Choroid plexus enlargement is negatively associated with cognitive performance in a DTI-ALPS-dependent manner

Area of Science:

• Neuroimaging
• Neuroscience
• Brain Fluid Dynamics

Background:

• Brain fluid homeostasis disturbances are linked to neurodegeneration.
• Choroid plexus (CP) alterations and impaired glymphatic transport correlate with cognitive decline.
• The interaction between CP structure and glymphatic function in human cognition is not well understood.

Purpose of the Study:

• To investigate the relationship between CP volume, glymphatic diffusion, and cognitive performance.
• To explore the interaction between CP structure and glymphatic transport in memory clinic patients.
• To determine if CP volume and glymphatic diffusion jointly influence cognitive function.

Main Methods:

• 100 memory clinic patients underwent Diffusion Tensor Imaging Analysis along the Perivascular Space (DTI-ALPS) for glymphatic diffusion assessment.
• Structural MRI with FastSurfer segmentation quantified CP and white matter hyperintensity (WMH) volumes.
• Multivariable linear regression models analyzed associations between CP volume, ALPS index, and cognitive scores (MoCA, MMSE), adjusting for covariates and testing for interactions.

Main Results:

• Larger CP volume correlated with a lower ALPS index (p=0.015).
• A significant interaction between CP volume and ALPS index affected cognitive performance (p=0.036).
• Cognitive performance varied based on the interplay between CP volume and DTI-ALPS, with larger CP volumes associated with poorer scores at higher ALPS values.

Conclusions:

• CP enlargement is linked to glymphatic diffusion, with their interaction influencing cognitive performance.
• The findings suggest state-dependent correlations between cerebrospinal fluid regulatory systems and cognition.
• Interpreting diffusion markers of brain clearance requires careful consideration of their complex interplay with structures like the CP.