Accelerated Aging after Traumatic Brain Injury: An ENIGMA Multi-Cohort Mega-Analysis

Area of Science:

• Neuroimaging
• Traumatic Brain Injury Research
• Aging and Brain Health

Background:

• Long-term structural brain changes after traumatic brain injury (TBI) are not fully understood.
• Brain-age estimation using MRI offers a potential method to quantify these long-term effects.
• Previous studies suggest complicated mild, moderate, and severe TBI (cmsTBI) is linked to an increased predicted age difference (PAD).

Purpose of the Study:

• To investigate if PAD increases with time since injury (TSI) in cmsTBI patients.
• To determine if injury severity and sex influence the progression of PAD over time.
• To explore the relationship between PAD and cognitive performance post-TBI.

Main Methods:

• Utilized a large TBI sample (n=343) and controls (n=540) from the ENIGMA AMS-TBI working group.
• Aggregated cross-sectional T1w-MRI data across 7 cohorts.
• Calculated brain age using a predictive modeling algorithm similar to prior TBI studies.

Main Results:

• PAD was found to widen with increasing TSI.
• Men exhibited a more advanced brain age compared to women.
• No significant association was detected between PAD and cognitive performance.

Conclusions:

• Brain structural changes following cmsTBI are dynamic and evolve over decades.
• An initial period of change is followed by relative stability, then further alterations in brain morphometry.
• These findings highlight the progressive nature of structural brain changes after TBI.