Choroid plexus atrophy in premanifest synucleinopathy using 7 Tesla MRI: an underlooked mechanism for α-synuclein accumulation?

Motivation: As opposed to Alzheimer's disease, the mechanism linking neurotoxic protein accumulation to alterations in neurofluid turnover and in neuroimmunity due to choroid plexus (ChP) changes is understudied in premanifest synucleinopathy. Goal(s): To determine changes in the structure of ChP in premanifest synucleinopathy and to generate a ChP probabilistic atlas. Approach: ChP in multi-contrast 7 Tesla images of 12 premanifest synucleinopathy and 12 sex-and-age-matched controls were evaluated in terms of volume and signal intensity. Results: Reduced ChP volume in premanifest synucleinopathy suggested ChP atrophy that may result in neurofluid dynamics and neuroimmune function impairment; a probabilistic atlas of ChP was generated. Impact: ChP atrophy observed in premanifest synucleinopathy using high-resolution multi-contrast 7-Tesla MRI suggests a potential role of ChP in pathophysiology of synucleinopathies, urging further investigation. Probabilistic ChP atlas may aid precise MRI localization in future studies of ChP in living humans.