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Han, L. K. M.

Publications and source records attributed to Han, L. K. M..

3 recordsLinked to original sources

Lifestyle, Early-life, and Genetic Health Risk Factors Underlying the Brain Age Gap: A Mega-Analysis Across 3,934 Individuals from the ENIGMA MDD Consortium

BackgroundLarge-scale studies show that adults with major depressive disorder (MDD) generally have a higher imaging-predicted age relative to their chronological age (i.e., positive brain age gap) compared to controls, though considerable within-group variation exists. This study examines lifestyle, early-life, and genetic health risk factors contributing to the brain age gap. Identifying risk and resilience factors could help protect brain and mental health. MethodsUsing an established model trained on FreeSurfer-derived brain regions (www.photon-ai.com/enigma_brainage), we generated brain age predictions for 1,846 controls and 2,088 individuals with MDD (aged 18-75) from 12 international cohorts. Polygenic risk scores (PRS) were calculated for major depression, C-reactive protein, and body mass index (BMI) using large-scale GWAS results. Linear mixed models were applied to assess lifestyle (BMI, smoking, education), early-life childhood trauma, and genetic (PRS) health risk associations with the brain age gap. Additionally, we evaluated the link between the brain age gap and peripheral biological age indicators (epigenetic clocks). ResultsHigher brain age gaps were significantly associated with BMI ({beta}=0.01, PFDR=0.02) and smoking ({beta}=0.11, PFDR=0.02), while lower brain age gaps were linked to higher education ({beta}=-0.02, PFDR=0.02). Higher childhood trauma scores predicted a higher brain age gap ({beta}=0.04, P=0.01). Higher brain age gaps were positively associated with all PRS ({beta}s=0.04-0.16, PsFDR=0.02-0.03). There were no significant interactions between diagnosis and assessed factors on the brain age gap. In a multivariable model, only modifiable health factors--BMI, smoking, and education--remained uniquely associated with brain age gaps. ConclusionsGenetic liability for depression and related traits is linked to poorer brain health, but health behaviors potentially offer a key opportunity for intervention. This study underscores the importance of targeting modifiable lifestyle factors to mitigate poor brain health in depressed individuals, an approach perhaps under-recognized in clinical practice.

neuroscience↗

Dissecting heterogeneity in cortical thickness abnormalities in major depressive disorder: a large-scale ENIGMA MDD normative modelling study

ImportanceMajor depressive disorder (MDD) is highly heterogeneous, with marked individual differences in clinical presentation and neurobiology, which may obscure identification of structural brain abnormalities in MDD. To explore this, we used normative modeling to index regional patterns of variability in cortical thickness (CT) across individual patients. ObjectiveTo use normative modeling in a large dataset from the ENIGMA MDD consortium to obtain individualised CT deviations from the norm (relative to age, sex and site) and examine the relationship between these deviations and clinical characteristics. Design, setting, and participantsA normative model adjusting for age, sex and site effects was trained on 35 CT measures from FreeSurfer parcellation of 3,181 healthy controls (HC) from 34 sites (40 scanners). Individualised z-score deviations from this norm for each CT measure were calculated for a test set of 2,119 HC and 3,645 individuals with MDD. For each individual, each CT z-score was classified as being within the normal range (95% of individuals) or within the extreme range (2.5% of individuals with the thinnest or thickest cortices). Main outcome measuresZ-score deviations of CT measures of MDD individuals as estimated from a normative model based on HC. ResultsZ-score distributions of CT measures were largely overlapping between MDD and HC (minimum 92%, range 92-98%), with overall thinner cortices in MDD. 34.5% of MDD individuals, and 30% of HC individuals, showed an extreme deviation in at least one region, and these deviations were widely distributed across the brain. There was high heterogeneity in the spatial location of CT deviations across individuals with MDD: a maximum of 12% of individuals with MDD showed an extreme deviation in the same location. Extreme negative CT deviations were associated with having an earlier onset of depression and more severe depressive symptoms in the MDD group, and with higher BMI across MDD and HC groups. Extreme positive deviations were associated with being remitted, of not taking antidepressants and less severe symptoms. Conclusions and relevanceOur study illustrates a large heterogeneity in the spatial location of CT abnormalities across patients with MDD and confirms a substantial overlap of CT measures with HC. We also demonstrate that individualised extreme deviations can identify protective factors and individuals with a more severe clinical picture. Key points QuestionCan z-scores derived from normative modelling shed light on the heterogeneous group-level findings of cortical thickness abnormalities in major depression and what characterises individuals at the extreme ends of cortical thickness abnormalities? FindingWe confirmed a large overlap in z-score distributions between depressed individuals and healthy controls and a heterogeneous spatial distribution of extreme z-deviations across brain regions across individual patients. Lower z-scores for cortical thickness were related to more severe clinical characteristics. MeaningOur findings confirm the heterogeneity in individual variation in the location and extent of CT abnormalities across patients with MDD and stress the importance of individualised predictions when examining cortical thickness abnormalities.

neuroscience↗

Mind the gap: performance metric evaluation in brain-age prediction

Estimating age based on neuroimaging-derived data has become a popular approach to developing markers for brain integrity and health. While a variety of machine-learning algorithms can provide accurate predictions of age based on brain characteristics, there is significant variation in model accuracy reported across studies. We predicted age based on neuroimaging data in two population-based datasets, and assessed the effects of age range, sample size, and age-bias correction on the model performance metrics r, R2, Root Mean Squared Error (RMSE), and Mean Absolute Error (MAE). The results showed that these metrics vary considerably depending on cohort age range; r and R2 values are lower when measured in samples with a narrower age range. RMSE and MAE are also lower in samples with a narrower age range due to smaller errors/brain age delta values when predictions are closer to the mean age of the group. Across subsets with different age ranges, performance metrics improve with increasing sample size. Performance metrics further vary depending on prediction variance as well as mean age difference between training and test sets, and age-bias corrected metrics indicate high accuracy - also for models showing poor initial performance. In conclusion, performance metrics used for evaluating age prediction models depend on cohort and study-specific data characteristics, and cannot be directly compared across different studies. Since age-bias corrected metrics in general indicate high accuracy, even for poorly performing models, inspection of uncorrected model results provides important information about underlying model attributes such as prediction variance.

neuroscience↗