How chronic cortical hypoperfusion affects choroid plexus in patients with moyamoya disease?

Motivation: How chronic cortical hypoperfusion affects choroid plexus, an important structure to maintain neurofluid dynamics, has rarely reported. Goal(s): To investigate changes of choroid plexus after revascularization surgery to improve chronic hypoperfusion in patients with moyamoya disease. Approach: Eighteen adult patients with moyamoya disease were evaluated with T1WI and ASL before and one year after surgery. Choroid plexus volume and cortical perfusion were compared before and one year after the surgery. Results: After the surgery, choroid plexus volume decreased (1.65 (0.55) ml vs. 1.52 (0.51) ml; P=0.014), while cortical perfusion improved (P=0.001). Impact: Choroid plexus may be hyperactivated and proliferated when cortical hypoperfusion and decreased glymphatic system function exist. After the revascularization surgery and restoration of cortical perfusion and glymphatic system function, choroid plexus may shrink to the normal function.