The choroid plexus does not seem to be involved in neuromyelitis optica spectrum disorder (NMOSD) unlike multiple sclerosis (MS), according to a new study published in Neurology: Neuroimmunology & Neuroinflammation. This finding provides clues to better understanding the pathogenesis of these diseases, the authors said.

The choroid plexus of the brain, which produces most of the cerebrospinal fluid, has been shown to play a key role in the inflammation of the central nervous system. For example, the choroid plexus was found to be enlarged in patients with MS compared to healthy controls. However, its possible involvement in NMOSD has not been assessed.

Here, a team of researchers led by Özgür Yaldizli, MD, compared the volume of the choroid plexus in patients with MS and NMOSD using T1-weighted magnetic resonance imaging sequences. The researchers retrospectively analyzed 180 patients with MS and 98 patients with NMOSD and used 94 healthy people and 47 patients with migraine as controls.

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They found that the volume of the choroid plexus was indeed larger in patients with MS compared to healthy controls, and it was also larger compared to patients with NMSOD and those with migraine.

However, when the researchers compared the volume of the choroid plexus between healthy controls, people with migraine, and patients with NMSOD, they found no difference. This was the case after adjustment for age, sex, and intracranial volume.

In MS, the volume of the choroid plexus was associated with the T2-weighted lesion number in a linear model adjusted for age, sex, total intracranial volume, duration of the disease, number of relapses, course of the disease, Expanded Disability Status Scale score, any disease-modifying treatment, and the duration of treatment. This was not the case in NMSOD.

“Further prospective studies are warranted to investigate whether the choroid plexus volume is useful to differentiate MS from NMOSD in clinical practice,” the researchers said.


Müller J, Sinnecker T, Wendebourg MJ, et al. Choroid plexus volume in multiple sclerosis vs neuromyelitis optica spectrum disorder: a retrospective, cross-sectional analysis. Neurol.: Neuroimmunol NeuroInflamm. 2022;9(3):e1147. doi:10.1212/NXI.0000000000001147