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MRI signature of brain age underlying post-traumatic stress disorder in World Trade Center responders

  • Azzurra Invernizzi
  • , Francesco La Rosa
  • , Anna Sather
  • , Elza Rechtman
  • , Ismail Nabeel
  • , R. Sean Morrison
  • , Alison C. Pellecchia
  • , Stephanie Santiago-Michels
  • , Evelyn J. Bromet
  • , Roberto G. Lucchini
  • , Benjamin J. Luft
  • , Sean A. Clouston
  • , Erin S. Beck
  • , Cheuk Y. Tang
  • , Megan K. Horton
  • Icahn School of Medicine at Mount Sinai
  • Stony Brook University
  • City University of New York
  • Florida International University

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Approximately 23% of the men and women who participated in rescue and recovery efforts at the 9/11 World Trade Center (WTC) site experience persistent, clinically significant post-traumatic stress disorder (PTSD). Recent structural and functional magnetic resonance imaging (MRI) studies demonstrate significant neural differences between WTC responders with and without PTSD. Here, we used brain age, a novel MRI-based data-driven biomarker optimized to detect accelerated structural aging and examined the impact of PTSD on this process. Using BrainAgeNeX, a novel convolutional neural network that bypasses brain parcellation and has been trained and validated on over 11,000 T1-weighted MRI scans, we predicted brain age in WTC responders with PTSD (WTC-PTSD, n = 47) and age/sex matched responders without PTSD (non-PTSD, n = 52). Brain Age Difference (BAD) was then calculated for each WTC responder by subtracting chronological age from brain age. We found that BAD was significantly older in WTC-PTSD compared to non-PTSD responders (BADno_PTSD = −0.43 y; BADWTC_PTSD = 3.07 y; p < 0.001). Further, we found that WTC exposure duration (months working on site) moderates the association between PTSD and BAD (p = 0.005). Our results suggest that brain age is a relevant marker of structural damage in WTC responders with and without PTSD. PTSD may be a risk factor for accelerated aging in trauma-exposed populations.

Original languageEnglish
Article number23
JournalTranslational Psychiatry
Volume16
Issue number1
DOIs
StatePublished - Dec 2026

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