Correlation between change in choroid plexus volume and cognitive function in patients with Parkinson’s disease

ZHOU Suyi; ZHEN Zhiming; PANG Huilin; LIU Zhi; LIU Yanhui; CHEN Wei; CHEN Wei

doi:10.16016/j.2097-0927.202409094

您当前的位置：

首页 >

文章列表页 >

Correlation between change in choroid plexus volume and cognitive function in patients with Parkinson’s disease

Neuroscience | 更新时间：2025-04-14

- Correlation between change in choroid plexus volume and cognitive function in patients with Parkinson’s disease
- Journal of Army Medical University Vol. 47, Issue 7, Pages: 649-655(2025)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）第一附属医院：放射科，重庆
  2.陆军军医大学（第三军医大学）第一附属医院：神经外科，重庆
  3.四川大学华西医院神经外科，四川成都
  4.西门子数字医疗科技（上海）有限公司广州分公司，广东广州
- 作者简介：
  
  CHEN Wei， E-mail： landcw@tmmu.edu.cn
- 基金信息：
  
  Supported by the Project of Science and Technology Plan of Sichuan Province(2023YFQ0002);the Natural Science Foundation of Chongqing(cstc2017shms-zdyfX0015)
- DOI：10.16016/j.2097-0927.202409094
  CLC： R322.27;R445.2;R742.5
- Received：13 September 2024，
  
  Revised：14 February 2025，
  
  Published：15 April 2025
- 稿件说明：
移动端阅览
周素伊,甄志铭,庞慧琳,等.帕金森病患者脉络丛体积改变与认知功能的相关性研究[J].陆军军医大学学报,2025,47(07):649-655.

ZHOU Suyi,ZHEN Zhiming,PANG Huilin,et al.Correlation between change in choroid plexus volume and cognitive function in patients with Parkinson’s disease[J].J Army Med Univ,2025,47(07):649-655.
周素伊,甄志铭,庞慧琳,等.帕金森病患者脉络丛体积改变与认知功能的相关性研究[J].陆军军医大学学报,2025,47(07):649-655. DOI：10.16016/j.2097-0927.202409094.

ZHOU Suyi,ZHEN Zhiming,PANG Huilin,et al.Correlation between change in choroid plexus volume and cognitive function in patients with Parkinson’s disease[J].J Army Med Univ,2025,47(07):649-655. DOI：10.16016/j.2097-0927.202409094.

摘要

目的

探讨帕金森病（Parkinson’s disease， PD）患者不同认知状态下脉络丛（choroid plexus，CP）体积变化及其与其他脑区结构体积的相关性。

方法

本研究为横断面研究，纳入2023年5月至2024年4月期间就诊于陆军军医大学第一附属医院神经外科的48例PD患者及从健康体检中心招募的35例健康对照（healthy controls， HC），基于简易精神状态检查量表（Mini-Mental State Examination， MMSE）评估结果，将PD患者分为帕金森病伴认知功能障碍组（Parkinson’s disease with cognitive impairment， PD-CI）27例和帕金森病认知功能正常组（Parkinson’s disease with normal cognitive function， PD-NC）21例。采用3.0T磁共振成像（magnetic resonance imaging， MRI）进行MPRAGE序列扫描，并使用FreeSurfer 6.0软件获得脉络丛体积（choroid plexus volume， CPV）与其他脑区结构的体积。对CPV进行校正，计算其与估算的总颅内体积（estimated total intracranial volume， eTIV）的比值。调整混杂因素后，通过偏相关分析评估CPV/eTIV比值与其他脑区结构体积及认知量表评分之间的关系。使用多元线性回归分析进一步探究PD-CI组中CPV与认知功能之间的关系。

