Assessment of the choroid plexuses volume in radiologically isolated syndrome
Abstract
Objective: to investigate the volume of the choroid plexuses (ChP) in individuals with radiologically isolated syndrome (RIS) and its impact on conversion to multiple sclerosis (MS), and to assess the level of neuroinflammation in individuals with RIS. Material and methods. A prospective observational study was conducted at the Federal Centre for Brain and Neurotechnologies, in which data from two groups of participants were analysed: individuals with RIS (n=32) and healthy volunteers (control group; n=30). The diagnosis of RIS was established in accordance with the 2017 McDonald criteria. All examinations were performed on a single MRI scanner with a magnetic field strength of 1.5 T. MRI morphometry of the cerebellum was performed on T1-weighted images using manual segmentation in the 3D Slicer software. Intracranial volume was determined using the automated web-based volBrain system. Statistical analysis was performed for both the absolute value of the ChP volume and the value normalized to intracranial volume. Results. No statistically significant differences in age or sex were found between the RIS and control groups (p=0.21 and p=0.20, respectively). No differences in age or sex were observed either among individuals with RIS who subsequently converted and those who did not (p=0.67 and p=0.44, respectively). However, in patients with subsequent conversion, the ChP volume was already higher at baseline. The normalized ChP volume was higher in patients with conversion compared with those without conversion (1.435 [1.188; 1.715] mm3 versus 1.003 [0.918; 1.325] mm3; p=0.015), and the absolute ChP volume was also higher in the conversion group (1,878 [1,724; 2,333] versus 1,368 [1,163; 1,770]; p=0.024). According to the results of logistic regression, the normalized ChP volume was a significant predictor of conversion to MS (odds ratio 18.5; 95% CI 1.67–369.6), and the model’s diagnostic performance was satisfactory (AUC=0.78; 95% CI 0.62–0.94; p=0.016). Conclusion. An increase in ChP volume, as measured by MRI morphometry, may be regarded as a non-invasive marker of neuroinflammation in the central nervous system and a potential predictor of disease progression, detectable in the early stages of the pathological process using standard MRI sequences.