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Advanced brain ageing in adult psychopathology: A systematic review and meta-analysis of structural MRI studies. J Psychiatr Res 2023; 157:180-191. [PMID: 36473289 DOI: 10.1016/j.jpsychires.2022.11.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/14/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022]
Abstract
Evidence suggests that psychopathology is associated with an advanced brain ageing process, typically mapped using machine learning models that predict an individual's age based on structural neuroimaging data. The brain predicted age difference (brain-PAD) captures the deviation of brain age from chronological age. Substantial heterogeneity between studies has introduced uncertainty regarding the magnitude of the brain-PAD in adult psychopathology. The present meta-analysis aimed to quantify structural MRI-based brain-PAD in adult psychotic and mood disorders, while addressing possible sources of heterogeneity related to diagnosis subtypes, segmentation method, age and sex. Clinical factors influencing brain ageing in axis 1 psychiatric disorders were systematically reviewed. Thirty-three studies were included for review. A random-effects meta-analysis revealed a brain-PAD of +3.12 (standard error = 0.49) years in psychotic disorders (n = 16 studies), +2.04 (0.10) years in bipolar disorder (n = 5), and +0.90 (0.20) years in major depression (n = 7). An exploratory meta-analysis found a brain-PAD of +1.57 (0.67) in first episode psychosis (n = 4), which was smaller than that observed in psychosis and schizophrenia (n = 10, +3.87 (0.61)). Patient mean age significantly explained heterogeneity in effect size estimates in psychotic disorders, but not mood disorders. The systematic review determined that clinical factors, such as higher symptom severity, may be associated with a larger brain-PAD in psychopathology. In conclusion, larger structural MRI-based brain-PAD was confirmed in adult psychopathology. Preliminary evidence was obtained that brain ageing is greater in those with prolonged duration of psychotic disorders. Accentuated brain ageing may underlie the cognitive difficulties experienced by some patients, and may be progressive in nature.
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Soehner AM, Hayes RA, Franzen PL, Goldstein TR, Hasler BP, Buysse DJ, Siegle GJ, Dahl RE, Forbes EE, Ladouceur CD, McMakin DL, Ryan ND, Silk JS, Jalbrzikowski M. Naturalistic Sleep Patterns are Linked to Global Structural Brain Aging in Adolescence. J Adolesc Health 2023; 72:96-104. [PMID: 36270890 PMCID: PMC9881228 DOI: 10.1016/j.jadohealth.2022.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE We examined whether interindividual differences in naturalistic sleep patterns correlate with any deviations from typical brain aging. METHODS Our sample consisted of 251 participants without current psychiatric diagnoses (9-25 years; mean [standard deviation] = 17.4 ± 4.52 yr; 58% female) drawn from the Neuroimaging and Pediatric Sleep Databank. Participants completed a T1-weighted structural magnetic resonance imaging scan and 5-7 days of wrist actigraphy to assess naturalistic sleep patterns (duration, timing, continuity, and regularity). We estimated brain age from extracted structural magnetic resonance imaging indices and calculated brain age gap (estimated brain age-chronological age). Robust regressions tested cross-sectional associations between brain age gap and sleep patterns. Exploratory models investigated moderating effects of age and biological gender and, in a subset of the sample, links between sleep, brain age gap, and depression severity (Patient-Reported Outcomes Measurement Information System Depression). RESULTS Later sleep timing (midsleep) was associated with more advanced brain aging (larger brain age gap), β = 0.1575, puncorr = .0042, pfdr = .0167. Exploratory models suggested that this effect may be driven by males, although the interaction of gender and brain age gap did not survive multiple comparison correction (β = 0.2459, puncorr = .0336, pfdr = .1061). Sleep duration, continuity, and regularity were not significantly associated with brain age gap. Age did not moderate any brain age gap-sleep relationships. In this psychiatrically healthy sample, depression severity was also not associated with brain age gap or sleep. DISCUSSION Later midsleep may be one behavioral cause or correlate of more advanced brain aging, particularly among males. Future studies should examine whether advanced brain aging and individual differences in sleep precede the onset of suboptimal cognitive-emotional outcomes in adolescents.
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Affiliation(s)
- Adriane M Soehner
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Rebecca A Hayes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Tina R Goldstein
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Ronald E Dahl
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Dana L McMakin
- Department of Psychology, Florida International University, Miami, Florida
| | - Neal D Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Maria Jalbrzikowski
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
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Drobinin V, Van Gestel H, Helmick CA, Schmidt MH, Bowen CV, Uher R. The developmental brain age is associated with adversity, depression, and functional outcomes among adolescents. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 7:406-414. [PMID: 34555562 DOI: 10.1016/j.bpsc.2021.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Most psychiatric disorders emerge in the second decade of life. In the present study we examined whether environmental adversity, developmental antecedents, major depressive disorder (MDD), and functional impairment correlate with deviation from normative brain development in adolescence. METHODS We trained a brain age prediction model using 189 structural MRI brain features in 1299 typically developing adolescents (age range 9-19 years old, M = 13.5, SD = 3.04), validated the model in a holdout set of 322 adolescents (M = 13.5, SD = 3.07), and used it to predict age in an independent risk-enriched cohort of 150 adolescents (M = 13.6, SD = 2.82). We tested associations between the brain-age-gap and adversity, early antecedents, depression, and functional impairment. RESULTS We accurately predicted chronological age in typically developing adolescents (mean absolute error (MAE) = 1.53 years). The model generalized to the validation set (MAE = 1.55 years, 1.98 bias adjusted) and to the independent at-risk sample (MAE = 1.49 years, 1.86 bias adjusted). The brain age estimate was reliable in repeated scans (intra class correlation = 0.94). Experience of environmental advertises (β = 0.18, 95% CI [0.04, 0.31], p = 0.02), diagnosis of MDD (β = 0.61, 95% CI [0.23, 0.99], p = 0.01) and functional impairment (β = 0.16, 95% CI [0.05, 0.27], p = 0.01) were associated with a positive brain-age-gap. CONCLUSIONS Risk factors, diagnosis, and impact of mental illness are associated with an older appearing brain during development.
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Affiliation(s)
| | | | - Carl A Helmick
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Matthias H Schmidt
- Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Chris V Bowen
- Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
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