结果

与HC组相比，PD-CI组的CPV显著增大（

0.029）。PD-CI组中，CPV/eTIV比值与侧脑室体积（

0.689，

0.001）、第三脑室体积（

0.592，

0.006）、脑脊液（cerebrospinal fluid，CSF）体积（

0.508，

0.022）、脑白质高信号（white matter hyperintensities， WMH）体积（

0.486，

0.030）呈显著正相关，同时与尾状核体积（

-0.530，

0.016）、丘脑体积（

-0.477，

0.033）及MMSE评分呈显著负相关（

-0.483，

0.031）。而PD-NC组中，CPV/eTIV比值仅与CSF体积（

0.571，

0.021）呈显著正相关；在PD-CI组中，CPV/eTIV比值与MMSE评分行多元线性回归分析，结果显示两者仍呈显著负相关（β=-0.388，

0.046）。

结论

PD患者的认知功能障碍可能与CPV变化密切相关，提示CPV可作为评估PD认知损伤的潜在影像学标志物。

Abstract

Objective‍　‍To investigate the change in choroid plexus (CP) volume in Parkinson’s disease (PD) patients with different cognitive states and its correlation with structural volumes of other brain regions. Methods‍　‍A cross-sectional study was conducted on 48 PD patients admitted in Department of Neurosurgery of the First Affiliated Hospital of Army Medical University between May 2023 and April 2024

and on 35 healthy controls (HC) recruited through a physical exam center. According to the results of Mini-Mental State Examination (MMSE)

the patients were divided into PD with cognitive impairment (PD-CI) group (

=27) and PD with normal cognitive function (PD-NC) group (

=21). 3.0T magnetic resonance imaging (MRI) was performed using MPRAGE sequences

and CP volume and volumes of other brain regions were obtained using FreeSurfer 6.0 software. The CP volume was adjusted by calculating the ratio of its volume to estimated total intracranial volume (eTIV). After controlling for confounders

partial correlation analysis was used to assess the relationship between the CPV/eTIV ratio and the volumes of other brain regions as well as cognitive scale scores. Additionally

multiple linear regression analysis was performed to further explore the relationship between CPV and cognitive function in the PD-CI group. Results‍　‍Compared to the HC group

the CPV in the PD-CI group was significantly larger (

=0.029). In the PD-CI group

the CPV/eTIV ratio showed significant positive correlations with the volume of the lateral ventricles (

=0.689

=0.001)

the volume of the third ventricle (

=0.592

=0.006)

the volume of cerebrospinal fluid (CSF) (

=0.508

=0.022)

and white matter hyperintensities (WMH) (

=0.486

=0.030)

but was negatively correlated with the volume of the caudate nucleus (

=-0.530

=0.016)

the volume of the thalamus (

=-0.477

=0.033)

and the MMSE scores (

=-0.483

=0.031). But in the PD-NC group

the CPV/eTIV ratio was only positively correlated with CSF volume (

=0.571

=0.021). Multiple linear regression analysis indicated that the CPV/eTIV ratio and MMSE scores remained significantly negatively correlated in the PD-CI group (β=-0.388

=0.046). Conclusion‍　‍Cognitive impairment in PD patients may be closely associated with the change in CP volume

suggesting that the volu

me can serve as a potential imaging marker in assessment of cognitive impairment in PD patients.

关键词

Keywords

references

DE LAU L M ， SCHIPPER C M ， HOFMAN A ， et al . Prognosis of parkinson disease： risk of dementia and mortality： the Rotterdam study ［J］. Arch Neurol ， 2005 ， 62 （ 8 ）： 1265 - 1269 . DOI： 10.1001/archneur.62.8.1265 http://dx.doi.org/10.1001/archneur.62.8.1265 .

李静，胡晓飞，周振华 . 帕金森病运动亚型患者运动症状及认知功能进展特征： 3年纵向研究［J］. 第三军医大学学报， 2020 ， 42 （ 13 ）： 1273 - 1278 . DOI： 10.16016/j.1000-5404.202001202 http://dx.doi.org/10.16016/j.1000-5404.202001202 .

LI J ， HU X F ， ZHOU Z H . Progression characteristics of motor symptoms and cognitive function in patients with motor subtype of Parkinson’s disease： a 3-year longitudinal study ［J］. J Third Mil Med Univ ， 2020 ， 42 （ 13 ）： 1273 - 1278 . DOI： 10.16016/j.1000-5404.202001202 http://dx.doi.org/10.16016/j.1000-5404.202001202 .

WILLIAMS-GRAY C H ， MASON S L ， EVANS J R ， et al . The CamPaIGN study of Parkinson’s disease： 10-year outlook in an incident population-based cohort ［J］. J Neurol Neurosurg Psychiatry ， 2013 ， 84 （ 11 ）： 1258 - 1264 . DOI： 10.1136/jnnp-2013-305277 http://dx.doi.org/10.1136/jnnp-2013-305277 .

