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. 2023 Apr 15;44(6):2465-2478.
doi: 10.1002/hbm.26224. Epub 2023 Feb 6.

A preliminary choroid plexus volumetric study in individuals with psychosis

Olcay Senay  1   2 , Magdalena Seethaler  1   3 , Nikos Makris  1   4   5 , Edward Yeterian  1   5   6 , Jarrett Rushmore  1   4   5 , Kang Ik K Cho  1 , Elizabeth Rizzoni  1 , Carina Heller  1   7 , Ofer Pasternak  1 , Filip Szczepankiewicz  8 , Carl-Frederik Westin  8 , Jan Losak  9 , Libor Ustohal  9 , Josef Tomandl  9 , Lubomir Vojtisek  9 , Peter Kudlicka  9 , Zora Kikinis  1 , Daphne Holt  10 , Kathryn E Lewandowski  11 , Paulo Lizano  12 , Matcheri S Keshavan  12 , Dost Öngür  11 , Tomas Kasparek  13 , Alan Breier  14 , Martha E Shenton  1   8 , Johanna Seitz-Holland  1   10 , Marek Kubicki  1   8   10
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A preliminary choroid plexus volumetric study in individuals with psychosis

Olcay Senay et al. Hum Brain Mapp. .

Abstract

The choroid plexus (ChP) is part of the blood-cerebrospinal fluid barrier, regulating brain homeostasis and the brain's response to peripheral events. Its upregulation and enlargement are considered essential in psychosis. However, the timing of the ChP enlargement has not been established. This study introduces a novel magnetic resonance imaging-based segmentation method to examine ChP volumes in two cohorts of individuals with psychosis. The first sample consists of 41 individuals with early course psychosis (mean duration of illness = 1.78 years) and 30 healthy individuals. The second sample consists of 30 individuals with chronic psychosis (mean duration of illness = 7.96 years) and 34 healthy individuals. We utilized manual segmentation to measure ChP volumes. We applied ANCOVAs to compare normalized ChP volumes between groups and partial correlations to investigate the relationship between ChP, LV volumes, and clinical characteristics. Our segmentation demonstrated good reliability (.87). We further showed a significant ChP volume increase in early psychosis (left: p < .00010, right: p < .00010) and a significant positive correlation between higher ChP and higher LV volumes in chronic psychosis (left: r = .54, p = .0030, right: r = .68; p < .0010). Our study suggests that ChP enlargement may be a marker of acute response around disease onset. It might also play a modulatory role in the chronic enlargement of lateral ventricles, often reported in psychosis. Future longitudinal studies should investigate the dynamics of ChP enlargement as a promising marker for novel therapeutic strategies.

Keywords: cerebrospinal fluid; manual segmentation; neuroinflammation; perivascular space; schizophrenia; ventricle.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Manual segmentation of the Choroid Plexus using Slicer® (a) Axial view (b) Coronal view (c) Sagittal view. The coronal view was foremost used to guide the manual segmentation (b). ChP voxels were defined as hyperintense voxels within the ventricles. Voxels surrounded by clearly identified ChP tissue and located immediately next to a hypointense non‐ChP voxel were included. In the case of two adjacent voxels with the same density at the boundary, the inner one was included (red arrow), and the outer one was excluded (red circle). After the segmentation in the coronal view, editing was conducted in the axial and sagittal view (a, c), making sure not to include grey or white matter, especially at the boundaries of the lateral ventricles (green arrow), thalamus (yellow arrow), and corpus callosum (blue arrow). Further, a simultaneous 3D image (d) served to check for holes, gaps, and islands of (non‐) ChP tissue, which we then eliminated manually.
FIGURE 2
FIGURE 2
Choroid Plexus volume. Violin plots for Choroid Plexus (ChP) volume in (a) early course psychosis (ECP) individuals and healthy controls (HC) and (b) chronic psychosis (CP) individuals and (HC). Broken lines: median; Dotted lines: quartiles.
See this image and copyright information in PMC

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