Imaging the hidden player: Choroid plexus enlargement in multiple sclerosis.

Area of Science:

• Neuroimmunology
• Neurology
• Radiology

Background:

• The choroid plexus (CP) regulates cerebrospinal fluid (CSF) and immune surveillance at the blood-CSF barrier.
• The CP is increasingly recognized for its role in multiple sclerosis (MS) pathophysiology.

Purpose of the Study:

• To review evidence on CP enlargement as a potential biomarker in MS.
• To explore the CP's immunological functions and its association with MS progression.

Main Methods:

• Magnetic resonance imaging (MRI) and positron emission tomography (PET) for quantifying CP volume.
• Correlation analysis of CP volume with MS lesion load, neuroinflammation markers, and neurodegeneration indicators.

Main Results:

• CP enlargement is observed across various MS stages and correlates with inflammatory markers and lesion activity.
• CP enlargement is linked to neurodegenerative processes like gray matter atrophy and cognitive decline in MS patients.

Conclusions:

• CP imaging, particularly enlargement, presents a novel perspective on MS pathogenesis, connecting inflammatory and degenerative pathways.
• Further research and standardization are needed to establish CP metrics for MS monitoring and therapeutic strategies.