Related Experiment Video
Updated: Jun 17, 2026
Microdissection and Whole Mount Scanning Electron Microscopy Visualization of Mouse Choroid Plexus
Published on: December 16, 2022
Choroid Plexus Volume in Pediatric-Onset Multiple Sclerosis
Eleonora A Grasso1, Luke Bloy1, Phillip Kaplan1
1From the Departments of Neurology (E.A.G., P.K., B.L.B.), Radiology (L.B.), Children's Hospital of Philadelphia, PA; Department of Neurology (A.B.-O.), University of Pennsylvania, PA; Division of Neurology (E.A.Y.), The Hospital for Sick Children, Toronto, Canada; McConnell Brain Imaging Centre (D.L.A.), Montreal Neurological Institute, Montreal, Canada; Department of Neurology (S.N.), McGill University, Montreal, Canada; Departments of Medicine and Community Health Sciences (R.A.M.), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada; and Department of Medicine (G.F.), University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Canada.
Insights
Children with pediatric-onset multiple sclerosis (MS) have larger choroid plexus volumes (CPV) at diagnosis than healthy children. This increased CPV did not predict disease activity or disability in the first year of MS.
Area of Science:
- Neuroimmunology
- Pediatric Neurology
- Neuroimaging
Background:
- The choroid plexus (CP) is implicated in central nervous system (CNS) inflammation in multiple sclerosis (MS).
- Pediatric-onset MS (POMS) exhibits significant inflammatory activity, making it a relevant model for studying early inflammatory changes.
Purpose of the Study:
- To compare choroid plexus volume (CPV) in children with POMS versus healthy controls (HCs).
- To assess changes in CPV during the first year of POMS.
- To investigate associations between CPV, brain volumes, disease activity, and disability in POMS.
Main Methods:
- 1.5T MRI scans were analyzed for 23 POMS participants and 23 HCs, with 18 POMS participants having 12-month follow-up scans.
- Manual segmentation was used to determine CPV, normalized for intracranial volume.
- Correlations were examined between CPV and brain/lesion volumes, relapse rates, and Expanded Disability Status Scale (EDSS) scores.
Main Results:
- Normalized CPV was significantly greater in POMS participants (1.51 × 10-3) compared to HCs (1.21 × 10-3; p=0.001).
- CPV did not significantly change over the first year in POMS participants (p=0.352).
- CPV correlated with lateral ventricular volume but not with brain volumes, T2 lesions, relapse activity, or EDSS scores.
Conclusions:
- Baseline CPV is elevated in children with POMS compared to HCs.
- Elevated baseline CPV does not appear to predict disease activity or neurological outcomes within the first year of POMS.
- While increased CPV may indicate early inflammation in MS, its correlation with ventricular volume warrants further investigation.
Background And Objectives:
Recent studies suggest that the choroid plexus (CP) may function as a site of access of inflammatory cells into the CNS in multiple sclerosis (MS). Pediatric-onset MS (POMS) is characterized by a high inflammatory burden, as evidenced by a high relapse rate and volume of T2 lesions, making patients with POMS an informative population to evaluate choroid plexus volume (CPV). The objectives of the study were (1) to evaluate CPV at symptom onset in participants with POMS compared with healthy controls (HCs); (2) to evaluate changes in CPV in the first year of disease in participants with POMS; and (3) to evaluate associations between CPV, brain volumes, relapse activity, and disability in participants with POMS.
Methods:
Baseline 1.5T MRI scans were acquired from 23 participants with POMS and 23 age-matched and sex-matched HCs; 18 participants with POMS also had 12-month follow-up MRI scans. The CP of the lateral ventricles was segmented manually. CP and brain structure volumes were normalized for total intracranial volume. The number of relapses, T2 and gadolinium-enhancing T1 lesion counts, and Expanded Disability Status Scale (EDSS) scores at 12 months were also analyzed. Baseline CPVs were compared between groups using the Wilcoxon exact test, and CPV change from baseline to 12 months in participants with POMS was compared using the Wilcoxon signed-rank test. The relationship between CPV and brain volumetric measures, T2 lesion volumes, lesion count, number of relapses, and EDSS scores was assessed through Spearman correlation.
Results:
The median normalized CPV was 1.51 × 10-3 (interquartile range [IQR]: 1.32-1.76) in POMS baseline scans and 1.21 × 10-3 (IQR: 1.1-1.47) in HC scans (p = 0.001). CPV did not significantly change at 12 months in the 18 participants with POMS with follow-up scans (p = 0.352). CPV in participants with POMS and HCs correlated with lateral ventricular volume (p = 0.012 for both groups) but did not correlate with brain and T2 lesion volumes or lesion count at baseline, nor with relapse activity or EDSS scores at 12 months in participants with POMS.
Discussion:
CPV measured at baseline is greater in participants with POMS than in HCs. Baseline CPV did not predict higher disease activity or worse neurologic outcomes over 1 year. While higher CPV may be an early feature of inflammation in MS, its strong correlation with ventricular volumes could also reflect enlargement secondary to the mechanical attachment of CP to the ventricular wall.
More Related Videos
Related Concept Videos
01:18Anatomy of the Brain: Ventricles
01:19Multiple Sclerosis l: Introduction
01:14Increased Intracranial Pressure l: Introduction
01:29Increased Intracranial Pressure ll: Pathophysiology
01:22Cerebral Edema ll: Pathophysiology