Correlation between change in choroid plexus volume and cognitive function in patients with Parkinson’s disease

Objective‍ ‍To investigate the change in choroid plexus (CP) volume in Parkinson’s disease (PD) patients with different cognitive states and its correlation with structural volumes of other brain regions. Methods‍ ‍A cross-sectional study was conducted on 48 PD patients admitted in Department of Neurosurgery of the First Affiliated Hospital of Army Medical University between May 2023 and April 2024, and on 35 healthy controls (HC) recruited through a physical exam center. According to the results of Mini-Mental State Examination (MMSE), the patients were divided into PD with cognitive impairment (PD-CI) group (n=27) and PD with normal cognitive function (PD-NC) group (n=21). 3.0T magnetic resonance imaging (MRI) was performed using MPRAGE sequences, and CP volume and volumes of other brain regions were obtained using FreeSurfer 6.0 software. The CP volume was adjusted by calculating the ratio of its volume to estimated total intracranial volume (eTIV). After controlling for confounders, partial correlation analysis was used to assess the relationship between the CPV/eTIV ratio and the volumes of other brain regions as well as cognitive scale scores. Additionally, multiple linear regression analysis was performed to further explore the relationship between CPV and cognitive function in the PD-CI group. Results‍ ‍Compared to the HC group, the CPV in the PD-CI group was significantly larger (P=0.029). In the PD-CI group, the CPV/eTIV ratio showed significant positive correlations with the volume of the lateral ventricles (r=0.689, P=0.001), the volume of the third ventricle (r=0.592, P=0.006), the volume of cerebrospinal fluid (CSF) (r=0.508, P=0.022), and white matter hyperintensities (WMH) (r=0.486, P=0.030), but was negatively correlated with the volume of the caudate nucleus (r=-0.530, P=0.016), the volume of the thalamus (r=-0.477, P=0.033), and the MMSE scores (r=-0.483, P=0.031). But in the PD-NC group, the CPV/eTIV ratio was only positively correlated with CSF volume (r=0.571, P=0.021). Multiple linear regression analysis indicated that the CPV/eTIV ratio and MMSE scores remained significantly negatively correlated in the PD-CI group (β=-0.388, P=0.046). Conclusion‍ ‍Cognitive impairment in PD patients may be closely associated with the change in CP volume, suggesting that the volume can serve as a potential imaging marker in assessment of cognitive impairment in PD patients.