Investigating the association between choroid plexus volume and the pathogenesis of Parkinson's disease

Parkinson's disease (PD) involves motor and cognitive impairments, with recent evidence suggesting that changes in choroid plexus volume (CPV) may contribute to disease progression by affecting protein accumulation in the brain. This study aims to assess the relationship between CPV and PD symptoms, and explore its potential as a biomarker for tracking disease progression.

Data from 236 newly diagnosed, untreated PD patients and 47 healthy controls were retrospectively obtained from a large (n = 412) longitudinal study of patients. CPV was measured using T1-weighted Magnetic Resonance Imaging and normalized by intracranial volume. Clinical assessments included Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS), Montreal Cognitive Assessment (MoCA), Letter-Number Sequencing (LNS), and Symbol Digit Modalities Test (SDMT). Cross-sectional, longitudinal analyses, and mediation analysis, were performed.

PD patients had significantly lower CPV than controls (p < 0.001). Reduced CPV was associated with worse motor (MDS-UPDRS, p = 0.017) and cognitive scores (MoCA, p = 0.005). Over three years, patients with lower CPV experienced faster declines in working memory and processing speed (LNS, p = 0.018; SDMT, p = 0.014). Mediation analysis indicated that Tau protein levels partly mediated the relationship between CPV and baseline cognitive function.

CPV is strongly associated with motor and cognitive decline in PD and may serve as a biomarker for disease progression. Its reduction appears to be linked to pathological protein accumulation, accelerating cognitive deterioration. Incorporating CPV measurements in clinical practice could improve PD diagnosis and management.