Multimodal MRI reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer’s disease
Abstract There is increasing evidence that cerebrospinal fluid (CSF) circulation plays a key role in the pathophysiology of Alzheimer’s disease (AD), although the underlying mechanisms remain poorly understood. This study evaluated CSF circulation in patients with AD using magnetic resonance imaging...
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Nature Portfolio
2025-08-01
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| Online Access: | https://doi.org/10.1038/s41598-025-15923-8 |
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| author | Weiqi Lin Huijuan Chen Zhanrong Zhang Yiying Zhang Xingqun Wang Yihao Guo Haodong Qin Tao Liu Feng Chen |
| author_facet | Weiqi Lin Huijuan Chen Zhanrong Zhang Yiying Zhang Xingqun Wang Yihao Guo Haodong Qin Tao Liu Feng Chen |
| author_sort | Weiqi Lin |
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| description | Abstract There is increasing evidence that cerebrospinal fluid (CSF) circulation plays a key role in the pathophysiology of Alzheimer’s disease (AD), although the underlying mechanisms remain poorly understood. This study evaluated CSF circulation in patients with AD using magnetic resonance imaging (MRI)-derived measures, including choroid plexus (CP) volume, CSF volume, and diffusion tensor imaging along the perivascular space (DTI-ALPS) index. The study included 188 participants: 28 with AD, 40 with mild cognitive impairment (MCI), 66 with subjective cognitive decline (SCD), and 54 normal controls (NCs). Participants underwent structural T1-weighted MRI, diffusion tensor imaging, clinical assessment, and plasma biomarker analysis. After adjustments for age, sex, and education, group differences in the DTI-ALPS index, CP volume, and CSF volume were examined. Correlation and mediation analyses were conducted to assess the relationships of clinical parameters with DTI-ALPS index, CP volume, and CSF volume. The AD group exhibited a significantly lower DTI-ALPS index and higher CP and CSF volumes compared with the MCI, SCD, and NC groups. The DTI-ALPS index showed a strong negative correlation with both CP and CSF volumes, whereas CP volume was positively correlated with CSF volume. Mediation analysis revealed interactive relationships among the DTI-ALPS index, CP volume, and CSF volume. This study demonstrates that CSF circulation is disrupted in AD patients. Additionally, CP volume influences glymphatic drainage through its effects on CSF volume, indicating a potential role in AD pathophysiology. |
| format | Article |
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| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-08-01 |
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| spelling | doaj-art-ff4042a498ef4cd584be265fc74f92de2025-08-24T11:18:36ZengNature PortfolioScientific Reports2045-23222025-08-0115111210.1038/s41598-025-15923-8Multimodal MRI reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer’s diseaseWeiqi Lin0Huijuan Chen1Zhanrong Zhang2Yiying Zhang3Xingqun Wang4Yihao Guo5Haodong Qin6Tao Liu7Feng Chen8Hainan Affiliated Hospital of Hainan Medical University(Department of Radiology, Hainan General Hospital)Hainan Affiliated Hospital of Hainan Medical University(Department of Radiology, Hainan General Hospital)Hainan Affiliated Hospital of Hainan Medical University(Department of Radiology, Hainan General Hospital)Hainan Affiliated Hospital of Hainan Medical University(Department of Radiology, Hainan General Hospital)Hainan Affiliated Hospital of Hainan Medical University(Department of Radiology, Hainan General Hospital)Hainan Affiliated Hospital of Hainan Medical University(Department of Radiology, Hainan General Hospital)MR Research Collaboration, Siemens HealthineersHainan Affiliated Hospital of Hainan Medical UniversityHainan Affiliated Hospital of Hainan Medical University(Department of Radiology, Hainan General Hospital)Abstract There is increasing evidence that cerebrospinal fluid (CSF) circulation plays a key role in the pathophysiology of Alzheimer’s disease (AD), although the underlying mechanisms remain poorly understood. This study evaluated CSF circulation in patients with AD using magnetic resonance imaging (MRI)-derived measures, including choroid plexus (CP) volume, CSF volume, and diffusion tensor imaging along the perivascular space (DTI-ALPS) index. The study included 188 participants: 28 with AD, 40 with mild cognitive impairment (MCI), 66 with subjective cognitive decline (SCD), and 54 normal controls (NCs). Participants underwent structural T1-weighted MRI, diffusion tensor imaging, clinical assessment, and plasma biomarker analysis. After adjustments for age, sex, and education, group differences in the DTI-ALPS index, CP volume, and CSF volume were examined. Correlation and mediation analyses were conducted to assess the relationships of clinical parameters with DTI-ALPS index, CP volume, and CSF volume. The AD group exhibited a significantly lower DTI-ALPS index and higher CP and CSF volumes compared with the MCI, SCD, and NC groups. The DTI-ALPS index showed a strong negative correlation with both CP and CSF volumes, whereas CP volume was positively correlated with CSF volume. Mediation analysis revealed interactive relationships among the DTI-ALPS index, CP volume, and CSF volume. This study demonstrates that CSF circulation is disrupted in AD patients. Additionally, CP volume influences glymphatic drainage through its effects on CSF volume, indicating a potential role in AD pathophysiology.https://doi.org/10.1038/s41598-025-15923-8Cerebrospinal fluid circulationDTI-ALPSChoroid plexus volumeCerebrospinal fluid volumeAlzheimer’s disease |
| spellingShingle | Weiqi Lin Huijuan Chen Zhanrong Zhang Yiying Zhang Xingqun Wang Yihao Guo Haodong Qin Tao Liu Feng Chen Multimodal MRI reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer’s disease Scientific Reports Cerebrospinal fluid circulation DTI-ALPS Choroid plexus volume Cerebrospinal fluid volume Alzheimer’s disease |
| title | Multimodal MRI reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer’s disease |
| title_full | Multimodal MRI reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer’s disease |
| title_fullStr | Multimodal MRI reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer’s disease |
| title_full_unstemmed | Multimodal MRI reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer’s disease |
| title_short | Multimodal MRI reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer’s disease |
| title_sort | multimodal mri reveals impaired glymphatic function with choroid plexus enlargement and cerebrospinal fluid expansion in alzheimer s disease |
| topic | Cerebrospinal fluid circulation DTI-ALPS Choroid plexus volume Cerebrospinal fluid volume Alzheimer’s disease |
| url | https://doi.org/10.1038/s41598-025-15923-8 |
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