Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China.
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China.
Mult Scler Relat Disord. 2024 May;85:105550. doi: 10.1016/j.msard.2024.105550. Epub 2024 Mar 11.
To investigate the potential link among choroid plexus (CP) volume, glymphatic clearance and brain structural change in relapsing-remitting multiple sclerosis (RRMS) patients.
Sixty-five RRMS patients and 48 healthy controls (HC) underwent MRI examination. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) was calculated to reflect glymphatic system function. The brain structure volume and DTI-ALPS index were compared between RRMS and HC. The mediating effect of the DTI-ALPS index between CP volume and brain structural changes was further investigated. The longitudinal changes of brain structure and DTI-ALPS index were compared in 20 RRMS patients.
Compared to HC, CP volume in RRMS was significantly increased (P < 0.001), and DTI-ALPS index was significantly decreased (P = 0.001). The volumes of white matter, thalamus, putamen and pallidum were significantly decreased in RRMS, and the volumes of lateral ventricle and third ventricle were increased. Mediation analysis showed DTI-ALPS index partially mediated the association between CP enlargement and deep gray matter (DGM) atrophy in RRMS, and between CP enlargement and ventricle enlargement. CP volume and DTI-ALPS index were also significantly correlated with Expanded Disability Status Scale (EDSS) (P = 0.006, P = 0.043). Notably, the variation of DTI_ALPS index during the follow-up period were significantly and negatively correlated with the variation of EDSS (P = 0.045).
Enlarged CP volume and decreased DTI_ALPS index may be closely related to DGM atrophy and ventricular enlargement in RRMS, and may be potential imaging markers of clinical disability.
研究复发缓解型多发性硬化症（RRMS）患者脉络丛（CP）体积、神经胶质淋巴系统清除率和脑结构变化之间的潜在联系。
65 例 RRMS 患者和 48 例健康对照者（HC）接受 MRI 检查。计算血管周围空间的弥散张量图像分析（DTI-ALPS），以反映神经胶质淋巴系统功能。比较 RRMS 和 HC 之间脑结构体积和 DTI-ALPS 指数。进一步研究 DTI-ALPS 指数在 CP 体积与脑结构变化之间的中介作用。比较 20 例 RRMS 患者脑结构和 DTI-ALPS 指数的纵向变化。
与 HC 相比，RRMS 的 CP 体积明显增加（P < 0.001），DTI-ALPS 指数明显降低（P = 0.001）。RRMS 的白质、丘脑、壳核和苍白球体积明显减少，侧脑室和第三脑室体积增加。中介分析显示，DTI-ALPS 指数部分介导了 CP 扩大与 RRMS 深部灰质（DGM）萎缩之间的关联，以及 CP 扩大与脑室扩大之间的关联。CP 体积和 DTI-ALPS 指数与扩展残疾状态量表（EDSS）也显著相关（P = 0.006，P = 0.043）。值得注意的是，随访期间 DTI_ALPS 指数的变化与 EDSS 的变化呈显著负相关（P = 0.045）。
CP 体积增大和 DTI_ALPS 指数降低可能与 RRMS 中 DGM 萎缩和脑室扩大密切相关，可能是临床残疾的潜在影像学标志物。
