Wei Ren, Xu Xiaolu, Duan Yunyun, Zhang Ningnannan, Sun Jie, Li Haiqing, Li Yuxin, Li Yongmei, Zeng Chun, Han Xuemei, Zhou Fuqing, Huang Muhua, Li Runzhi, Zhuo Zhizheng, Barkhof Frederik, H Cole James, Liu Yaou
Department of Radiology, Beijing Tiantan Hospital, Beijing, China.
Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China.
J Neurol Neurosurg Psychiatry. 2023 Jan;94(1):31-37. doi: 10.1136/jnnp-2022-329680. Epub 2022 Oct 10.
To evaluate the clinical significance of deep learning-derived brain age prediction in neuromyelitis optica spectrum disorder (NMOSD) relative to relapsing-remitting multiple sclerosis (RRMS).
This cohort study used data retrospectively collected from 6 tertiary neurological centres in China between 2009 and 2018. In total, 199 patients with NMOSD and 200 patients with RRMS were studied alongside 269 healthy controls. Clinical follow-up was available in 85 patients with NMOSD and 124 patients with RRMS (mean duration NMOSD=5.8±1.9 (1.9-9.9) years, RRMS=5.2±1.7 (1.5-9.2) years). Deep learning was used to learn 'brain age' from MRI scans in the healthy controls and estimate the brain age gap (BAG) in patients.
A significantly higher BAG was found in the NMOSD (5.4±8.2 years) and RRMS (13.0±14.7 years) groups compared with healthy controls. A higher baseline disability score and advanced brain volume loss were associated with increased BAG in both patient groups. A longer disease duration was associated with increased BAG in RRMS. BAG significantly predicted Expanded Disability Status Scale worsening in patients with NMOSD and RRMS.
There is a clear BAG in NMOSD, although smaller than in RRMS. The BAG is a clinically relevant MRI marker in NMOSD and RRMS.
评估相对于复发缓解型多发性硬化症（RRMS），深度学习衍生的脑年龄预测在视神经脊髓炎谱系障碍（NMOSD）中的临床意义。
这项队列研究使用了2009年至2018年期间从中国6个三级神经科中心回顾性收集的数据。总共对199例NMOSD患者、200例RRMS患者以及269名健康对照者进行了研究。对85例NMOSD患者和124例RRMS患者进行了临床随访（平均病程：NMOSD = 5.8±1.9（1.9 - 9.9）年，RRMS = 5.2±1.7（1.5 - 9.2）年）。使用深度学习从健康对照者的MRI扫描中学习“脑年龄”，并估计患者的脑年龄差距（BAG）。
与健康对照者相比，NMOSD组（5.4±8.2岁）和RRMS组（13.0±14.7岁）的BAG显著更高。两组患者中，较高的基线残疾评分和更严重的脑体积损失与BAG增加相关。RRMS患者中，病程较长与BAG增加相关。BAG显著预测了NMOSD和RRMS患者扩展残疾状态量表的恶化情况。
NMOSD存在明显的BAG，尽管比RRMS小。BAG是NMOSD和RRMS中具有临床相关性的MRI标志物。
