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
- PET, FUNCTIONAL IMAGING
Data availability statement
Data generated or analysed during the study are available from the corresponding author by request.
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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.
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