Global and Voxel-Wise Brain Age Prediction Analyses Following Perinatal Stroke

Ravi Amir Santiago Bullock1, Helen L Carlson2, Martin Bardhi2

  • 1Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada.

Human Brain Mapping
|August 3, 2026
PubMed

Insights

Biological brain age prediction reveals developmental differences in children with perinatal stroke. Positive brain age gaps correlate with motor deficits, suggesting potential biomarkers for personalized rehabilitation strategies.

Area of Science:

  • Neuroscience
  • Pediatric Neurology
  • Medical Imaging

Background:

  • Perinatal stroke impacts millions globally, often causing lifelong disabilities and necessitating targeted rehabilitation.
  • Biological brain age prediction is a potential biomarker for neurodevelopmental analysis post-stroke, but its utility in pediatric stroke remains unexplored.

Purpose of the Study:

  • To analyze neurodevelopment in children with perinatal stroke using machine learning-based biological brain age prediction.
  • To investigate brain age gap (BAG) trends globally and voxel-wise in the contralesional hemisphere.
  • To correlate BAGs with motor function and explore sex-specific differences.

Main Methods:

  • Developed and trained machine learning models for biological brain age prediction using T1-weighted MRI scans from typically developing children.
  • Applied trained models to MRI data from children with perinatal stroke (arterial ischemic stroke [AIS] and periventricular venous infarction [PVI]) and age/sex-matched controls.
  • Utilized statistical tests (Wilcoxon signed-rank, Mann-Whitney U) for BAG comparisons and Spearman correlation for BAG-motor score relationships, including sex-specific analyses.

Main Results:

  • Children with perinatal stroke, especially AIS, showed significantly more positive global and voxel-wise BAGs compared to controls.
  • Motor scores were negatively correlated with both global and voxel-wise BAGs in the contralesional hemisphere.
  • The relationship between BAGs and motor scores exhibited sex-specific differences.

Conclusions:

  • This study pioneers voxel-wise brain age prediction in a pediatric cohort and its application to perinatal stroke.
  • Positive brain age gaps in perinatal stroke suggest neurodevelopmental alterations that correlate with motor impairments.
  • Brain age prediction holds promise as a biomarker for pediatric neurological conditions and guiding personalized rehabilitation.

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