang et al, 29 who also established an association between enlarged CP and reduced deep grey matter volume, but found no such relationship with cortical volume.…”

Section: Increase Of Cp Volume and Inflammationsupporting

confidence: 82%

“…28 However, numerous experimental, postmortem and imaging studies have consistently demonstrated the presence of parenchymal inflammation in CP tissue. [5][6][7]15,23,29 These studies have also highlighted the close association between this inflammation and the observed increase in CP volume, strongly suggesting that inflammation is the probable cause of this enlargement. Therefore, it is possible that the broad range of CP enlargement observed in our study likely reflects varying degrees of CP inflammation in our RRMS cohort.…”

Section: Increase Of Cp Volume and Inflammationmentioning

confidence: 70%

“…This association suggests that CP could be indirectly implicated in forming or sustaining the smouldering inflammatory process at the rim of chronic periventricular MS lesions, possibly through the secretion of pro-inflammatory cytokines or the regulation of immune cell trafficking and microglial activation [30][31][32] This view is supported by our earlier study which demonstrated a clear link between the size of the CP and the rate of chronic lesion expansion in patients with RRMS 8 and also aligns with a recent publication demonstrating larger CP volume in patients with chronic active lesions. 29,33 Moreover, the link between change of CPn volume and expansion of chronic lesions (which occurs predominantly near the ventricles 34 ) may partially explain the predominantly periventricular effect of CP enlargement on brain atrophy. While our results show that CP enlargement significantly correlates with atrophy of both white and grey matter, supporting the view that inflammation originating in the CP may contribute to ongoing neurodegeneration, this association is considerably stronger for the central brain (ventricle enlargement vs total brain atrophy or deep grey matter loss vs cortical atrophy).…”

Section: Increase Of Cp Volume and Inflammationmentioning

confidence: 99%

See 2 more Smart Citations

Longitudinal enlargement of choroid plexus is associated with chronic lesion expansion and neurodegeneration in RRMS patients

Klistorner,

Barnett,

Wang

et al. 2024

Mult Scler

View full text Add to dashboard Cite

Background and Objective: We explored dynamic changes in the choroid plexus (CP) in patients with relapsing-remitting multiple sclerosis (RRMS) and assessed its relationship with chronic lesion expansion and atrophy in various brain compartments. Methods: Fifty-seven RRMS patients were annually assessed for a minimum of 48 months with 3D FLAIR, pre- and post-contrast 3D T1 and diffusion-weighted magnetic resonance imaging (MRI). The CP was manually segmented at baseline and last follow-up. Results: The volume of CP significantly increased by 1.4% annually. However, the extent of CP enlargement varied considerably among individuals (ranging from −3.6 to 150.8 mm3 or −0.2% to 6.3%). The magnitude of CP enlargement significantly correlated with central ( r = 0.70, p < 0.001) and total brain atrophy ( r = −0.57, p < 0.001), white ( r = −0.61, p < 0.001) and deep grey matter atrophy ( r = −0.60, p < 0.001). Progressive CP enlargement was significantly associated with the volume and extent of chronic lesion expansion ( r = 0.60, p < 0.001), but not with the number or volume of new lesions. Conclusion: This study provides evidence of progressive CP enlargement in patients with RRMS. Our findings also demonstrate that enlargement of the CP volume is linked to the expansion of chronic lesions and neurodegeneration of periventricular white and grey matter in RRMS patients.

show abstract

Section: Increase Of Cp Volume and Inflammationsupporting

confidence: 82%

Section: Increase Of Cp Volume and Inflammationmentioning

confidence: 70%

Section: Increase Of Cp Volume and Inflammationmentioning

confidence: 99%

See 1 more Smart Citation

Longitudinal enlargement of choroid plexus is associated with chronic lesion expansion and neurodegeneration in RRMS patients

Klistorner,

Barnett,

Wang

et al. 2024

Mult Scler

View full text Add to dashboard Cite

show abstract

“…Our results are in line with a recent study showing that CP volume was significantly higher in cognitively impaired compared with patients with cognitively preserved MS according to Montreal Cognitive Assessment scores and that higher CP volume was associated with worse SDMT performance. 21 …”

