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Updated: Jan 7, 2026

Dynamic Visual Tests to Identify and Quantify Visual Damage and Repair Following Demyelination in Optic Neuritis Patients
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Glymphatic dysfunction in neuromyelitis optica spectrum disorder.

Ying Zhang1,2, Hongxi Chen1, Ziyan Shi1

  • 1Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Frontiers in Immunology
|December 29, 2025
PubMed
Summary
This summary is machine-generated.

Neuromyelitis optica spectrum disorder (NMOSD) patients show subtle choroid plexus volume changes linked to disability. These findings suggest glymphatic dysfunction and highlight choroid plexus alterations as potential imaging biomarkers for NMOSD.

Keywords:
DTI-ALPSchoroid plexusglymphatic dysfunctionneuromyelitis optica spectrum disorderperivascular spaces

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Area of Science:

  • Neuroimmunology
  • Neuroimaging
  • Glymphatic System Research

Background:

  • Neuromyelitis optica spectrum disorder (NMOSD) is characterized by aquaporin-4-mediated astrocyte injury.
  • This injury may lead to impaired glymphatic system function.
  • Glymphatic dysfunction is implicated in the pathophysiology of NMOSD.

Purpose of the Study:

  • To assess glymphatic function in NMOSD patients using MRI-based metrics.
  • To investigate the association between glymphatic function, disability, and brain structure in NMOSD.
  • To explore the potential of imaging biomarkers for NMOSD disease burden.

Main Methods:

  • Utilized 3T MRI (3D-FSPGR and DTI) in 39 AQP4-IgG-positive NMOSD patients and 21 healthy controls.
  • Assessed glymphatic function via diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, choroid plexus (CP) volume, and perivascular space (PVS) metrics.
  • Correlated imaging findings with clinical assessments including EDSS, HAMA, HAMD, FIS, and PSQI, employing statistical analyses with FDR correction.

Main Results:

  • NMOSD patients showed trends toward higher DTI-ALPS, larger CP volume, and altered PVS compared to controls.
  • Within the NMOSD cohort, CP volume positively correlated with Expanded Disability Status Scale (EDSS) and lateral ventricle volume.
  • Baseline EDSS correlated with anxiety (HAMA) and depression (HAMD) scores; older age predicted lower odds of disability improvement.

Conclusions:

  • Subtle choroid plexus volume enlargement in NMOSD is associated with disability and ventricular enlargement, suggesting glymphatic dysfunction.
  • Choroid plexus alterations may serve as a potential imaging biomarker for NMOSD disease burden.
  • These findings contribute to understanding NMOSD pathophysiology and identifying imaging markers.