{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T03:35:18Z","timestamp":1790566518127,"version":"4.1.0"},"reference-count":27,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81870958"],"award-info":[{"award-number":["81870958"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Beijing Municipal Natural Science Foundation for Distinguished Young Scholars","award":["JQ20035"],"award-info":[{"award-number":["JQ20035"]}]},{"name":"Beijing Young Scholarship, and the Capital\u2019s Funds for Health Improvement and Research","award":["CFH2022-1-2042"],"award-info":[{"award-number":["CFH2022-1-2042"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the clinical significance of deep learning-derived brain age prediction in neuromyelitis optica spectrum disorder (NMOSD) relative to relapsing-remitting multiple sclerosis (RRMS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cohort study used data retrospectively collected from 6 tertiary neurological centres in China between 2009 and 2018. In total, 199 patients with NMOSD and 200 patients with RRMS were studied alongside 269 healthy controls. Clinical follow-up was available in 85 patients with NMOSD and 124 patients with RRMS (mean duration NMOSD=5.8\u00b11.9 (1.9\u20139.9) years, RRMS=5.2\u00b11.7 (1.5\u20139.2) years). Deep learning was used to learn \u2018brain age\u2019 from MRI scans in the healthy controls and estimate the brain age gap (BAG) in patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significantly higher BAG was found in the NMOSD (5.4\u00b18.2 years) and RRMS (13.0\u00b114.7 years) groups compared with healthy controls. A higher baseline disability score and advanced brain volume loss were associated with increased BAG in both patient groups. A longer disease duration was associated with increased BAG in RRMS. BAG significantly predicted Expanded Disability Status Scale worsening in patients with NMOSD and RRMS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is a clear BAG in NMOSD, although smaller than in RRMS. 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