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Choroid plexus enlargement in secondary progressive MS: phenotype comparison.

Samuel Klistorner1, Michael H Barnett2, Chenyu Wang3

  • 1Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.

Multiple Sclerosis and Related Disorders
|November 14, 2025
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Summary

Choroid plexus volume increases with multiple sclerosis (MS) progression, particularly in secondary progressive MS (SPMS). This enlargement, linked to inflammation and tissue damage, may serve as a key biomarker for MS.

Keywords:
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Area of Science:

  • Neuroimmunology
  • Neuroimaging
  • Biomarker Discovery

Background:

  • The choroid plexus (CP) is implicated in chronic inflammation in multiple sclerosis (MS).
  • CP enlargement is noted in early MS, but its role in secondary progressive MS (SPMS) remains unclear.
  • Understanding CP volume changes is crucial for MS progression insights.

Purpose of the Study:

  • Quantify CP volume in SPMS patients.
  • Compare CP volume across MS phenotypes (CIS, RRMS, SPMS).
  • Assess CP volume associations with MS disease severity and progression.

Main Methods:

  • Manual segmentation and normalization of CP volumes in 121 MS patients (CIS, RRMS, SPMS).
  • Age correction using a healthy control cohort (n=109).
  • Cross-sectional and longitudinal analyses of CP volume, ventricular size, lesion burden, and brain atrophy.

Main Results:

  • Significant CP volume increase across MS phenotypes: SPMS showed 32% higher than CIS and 25% higher than RRMS.
  • CP enlargement in SPMS was independent of ventricular size.
  • Baseline CP volume correlated significantly with chronic lesion expansion (r²=0.33) and brain volume loss (r²=0.51) in SPMS.

Conclusions:

  • CP enlargement is a progressive feature of MS, distinct from ventricular expansion.
  • In SPMS, CP enlargement may indicate ongoing inflammation and contribute to tissue damage.
  • CP volume shows potential as a biomarker for MS progression and inflammation.