Enlarged choroid plexus related to iron rim lesions and deep gray matter atrophy in relapsing-remitting multiple sclerosis

作者全名："Wang, Xiaohua; Zhu, Qiyuan; Yan, Zichun; Shi, Zhuowei; Xu, Yuhui; Liu, Yanbing; Li, Yongmei"

作者地址："[Wang, Xiaohua; Liu, Yanbing] Chongqing Med Univ, Coll Med Informat, Chongqing, Peoples R China; [Zhu, Qiyuan; Yan, Zichun; Shi, Zhuowei; Xu, Yuhui; Li, Yongmei] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing, Peoples R China"

通信作者："Li, YM (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, Chongqing, Peoples R China."

来源：MULTIPLE SCLEROSIS AND RELATED DISORDERS

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:000998676500001

JCR分区：Q2

影响因子：2.9

年份：2023

卷号：75

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Relapsing -remitting multiple sclerosis (RRMS); Choroid plexus (CP); White matter lesions (WMLs); Iron rim lesions (IRLs); Brain atrophy

摘要："Background: Choroid plexus (CP) is considered to be linked to inflammation of multiple sclerosis (MS), but its connection with markers of inflammation in vivo in MS is unclear, the markers such as lesions load and brain atrophy, particularly the white matter lesions (WMLs) edge surrounded by an iron rim, termed as iron rim lesions (IRLs). Purpose: To investigate the association between CP volume and brain lesions load, especially IRLs load and atrophy in MS, and its relationship with clinical characteristics. Methods: 3.0 T brain MRI images were acquired from 99 relapsing-remitting MS (RRMS) and 60 healthy controls (HCs) to obtain the volumes of CP, whole brain and lesions. Volumes were expressed as a ratio of intracranial volume. Expanded Disability Status Scale (EDSS), Montreal Cognitive Assessment (MoCA) and Symbol Digit Modalities Test (SDMT) were used to assess the severity of disability and cognitive function. Student's t-test and Multivariable regression analyses were performed to evaluate the difference of CP volumes between RRMS and HC and the association between CP volume and lesions load, brain volumes and clinical scale scores in RRMS. Results: CP volume was 30% larger in patients with RRMS than HCs (p < 0.001) and was 20% larger in patients with IRLs than those without IRLs (p = 0.007). Moreover, the larger CP volume was related to greater WMLs volume in the whole RRMS (r = 0.46, p < 0.001). Further analysis in patients with IRLs showed a positive correlation between CP volume and WMLs volume (r = 0.45, p = 0.003), and IRLs volume (r = 0.51, p < 0.001). Meanwhile, enlarged CP was related to lower volumes in the whole brain (r = -0.30, p = 0.006), deep gray matter (r = -0.51, p < 0.001) and most regional deep gray matter nuclei (except amygdala), but no correlation with cortical lesions or cortex volume (both p > 0.05). In addition, CP volume was significantly higher in patients with cognitive impairment than those with cognitive preservation by MoCA scores (p = 0.011); the larger CP volume was associated with higher EDSS scores (r = 0.25, p = 0.014) and lower SDMT Z scores in RRMS (r = -0.26, p = 0.014). Conclusion: The enlargement of CP in RRMS had close correlations with inflammatory lesions, especially IRLs and deep gray matter atrophy, but not the cortex. Meanwhile, the larger CP volume was associated with higher disability and lower cognitive scores. CP volume may be a surrogate imaging marker for MS disease activity."

基金机构：Key Project of Technological Inno- vation and Application Development of Chongqing Science and Tech- nology Bureau [CSTC2021 jscx-gksb-N0008]; Key Project of Chongqing Science and Health Joint Medical Research Project [2023ZDXM006]

基金资助正文：Funding This work was supported by the Key Project of Technological Inno- vation and Application Development of Chongqing Science and Tech- nology Bureau (Grant No: CSTC2021 jscx-gksb-N0008) and the Key Project of Chongqing Science and Health Joint Medical Research Project (Grant No: 2023ZDXM006) .