Choroid plexus changes on magnetic resonance imaging in multiple sclerosis and neuromyelitis optica spectrum disorder

Objective: To investigate alterations in the choroid plexus in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) using brain magnetic resonance imaging (MRI). Methods: We prospectively recruited consecutive patients with MS or NMOSD from July 2018 to February 2019. The inclusion criterion was brain MRI within three months from onset of acute neurological symptoms. The thickness and enhancement ratio of the choroid plexus on gadolinium-enhanced T1-weighted images of patients with MS (n = 51), patients with NMOSD (n = 32), and healthy controls (HCs, n = 28) were compared. Results: MRI in patients with MS or NMOSD showed a comparably thick but more enhanced choroid plexus compared with that of HCs. In the axial view, enhancement ratios of the lateral ventricle of MS and NMOSD patients and HCs were 1.64 +/- 0.34, 1.65 +/- 0.25, and 1.39 +/- 0.17, respectively (P > .999 for MS vs. NMOSD; P = .001 for MS vs. HCs; P = .001 for NMOSD vs. HCs). Conclusions: The choroid plexus was significantly more enhanced on brain MRI of patients with MS or NMOSD than on that of HCs, suggesting the involvement of the choroid plexus in the autoimmune inflammatory processes in MS and NMOSD.