Association Between Choroid Plexus Morphological Alterations, Alzheimer Pathologies, and Cognitive Impairment: A...

Area of Science:

• Neuroimaging
• Neuropathology
• Cognitive Neuroscience

Background:

• The choroid plexus (ChP) is vital for brain health, but Alzheimer disease (AD) pathologies can damage it, potentially accelerating neurodegeneration.
• Previous studies indicate enlarged ChP volume in AD patients, but detailed morphological changes and their clinical relevance remain unclear.

Purpose of the Study:

• To investigate AD-related morphological features of the choroid plexus (ChP).
• To explore the association between these ChP features and cognitive decline in individuals at risk for AD.

Main Methods:

• Utilized retrospective data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) including MRI, PET scans, and cognitive assessments.
• Developed a deep learning model for precise ChP segmentation and analyzed high-order morphological features.
• Employed partial correlation and chain mediation analyses to link ChP features with cognitive scores and linear mixed models to predict cognitive decline.

Main Results:

• Alzheimer disease pathologies were associated with ChP hypertrophy, irregular shapes, and nonuniform signals (p < 0.05).
• ChP features mediated the relationship between AD pathologies and cognitive scores (e.g., Montreal Cognitive Assessment).
• Specific ChP morphological features predicted longitudinal cognitive decline in amyloid-beta positive participants (p < 0.05).

Conclusions:

• The study successfully identified complex morphological alterations in the ChP associated with AD.
• These findings suggest that AD pathologies disrupt ChP structure, contributing to clinical progression.
• Further imaging-histopathological studies are needed to elucidate the underlying pathological substrates of these ChP changes.