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Updated: Aug 13, 2026

Manual Segmentation of the Human Choroid Plexus Using Brain MRI
Published on: December 15, 2023
Choroid plexus volume in pathology-confirmed Alzheimer's disease
Francis Fernandes1, Avyarthana Dey2, Andy Ma2
1Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute - St. Michael's Hospital, Toronto, Ontario, Canada; Institute of Medical Sciences, Temerty Faculty of Medicine - University of Toronto, Toronto, Ontario, Canada.
Choroid plexus (CP) volume increases with Alzheimer's disease (AD) pathology and cognitive impairment. Larger CP volume in AD patients suggests its role as a potential biomarker for disease progression.
Area of Science:
- Neurology
- Neuroimaging
- Biomarkers
Background:
- The choroid plexus (CP) volume increases throughout the Alzheimer's disease (AD) continuum.
- CP's potential as a clearance-related biomarker is suggested, but ante-mortem CP volume lacks examination against post-mortem AD pathology.
- Post-mortem pathology is the gold standard for AD diagnosis.
Purpose of the Study:
- To investigate the association between ante-mortem choroid plexus volume and post-mortem Alzheimer's disease (AD) pathology.
- To explore the relationship between normalized CP volume (NCPV) and cognitive impairment (CI) in individuals with confirmed AD pathology.
Main Methods:
- Structural magnetic resonance imaging (MRI) and post-mortem pathology data were analyzed from participants with ≤ 5 years between imaging and death.
- Normalized CP volume (NCPV) was semi-automatically segmented from lateral ventricles.
- Bayesian linear regression was used to assess associations with cognitive impairment (CI), AD pathology, and clinical/demographic factors.
Main Results:
- Higher levels of AD pathology and CI were correlated with increased NCPV.
- Female sex was associated with decreased NCPV.
- Individuals with greater CI showed larger NCPV, even with similar AD pathology levels.
Conclusions:
- CP enlargement is linked to neuropathologically confirmed AD burden and cognitive impairment.
- These findings support further research into choroid plexus (CP) structure and function in Alzheimer's disease (AD).
- CP volume may serve as a valuable biomarker in AD research.
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