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. 2023 Apr 29;10(6):990–1001. doi: 10.1002/acn3.51782

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© 2023 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.

This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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Longitudinal changes in brain age are related to disability. Longitudinally predicted brain age by BrainAgeR is shown as spaghetti plots for CIS (A), RRMS (B), SPMS (C), and PPMS (D) participants. In each case, predicted age over‐estimates actual age and single subjects demonstrate increasing predicted brain age with increasing actual age. To facilitate visualization, only a randomly selected fraction of the total data are shown for purpose of illustration; all subjects are considered statistically. Next, the longitudinal marginal rate of change in predicted brain age was calculated for each subject and expressed as change in predicted brain age (ΔBrainAge) per actual year attributable to PDDS (E), MS disease course (F), and DMT efficacy (G). Higher disability was associated with accelerated brain aging.