Brain Age Modeling and Cognitive Outcomes in Young Adults With and Without Sickle Cell Anemia

作者：Andria L. Ford, Slim Fellah, Yan Wang, Kira Unger-Levinson, Maria Hagan, Martin Reis, Amy Mirro, J. B. Lewis, Chunwei Ying, Kristin P. Guilliams, Melanie E. Fields, Hongyu An, Allison A. King, Yasheng Chen · 发表于：JAMA Network Open · 年份：2025 · DOI：10.1001/jamanetworkopen.2024.53669 · 被引用次数：8 · 研究领域：Hemoglobinopathies and Related Disorders、Epilepsy research and treatment、Iron Metabolism and Disorders

Importance: Both sickle cell anemia (SCA) and socioeconomic status have been associated with altered brain structure and cognitive disability, yet precise mechanisms underlying these associations are unclear. Objective: To determine whether brains of individuals with and without SCA appear older than chronological age and if brain age modeling using brain age gap (BAG) can estimate cognitive outcomes and mediate the association of socioeconomic status and disease with these outcomes. Design, Setting, and Participants: In this cross-sectional study of 230 adults with and without SCA, individuals underwent brain magnetic resonance imaging (MRI) and cognitive assessment. Brain age was estimated using DeepBrainNet, a model trained to estimate chronological age from 14 468 structural MRIs from healthy individuals across the lifespan. BAG was defined as estimated brain age minus chronological age. Linear regression examined clinical factors associated with BAG and the ability of BAG to estimate cognitive performance compared to neuroimaging metrics of brain health and ischemic brain injury, such as normalized whole brain volume, white matter mean diffusivity (MD), and infarct volume. BAG and white matter MD were tested further as mediators of the association of socioeconomic status and SCA with cognitive performance. Data were analyzed from October 15, 2023, to July 1, 2024. Exposures: SCA disease status and economic deprivation as measured using the area deprivation index (ADI). M...