Choroid plexus volume as a marker of retinal atrophy in relapsing remitting multiple sclerosis

Raghib, Muhammad F.; Bao, Fen; Elkhooly, Mahmoud; Bernitsas, Evanthia

doi:10.1016/j.jns.2024.122884

Cited by 4 publications

(4 citation statements)

References 58 publications

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“…Fleischer and colleagues, on the other hand, demonstrated a significant correlation between CP enlargement and clinical disability (EDSS score) in a cohort of CIS and RRMS individuals, both cross-sectionally and longitudinally, after 4-year follow-ups, supporting the clinical relevance of plexus volumetric analysis, among others [5,23,30]. Cognitive impairment, measured with the Symbol Digit Modalities Test (SDMT) score, was also associated with plexus enlargement [23].…”

Section: Klistorner Et Al Failed To Show a Correlation Between Cpv An...mentioning

confidence: 91%

“…T1W sequences are commonly used to measure the CP within the lateral ventricles, the largest CP among brain ventricles. However, the vast majority of researchers do not include the infratentorial proportion, which corresponds approximately to one-third of total CPV; most probably because T1W images do not have enough resolution for the segmentation of the CPs of the third and fourth ventricle [5,19,32,45]. Higher resolution images or 7 Tesla MRI sequences may facilitate the volumetric CP analysis.…”

Section: Cp Volumetric Analysis Limitations Of Current Methodologiesmentioning

confidence: 99%

“…Raghib and co-workers recently demonstrated a positive correlation of higher plexus volume with retinal atrophy, using optical coherence tomography (OCT), and low retinal nerve fiber layer (RNFL) thickness has already been linked with diffuse abnormalities in NAWM and thalamic atrophy in RRMS [5,38]. However, it remains unclear how the enlarged CP could be implicated in the pathophysiology of retinal volume loss.…”

Section: Cp Enlargement As a Biomarker Of Neurodegenerationmentioning

confidence: 99%

“…The plexus is important not only for the production of CSF but also for brain waste removal through the "glymphatic clearance" (a recently described glial cell supportedlymphatic system) of CSF along the periarterial spaces [5,6]. Furthermore, the CP is also responsible for regulating the entry of immune cells into the brain parenchyma [7,8].…”

Section: Introductionmentioning

confidence: 99%

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The Time Trajectory of Choroid Plexus Enlargement in Multiple Sclerosis

Andravizou,

Stavropoulou De Lorenzo,

Kesidou

et al. 2024

Healthcare

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Choroid plexus (CP) can be seen as a watchtower of the central nervous system (CNS) that actively regulates CNS homeostasis. A growing body of literature suggests that CP alterations are involved in the pathogenesis of multiple sclerosis (MS) but the underlying mechanisms remain elusive. CPs are enlarged and inflamed in relapsing-remitting (RRMS) but also in clinically isolated syndrome (CIS) and radiologically isolated syndrome (RIS) stages, far beyond MS diagnosis. Increases in the choroid plexus/total intracranial volume (CP/TIV) ratio have been robustly associated with increased lesion load, higher translocator protein (TSPO) uptake in normal-appearing white matter (NAWM) and thalami, as well as with higher annual relapse rate and disability progression in highly active RRMS individuals, but not in progressive MS. The CP/TIV ratio has only slightly been correlated with magnetic resonance imaging (MRI) findings (cortical or whole brain atrophy) and clinical outcomes (EDSS score) in progressive MS. Therefore, we suggest that plexus volumetric assessments should be mainly applied to the early disease stages of MS, whereas it should be taken into consideration with caution in progressive MS. In this review, we attempt to clarify the pathological significance of the temporal CP volume (CPV) changes in MS and highlight the pitfalls and limitations of CP volumetric analysis.

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Section: Klistorner Et Al Failed To Show a Correlation Between Cpv An...mentioning

confidence: 91%

Section: Cp Volumetric Analysis Limitations Of Current Methodologiesmentioning

confidence: 99%

Section: Cp Enlargement As a Biomarker Of Neurodegenerationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Time Trajectory of Choroid Plexus Enlargement in Multiple Sclerosis

Andravizou,

Stavropoulou De Lorenzo,

Kesidou

et al. 2024

Healthcare

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Choroid plexus volume changes in multiple sclerosis: insights from a systematic review and meta-analysis of magnetic resonance imaging studies

Kolahi,

Zarei,

Issaiy

et al. 2024

Neuroradiology

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Choroid Plexus Volume in Pediatric-Onset Multiple Sclerosis

Grasso,

Bloy,

Kaplan

et al. 2024

Neurol Neuroimmunol Neuroinflamm

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Background and ObjectivesRecent studies suggest that the choroid plexus (CP) may function as a site of access of inflammatory cells into the CNS in multiple sclerosis (MS). Pediatric-onset MS (POMS) is characterized by a high inflammatory burden, as evidenced by a high relapse rate and volume of T2 lesions, making patients with POMS an informative population to evaluate choroid plexus volume (CPV). The objectives of the study were (1) to evaluate CPV at symptom onset in participants with POMS compared with healthy controls (HCs); (2) to evaluate changes in CPV in the first year of disease in participants with POMS; and (3) to evaluate associations between CPV, brain volumes, relapse activity, and disability in participants with POMS.MethodsBaseline 1.5T MRI scans were acquired from 23 participants with POMS and 23 age-matched and sex-matched HCs; 18 participants with POMS also had 12-month follow-up MRI scans. The CP of the lateral ventricles was segmented manually. CP and brain structure volumes were normalized for total intracranial volume. The number of relapses, T2 and gadolinium-enhancing T1 lesion counts, and Expanded Disability Status Scale (EDSS) scores at 12 months were also analyzed. Baseline CPVs were compared between groups using the Wilcoxon exact test, and CPV change from baseline to 12 months in participants with POMS was compared using the Wilcoxon signed-rank test. The relationship between CPV and brain volumetric measures, T2 lesion volumes, lesion count, number of relapses, and EDSS scores was assessed through Spearman correlation.ResultsThe median normalized CPV was 1.51 × 10−3 (interquartile range [IQR]: 1.32–1.76) in POMS baseline scans and 1.21 × 10−3 (IQR: 1.1–1.47) in HC scans (p = 0.001). CPV did not significantly change at 12 months in the 18 participants with POMS with follow-up scans (p = 0.352). CPV in participants with POMS and HCs correlated with lateral ventricular volume (p = 0.012 for both groups) but did not correlate with brain and T2 lesion volumes or lesion count at baseline, nor with relapse activity or EDSS scores at 12 months in participants with POMS.DiscussionCPV measured at baseline is greater in participants with POMS than in HCs. Baseline CPV did not predict higher disease activity or worse neurologic outcomes over 1 year. While higher CPV may be an early feature of inflammation in MS, its strong correlation with ventricular volumes could also reflect enlargement secondary to the mechanical attachment of CP to the ventricular wall.

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Choroid plexus volume as a marker of retinal atrophy in relapsing remitting multiple sclerosis

Cited by 4 publications

References 58 publications

The Time Trajectory of Choroid Plexus Enlargement in Multiple Sclerosis

The Time Trajectory of Choroid Plexus Enlargement in Multiple Sclerosis

Choroid plexus volume changes in multiple sclerosis: insights from a systematic review and meta-analysis of magnetic resonance imaging studies

Choroid Plexus Volume in Pediatric-Onset Multiple Sclerosis

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