Researchers at the Konkuk University School of Medicine in Seoul, Korea, report that increased volume of the choroid plexus (CP) is linked to greater cognitive impairment and Alzheimer’s disease (AD). The findings were uncovered by using magnetic resonance imaging (MRI) to analyze patients at different stages of cognitive impairment.

The findings, “Choroid Plexus Volume and Permeability at Brain MRI within the Alzheimer Disease Clinical Spectrum,” were published in the journal Radiology.

“Mounting evidence suggests that the CP plays an important role in the pathophysiology of AD, but its imaging profile in cognitive impairment remains unclear,” wrote the researchers.

“Researchers believe impaired clearance rather than overproduction of abnormal amyloid and tau is responsible for Alzheimer’s disease,” said study senior author Won-Jin Moon, MD, PhD, professor of radiology and chairperson of the department of radiology at the Konkuk University School of Medicine. “Thus, we assume that the abnormal status of choroid plexus is linked to the failure of clearance leading to waste and toxic protein accumulation in the brain and failure of immune surveillance leading to neuroinflammation.”

The researchers performed brain MRIs on 532 participants at various stages of cognitive impairment. Of the 532 participants, 132 underwent permeability imaging using dynamic contrast-enhanced MRI.

“Our study found that the enlarged choroid plexus volume is independently associated with increased cognitive impairment,” Moon said. “We found no relationship between choroid plexus volume and amyloid pathology but a clear relationship between the choroid plexus volume and cognitive impairment severity.”

“I think our findings on the choroid plexus can suggest it as a new potential MR imaging surrogate for an impaired clearance system and neuroinflammation,” Moon said.

“If we combine choroid plexus volume and hippocampal volume in a screening stage, it may help us better discriminate the more vulnerable patients from the less vulnerable ones,” Moon added.

The researchers plan to follow up with a longitudinal study. They will explore changes in CP volume over time as the disease progresses.