Xu Xiaomeng, Yang Xinyuan, Zhang Junfang, Wang Yan, Selim Magdy, Zheng Yingting, Shen Ruinan, Sun Lipeng, Huang Qi, Wang Wenjing, Xu Wei, Guan Yihui, Liu Jun, Deng Yulei, Xie Fang, Li Binyin
Department of Neurology and Institute of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Clinical Neuroscience Center, Ruijin Hospital LuWan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Alzheimers Dement. 2025 May;21(5):e70239. doi: 10.1002/alz.70239.
Free-water imaging of the choroid plexus (CP) may improve the evaluation of Alzheimer's disease (AD).
Our study investigated the role of free-water fraction (FWf) of CP in AD among 216 participants (133 Aβ+ participants and 83 Aβ- controls) enrolled in the NeuroBank-Dementia cohort at Ruijin Hospital (RJNB-D). The Alzheimer's Disease Neuroimaging Initiative dataset was used for external validation.
At baseline, Aβ+ participants showed higher CP FWf, increased white matter hyperintensity (WMH) volume, and decreased diffusion tensor image analysis along the perivascular space (DTI-ALPS). In Aβ+ participants, DTI-ALPS mediated the association between CP FWf and periventricular WMH. CP FWf was associated with cortical tau accumulation, synaptic loss, hippocampal and cortical atrophy, and cognitive performance. During follow-up, CP FWf increased faster in Aβ+ participants than controls.
Elevated CP FWf indicated impaired glymphatic function and AD neurodegeneration, and can be a sensitive biomarker for AD progression. The study was registered on ClinicalTrials.gov (NCT05623124).
This cohort study found higher free-water fraction (FWf) of the choroid plexus (CP) in amyloid beta (Aβ)+ participants. CP FWf was related to glymphatic function, brain atrophy, tau burden, synaptic loss, and cognition. Aβ+ participants showed faster growth of CP FWf than Aβ- controls during follow-up. The growth rate of CP FWf exceeded that of white matter lesion and tau accumulation in Aβ+ participants. CP FWf can serve as a sensitive imaging marker of glymphatic function and Alzheimer's disease progression.
脉络丛（CP）的自由水成像可能会改善对阿尔茨海默病（AD）的评估。
我们的研究在瑞金医院神经库-痴呆队列（RJNB-D）纳入的216名参与者（133名Aβ阳性参与者和83名Aβ阴性对照）中，研究了CP的自由水分数（FWf）在AD中的作用。使用阿尔茨海默病神经影像学倡议数据集进行外部验证。
在基线时，Aβ阳性参与者表现出较高的CP FWf、白质高信号（WMH）体积增加以及沿血管周围间隙的扩散张量成像分析（DTI-ALPS）降低。在Aβ阳性参与者中，DTI-ALPS介导了CP FWf与脑室周围WMH之间的关联。CP FWf与皮质tau积累、突触丧失、海马和皮质萎缩以及认知表现相关。在随访期间，Aβ阳性参与者的CP FWf升高速度比对照组更快。
CP FWf升高表明类淋巴功能受损和AD神经变性，并且可以作为AD进展的敏感生物标志物。该研究已在ClinicalTrials.gov上注册（NCT05623124）。
这项队列研究发现淀粉样β（Aβ）阳性参与者的脉络丛（CP）自由水分数（FWf）较高。CP FWf与类淋巴功能、脑萎缩、tau负担、突触丧失和认知有关。在随访期间，Aβ阳性参与者的CP FWf增长速度比Aβ阴性对照更快。在Aβ阳性参与者中，CP FWf的增长率超过了白质病变和tau积累的增长率。CP FWf可作为类淋巴功能和阿尔茨海默病进展的敏感成像标志物。
