Get started
Work

Choroid plexus free‐water reflects glymphatic dysfunction and neuroinflammation: a potential imaging marker in Alzheimer's disease

Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Free-water imaging of the choroid plexus (CP) is an index revealing components of the CP, and shows promise for early diagnosis and accurate monitoring of Alzheimer disease (AD). METHODS: Our study evaluated free water fraction (FWf) of CP in 216 participants (133 Aβ+ participants and 83 Aβ- controls) continuously enrolled in the Ruijin NeuroBank of Alzheimer's Disease and Dementia (RJNB-D) cohort. The ADNI dataset was used for external validation. RESULTS: Following adjustment for age, sex, and ApoE genotype, the CP FWf and decreased diffusion tensor image analysis of the perivascular space (DTI-ALPS) index were independently associated with Aβ positivity in both RJNB-D and ADNI datasets (all p < 0.05, Figure 1A and B). In Aβ+ participants, DTI-ALPS mediated the association between CP FWf and periventricular white matter hyperintensity (pWMH) (mediated effect = 35.76%). CP FWf was associated with cortical Tau accumulation, synaptic loss, hippocampal and cortical atrophy, impaired cognitive performance, and elevated levels of NFL, GFAP, NRGN, and TNF-α. (all p < 0.05, Figure 2). Longitudinally, CP FWf increased faster in Aβ+ participants than Aβ- controls (time × group interaction effect p = 0.046, Figure 3A). The growth of CP FWf was associated with a reduction in DTI-ALPS (ρ = -0.42, p = 0.006), and the growth rate of CP FWf surpassed that of pWMH, Tau, and GFAP. (Figure 3B, C and D). CONCLUSION: Elevated CP FWf indicates impaired glymphatic function and AD neurodegeneration, and can be a sensitive biomarker for AD progression. The study was registered on ClinicalTrials.gov (NCT05623124).
DOI: 10.1002/alz70856_097697
Language: English
Field: Medicine
Open Access status: hybrid
Estimated APC paid: $4,200
OpenAlex ID: W7117126507
FWCI:
Cites:
Cited by:
Related to: