Association between choroid plexus enlargement and impaired glymphatic function in relapsing-remitting multiple...

Area of Science:

• Neuroscience
• Radiology
• Immunology

Background:

• The glymphatic system and choroid plexus (CP) roles in multiple sclerosis (MS) are not fully understood longitudinally.
• Relapsing-remitting MS (RRMS) involves complex pathological mechanisms.
• Understanding these changes is crucial for MS management.

Purpose of the Study:

• To characterize glymphatic system function and CP alterations in RRMS.
• To analyze their longitudinal evolution in RRMS.
• To examine correlations with clinical variables like white matter lesions.

Main Methods:

• Recruited 92 RRMS patients and 40 healthy controls (HCs).
• Utilized diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) index and normalized choroid plexus volume (CPV).
• Compared DTI-ALPS and CPV between groups at baseline and follow-up, assessing correlations with lesion volume and disease duration.

Main Results:

• RRMS patients had significantly lower ALPS index and larger CPV than HCs.
• Lower ALPS index correlated with larger CPV, greater white matter lesion (WML) and cortical lesion volume, and longer disease duration.
• CPV increased slightly over time in RRMS patients, while ALPS index remained stable.

Conclusions:

• Impaired glymphatic function and enlarged CP volume are implicated in MS pathology.
• CP enlargement may be a persistent feature in MS.
• DTI-ALPS index and CP volume show potential as imaging biomarkers, with the CP as a therapeutic target.