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Choroid Plexus Volume in Multiple Sclerosis vs Neuromyelitis Optica Spectrum Disorder: A Retrospective,
Jannis Müller1, Tim Sinnecker1, Maria Janina Wendebourg1
1From the Neurology Clinic and Policlinic (J.M., T.S., M.J.W., R.S., J.K., S.S., P.B., T.D., M.B., A.C., C.T., K.P., A.-K.P., S.R., L.K., C.G., O.Y.), Departments of Head, Spine and Neuromedicine, MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Clinical Research and Biomedical Engineering, University Hospital Basel and University of Basel; Translational Imaging in Neurology (ThINk) Basel (J.M., S.S., M.B., A.C., C.T., K.P., C.G., O.Y.), Department of Biomedical Engineering, University Hospital Basel and University of Basel, Switzerland; Department of Biomedical Engineering (P.C., C.J., F.S., J.W., C.G.), University of Basel, Allschwil, Switzerland; Medical Imaging Analysis Center AG (M.A., J.W.); Section of Neuroradiology (T.L.), Clinic for Radiology & Nuclear Medicine, University Hospital Basel and University of Basel, Switzerland; Reha Rheinfelden (K.P.), Rheinfelden, Switzerland; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (S.A., A.D., A.B., J.W., F.P.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Germany; Department of Neurology (A.B.), University of California, Irvine; Department of Neurology (K.R.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; Martinos Center for Biomedical Imaging (N.H.), Massachusetts General Hospital and Harvard Medical School, Boston; Gillberg Neuropsychiatry Center (N.H.), Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Neurology (S.F., M.W., K.M., T.M., N.I., J.-I.K.), Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Neurology (J.-I.K.), Brain and Nerve Center, Fukuoka Central Hospital, International University of Health and Welfare, Fukuoka; and Translational Neuroscience Center (J.-I.K.), Graduate School of Medicine, and School of Pharmacy at Fukuoka, International University of Health and Welfare, Okawa, Japan.
The choroid plexus is enlarged in multiple sclerosis (MS) but not in neuromyelitis optica spectrum disorder (NMOSD). This finding suggests distinct roles for the choroid plexus in the central nervous system inflammation of these conditions.
Area of Science:
- Neuroimmunology
- Neuroimaging
- Central Nervous System (CNS) Inflammation
Background:
- The choroid plexus plays a key role in CNS inflammation.
- Previous research indicates enlarged choroid plexus in multiple sclerosis (MS) compared to healthy individuals.
- The choroid plexus's role in neuromyelitis optica spectrum disorder (NMOSD) remains unclear.
Purpose of the Study:
- To compare choroid plexus volume in patients with MS and NMOSD.
- To investigate the association between choroid plexus volume and disease characteristics in MS and NMOSD.
Main Methods:
- Retrospective, cross-sectional study utilizing convenience sampling from 4 international MS centers.
- Fully automated segmentation of the choroid plexus on T1-weighted MRI using a deep learning algorithm (Multi-Dimensional Gated Recurrent Units).
- Uni- and multivariable linear models to analyze associations between choroid plexus volume and clinical/MRI parameters.
Main Results:
- Choroid plexus volume was significantly larger in MS (median 1,690 µL) compared to NMOSD (median 1,403 µL), healthy controls (median 1,533 µL), and migraine patients (median 1,404 µL).
- No significant difference in choroid plexus volume was observed between NMOSD, migraine patients, and healthy controls.
- In MS, but not NMOSD, choroid plexus volume correlated with the number of T2-weighted lesions, even after adjusting for multiple clinical and demographic factors.
Conclusions:
- The choroid plexus is implicated in the pathogenesis of MS, unlike in NMOSD.
- Findings suggest distinct mechanisms of CNS inflammation in MS and NMOSD involving the choroid plexus.
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