Association of choroid plexus volume with MRI indices of DTI-derived parameters and perivascular spaces in patients with neurodegenerative diseases.

OBJECTIVE

To compare the association between CP volume fraction (CPVF) and glymphatic function (assessed by perivascular space volume fraction [PVSVF], white matter free water fraction [FW-WM], and diffusion tensor imaging analysis along perivascular spaces [DTI-ALPS]) in patients with Alzheimer's disease (AD), Parkinson's disease (PD), idiopathic normal pressure hydrocephalus (iNPH), and healthy controls (HCs), and explore the utility of multiparametric MRI integration for differential diagnosis.

PATIENTS AND

METHODS

This single-centre cohort study included 33 iNPH patients, 42 AD patients, 49 PD patients, and 30 HCs. Group differences in 3.0-T MRI parameters were assessed using a general linear univariate model adjusted for age and sex. Partial correlation analysis was performed to evaluate correlations between CPVF and glymphatic parameters in each group. A composite score combining the four MRI parameters was generated via multiple logistic regression, with diagnostic performance evaluated using receiver operating characteristic curves.

RESULTS

Patients with iNPH, AD, and PD showed significantly higher CPVF, FW-WM, and MRI-PVS and lower DTI-ALPS than HCs (all p < 0.001). iNPH involved significantly higher CPVF and lower FW-WM and DTI-ALPS than AD or PD (all p < 0.001). In PD, CPVF was significantly negatively correlated with DTI-ALPS (r =  - 0.509, p fdr = 0.003), while CPVF also showed a significant positive correlation with FW-WM (r = 0.532, pfdr = 0.003). Additionally, the AUC of the composite score indicated good performance in differentiating iNPH from AD and PD (AUC = 0.902 and 0.96, respectively).

CONCLUSION

MRI indices of CSF dynamics and glymphatic function exhibit disease-specific patterns, with unique inter-relationships in PD.