Association of Choroid Plexus Volume with White Matter Microstructure, Inflammatory Biomarkers, and Neuropsychological Performance in Crohn's Disease.

RATIONALE AND

OBJECTIVES

Dysregulation of the gut-brain axis may underlie neuropsychological impairment in Crohn's disease (CD), but the mechanisms remain incompletely understood. Choroid plexus volume (CPV), white matter (WM) microstructural alterations, and systemic inflammation have been implicated as contributors. We investigated the associations among CPV, WM damage, inflammatory biomarkers, and neuropsychological performance in CD.

METHODS

This study enrolled 140 patients with CD and 60 healthy controls (HC). All participants underwent clinical assessment, MRI scans, and neuropsychological testing, with CD patients additionally taking routine blood and fecal examinations. CPV was automatically quantified using the FreeSurfer, while WM integrity was assessed using the peak width of skeletonized mean diffusivity (PSMD). We compared CPV and PSMD between groups and assessed their correlations with clinical characteristics, inflammatory biomarkers, and neuropsychological scores.

RESULTS

Relative to HC, patients with CD showed larger CPV (p = 0.016) and higher PSMD (p = 0.043). A significant positive correlation was observed between CPV and PSMD values (r = 0.20, p = 0.022) in CD. CPV increased with age (r = 0.333, p < 0.001) and showed negative correlations with fecal calprotectin (r = -0.282, p = 0.024) and SDS scores (r = -0.252, p = 0.015), while PSMD also increased with age (r = 0.332, p < 0.001) and disease duration (r = 0.182, p = 0.047).

CONCLUSION

Patients with CD exhibit alterations in CPV and WM integrity. These changes relate to inflammatory biomarkers and neuropsychological performance, supporting the involvement of choroid plexus and white matter microstructure in gut-brain axis regulation.