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Paramagnetic rim lesions are associated with choroid plexus inflammation and expansion over 5 years in people with
Jack A Reeves1, Ashley Tranquille1, Alexander Bartnik1
1Department of Neurology, Buffalo Neuroimaging Analysis Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 77 Goodell Street, Suite 440, Buffalo, NY, 14203, USA.
Background:
Chronic active white matter inflammation is linked with multiple sclerosis (MS) clinical severity and is likely integral in MS progression. It has also been associated with choroid plexus (CP) inflammation in vivo, pointing to a potential pathophysiological link between the two phenomena. However, how these aspects of the disease co-evolve over time remains poorly understood nor has their relationship been specifically assessed in people with progressive MS (pwPMS).
Methods:
In this retrospective analysis of a longitudinal study, 129 people with MS (pwMS; 86 people with relapsing remitting (pwRRMS) and 43 pwPMS) were imaged with 3 T MRI at baseline and after 5.4 years of follow-up. CP volume and CP pseudo-T2 (pT2) were calculated as measures reflecting CP inflammation in MS. Paramagnetic rim lesions (PRLs), a marker of chronic active white matter inflammation, were assessed at baseline for the whole cohort, and longitudinally in 96 pwMS with available data (66 pwRRMS, 32 pwPMS). Baseline and longitudinal associations between the CP and PRLs, including interactions with disease course, were assessed, adjusted for covariates including age and sex.
Results:
PwMS with PRLs had significantly larger CP volume at baseline than pwMS without PRLs after correcting for age, sex, and disease duration (mean difference: 0.3 ± 1.2 mL; p = 0.042). Longitudinally, baseline PRL number was associated with increased CP volume in pwPMS (B = 0.22 mL/mL; p < 0.001), but not people with relapsing-remitting MS (B = - 0.01 mL/mL; p > 0.7).
Conclusion:
Increased CP volume is related to chronic white matter inflammation, particularly in pwPMS.
Insights
Chronic active white matter inflammation, marked by paramagnetic rim lesions (PRLs), is linked to larger choroid plexus (CP) volume in people with multiple sclerosis (MS). This association is particularly significant in those with progressive MS (pwPMS).
Area of Science:
- Neuroimmunology
- Neuroimaging
- Multiple Sclerosis Pathophysiology
Background:
- Chronic active white matter inflammation correlates with multiple sclerosis (MS) severity and progression.
- Choroid plexus (CP) inflammation is observed in MS, suggesting a potential link with white matter disease.
- The temporal relationship between CP and white matter inflammation, especially in progressive MS, is not well understood.
Purpose of the Study:
- To investigate the longitudinal relationship between chronic active white matter inflammation and CP volume in people with MS (pwMS).
- To assess if this relationship differs between relapsing-remitting MS (pwRRMS) and progressive MS (pwPMS).
Main Methods:
- Retrospective analysis of a longitudinal study involving 129 pwMS (86 pwRRMS, 43 pwPMS) with 3 Tesla MRI scans at baseline and after 5.4 years.
- Choroid plexus (CP) volume and pseudo-T2 (pT2) were measured as indicators of CP inflammation.
- Paramagnetic rim lesions (PRLs), a marker of chronic active white matter inflammation, were assessed, and their association with CP measures was analyzed, adjusting for covariates.
Main Results:
- PwMS with PRLs exhibited significantly larger CP volume at baseline compared to those without PRLs (p=0.042).
- Longitudinally, baseline PRL count was associated with increased CP volume in pwPMS (B=0.22 mL/mL; p<0.001).
- No significant longitudinal association was found between PRLs and CP volume in pwRRMS (p>0.7).
Conclusions:
- Increased CP volume is associated with chronic white matter inflammation in MS.
- This relationship is particularly pronounced in people with progressive MS, highlighting a potential disease-specific interaction.
