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Accelerated Brain Aging Identifies Functional Vulnerability Beyond Chronological Age in Multiple Sclerosis.

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Brain-predicted age difference (Brain-PAD) is higher in multiple sclerosis (MS) patients. This accelerated brain aging metric is linked to poorer balance control and reduced physical activity in individuals with MS.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Gerontology

Background:

  • Chronological age is an insufficient measure of neurodegeneration and functional decline in multiple sclerosis (MS).
  • Brain-predicted age difference (Brain-PAD) offers an MRI-based index of accelerated brain aging.
  • The relationship between Brain-PAD and mobility or real-world behavior in MS is not well understood.

Purpose of the Study:

  • To investigate the association between Brain-PAD and functional mobility and physical activity in adults with MS.
  • To determine if Brain-PAD explains variance in mobility and physical activity beyond chronological age and disability.

Main Methods:

  • Structural MRI scans were acquired from 43 adults with MS.
  • Brain age was calculated using PyBrainAge, analyzing cortical thickness and subcortical volumes.
  • Hierarchical regression analyses assessed Brain-PAD's impact on mobility (Mini-BESTest, walking velocity) and physical activity (MVPA), controlling for age and PDDS.

Main Results:

  • Brain-PAD was significantly elevated in the MS cohort (mean difference = 8.4 years).
  • Brain-PAD accounted for additional variance in overall balance (Mini-BESTest) and anticipatory control, but not walking velocity.
  • Higher Brain-PAD correlated with lower moderate-to-vigorous physical activity (MVPA), explaining significant additional variance.

Conclusions:

  • Brain-PAD is elevated in individuals with MS, indicating accelerated brain aging.
  • Brain-PAD is a relevant biomarker for identifying functional vulnerability, specifically in balance control and real-world physical activity.
  • This MRI-derived measure holds potential for assessing functional decline beyond traditional metrics in MS.