Choroid Plexus Volume and Perfusion Abnormalities May Explain Pathophysiology and Cognitive Impairment in Cerebral Small Vessel Disease

Motivation: The choroid plexus (CP) is involved in the pathophysiology of cerebral small vessel disease (CSVD), but its specific imaging and clinical impacts remain unclear. Goal(s): This study aimed to quantify CP abnormalities and examine their associations with CSVD imaging markers and cognitive function. Approach: We included 90 CSVD patients and 26 healthy controls. Manual CP segmentation was performed, and normalized CP volume, magnetic susceptibility, and perfusion metrics were measured using T1-weighted imaging, quantitative susceptibility mapping, and arterial spin labeling. Results: CSVD patients exhibited enlarged CP volume, reduced susceptibility and perfusion, with correlations to disease burden and specific cognitive domains. Impact: The study reveals CP structural and functional abnormalities as contributors to CSVD-related brain damage and cognitive decline, offering new insights into CSVD pathophysiology. These findings highlight CP-targeted interventions as a potential therapeutic strategy.