健康衰老及多种神经系统疾病中的估计脑龄

Estimated Brain Age in Healthy Aging and Across Multiple Neurological Disorders.

作者信息

Chai Li, Sun Jun, Zhuo Zhizheng, Wei Ren, Xu Xiaolu, Duan Yunyun, Tian Decai, Bai Yutong, Zhang Ningnannan, Li Haiqing, Li Yuxin, Li Yongmei, Zhou Fuqing, Xu Jun, Cole James H, Barkhof Frederik, Zhang Jianguo, Zheng Huaguang, Liu Yaou

机构信息

Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

J Magn Reson Imaging. 2024 Nov 26. doi: 10.1002/jmri.29667.

DOI:10.1002/jmri.29667

PMID:39588683

Abstract

BACKGROUND

The brain aging in the general population and patients with neurological disorders is not well understood.

PURPOSE

To characterize brain aging in the above conditions and its clinical relevance.

STUDY TYPE

Retrospective.

POPULATION

A total of 2913 healthy controls (HC), with 1395 females; 331 multiple sclerosis (MS); 189 neuromyelitis optica spectrum disorder (NMOSD); 239 Alzheimer's disease (AD); 244 Parkinson's disease (PD); and 338 cerebral small vessel disease (cSVD).

FIELD STRENGTH/SEQUENCE: 3.0 T/Three-dimensional (3D) T1-weighted images.

ASSESSMENT

The brain age was estimated by our previously developed model, using a 3D convolutional neural network trained on 9794 3D T1-weighted images of healthy individuals. Brain age gap (BAG), the difference between chronological age and estimated brain age, was calculated to represent accelerated and resilient brain conditions. We compared MRI metrics between individuals with accelerated (BAG ≥ 5 years) and resilient brain age (BAG ≤ -5 years) in HC, and correlated BAG with MRI metrics, and cognitive and physical measures across neurological disorders.

STATISTICAL TESTS

Student's t test, Wilcoxon test, chi-square test or Fisher's exact test, and correlation analysis. P < 0.05 was considered statistically significant.

RESULTS

In HC, individuals with accelerated brain age exhibited significantly higher white matter hyperintensity (WMH) and lower regional brain volumes than those with resilient brain age. BAG was significantly higher in MS (10.30 ± 12.6 years), NMOSD (2.96 ± 7.8 years), AD (6.50 ± 6.6 years), PD (4.24 ± 4.8 years), and cSVD (3.24 ± 5.9 years) compared to HC. Increased BAG was significantly associated with regional brain atrophy, WMH burden, and cognitive impairment across neurological disorders. Increased BAG was significantly correlated with physical disability in MS (r = 0.17).

DATA CONCLUSION

Healthy individuals with accelerated brain age show high WMH burden and regional volume reduction. Neurological disorders exhibit distinct accelerated brain aging, correlated with impaired cognitive and physical function.

LEVEL OF EVIDENCE

4 TECHNICAL EFFICACY: Stage 2.

摘要

背景

普通人群和神经疾病患者的大脑衰老情况尚未得到充分了解。

目的

描述上述情况下的大脑衰老及其临床相关性。

研究类型

回顾性研究。

研究对象

共有2913名健康对照者（HC），其中女性1395名；331例多发性硬化症（MS）患者；189例视神经脊髓炎谱系障碍（NMOSD）患者；239例阿尔茨海默病（AD）患者；244例帕金森病（PD）患者；以及338例脑小血管病（cSVD）患者。

场强/序列：3.0 T/三维（3D）T1加权图像。

评估

使用我们之前开发的模型估计脑龄，该模型基于对9794例健康个体的3D T1加权图像训练的三维卷积神经网络。计算脑龄差距（BAG），即实际年龄与估计脑龄之间的差值，以代表大脑加速衰老和具有弹性的状况。我们比较了健康对照者中脑龄加速（BAG≥5岁）和脑龄具有弹性（BAG≤-5岁）个体之间的MRI指标，并将BAG与MRI指标以及神经疾病患者的认知和身体测量指标进行了相关性分析。

统计检验

学生t检验、威尔科克森检验、卡方检验或费舍尔精确检验以及相关性分析。P<0.05被认为具有统计学意义。

结果

在健康对照者中，脑龄加速的个体与脑龄具有弹性的个体相比，表现出显著更高的白质高信号（WMH）和更低的局部脑容量。与健康对照者相比，MS（10.30±12.6岁）、NMOSD（2.96±7.8岁）、AD（6.50±6.6岁）、PD（4.24±4.8岁）和cSVD（3.24±5.9岁）患者的BAG显著更高。在所有神经疾病中，BAG升高与局部脑萎缩、WMH负担和认知障碍显著相关。在MS中，BAG升高与身体残疾显著相关（r=0.17）。