Brain aging extends beyond schizophrenia

By Eleanor McDermid, Senior medwireNews Reporter

Accelerated brain aging may be a common feature of psychiatric disorders, say researchers.

Nikolaos Koutsouleris (Ludwig-Maximilian University, Munich, Germany) and colleagues used structural magnetic resonance imaging data from 800 mentally healthy people to construct a multivariate model that could predict a person’s age from their brain imaging results.

When applied to patients with psychiatric disorders, all had a difference between their chronologic and neuroanatomic age (brain age gap estimation; BrainAGE), with the latter being higher than the former. The largest difference, of 5.5 years, was found in 141 patients with schizophrenia, followed by 4.0 years in 104 patients with major depression, 3.3 years in 57 patients with borderline personality disorder (BPD), and 1.7 years in 89 patients with at-risk mental states (ARMS).

Notably, age at onset had a large impact on BrainAGE, which was 5.9 years in patients with early age at onset, compared with 3.1 years in those with a later onset age. This effect was driven by patients with depression and BPD; those with an early age at onset had a BrainAGE in line with that of the schizophrenia group.

“This aligns with the clinical observation of an earlier occurrence of both illnesses being associated with a more debilitating disease course, such as a higher incidence of suicidal attempts, prolonged duration of disease episodes as well as higher levels of psychiatric comorbidity,” write the researchers in Schizophrenia Bulletin.

They add that this finding “supports the hypothesis that the disruption of normal brain maturation during specific and critical time windows in adolescence and early adulthood constitutes a neurobiological predisposition for the development of psychopathological abnormalities across the affective and psychotic disease spectrums.”

In general, BrainAGE was related to disease severity rather than duration. There was an increase in BrainAGE from no change in 21 people with early ARMS, to 2.7 years in 68 patients with late ARMS, 4.2 years in 61 with recent-onset schizophrenia, and 6.4 years in 80 patients with recurrent schizophrenia.

Yet BrainAGE did not correlate with illness duration, which “suggests that BrainAGE represents a neuroanatomical vulnerability marker, whose expression parallels the accumulating risk for adverse disease outcomes,” say the researchers.

A quarter of the BrainAGE differences among the schizophrenia patients was explained by negative and disorganization symptoms, in line with previous research linking these symptoms to neuroanatomic abnormalities.

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