MELZER T R ， WATTS R ， MACASKILL M R ， et al . Grey matter atrophy in cognitively impaired Parkinson’s disease ［J］. J Neurol Neurosurg Psychiatry ， 2012 ， 83 （ 2 ）： 188 - 194 . DOI： 10.1136/jnnp-2011-300828 http://dx.doi.org/10.1136/jnnp-2011-300828 .

APOSTOLOVA L G ， BEYER M ， GREEN A E ， et al . Hippocampal， caudate， and ventricular changes in Parkinson’s disease with and without dementia ［J］. Mov Disord ， 2010 ， 25 （ 6 ）： 687 - 695 . DOI： 10.1002/mds.22799 http://dx.doi.org/10.1002/mds.22799 .

HONMA M ， KURODA T ， FUTAMURA A ， et al . Mental time dysfunction in Parkinson’s and Alzheimer’s diseases ［J］. Brain Nerve ， 2015 ， 67 （ 3 ）： 297 - 302 . DOI： 10.11477/mf.1416200135 http://dx.doi.org/10.11477/mf.1416200135 .

TIJMS B M ， VROMEN E M ， MJAAVATTEN O ， et al . Cerebrospinal fluid proteomics in patients with Alzheimer’s disease reveals five molecular subtypes with distinct genetic risk profiles ［J］. Nat Aging ， 2024 ， 4 ： 33 - 47 . DOI： 10.1038/s43587-023-00550-7 http://dx.doi.org/10.1038/s43587-023-00550-7 .

CHOI J D ， MOON Y ， KIM H J ， et al . Choroid plexus volume and permeability at brain MRI within the Alzheimer disease clinical spectrum ［J］. Radiology ， 2022 ， 304 （ 3 ）： 635 - 645 . DOI： 10.1148/radiol.212400 http://dx.doi.org/10.1148/radiol.212400 .

MORRIS H R ， SPILLANTINI M G ， SUE C M ， et al . The pathogenesis of Parkinson’s disease ［J］. Lancet ， 2024 ， 403 （ 10423 ）： 293 - 304 . DOI： 10.1016/S0140-6736（23）01478-2 http://dx.doi.org/10.1016/S0140-6736（23）01478-2 .

JEONG S H ， JEONG H J ， SUNWOO M K ， et al . Association between choroid plexus volume and cognition in Parkinson disease ［J］. Eur J Neurol ， 2023 ， 30 （ 10 ）： 3114 - 3123 . DOI： 10.1111/ene.15999 http://dx.doi.org/10.1111/ene.15999 .

中华医学会神经病学分会帕金森病及运动障碍学组，中国医师协会神经内科医师分会帕金森病及运动障碍专业 . 中国帕金森病的诊断标准（2016版）［J］. 中华神经科杂志， 2016 ， 49 （ 4 ）： 268 - 271 . DOI： 10.3760/cma.j.issn.1006-7876.2016.04.002 http://dx.doi.org/10.3760/cma.j.issn.1006-7876.2016.04.002 .

Parkinson’s Disease and Movement Disorders Group of Neurology Branch of Chinese Medical Association ， Parkinson’s Disease and Movement Disorders Professional Committee of Neurologist Branch of Chinese Medical Doctor Association . Chinese diagnostic criteria for Parkinson’s disease （2016 Edition）［J］. Chin J Neurol ， 2016 ， 49 （ 4 ）： 268 - 271 . DOI： 10.3760/cma.j.issn.1006-7876.2016.04.002 http://dx.doi.org/10.3760/cma.j.issn.1006-7876.2016.04.002 .

FOLSTEIN M F ， FOLSTEIN S E ， MCHUGH P R . “ Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician ［J］. J Psychiatr Res ， 1975 ， 12 （ 3 ）： 189 - 198 .

MÜLLER J ， SINNECKER T ， WENDEBOURG M J ， et al . Choroid plexus volume in multiple sclerosis vs neuromyelitis optica spectrum disorder： a retrospective， cross-sectional analysis ［J］. Neurol Neuroimmunol Neuroinflamm ， 2022 ， 9 （ 3 ）： e1147 . DOI： 10.1212/NXI.0000000000001147 http://dx.doi.org/10.1212/NXI.0000000000001147 .

HE P K ， GAO Y Y ， SHI L ， et al . The association of CSF biomarkers and cognitive decline with choroid plexus volume in early Parkinson’s disease ［J］. Parkinsonism Relat Disord ， 2024 ， 120 ： 105987 . DOI： 10.1016/j.parkreldis. 2023.105987 http://dx.doi.org/10.1016/j.parkreldis.2023.105987 .

