{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:00:06Z","timestamp":1777950006261,"version":"3.51.4"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Radiotherapy (RT) often causes delayed radiation-induced brain injury (RBI) with unclear pathophysiology; emerging evidence links this to glymphatic dysfunction, but radiation effects on cerebrospinal fluid (CSF) dynamics and interstitial fluid-CSF exchange are unstudied. Thus, we used choroid plexus (CP) volume and free-water fraction (FWF) imaging to assess glymphatic changes in Nasopharyngeal carcinoma (NPC) patients after RT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>In this cross-sectional cohort of 101 NPC patients (45 pre-RT and 56 post-RT) underwent 3\u202fT MRI, including T1-weighted and diffusion tensor imaging. Automated CP segmentation and tract-specific FWF analysis are performed. Spearman correlation models assessed radiation-dose relationships with CP volume and Whiter matter (WM) FWF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We observed that post-RT patients exhibited significant bilateral CP enlargement (total CP: 2560.56\u202f\u00b1\u202f636.72\u202fmm\n                      <jats:sup>3<\/jats:sup>\n                      , left: 1196.92\u202f\u00b1\u202f334.53\u202fmm\n                      <jats:sup>3<\/jats:sup>\n                      , right: 1363.64\u202f\u00b1\u202f365.84\u202fmm\n                      <jats:sup>3<\/jats:sup>\n                      ; all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05) and elevated FWF in critical WM tracts, including the pontine crossing tract (PCT), bilateral corticospinal tracts (CST), middle cerebellar peduncle, right inferior cerebellar peduncle, and left medial lemniscus. Radiational dose exhibit strong dose-dependent correlations with CP volume and WM FWF. Maximum doses to the brainstem (MDRT_BS) and left temporal lobe (MDRT_LT) showed the strongest associations: MDRT_LT correlated with left CP volume (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.599,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), right CP volume (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f0.585, p\u202f&amp;lt;\u202f0.001), and bilateral CST FWF (left:\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.414,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.005; right:\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.354,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.017). CP volume positively correlated with FWF in the PCT and CST (left CST vs. total CP:\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.374,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.011). These associations remained significant after adjusting for age, gender, and intracranial volume (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.31\u20130.58, all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The observed association between choroid plexus enlargement and elevated white matter free-water fraction suggests RT-associated glymphatic dysfunction in NPC, offers a novel perspective on the pathogenesis of RBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnins.2026.1690724","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T05:32:10Z","timestamp":1777872730000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Altered glymphatic function in nasopharyngeal carcinoma following radiotherapy: novel insights from choroid plexus volume and free-water fraction analyses"],"prefix":"10.3389","volume":"20","author":[{"given":"Lingling","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital, University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianchun","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital, University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keyang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital, University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kun","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Second Affiliated Hospital, University of South China","place":["Hengyang, Hunan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuting","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Radiology, Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"National Clinical Research Center for Geriatric Diseases, Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuping","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound Imaging, The Second People's Hospital of Yichun City","place":["Yichun, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[{"name":"Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian-ming","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center","place":["Guangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, The Fifth Affiliated Hospital of Jinan University (Shenhe People\u2019s Hospital)","place":["Heyuan, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]},{"name":"National Clinical Research Center for Geriatric Diseases, Xiangya Hospital, Central South University","place":["Changsha, Hunan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1162","DOI":"10.15252\/emmm.201606271","article-title":"Identification of a novel mechanism of blood-brain communication during peripheral inflammation via choroid plexus-derived extracellular vesicles","volume":"8","author":"Balusu","year":"2016","journal-title":"EMBO Mol. 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