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The Alzheimer's Disease Neuroimaging Initiative dataset was used for external validation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>At baseline, A\u03b2+ participants showed higher CP FWf, increased white matter hyperintensity (WMH) volume, and decreased diffusion tensor image analysis along the perivascular space (DTI\u2010ALPS). In A\u03b2+ participants, DTI\u2010ALPS mediated the association between CP FWf and periventricular WMH. CP FWf was associated with cortical tau accumulation, synaptic loss, hippocampal and cortical atrophy, and cognitive performance. During follow\u2010up, CP FWf increased faster in A\u03b2+ participants than controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Elevated CP FWf indicated impaired glymphatic function and AD neurodegeneration, and can be a sensitive biomarker for AD progression. The study was registered on ClinicalTrials.gov (NCT05623124).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>This cohort study found higher free\u2010water fraction (FWf) of the choroid plexus (CP) in amyloid beta (A\u03b2)+ participants.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>CP FWf was related to glymphatic function, brain atrophy, tau burden, synaptic loss, and cognition.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>A\u03b2+ participants showed faster growth of CP FWf than A\u03b2\u2013 controls during follow\u2010up.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The growth rate of CP FWf exceeded that of white matter lesion and tau accumulation in A\u03b2+ participants.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>CP FWf can serve as a sensitive imaging marker of glymphatic function and Alzheimer's disease progression.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70239","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T01:25:01Z","timestamp":1747790701000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Choroid plexus free\u2010water correlates with glymphatic function in Alzheimer's disease"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1717-538X","authenticated-orcid":false,"given":"Xiaomeng","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Neurology and Institute of Neurology Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Clinical Neuroscience Center Ruijin Hospital LuWan Branch Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyuan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute of Neurology Ruijin Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junfang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute of Neurology Ruijin Hospital Shanghai Jiao Tong University School of Medicine  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