YAO J ， HUANG T ， TIAN Y Y ， et al . Early detection of dopaminergic dysfunction and glymphatic system impairment in Parkinson’s disease ［J］. Parkinsonism Relat Disord ， 2024 ， 127 ： 107089 . DOI： 10.1016/j.parkreldis. 2024.107089 http://dx.doi.org/10.1016/j.parkreldis.2024.107089 .

LOPES D M ， LLEWELLYN S K ， HARRISON I F . Propagation of tau and α-synuclein in the brain： therapeutic potential of the glymphatic system ［J］. Transl Neurodegener ， 2022 ， 11 （ 1 ）： 19 . DOI： 10.1186/s40035-022-00293-2 http://dx.doi.org/10.1186/s40035-022-00293-2 .

CUI J ， XU H X ， LEHTINEN M K . Macrophages on the margin： choroid plexus immune responses ［J］. Trends Neurosci ， 2021 ， 44 （ 11 ）： 864 - 875 . DOI： 10.1016/j.tins. 2021.07.002 http://dx.doi.org/10.1016/j.tins.2021.07.002 .

SHECHTER R ， MILLER O ， YOVEL G ， et al . Recruitment of beneficial M2 macrophages to injured spinal cord is orchestrated by remote brain choroid plexus ［J］. Immunity ， 2013 ， 38 （ 3 ）： 555 - 569 . DOI： 10.1016/j.immuni.2013.02.012 http://dx.doi.org/10.1016/j.immuni.2013.02.012 .

WEWER C ， SEIBT A ， WOLBURG H ， et al . Transcellular migration of neutrophil granulocytes through the blood-cerebrospinal fluid barrier after infection with Streptococcus suis ［J］. J Neuroinflamm ， 2011 ， 8 ： 51 . DOI： 10.1186/1742-2094-8-51 http://dx.doi.org/10.1186/1742-2094-8-51 .

RAYASAM A ， FAUSTINO J ， LECUYER M ， et al . Neonatal stroke and TLR1/2 ligand recruit myeloid cells through the choroid plexus in a CX3CR1-CCR2- and context-specific manner ［J］. J Neurosci ， 2020 ， 40 （ 19 ）： 3849 - 3861 . DOI： 10.1523/jneurosci.2149-19.2020 http://dx.doi.org/10.1523/jneurosci.2149-19.2020 .

SENAY O ， SEETHALER M ， MAKRIS N ， et al . A preliminary choroid plexus volumetric study in individuals with psychosis ［J］. Hum Brain Mapp ， 2023 ， 44 （ 6 ）： 2465 - 2478 . DOI： 10.1002/hbm.26224 http://dx.doi.org/10.1002/hbm.26224 .

FLEISCHER V ， GONZALEZ-ESCAMILLA G ， CIOLAC D ， et al . Translational value of choroid plexus imaging for tracking neuroinflammation in mice and humans ［J］. Proc Natl Acad Sci U S A ， 2021 ， 118 （ 36 ）： e2025000118 . DOI： 10.1073/pnas.2025000118 http://dx.doi.org/10.1073/pnas.2025000118 .

KARIMY J K ， ZHANG J W ， KURLAND D B ， et al . Inflammation-dependent cerebrospinal fluid hypersecretion by the choroid plexus epithelium in posthemorrhagic hydrocephalus ［J］. Nat Med ， 2017 ， 23 ： 997 - 1003 . DOI： 10.1038/nm.4361 http://dx.doi.org/10.1038/nm.4361 .

KURODA T ， HONMA M ， MORI Y ， et al . Increased presence of cerebral microbleeds correlates with ventricular enlargement and increased white matter hyperintensities in Alzheimer’s disease ［J］. Front Aging Neurosci ， 2020 ， 12 ： 13 . DOI： 10.3389/fnagi.2020.00013 http://dx.doi.org/10.3389/fnagi.2020.00013 .

MUNICIO C ， CARRERO L ， ANTEQUERA D ， et al . Choroid plexus aquaporins in CSF homeostasis and the glymphatic system： their relevance for Alzheimer’s disease ［J］. Int J Mol Sci ， 2023 ， 24 （ 1 ）： 878 . DOI： 10.3390/ijms24010878 http://dx.doi.org/10.3390/ijms24010878 .

