Yin Xi, Wang Miao, Zhao Fenqiang, Li Fengzhu, Tang Yuxing, Wang Xiaoyu, Duan Caohui, Wang Song, Xiong Yongqin, Yao Jiarui, Chen Tong, Wang Zhenfu, Li Yifan, Lou Xin, Gao Zhongbao
Department of Neurology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
DAMO Academy, Alibaba group, Hangzhou 310023, China; Hupan Lab, Hangzhou 310023, China.
Neurobiol Dis. 2025 Aug;212:106984. doi: 10.1016/j.nbd.2025.106984. Epub 2025 Jun 2.
The choroid plexus (CP), an important structure involved in cerebrospinal fluid (CSF) circulation, plays a key role in clearing harmful metabolites from the brain. However, the relationship between CP and the development of Parkinson's disease (PD) remains unclear, especially in those with freezing of gait (FOG). We aim to investigate the association between the CP area and CP/lateral ventricle area (CP/Ven) index with clinical symptoms of PD and the development of FOG.
Seventy-three patients with PD (17 with FOG and 56 without FOG) and 49 healthy controls (HCs) underwent 7 T magnetic resonance imaging and neurological assessments. The CP area and CP/Ven index were calculated, and the differences across groups were compared. Spearman's rank correlation was used to evaluate associations between these indices and clinical scales. Binary logistic regression was used to explore the impact of the CP area and CP/Ven index on FOG occurrence in PD.
Patients with FOG (PD-FOG) exhibited significantly higher CP area and CP/Ven index than those without FOG (PD-nFOG). Both the CP area and CP/Ven index were positively correlated with the PD motor scale scores, especially postural instability/gait disturbance. Receiver operating characteristic curve analysis showed that the CP area and CP/Ven index effectively distinguished PD-FOG from PD-nFOG, with area under curve of 0.887 and 0.854, respectively. Logistic regression analysis confirmed that both indices independently increased the risk of FOG in PD.
Elevated CP area and CP/Ven index are novel, noninvasive neuroimaging markers of FOG in PD.
脉络丛（CP）是参与脑脊液（CSF）循环的重要结构，在清除脑内有害代谢产物方面起关键作用。然而，CP与帕金森病（PD）发生发展的关系仍不清楚，尤其是在步态冻结（FOG）患者中。我们旨在研究CP面积及CP/侧脑室面积（CP/Ven）指数与PD临床症状及FOG发生发展之间的关联。
73例PD患者（17例有FOG，56例无FOG）和49名健康对照者（HCs）接受了7T磁共振成像及神经学评估。计算CP面积及CP/Ven指数，并比较组间差异。采用Spearman等级相关分析评估这些指数与临床量表之间的关联。采用二元逻辑回归分析探讨CP面积及CP/Ven指数对PD患者FOG发生的影响。
有FOG的患者（PD-FOG）的CP面积及CP/Ven指数显著高于无FOG的患者（PD-nFOG）。CP面积及CP/Ven指数均与PD运动量表评分呈正相关，尤其是姿势不稳/步态障碍。受试者工作特征曲线分析显示，CP面积及CP/Ven指数能有效区分PD-FOG与PD-nFOG，曲线下面积分别为0.887和0.854。逻辑回归分析证实，这两个指数均独立增加了PD患者发生FOG的风险。
CP面积及CP/Ven指数升高是PD患者FOG的新型无创神经影像学标志物。
