Dementia Theme, The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
Int J Stroke. 2019 Dec;14(9):923-930. doi: 10.1177/1747493019851277. Epub 2019 May 17.
Cerebrospinal fluid circulation is crucial for the functioning of the brain. Aging and brain pathologies such as Alzheimer's disease have been associated with a change in the morphology of the ventricles and the choroid plexus. Despite the evidence from animal models that the cerebrospinal fluid system plays an important role in neuroinflammation and the restoration of the brain after ischemic brain injury, little is known about changes to the choroid plexus after stroke in humans.
Our goal was to characterize structural choroid plexus changes poststroke.
We used an automatic segmentation tool to estimate the volumes of choroid plexus and lateral ventricles in stroke and control participants at three time points (at baseline, 3 and 12 months) over the first year after stroke. We assessed group differences cross-sectionally at each time point and longitudinally. For stroke participants, we specifically differentiated between ipsi- and contra-lesional volumes. Statistical analyses were conducted for each region separately and included covariates such as age, sex, total intracranial volume, and years of education.
We observed significantly larger choroid plexus volumes in stroke participants compared to controls in both cross-sectional and longitudinal analyses. Choroid plexus volumes did not exhibit any change over the first year after stroke, with no difference between ipsi- and contra-lesional volumes. This was in contrast to the volume of lateral ventricles that we found to enlarge over time in all participants, with more accelerated expansion in stroke survivors ipsi-lesionally.
Our results suggest that chronic stages of stroke are characterized by larger choroid plexus volumes, but the enlargement likely takes place prior to or very early after the stroke incident.
脑脊液循环对大脑的功能至关重要。衰老和阿尔茨海默病等脑部病变与脑室和脉络丛的形态变化有关。尽管动物模型的证据表明,脑脊液系统在神经炎症和缺血性脑损伤后大脑的恢复中发挥重要作用,但人们对人类中风后脉络丛的变化知之甚少。
我们的目标是描述中风后脉络丛的结构变化。
我们使用自动分割工具来估计中风患者和对照组参与者在中风后第一年的三个时间点(基线、3 个月和 12 个月)的脉络丛和侧脑室体积。我们在每个时间点进行了横断面组间差异评估,并进行了纵向评估。对于中风患者,我们特别区分了同侧和对侧病变体积。分别对每个区域进行统计分析,并包括年龄、性别、总颅内体积和受教育年限等协变量。
我们观察到,在横断面和纵向分析中,中风患者的脉络丛体积明显大于对照组。在中风后的第一年,脉络丛体积没有任何变化,同侧和对侧病变体积之间没有差异。这与我们发现的侧脑室体积形成对比,所有参与者的侧脑室体积随时间增大,中风幸存者同侧病变的扩张速度更快。
我们的结果表明,中风的慢性阶段表现为脉络丛体积增大,但这种增大可能发生在中风事件之前或非常早期。