继发进展型多发性硬化症中脉络丛增大：表型比较
Choroid Plexus Enlargement in Secondary Progressive MS: phenotype comparison.
作者信息
Klistorner Samuel, Barnett Michael H, Wang Chenyu, Van der Walt Anneke, Butzkueven Helmut, Gong Zhaoyuan, Bouhrara Mustapha, Parratt John, Yiannikas Con, Klistorner Alexander
机构信息
Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia.
出版信息
medRxiv. 2025 Apr 1:2025.03.31.25324925. doi: 10.1101/2025.03.31.25324925.
BACKGROUND
The choroid plexus (CP) is increasingly recognised as a contributor to chronic inflammation in multiple sclerosis (MS). While CP enlargement is reported in early MS, its role in secondary progressive MS (SPMS) is poorly understood.
OBJECTIVE
We aimed to quantify CP volume in SPMS and compare it to relapsing-remitting MS (RRMS) and clinically isolated syndrome (CIS), and to assess associations with disease severity and progression.
METHODS
CP volumes were manually segmented and normalised to intracranial volume. Age correction was applied using a healthy control cohort. Cross-sectional and longitudinal analyses evaluated relationships with ventricular volume, lesion burden, and brain atrophy.
RESULTS
CP volume increased significantly across MS phenotypes: SPMS patients showed 26% higher CP volume than CIS (p=0.010) and 17% higher than RRMS (p=0.034). CP enlargement in SPMS was independent of ventricular size, indicating distinct underlying mechanisms. While lesion burden was the primary determinant of brain atrophy in SPMS, longitudinal data revealed significant associations between CP volume, chronic lesion expansion (r=0.31), and brain volume loss (r=0.52).
CONCLUSION
CP enlargement is a progressive feature of MS, not driven by ventricular expansion. In SPMS, it may reflect ongoing inflammation contributing to tissue damage, supporting its role as a biomarker.
背景
脉络丛（CP）越来越被认为是多发性硬化症（MS）慢性炎症的一个促成因素。虽然在早期MS中报告有脉络丛增大，但其在继发进展型MS（SPMS）中的作用却知之甚少。
目的
我们旨在量化SPMS中的脉络丛体积，并将其与复发缓解型MS（RRMS）和临床孤立综合征（CIS）进行比较，并评估其与疾病严重程度和进展的相关性。
方法
手动分割脉络丛体积并将其标准化为颅内体积。使用健康对照队列进行年龄校正。横断面和纵向分析评估了与脑室体积、病灶负荷和脑萎缩的关系。
结果
脉络丛体积在不同MS表型中显著增加：SPMS患者的脉络丛体积比CIS高26%（p = 0.010），比RRMS高17%（p = 0.034）。SPMS中的脉络丛增大与脑室大小无关，表明存在不同的潜在机制。虽然病灶负荷是SPMS脑萎缩的主要决定因素，但纵向数据显示脉络丛体积、慢性病灶扩大（r = 0.31）和脑体积损失（r = 0.52）之间存在显著关联。
结论
脉络丛增大是MS的一个进行性特征，并非由脑室扩张驱动。在SPMS中，它可能反映了持续的炎症导致组织损伤，支持其作为生物标志物的作用。
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