Accelerated brain age in Moyamoya disease patients: a deep learning approach and correlation with disease severity.

Introduction: This study aims to utilize a DenseNet based deep learning framework to predict brain age in patients with Moyamoya disease (MMD), examining the relationship between brain age and disease severity to enhance diagnostic and prognostic capabilities. Methods: We analyzed unenhanced MRI scans from 432 adult MMD patients and 565 normal controls collected between January 2018 and December 2022. Data preprocessing involved converting DICOM files to NIFTI format and labeling based on established diagnostic criteria. A DenseNet121 architecture, implemented using PyTorch, was employed to predict brain age. Statistical analyses included correlation assessments and comparisons between predicted brain age, chronological age, and MRA scores. Results: The predicted brain age for MMD patients was significantly higher than their chronological age, averaging 37.9 years versus 35.8 years (p < 0.01). For normal controls, predicted brain age matched chronological age at 36.5 years. Delta age (difference between predicted brain age and chronological age) was significantly elevated in MMD patients (p < 0.001) and positively correlated with MRA scores, indicating a link between arterial stenosis severity and accelerated brain aging. Discussion: The DenseNet based model effectively predicts brain age, revealing that MMD patients experience accelerated brain aging correlated with disease severity. These findings highlight the potential of brain age prediction as a biomarker for MMD, aiding in personalized treatment strategies and early intervention. Future research should explore multi-center datasets and longitudinal data to validate and extend these findings.