“Brain age has not been widely explored in stroke. A lot of stroke research has focused on how damage to the brain results in negative health outcomes, but there has been less research on how the integrity of the remaining brain tissue supports recovery. We expected that younger-appearing brains would be buffered from the effects of the lesion damage and therefore have less impacts on behavior,” says Sook-Lei Liew, PhD, lead author of the study and associate professor with joint appointments at the Stevens INI, the Chan Division of Occupational Science and Occupational Therapy, the Division of Biokinesiology and Physical Therapy, and the USC Viterbi School of Engineering.

The research team conducted an observational study using a multi-site data set of 3D brain structural MRIs and clinical measures from ENIGMA Stroke Recovery, a collaborative working group of more than 100 experts worldwide who pool together post-stroke MRI data to create well-powered, diverse samples. The primary mission of the group is to create a worldwide network of stroke neuroimaging centers focused on understanding the mechanisms of stroke recovery.


The new study showed that younger brain age is associated with superior post-stroke outcomes. The researchers note that inclusion of imaging-based assessments of brain age and brain resilience may improve the prediction of post-stroke outcomes and open new possibilities for potential therapeutic targets.

“The health of your overall brain can protect you from the functional consequences of stroke. That is, the healthier your brain is, first, the less likely you are to have a stroke, and second, the less likely you are to have poor outcomes if you do have a stroke. There’s so much research on the aging brain right now, and therapeutics being developed to slow brain aging. This study ties brain aging to stroke outcomes, so any therapeutics developed to slow brain aging might also be helpful to improve outcomes after stroke,” notes Liew.

For this study, the team of experts used high-resolution MRI data from research studies. They plan to progress their brain age assessment work by applying it to routine clinical MRI data to determine if it can be an easily implemented biomarker for stroke rehabilitation outcomes. Researchers at the Stevens INI collaborate on a variety of stroke research, including the Stroke Pre-Clinical Assessment Network (SPAN), which was established to address a significant need in the scientific investigation of stroke treatment. Additionally, Liew and other USC collaborators recently released an expanded, open-source data set of brain scans from stroke patients in hopes of accelerating large-scale stroke recovery research.

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