Evidence map›Paper›PMID 41535829›Full record

ArticleBMC medicine2026

Accelerated brain aging in amyotrophic lateral sclerosis and its prognostic associations: a cohort study.

Chenhao Fang, Jiaoting Jin, Wen Shi, Xiaoyu Xu, Haining Li, Qianqian Duan, Xinyi Yu, Shan Wu, Tao Lu, Fangfang Hu and 9 more

Abstract read
In one paragraph

Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Chenhao Fang *Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.
Jiaoting Jin *Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Wen ShiDepartment of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, 21287, USA.
Xiaoyu XuInstitute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.
Haining LiDepartment of PET/CT Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Qianqian DuanDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Xi'an, 710061, China.
Xinyi YuDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Xi'an, 710061, China.
Shan WuDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Xi'an, 710061, China.
Tao LuDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Xi'an, 710061, China.
Fangfang HuDepartment of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Xin QinDepartment of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Jun HuangInstitute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.
Dengdi SunAnhui Provincial Key Laboratory of Multimodal Cognitive Computation, School of Artificial Intelligence, Anhui University, Hefei, 230601, China.
Ming ZhangDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Xi'an, 710061, China.
Sheng HeInstitute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China.
Jingxia DangDepartment of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China.
Qing HeState Key Laboratory of Cognitive Science and Mental Health, Institute of Biophysics, Chinese Academy of Sciences, Beijing, 100101, China. qing.he@ibp.ac.cn.
Qiuli ZhangDepartment of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University Xi'an, Xi'an, 710061, China. zhangql_2018@xjtu.edu.cn.
Shuoqiu GanInstitute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China. ganshuoqiu@gmail.com.

Funding

Anhui Provincial Natural Science Foundation 2408085MC081Key Research and Development Projects of Shaanxi Province 2020SF-098National Natural Science Foundation of China 32400880National Natural Science Foundation of China 32400926Natural Science Basic Research Program of Shaanxi Province 2022JQ-964
6 · The paper itself

Abstract

backgroundAmyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, appearing to be associated with accelerated brain aging. Although increased brain age has been associated with mortality risk in older adults, it remains unclear how the brain aging process is accelerated in ALS and how this acceleration relates to patient prognosis.

methodsOne hundred seventy sporadic ALS patients and 84 age- and sex-matched HCs were recruited and underwent neuropsychological tests and T1-weighted magnetic resonance imaging (MRI) scans. A brain-age prediction model was developed using a 3D-Conformer deep learning framework trained on 4310 healthy T1-weighted MRI data from public datasets. Brain age was predicted in HCs and ALS patients, and then the predicted-age difference (PAD = brain age-chronological age) was calculated. In the ALS cohort, the neuroanatomical association of PAD was examined, and cell-specific gene expression of PAD-related volume loss was analyzed using transcriptomic data from the Allen Human Brain Atlas. Associations between PAD, neuropsychological performance, clinical characteristics, and survival outcomes were further evaluated in ALS patients.

resultsThe brain aging process was accelerated in ALS by an average PAD of 1.77 years, which was predominantly associated with a widespread loss of gray matter volume. Cell-specific gene expression analyses showed microglia, inhibitory neurons, endothelial cells, and pericytes as significant contributors to the accelerated brain aging in ALS, with endothelial cells and pericytes being essential for constructing the blood-brain barrier (BBB) and microglia being involved in neuroinflammation. The acceleration in brain aging was more prominent in older patients and was associated with cognitive impairments. Notably, older brain age at initial diagnosis was an independent risk factor for death (hazard ratio, 1.026; 95% CI [1.008, 1.045]) and was associated with shorter survival and more rapid disease progression.

conclusionsAccelerated brain aging is common in ALS; this could be hypothesized to be associated with the interplay between BBB breakdown and neuroinflammation, leading to gray matter degeneration. Furthermore, older brain age at initial diagnosis is associated with worse clinical outcomes. These findings suggest that therapeutic strategies targeting neuroinflammation and BBB integrity may help attenuate accelerated brain aging and improve prognosis.

Indexed as

AgingAmyotrophic Lateral SclerosisBrainAgedCohort StudiesFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedNeuropsychological TestsPrognosisAccelerated brain agingAmyotrophic lateral sclerosisNeurobiological mechanismsSurvival prognosis

Identifiers

PMID41535829
PMCPMC12892719

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