The association of CSF biomarkers and cognitive decline with choroid plexus volume in early Parkinson's disease

Objective: This study aims to determine the link between choroid plexus (CP) volume and cognitive decline in patients with early -stage Parkinson's disease (PD) and to test whether pathological proteins in the cerebrospinal fluid (CSF) are involved in the modulation of any detrimental effects from CP volume. Methods: Data on 95 early -stage PD patients with 5 years of follow-up were collected from the Parkinson's Progression Marker Initiative cohort. The patients were separated into three groups based on tertiles of baseline CP volume. We then used a linear mixed model for longitudinal analysis and conducted path analysis to investigate mediating effects. Results: At baseline, the patients in both the upper and middle tertile group were older and had lower concentrations of CSF A beta 1-42 than those in the lowest tertile group. Longitudinal analysis showed that the upper tertile group suffered from a more rapid cognitive decline in the Symbol Digit Modalities test, Hopkins Verbal Learning Test (HVLT)-retention, and HVLT delayed recalled score. Furthermore, path analysis showed that the pathological effects of CP volume on the 5 -year decline in memory might be partly mediated by the CSF A beta 1-42/alpha syn ratio. Conclusion: CP enlargement could be an independent risk factor for decreased cognition in patients with earlystage PD, and this risk may be mediated by CSF pathological proteins.