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

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

Title: Brain age predicts long-term recovery in post-stroke aphasia
Author: Kristinsson, Sigfús Helgi
Busby, Natalie
Rorden, Christopher
Newman-Norlund, Roger
Den Ouden, Dirk B.
Magnúsdóttir, Sigríður
Hjaltason, Haukur   orcid.org/0000-0001-8963-1033
Thors, Helga
Hillis, Argye E.
Kjartansson, Olafur   orcid.org/0000-0001-6887-9451
... 2 more authors Show all authors
Date: 2022
Language: English
Department: Other departments
Faculty of Medicine
Internal Medicine and Emergency Services
Geriatric and Rehabilitation Services
Series: Brain Communications; 4(5)
ISSN: 2632-1297
DOI: https://doi.org/10.1093/braincomms/fcac252
Subject: Talmeinafræðingar; Taugasjúkdómafræði; Myndgreining (læknisfræði); age; ageing; aphasia; neuroimaging; stroke; Psychiatry and Mental Health; Biological Psychiatry; Cellular and Molecular Neuroscience; Neurology
URI: https://hdl.handle.net/20.500.11815/3850

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Kristinsson , S H , Busby , N , Rorden , C , Newman-Norlund , R , Den Ouden , D B , Magnúsdóttir , S , Hjaltason , H , Thors , H , Hillis , A E , Kjartansson , O , Bonilha , L & Fridriksson , J 2022 , ' Brain age predicts long-term recovery in post-stroke aphasia ' , Brain Communications , vol. 4 , no. 5 , fcac252 . https://doi.org/10.1093/braincomms/fcac252


The association between age and language recovery in stroke remains unclear. Here, we used neuroimaging data to estimate brain age, a measure of structural integrity, and examined the extent to which brain age at stroke onset is associated with (i) cross-sectional language performance, and (ii) longitudinal recovery of language function, beyond chronological age alone. A total of 49 participants (age: 65.2 ± 12.2 years, 25 female) underwent routine clinical neuroimaging (T1) and a bedside evaluation of language performance (Bedside Evaluation Screening Test-2) at onset of left hemisphere stroke. Brain age was estimated from enantiomorphically reconstructed brain scans using a machine learning algorithm trained on a large sample of healthy adults. A subsample of 30 participants returned for follow-up language assessments at least 2 years after stroke onset. To account for variability in age at stroke, we calculated proportional brain age difference, i.e. the proportional difference between brain age and chronological age. Multiple regression models were constructed to test the effects of proportional brain age difference on language outcomes. Lesion volume and chronological age were included as covariates in all models. Accelerated brain age compared with age was associated with worse overall aphasia severity (F(1, 48) = 5.65, P = 0.022), naming (F(1, 48) = 5.13, P = 0.028), and speech repetition (F(1, 48) = 8.49, P = 0.006) at stroke onset. Follow-up assessments were carried out ≥2 years after onset; decelerated brain age relative to age was significantly associated with reduced overall aphasia severity (F(1, 26) = 5.45, P = 0.028) and marginally failed to reach statistical significance for auditory comprehension (F(1, 26) = 2.87, P = 0.103). Proportional brain age difference was not found to be associated with changes in naming (F(1, 26) = 0.23, P = 0.880) and speech repetition (F(1, 26) = 0.00, P = 0.978). Chronological age was only associated with naming performance at stroke onset (F(1, 48) = 4.18, P = 0.047). These results indicate that brain age as estimated based on routine clinical brain scans may be a strong biomarker for language function and recovery after stroke.


Funding Information: This study was supported by the following grant sponsors: National Institute on Deafness and Other Communication Disorders (P50 DC014664; DC008355); National Institute of Neurological Disorders and Stroke (NS054266). Publisher Copyright: © 2022 The Author(s).

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