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Movement disorders
Original research
Association of choroid plexus volume with motor symptoms and dopaminergic degeneration in Parkinson’s disease
  1. Seong Ho Jeong1,2,
  2. Chae Jung Park3,
  3. Hyun-Jae Jeong4,
  4. Mun Kyung Sunwoo5,
  5. Sung Soo Ahn6,
  6. Seung-Koo Lee6,
  7. Phil Hyu Lee2,
  8. Yun Joong Kim2,7,8,
  9. Young Ho Sohn2,
  10. Seok Jong Chung2,7,8
  1. 1 Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, Korea (the Republic of)
  2. 2 Department of Neurology, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  3. 3 Department of Radiology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Geyonggi-do, Korea (the Republic of)
  4. 4 Research Institute of Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  5. 5 Department of Neurology, Daejin Medical Foundation Bundang Jesaeng Hospital, Seongnam, Gyeonggi-do, Korea (the Republic of)
  6. 6 Department of Radiology, Severance Hospital, Research Institute of Radiological Science and Centre for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  7. 7 Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Gyeonggi-do, Korea (the Republic of)
  8. 8 YONSEI BEYOND LAB, Yongin, Gyeonggi-do, South Korea
  1. Correspondence to Dr Seok Jong Chung, Department of Neurology, Yongin Severance Hospital, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Korea (the Republic of); sjchung{at}yuhs.ac

Abstract

Background The choroid plexus (CP) is involved in the clearance of harmful metabolites from the brain, as a part of the glymphatic system. This study aimed to investigate the association between CP volume (CPV), nigrostriatal dopaminergic degeneration and motor outcomes in Parkinson’s disease (PD).

Methods We retrospectively searched drug-naïve patients with early-stage PD who underwent dopamine transporter (DAT) scanning and MRI. Automatic CP segmentation was performed, and the CPV was calculated. The relationship between CPV, DAT availability and Unified PD Rating Scale Part III (UPDRS-III) scores was assessed using multivariate linear regression. We performed longitudinal analyses to assess motor outcomes according to CPV.

Results CPV was negatively associated with DAT availability in each striatal subregion (anterior caudate, β=−0.134, p=0.012; posterior caudate, β=−0.162, p=0.002; anterior putamen, β=−0.133, p=0.024; posterior putamen, β=−0.125, p=0.039; ventral putamen, β=−0.125, p=0.035), except for the ventral striatum. CPV was positively associated with the UPDRS-III score even after adjusting for DAT availability in the posterior putamen (β=0.121; p=0.035). A larger CPV was associated with the future development of freezing of gait in the Cox regression model (HR 1.539, p=0.027) and a more rapid increase in dopaminergic medication in the linear mixed model (CPV×time, p=0.037), but was not associated with the risk of developing levodopa-induced dyskinesia or wearing off.

Conclusion These findings suggest that CPV has the potential to serve as a biomarker for baseline and longitudinal motor disabilities in PD.

  • PARKINSON'S DISEASE
  • MRI
  • PET, FUNCTIONAL IMAGING

Data availability statement

Data generated or analysed during the study are available from the corresponding author by request.

http://dx.doi.org/10.1136/jnnp-2023-331170

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    Data availability statement

    Data generated or analysed during the study are available from the corresponding author by request.

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    Footnotes

    • SHJ and CJP are joint first authors.

    • Contributors SJC takes full responsibility for the overall content as the guarantor. SHJ drafted the structure of the present work, took care of data analysis, drafted the first version of the work and revised the following versions critically for important intellectual content. CJP and SJC contributed to drafting the structure of the present work and revised the first version of the work critically for important intellectual content. All authors had full access to all the data in the study, substantially contributed to the interpretation of data for the present work, revised the work critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SHJ, CJP and SJC accept full responsibility for the work and the conduct of the study, had access to the data and controlled the decision to publish.

    • Funding This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2021R1I1A1A01059678). Also, this research was supported by a grant from the Korea Health Technology R&D Project through the Korean Healthy Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number HI22C0224). This research was supported by the faculty research grants of Yonsei University College of Medicine (6-2020-0157).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.