Objective The choroid plexus (ChP) produces cerebrospinal fluid (CSF) and serves as a crucial component of the glymphatic system. This study investigated the characteristics of choroid plexus volume (CPV) changes in patients with patent foramen ovale-related migraine with aura (PFO-M), analyzed its correlation with migraine severity (including both visual analogue scale [VAS] and monthly migraine frequency [MMF]), and elucidated the mechanism of chronic long-term injury on ChP as well as the therapeutic significance of PFO closure. Methods A prospective study was conducted to enroll 76 patients with PFO-related migraine with aura (PFO group) and 50 healthy controls (HC group) who were treated in our hospital from September 2023 to September 2025. 3.0T magnetic resonance imaging (MRI) was used to measure the lateral ventricular CPV of all subjects, and both VAS and MMF were adopted to evaluate the migraine severity of patients. Intergroup differences in CPV were calculated, and the correlations between CPV and migraine severity indicators (VAS and MMF) in the PFO-M group was analyzed. 26 patients underwent follow-up MRI at 6 months postoperatively to measure CPV and reassess the VAS and MMF, and pre- and post-closure changes in these metrics were compared. Results (1) The CPV in the PFO-M group was significantly smaller than that in the HC group (1709.76 ± 468.23 mm³ vs. 2443.68 ± 797.48 mm³, t=-5.875, P < 0.001). (2) A significant negative correlation was observed between CPV and VAS (r=-0.788, P < 0.001) and MMF (r=-0.769, P < 0.001) in the PFO-M group. (3) Migraine severity in the PFO-M group at 6 months postoperatively was significantly lower compared with pre-closure levels (VAS: 1.04 ± 1.54 vs. 6.12 ± 1.84, t = 10.718, P < 0.001; MMF: 0.92 ± 1.32 vs. 5.08 ± 1.76, t = 10.316, P < 0.001). (4) There was no statistically significant difference in CPV of the PFO-M group between pre- and 6 months post-closure (1658.23 ± 421.99 mm³ vs. 1666.54 ± 486.86 mm³, t = 0.225, P = 0.823). Conclusion Patients with PFO-related migraine with aura show reduced choroid plexus volume correlated with migraine severity. PFO closure improves migraine symptoms, without significant changes in choroid plexus volume at 6 months, suggesting longer follow-up is needed.

Reduced choroid plexus volume aggravates the glymphatic system burden in patients with patent foramen ovale-related migraine with aura

期刊论文
发表日期：

2026年6月29日

查看全文

Liqiang Sun,
Kaige Cui,
Jing Hu,
Yu Zhai,
Jiping Yang

摘要

Objective

The choroid plexus (ChP) produces cerebrospinal fluid (CSF) and serves as a crucial component of the glymphatic system. This study investigated the characteristics of choroid plexus volume (CPV) changes in patients with patent foramen ovale-related migraine with aura (PFO-M), analyzed its correlation with migraine severity (including both visual analogue scale [VAS] and monthly migraine frequency [MMF]), and elucidated the mechanism of chronic long-term injury on ChP as well as the therapeutic significance of PFO closure.

Methods

A prospective study was conducted to enroll 76 patients with PFO-related migraine with aura (PFO group) and 50 healthy controls (HC group) who were treated in our hospital from September 2023 to September 2025. 3.0T magnetic resonance imaging (MRI) was used to measure the lateral ventricular CPV of all subjects, and both VAS and MMF were adopted to evaluate the migraine severity of patients. Intergroup differences in CPV were calculated, and the correlations between CPV and migraine severity indicators (VAS and MMF) in the PFO-M group was analyzed. 26 patients underwent follow-up MRI at 6 months postoperatively to measure CPV and reassess the VAS and MMF, and pre- and post-closure changes in these metrics were compared.

Results

(1) The CPV in the PFO-M group was significantly smaller than that in the HC group (1709.76 ± 468.23 mm³ vs. 2443.68 ± 797.48 mm³, t=-5.875, P < 0.001). (2) A significant negative correlation was observed between CPV and VAS (r=-0.788, P < 0.001) and MMF (r=-0.769, P < 0.001) in the PFO-M group. (3) Migraine severity in the PFO-M group at 6 months postoperatively was significantly lower compared with pre-closure levels (VAS: 1.04 ± 1.54 vs. 6.12 ± 1.84, t = 10.718, P < 0.001; MMF: 0.92 ± 1.32 vs. 5.08 ± 1.76, t = 10.316, P < 0.001). (4) There was no statistically significant difference in CPV of the PFO-M group between pre- and 6 months post-closure (1658.23 ± 421.99 mm³ vs. 1666.54 ± 486.86 mm³, t = 0.225, P = 0.823).

Conclusion

Patients with PFO-related migraine with aura show reduced choroid plexus volume correlated with migraine severity. PFO closure improves migraine symptoms, without significant changes in choroid plexus volume at 6 months, suggesting longer follow-up is needed.