Choroid Plexus Volume in Multiple Sclerosis vs Neuromyelitis Optica Spectrum Disorder: A Retrospective, Cross-sectional Analysis

Jannis Müller, Tim Sinnecker, Maria Janina Wendebourg, Regina Schläger, Jens Kuhle, Sabine Schädelin, Pascal Benkert, Tobias Derfuss, Philippe Cattin, Christoph Jud, Florian Spiess, Michael Amann, Therese Lincke, Muhamed Barakovic, Alessandro Cagol, Charidimos Tsagkas, Katrin Parmar, Anne Katrin Pröbstel, Sophia Reimann, Susanna AsseyerAnkelien Duchow, Alexander Brandt, Klemens Ruprecht, Nouchine Hadjikhani, Shoko Fukumoto, Mitsuru Watanabe, Katsuhisa Masaki, Takuya Matsushita, Noriko Isobe, Jun-Ichi Kira, Ludwig Kappos, Jens Würfel, Cristina Granziera, Friedemann Paul, Özgür Yaldizli

Research output: Contribution to journalArticlepeer-review

33 Citations (Scopus)


Background and ObjectivesThe choroid plexus has been shown to play a crucial role in CNS inflammation. Previous studies found larger choroid plexus in multiple sclerosis (MS) compared with healthy controls. However, it is not clear whether the choroid plexus is similarly involved in MS and in neuromyelitis optica spectrum disorder (NMOSD). Thus, the aim of this study was to compare the choroid plexus volume in MS and NMOSD.MethodsIn this retrospective, cross-sectional study, patients were included by convenience sampling from 4 international MS centers. The choroid plexus of the lateral ventricles was segmented fully automatically on T1-weighted MRI sequences using a deep learning algorithm (Multi-Dimensional Gated Recurrent Units). Uni- and multivariable linear models were applied to investigate associations between the choroid plexus volume, clinically meaningful disease characteristics, and MRI parameters.ResultsWe studied 180 patients with MS and 98 patients with NMOSD. In total, 94 healthy individuals and 47 patients with migraine served as controls. The choroid plexus volume was larger in MS (median 1,690 µL, interquartile range [IQR] 648 µL) than in NMOSD (median 1,403 µL, IQR 510 µL), healthy individuals (median 1,533 µL, IQR 570 µL), and patients with migraine (median 1,404 µL, IQR 524 µL; all p < 0.001), whereas there was no difference between NMOSD, migraine, and healthy controls. This was also true when adjusted for age, sex, and the intracranial volume. In contrast to NMOSD, the choroid plexus volume in MS was associated with the number of T2-weighted lesions in a linear model adjusted for age, sex, total intracranial volume, disease duration, relapses in the year before MRI, disease course, Expanded Disability Status Scale score, disease-modifying treatment, and treatment duration (beta 4.4; 95% CI 0.78-8.1; p = 0.018).DiscussionThis study supports an involvement of the choroid plexus in MS in contrast to NMOSD and provides clues to better understand the respective pathogenesis.

Original languageEnglish
Article numbere1147
JournalNeurology: Neuroimmunology and NeuroInflammation
Issue number3
Publication statusPublished - May 25 2022

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Neurology


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