Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Hum Brain Mapp. 2023 Apr 15;44(6):2465-2478. doi: 10.1002/hbm.26224. Epub 2023 Feb 6.
The choroid plexus (ChP) is part of the blood-cerebrospinal fluid barrier, regulating brain homeostasis and the brain's response to peripheral events. Its upregulation and enlargement are considered essential in psychosis. However, the timing of the ChP enlargement has not been established. This study introduces a novel magnetic resonance imaging-based segmentation method to examine ChP volumes in two cohorts of individuals with psychosis. The first sample consists of 41 individuals with early course psychosis (mean duration of illness = 1.78 years) and 30 healthy individuals. The second sample consists of 30 individuals with chronic psychosis (mean duration of illness = 7.96 years) and 34 healthy individuals. We utilized manual segmentation to measure ChP volumes. We applied ANCOVAs to compare normalized ChP volumes between groups and partial correlations to investigate the relationship between ChP, LV volumes, and clinical characteristics. Our segmentation demonstrated good reliability (.87). We further showed a significant ChP volume increase in early psychosis (left: p < .00010, right: p < .00010) and a significant positive correlation between higher ChP and higher LV volumes in chronic psychosis (left: r = .54, p = .0030, right: r = .68; p < .0010). Our study suggests that ChP enlargement may be a marker of acute response around disease onset. It might also play a modulatory role in the chronic enlargement of lateral ventricles, often reported in psychosis. Future longitudinal studies should investigate the dynamics of ChP enlargement as a promising marker for novel therapeutic strategies.
脉络丛(ChP)是血脑屏障的一部分,调节大脑内环境稳定和大脑对外周事件的反应。其上调和扩大被认为是精神病学的重要特征。然而,ChP 扩大的时间尚未确定。本研究介绍了一种新的基于磁共振成像的分割方法,用于检查两个精神病患者队列的 ChP 体积。第一个样本包括 41 名早期精神病患者(平均病程 1.78 年)和 30 名健康个体。第二个样本包括 30 名慢性精神病患者(平均病程 7.96 年)和 34 名健康个体。我们使用手动分割来测量 ChP 体积。我们应用协方差分析比较组间标准化 ChP 体积,并进行偏相关分析以研究 ChP 与 LV 体积和临床特征之间的关系。我们的分割方法显示出良好的可靠性(.87)。我们进一步表明,早期精神病患者的 ChP 体积显著增加(左侧:p <.00010,右侧:p <.00010),慢性精神病患者的 ChP 与 LV 体积之间存在显著正相关(左侧:r =.54,p =.0030,右侧:r =.68;p <.0010)。本研究表明,ChP 扩大可能是疾病发作前后急性反应的标志物。它可能在精神病患者中常报道的侧脑室慢性扩大中发挥调节作用。未来的纵向研究应探讨 ChP 扩大的动态,作为新的治疗策略的有前途的标志物。