Association of Choroid Plexus Volume with White Matter Microstructure, Inflammatory Biomarkers, and Neuropsychological Performance in Crohn’s Disease

Apr 2, 2026Academic radiology

Choroid Plexus Size Linked to White Matter Health, Inflammation, and Thinking Skills in Crohn's Disease

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Abstract

Patients with Crohn's disease have larger choroid plexus volumes and higher white matter microstructural alterations compared to healthy controls.

Choroid plexus volume is positively correlated with white matter damage in patients with Crohn's disease.
Choroid plexus volume increases with age and is negatively correlated with fecal calprotectin and neuropsychological scores.
White matter microstructural integrity also increases with age and disease duration in Crohn's disease patients.
Inflammatory biomarkers are associated with changes in choroid plexus and white matter integrity.

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RATIONALE AND OBJECTIVES: Dysregulation of the gut-brain axis may underlie neuropsychological impairment in Crohn's disease (CD), but the mechanisms remain incompletely understood. Choroid plexus volume (CPV), white matter (WM) microstructural alterations, and systemic inflammation have been implicated as contributors. We investigated the associations among CPV, WM damage, inflammatory biomarkers, and neuropsychological performance in CD.

METHODS: This study enrolled 140 patients with CD and 60 healthy controls (HC). All participants underwent clinical assessment, MRI scans, and neuropsychological testing, with CD patients additionally taking routine blood and fecal examinations. CPV was automatically quantified using the FreeSurfer, while WM integrity was assessed using the peak width of skeletonized mean diffusivity (PSMD). We compared CPV and PSMD between groups and assessed their correlations with clinical characteristics, inflammatory biomarkers, and neuropsychological scores.

RESULTS: Relative to HC, patients with CD showed larger CPV (p = 0.016) and higher PSMD (p = 0.043). A significant positive correlation was observed between CPV and PSMD values (r = 0.20, p = 0.022) in CD. CPV increased with age (r = 0.333, p < 0.001) and showed negative correlations with fecal calprotectin (r = -0.282, p = 0.024) and SDS scores (r = -0.252, p = 0.015), while PSMD also increased with age (r = 0.332, p < 0.001) and disease duration (r = 0.182, p = 0.047).

CONCLUSION: Patients with CD exhibit alterations in CPV and WM integrity. These changes relate to inflammatory biomarkers and neuropsychological performance, supporting the involvement of choroid plexus and white matter microstructure in gut-brain axis regulation.

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Association of Choroid Plexus Volume with White Matter Microstructure, Inflammatory Biomarkers, and Neuropsychological Performance in Crohn’s Disease

Abstract

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