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. 2024 Oct 14:15:1459356.
doi: 10.3389/fneur.2024.1459356. eCollection 2024.

Choroid plexus enlargement in patients with end-stage renal disease: implications for glymphatic system dysfunction

Sihyung Park #  1 , Bong Soo Park #  1 , Ho-Joon Lee  2 , Chang Min Heo  1 , Junghae Ko  1 , Dong Ah Lee  3 , Kang Min Park  3
Affiliations

Choroid plexus enlargement in patients with end-stage renal disease: implications for glymphatic system dysfunction

Sihyung Park et al. Front Neurol. .

Abstract

Objectives: The choroid plexus plays a role in eliminating detrimental metabolites from the brain as an integral component of the glymphatic system. This study aimed to investigate alterations in choroid plexus volume in patients with end-stage renal disease (ESRD) compared with healthy controls.

Methods: We enrolled 40 patients with ESRD and 42 healthy controls. They underwent brain magnetic resonance imaging (MRI), specifically using three dimensional T1-weighted imaging. We analyzed choroid plexus volumes and compared them between patients with ESRD and healthy controls. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index was calculated. We compared the DTI-ALPS index between the ESRD patients and healthy controls. Additionally, we evaluated the association between choroid plexus volume and neuropsychological tests results in patients with ESRD.

Results: There were significant differences in choroid plexus volumes between patients with ESRD and healthy controls. The choroid plexus volumes in patients with ESRD were higher than those in healthy controls (1.392 vs. 1.138%, p < 0.001). The DTI-ALPS index in patients with ESRD was lower than that in healthy controls (1.470 ± 0.239 vs. 1.641 ± 0.266, p = 0.005). There were no differences in choroid plexus volumes between patients with ESRD, regardless of the presence of cognitive impairment. However, among the neuropsychological tests, the scores for word-list recognition in verbal memory were negatively correlated with the choroid plexus volume (r = -0.428, p = 0.006).

Conclusion: We demonstrated a significant enlargement of the choroid plexus volume in patients with ESRD compared to healthy controls. This finding suggests that patients with ESRD have glymphatic system dysfunction, which may be related to cognitive impairment.

Keywords: ESRD; MRI; choroid plexus; cognition; glymphatic system.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Representative images showing choroid plexus segmentation (red) overlaid on three-dimensional T1-weighted magnetic resonance images in the axial (left), coronal (center), and sagittal (right) planes.
Figure 2
Figure 2
Differences in choroid plexus volumes between patients with ESRD and healthy controls The figure shows that the choroid plexus volumes in patients with ESRD are higher than those in healthy controls (2.514 vs. 2.190%, p < 0.001). Increased choroid plexus volumes suggest glymphatic system dysfunction in patients with ESRD.
See this image and copyright information in PMC

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