ArticleQuantitative imaging in medicine and surgery2026
Choroid plexus enlargement is associated with poor functional status in cerebral small vessel disease via reduced DTI-ALPS index: a 5T MRI study.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The choroid plexus (CP) regulates cerebrospinal fluid (CSF) production, neuroimmune monitoring, and glymphatic transport, but its role in glymphatic system and cerebral small vessel disease (CSVD) remains unclear. This study aimed to investigate whether CP enlargement correlates with poor functional status in CSVD and whether glymphatic activity, measured by diffusion tensor imaging along perivascular space (DTI-ALPS), mediates this relationship. Methods: A total of 70 CSVD participants and 44 age- and sex-matched healthy controls (HCs) underwent 5T ultra-high-field magnetic resonance imaging (MRI). The volumes of CP, lateral ventricles volume, white matter hyperintensities (WMHs), enlarged perivascular spaces (EPVS), and cerebral microbleeds (CMBs) were segmented automatically. Functional status was classified as fair or poor based on modified Rankin Scale (mRS) of <2 or ≥2. Group differences were assessed, and partial correlations, mediation analyses, and logistic regression were performed to quantify associations. Results: Severe CSVD showed a lower global DTI-ALPS index than HCs (1.261 Conclusions: CP enlargement is associated with poor functional status in CSVD, and this relationship is partly explained by reduced DTI-ALPS index, suggesting a glymphatic pathway involvement. Quantitative MRI metrics of CP volume and DTI-ALPS index may serve as potential imaging biomarkers for functional status in CSVD.
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