Brain age predicts long-term recovery in post-stroke aphasia

Area of Science:

• Neuroimaging
• Neurology
• Computational neuroscience

Background:

• The relationship between chronological age and post-stroke language recovery is not fully understood.
• Brain age, derived from neuroimaging, offers a potential biomarker for brain structural integrity.
• Investigating brain age's role in language outcomes can refine stroke recovery predictions.

Purpose of the Study:

• To assess the association between brain age at stroke onset and cross-sectional language performance.
• To determine if brain age predicts longitudinal language recovery post-stroke.
• To compare the predictive power of brain age versus chronological age for language outcomes.

Main Methods:

• Utilized neuroimaging (T1 scans) from 49 left hemisphere stroke patients to estimate brain age using a machine learning algorithm.
• Assessed language performance at stroke onset using the Bedside Evaluation Screening Test-2.
• Analyzed longitudinal language data from 30 participants at least 2 years post-stroke, calculating proportional brain age difference.

Main Results:

• Accelerated brain age was significantly associated with worse aphasia severity, naming, and speech repetition at stroke onset.
• Decelerated brain age correlated with reduced overall aphasia severity at follow-up (≥2 years post-stroke).
• Chronological age only predicted naming performance at stroke onset; brain age showed broader associations with language function and recovery.

Conclusions:

• Brain age is a robust biomarker for predicting language function and recovery following stroke.
• Routine clinical neuroimaging can provide valuable insights into post-stroke language prognosis.
• Brain age estimation offers a more comprehensive understanding of age-related factors in stroke recovery than chronological age alone.