Section: Discussionmentioning

confidence: 99%

“…A significantly higher CP volume was also found to be associated with worse cognitive performance. 21 However, these studies did not include a comprehensive neuropsychological battery, but only include some neuropsychological tests, such as the Paced Auditory Serial Addition Test (PASAT), the Symbol Digit Modalities Test (SDMT), or the California Verbal Learning Test-II. 10 , 19 , 20 Moreover, patients with MS were grouped according to the presence or not of at least 1 or 4 PRLs, the volume of PRLs was not evaluated, and it remained unclear whether the association with cognitive impairment was specific for PRLs.…”

Section: Introductionmentioning

confidence: 99%

Chronic Active Lesions and Larger Choroid Plexus Explain Cognition and Fatigue in Multiple Sclerosis

Preziosa,

Pagani,

Meani

et al. 2024

Neurol Neuroimmunol Neuroinflamm

View full text Add to dashboard Cite

Background and Objectives Chronic inflammation may contribute to cognitive dysfunction and fatigue in patients with multiple sclerosis (MS). Paramagnetic rim lesions (PRLs) and choroid plexus (CP) enlargement have been proposed as markers of chronic inflammation in MS being associated with a more severe disease course. However, their relation with cognitive impairment and fatigue has not been fully explored yet. Here, we investigated the contribution of PRL number and volume and CP enlargement to cognitive impairment and fatigue in patients with MS. Methods Brain 3T MRI, neurologic evaluation, and neuropsychological assessment, including the Brief Repeatable Battery of Neuropsychological Tests and Modified Fatigue Impact Scale, were obtained from 129 patients with MS and 73 age-matched and sex-matched healthy controls (HC). PRLs were identified on phase images of susceptibility-weighted imaging, whereas CP volume was quantified using a fully automatic method on brain three-dimensional T1-weighted and fluid-attenuated inversion recovery MRI sequences. Predictors of cognitive impairment and fatigue were identified using random forest. Results Thirty-six (27.9%) patients with MS were cognitively impaired, and 31/113 (27.4%) patients had fatigue. Fifty-nine (45.7%) patients with MS had ≥1 PRLs (median = 0, interquartile range = 0;2). Compared with HC, patients with MS showed significantly higher T2-hyperintense white matter lesion (WM) volume; lower normalized brain, thalamic, hippocampal, caudate, cortical, and WM volumes; and higher normalized CP volume ( p from <0.001 to 0.040). The predictors of cognitive impairment (relative importance) (out-of-bag area under the curve [OOB-AUC] = 0.707) were normalized brain volume (100%), normalized caudate volume (89.1%), normalized CP volume (80.3%), normalized cortical volume (70.3%), number (67.3%) and volume (66.7%) of PRLs, and T2-hyperintense WM lesion volume (64.0%). Normalized CP volume was the only predictor of the presence of fatigue (OOB-AUC = 0.563). Discussion Chronic inflammation, with higher number and volume of PRLs and enlarged CP, may contribute to cognitive impairment in MS in addition to gray matter atrophy. The contribution of enlarged CP in explaining fatigue supports the relevance of immune-related processes in determining this manifestation independently of disease severity. PRLs and CP enlargement may contribute to the pathophysiology of cognitive impairment and fatigue in MS, and they may represent clinically relevant therapeutic targets to limit the impact of these clinical manifestations in MS.

show abstract

Choroid plexus volume changes in multiple sclerosis: insights from a systematic review and meta-analysis of magnetic resonance imaging studies

Kolahi,

Zarei,

Issaiy

et al. 2024

Neuroradiology

View full text Add to dashboard Cite

Enlarged choroid plexus related to iron rim lesions and deep gray matter atrophy in relapsing-remitting multiple sclerosis

Cited by 16 publications

References 35 publications

Longitudinal enlargement of choroid plexus is associated with chronic lesion expansion and neurodegeneration in RRMS patients

Longitudinal enlargement of choroid plexus is associated with chronic lesion expansion and neurodegeneration in RRMS patients

Chronic Active Lesions and Larger Choroid Plexus Explain Cognition and Fatigue in Multiple Sclerosis

Choroid plexus volume changes in multiple sclerosis: insights from a systematic review and meta-analysis of magnetic resonance imaging studies

Contact Info

Product

Resources

About