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Radiomics-Derived Brain Age Predicts Functional Outcome After Acute Ischemic Stroke.

Martin Bretzner1, Anna K Bonkhoff2, Markus D Schirmer2

  • 1From the J. Philip Kistler Stroke Research Center (M.B., A.K.B., M.D.S., S.H., A. Dalca, K.D., A.-K.G., M.R.E., P.M.R., M.N., R.W.R., C.W., N.S.R.), A.A. Martinos Center for Biomedical Imaging (A. Dalca, O.W.), and Henry and Allison McCance Center for Brain Health (J. Rosand), Massachusetts General Hospital, Harvard Medical School, Boston; Lille Neuroscience & Cognition (M.B., X.L., R. Lopes, G.K.), Inserm, CHU Lille, U1172 and Institut Pasteur de Lille (M.G.), CNRS, Inserm, CHU Lille, US 41 - UMS 2014 - PLBS, Lille University, France; Computer Science and Artificial Intelligence Lab (A. Dalca, C.W., P.G.), Massachusetts Institute of Technology, Cambridge; Division of Preventive Medicine (P.M.R.), Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Medicine (O.R.B.), Division of Neurology, University of British Columbia, Vancouver, Canada; Department of Neurology (J.W.C., S.J.K.), University of Maryland School of Medicine and Veterans Affairs Maryland Health Care System, Baltimore, MD; School of Medical Sciences (A. Donatti, A. Sousa), University of Campinas (UNICAMP) and the Brazilian Institute of Neuroscience and Neurotechnology (BRAINN), Campinas, São Paulo; Departments of Neurosurgery (C.G.) and Neurology (R.Z.), Geisinger, Danville, PA; Department of Neurosurgery (C.G.), Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Division of Emergency Medicine (Laura Heitsch), Washington University School of Medicine, St. Louis; Department of Neurology (Laura Heitsch, C.-L.P.), Washington University School of Medicine & Barnes-Jewish Hospital, St. Louis, MO; Department of Clinical Neuroscience (L. Holmegaard, K.J., T.M.S., T.T.), Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Neurology (J.J.-C.), Neurovascular Research Group (NEUVAS), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions M`ediques), Universitat Autonoma de Barcelona, Spain; Department of Neurosciences (R. Lemmens), Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven - University of Leuven, Belgium; Department of Neurology (R. Lemmens), Laboratory of Neurobiology, VIB Vesalius Research Center, University Hospitals Leuven, Belgium; School of Medicine and Public Health (C.R.L.), University of Newcastle, New South Wales; Department of Neurology, John Hunter Hospital, Newcastle, New South Wales, Australia; Division of Endocrinology (P.F.M.), Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore; Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics (C.W.M.), University of Florida, Gainesville; Department of Neurology (J.F.M.), Mayo Clinic, Jacksonville, FL; Klinik und Poliklinik für Neurologie (A.R.), Universitätsmedizin Rostock, Germany; Department of Neurology (S.R., R.S.), Clinical Division of Neurogeriatrics, Medical University Graz, Austria; Center for Genomic Medicine (J. Rosand), Massachusetts General Hospital, Boston; Broad Institute (J. Rosand), Cambridge, MA; Department of Neurology and Evelyn F. McKnight Brain Institute (J. Roquer, T.R., R.L.S./M.S.), Miller School of Medicine, University of Miami, FL; Institute of Cardiovascular Research (P.S.), Royal Holloway University of London (ICR2UL), UK St Peter's and Ashford Hospitals, Egham, United Kingdom; Department of Neurology (A. Slowik), Jagiellonian University Medical College, Krakow, Poland; Division of Neurocritical Care & Emergency Neurology (D.S.), Department of Neurology, Helsinki University Central Hospital, Finland; Stroke Division (V.T.), Florey Institute of Neuroscience and Mental Health, Heidelberg; Department of Neurology (V.T.), Austin Health, Heidelberg, Australia; Departments of Radiology (A.V.) and Neurology and Rehabilitation Medicine (D.W.), University of Cincinnati College of Medicine, OH; Department of Clinical Sciences Lund, Radiology (J.W.) and Neurology (A.G.L.), Lund University, Sweden; Department of Radiology, Neuroradiology, Skåne University Hospital, Malmö, Sweden; Departments of Neurology and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville, VA; University of Technology Sydney (J.M.), Australia; Section of Neurology (A.G.L.), Skåne University Hospital, Lund, Sweden; Department of Laboratory Medicine (C.J.), Institute of Biomedicine, the Sahlgrenska Academy, University of Gothenburg, Sweden; and Department of Clinical Genetics and Genomics (C.J.), Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden. mbretzner@mgh.harvard.edu martin.bretzner@univ-lille.fr.

Neurology
|November 28, 2022
PubMed
Summary
This summary is machine-generated.

Advanced brain age in stroke patients, estimated using T2-FLAIR radiomics, is linked to cardiovascular risks and poorer functional outcomes. This brain age metric, relative brain age (RBA), offers new insights into stroke recovery.

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Area of Science:

  • Neuroimaging
  • Radiomics
  • Stroke Medicine

Background:

  • Chronological age significantly impacts post-stroke outcomes.
  • The influence of biological brain age, derived from neuroimaging, remains largely unexplored in stroke patients.

Purpose of the Study:

  • To determine if radiomics analysis of T2-FLAIR images can estimate brain age.
  • To investigate the association between advanced brain age and cardiovascular risk factors.
  • To assess the relationship between brain age and functional outcomes after stroke.

Main Methods:

  • Radiomics features were extracted from T2-FLAIR images of ischemic stroke patients.
  • Brain age was predicted using ElasticNet regression; relative brain age (RBA) was calculated.
  • Linear regression modeled RBA with cardiovascular risk factors; logistic regression analyzed functional outcomes with RBA.

Main Results:

  • T2-FLAIR radiomics accurately predicted chronological age (MAE 6.9 years, r=0.81).
  • Higher RBA was associated with hypertension, diabetes, smoking history, and prior stroke.
  • RBA, age, NIHSS, and prior stroke history independently predicted functional outcome (p<0.001).

Conclusions:

  • T2-FLAIR radiomics effectively predicts brain age and derives RBA.
  • An older-appearing brain (higher RBA) signifies accumulated cardiovascular risk and predicts worse stroke outcomes.