LI Y ， ZHOU Y ， ZHONG W ， et al . Choroid plexus enlargement exacerbates white matter hyperintensity growth through glymphatic impairment ［J］. Ann Neurol ， 2023 ， 94 （ 1 ）： 182 - 195 . DOI： 10.1002/ana.26648 http://dx.doi.org/10.1002/ana.26648 .

SUNWOO M K ， JEON S ， HAM J H ， et al . The burden of white matter hyperintensities is a predictor of progressive mild cognitive impairment in patients with Parkinson’s disease ［J］. Eur J Neurol ， 2014 ， 21 （ 6 ）： 922 -e50. DOI： 10.1111/ene.12412 http://dx.doi.org/10.1111/ene.12412 .

CARVALHO DE ABREU D C ， PIERUCCINI-FARIA F ， SARQUIS-ADAMSON Y ， et al . White matter hyperintensity burden predicts cognitive but not motor decline in Parkinson’s disease： results from the Ontario Neurode-generative Diseases Research Initiative ［J］. Eur J Neurol ， 2023 ， 30 （ 4 ）： 920 - 933 . DOI： 10.1111/ene.15692 http://dx.doi.org/10.1111/ene.15692 .

KAUR C ， RATHNASAMY G ， LING E A . The choroid plexus in healthy and diseased brain ［J］. J Neuropathol Exp Neurol ， 2016 ， 75 （ 3 ）： 198 - 213 . DOI： 10.1093/jnen/nlv030 http://dx.doi.org/10.1093/jnen/nlv030 .

LEH S E ， PTITO A ， CHAKRAVARTY M M ， et al . Fronto-striatal connections in the human brain： a probabilistic diffusion tractography study ［J］. Neurosci Lett ， 2007 ， 419 （ 2 ）： 113 - 118 . DOI： 10.1016/j.neulet.2007.04.049 http://dx.doi.org/10.1016/j.neulet.2007.04.049 .

MENDEZ M F ， ADAMS N L ， LEWANDOWSKI K S . Neurobehavioral changes associated with caudate lesions ［J］. Neurology ， 1989 ， 39 （ 3 ）： 349 - 354 . DOI： 10.1212/wnl.39.3.349 http://dx.doi.org/10.1212/wnl.39.3.349 .

BIESBROEK J M ， VERHAGEN M G ， VAN DER STIGCHEL S ， et al . When the central integrator disintegrates： a review of the role of the thalamus in cognition and dementia ［J］. Alzheimers Dement ， 2024 ， 20 （ 3 ）： 2209 - 2222 . DOI： 10.1002/alz.13563 http://dx.doi.org/10.1002/alz.13563 .

RÜB U ， DEL TREDICI K ， SCHULTZ C ， et al . Parkinson’s disease： the thalamic components of the limbic loop are severely impaired by α-synuclein immunopositive inclusion body pathology ［J］. Neurobiol Aging ， 2002 ， 23 （ 2 ）： 245 - 254 . DOI： 10.1016/S0197-4580（01）00269-X http://dx.doi.org/10.1016/S0197-4580（01）00269-X .

ZHANG Z ， TAN Q ， GUO P ， et al . NLRP3 inflammasome-mediated choroid plexus hypersecretion contributes to Hydrocephalus after intraventricular hemorrhage via phosphorylated NKCC1 channels ［J］. J Neuroinflamm ， 2022 ， 19 （ 1 ）： 163 . DOI： 10.1186/s12974-022-02530-x http://dx.doi.org/10.1186/s12974-022-02530-x .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Feasibility of ultrasonic quantitative evaluation for normal hip labrum size in adults

Serum metabolic differences between the patients with Alzheimer’s and Parkinson’s diseases

Characteristics of nondyskinesias in idiopathic REM sleep disorder

Related Author

WANG Xin

LIU Zhili

HUANG Yinpei

YU Dan

LI Bing

LI Qian

FU Zijuan

SUN Peng

Related Institution

Department of Otorhinolaryngology, Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University

Department of Neurology, Tangshan Workers’ Hospital

Department of Ultrasonography, 2Center for Joint Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University)

School of Basic Courses, Guangdong Pharmaceutical University

Department of Brain Disease, Chongqing Hospital of Traditional Chinese Medicine

⁰