{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:39:46Z","timestamp":1777354786190,"version":"3.51.4"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"publisher","award":["2020078"],"award-info":[{"award-number":["2020078"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"publisher","award":["2010011"],"award-info":[{"award-number":["2010011"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Cognition After Stroke Trial"},{"name":"Oslo Acute Revascularization Registry"},{"DOI":"10.13039\/100031365","name":"Oslo University Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100031365","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The National Association for Stroke Victims","award":["324499"],"award-info":[{"award-number":["324499"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Brain age is a promising neuroimaging biomarker, reflecting biological aging, but long-term trajectories and predictive value for cognitive outcomes post-stroke remains unclear. This study aimed to characterize brain aging trajectories over 8 years following a first-ever stroke and to evaluate the predictive value of brain age estimates for long-term cognitive outcomes. We analysed data from working-age (&amp;lt;65 years) ischaemic stroke patients with small- and medium-sized strokes (lesion volumes &amp;lt;70\u202fml), using two longitudinal stroke cohorts. T1-weighted MRI was acquired in the acute phase and at multiple time points up to 8 years post-stroke. Montreal cognitive assessment (MoCA) was assessed at follow-up sessions. Brain age was estimated using a state-of-the-art deep learning model. Brain-predicted age difference (Brain-PAD) was calculated as estimated brain age minus chronological age and corrected by regressing on age, age\u00b2 and sex. Linear mixed-effects models examined Brain-PAD over multiple time points (whole-brain, ipsilesional and contralesional). Normalized brain volume was derived from FreeSurfer and included in the whole-brain analysis. Linear regression models evaluated whether brain age was associated with cognitive performance (MoCA) at long-term follow-up. We included 120 patients [n = 50 (42%) female, mean \u00b1 SD age at discharge was 54.9 \u00b1 9 and National Institutes of Health Stroke Scale was 3.7 \u00b1 6.4], with a mean follow-up of 3.4 \u00b1 2.5 years. The mean MoCA score at follow-up was 24.7 \u00b1 3.7. Brain-PAD increased significantly over time in the whole-brain analysis (\u03b2\u202f=\u202f0.6\/year, P\u202f&amp;lt;\u202f0.01), indicating 60% acceleration in brain aging after stroke, with the association remaining significant after adjusting for normalized brain volume (\u03b2\u202f=\u202f0.5\/year, P\u202f&amp;lt;\u202f0.01). Accelerated brain aging was observed in the ipsilesional hemisphere (\u03b2\u202f=\u202f0.7\/year, P\u202f&amp;lt;\u202f0.01), but not the contralesional hemisphere (\u03b2\u202f=\u202f0.3\/year, P\u202f=\u202f0.12). Higher brain age in the acute phase of stroke predicted lower MoCA scores at follow-up (\u03b2 = \u22120.12, P &amp;lt; 0.05), whereas chronological age was not a significant predictor (P = 0.12). The association between brain age estimations and cognitive performance remained significant after adjusting for age, sex and education (\u03b2 = \u22120.42, P &amp;lt; 0.01). In this longitudinal study, we found accelerated brain aging following stroke. Furthermore, brain age was associated with cognitive outcomes several years later, highlighting its potential as an early biomarker for long-term cognitive prognosis.<\/jats:p>","DOI":"10.1093\/braincomms\/fcaf509","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T12:36:19Z","timestamp":1768048579000},"source":"Crossref","is-referenced-by-count":2,"title":["Brain age trajectories and cognition after stroke in two longitudinal cohorts"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2341-7733","authenticated-orcid":false,"given":"Gisle","family":"Berg Helland","sequence":"first","affiliation":[{"name":"Department of Neurology, Oslo University Hospital , 0424 Oslo ,","place":["Norway"]},{"name":"Department of Medicine, B\u00e6rum Hospital, Vestre Viken Hospital Trust , 3004, Drammen ,","place":["Norway"]},{"name":"Institute of Clinical Medicine, University of Oslo , 0318, Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e5kon","family":"Ihle-Hansen","sequence":"additional","affiliation":[{"name":"Department of Medicine, B\u00e6rum Hospital, Vestre Viken Hospital Trust , 3004, Drammen ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne Hege","family":"Aamodt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oslo University Hospital , 0424 Oslo ,","place":["Norway"]},{"name":"Department of Neuromedicine and Movement Science, The Norwegian University of Science and Technology , 7491, Trondheim ,","place":["Norway"]},{"name":"Primary Care and Mental Health, Faculty of Health and Life Sciences, University of Liverpool , L69 3GL, Liverpool ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esten H","family":"Leonardsen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , 0318, Oslo ,","place":["Norway"]},{"name":"Department of Psychology, University of Oslo , 0373, Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Kaufmann","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , 0318, Oslo ,","place":["Norway"]},{"name":"Department of Psychiatry and Psychotherapy, T\u00fcbingen Center for Mental Health, University of T\u00fcbingen , 72076,T\u00fcbingen ,","place":["Germany"]},{"name":"German Center for Mental Health (DZPG), Partner Site T\u00fcbingen , 72076, T\u00fcbingen ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian Anthony B","family":"Enriquez","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oslo University Hospital , 0424 Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9156-6357","authenticated-orcid":false,"given":"Mona K","family":"Beyer","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , 0318, Oslo ,","place":["Norway"]},{"name":"Division of Radiology and Nuclear Medicine, Oslo University Hospital , 0424, Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stein","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of Oslo , 0373, Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8609-9926","authenticated-orcid":false,"given":"Helle","family":"Stangeland","sequence":"additional","affiliation":[{"name":"Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital , 0424, Oslo ,","place":["Norway"]},{"name":"SHARE Centre for Resilience in Healthcare, Department of Quality and Health Technology, University of Stavanger , 4036, Stavanger ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hege","family":"Ihle-Hansen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oslo University Hospital , 0424 Oslo ,","place":["Norway"]},{"name":"Department of Medicine, B\u00e6rum Hospital, Vestre Viken Hospital Trust , 3004, Drammen ,","place":["Norway"]},{"name":"Department of Acute Medicine, Oslo University Hospital , 0424 Oslo ,","place":["Norway"]},{"name":"Institute of Health and Society, University of Oslo , 0450, Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanne F","family":"Harbo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oslo University Hospital , 0424 Oslo ,","place":["Norway"]},{"name":"Institute of Clinical Medicine, University of Oslo , 0318, Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8446-2111","authenticated-orcid":false,"given":"Einar August","family":"H\u00f8gest\u00f8l","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oslo University Hospital , 0424 Oslo ,","place":["Norway"]},{"name":"Institute of Clinical Medicine, University of Oslo , 0318, Oslo ,","place":["Norway"]},{"name":"Department of Psychology, University of Oslo , 0373, Oslo ,","place":["Norway"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guri","family":"Hagberg","sequence":"additional","affiliation":[{"name":"Department of Neurology, Oslo University Hospital , 0424 Oslo 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