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Background <p>GM1 gangliosidosis is an inherited, progressive, and fatal neurodegenerative lysosomal storage disorder with no approved treatment. In this study, we present the first use of MRI-based predicted brain age in GM1 gangliosidosis aimed at assessing the neuronal degeneration in this cohort.</p> Methods <p>We calculated a predicted brain age and Brain Structures Age Gap Estimation (BSAGE) for 81 MRI scans from 41 Type II (26 juvenile and 15 late-infantile) GM1 gangliosidosis patients and 897 MRI scans from 556 neurotypical controls (NC) utilizing <i>BrainStructuresAges</i>, a machine learning MRI analysis pipeline.</p> Results <p>NC shows whole-brain aging at a rate of 0.83 per chronological year compared with 1.57 in juvenile GM1 patients and 12.25 in late-infantile GM1 patients. Accelerated and distinct brain aging is observed throughout midbrain structures, including the thalamus and caudate nucleus, hindbrain structures, including the cerebellum and brainstem, and the ventricles in juvenile and late-infantile GM1 patients compared to NC, reflecting neurodegeneration from disease progression. Cross-sectional evaluations of BSAGE for the whole brain show an average BSAGE = 35.50 years in the late-infantile cohort, 21.19 years in the juvenile cohort, and 0.03 years in NC. Predicted brain age and BSAGE both correlate with cross-sectional and longitudinal clinical outcome assessments.</p> Conclusions <p>Predicted brain age accurately reflects the neurodegenerative clinical trajectories of the Type II GM1 disease subtypes. Correlations with clinical outcome assessments indicate evaluations of predicted brain aging may be an important candidate neuroimaging outcome measure for clinical trials in GM1 gangliosidosis.</p>

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Brain aging in Type II GM1 gangliosidosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Connor J. Lewis,
  • Selby I. Chipman,
  • Precilla D’Souza,
  • Jean M. Johnston,
  • Muhammad H. Yousef,
  • William A. Gahl,
  • Cynthia J. Tifft,
  • Maria T. Acosta

摘要

Background

GM1 gangliosidosis is an inherited, progressive, and fatal neurodegenerative lysosomal storage disorder with no approved treatment. In this study, we present the first use of MRI-based predicted brain age in GM1 gangliosidosis aimed at assessing the neuronal degeneration in this cohort.

Methods

We calculated a predicted brain age and Brain Structures Age Gap Estimation (BSAGE) for 81 MRI scans from 41 Type II (26 juvenile and 15 late-infantile) GM1 gangliosidosis patients and 897 MRI scans from 556 neurotypical controls (NC) utilizing BrainStructuresAges, a machine learning MRI analysis pipeline.

Results

NC shows whole-brain aging at a rate of 0.83 per chronological year compared with 1.57 in juvenile GM1 patients and 12.25 in late-infantile GM1 patients. Accelerated and distinct brain aging is observed throughout midbrain structures, including the thalamus and caudate nucleus, hindbrain structures, including the cerebellum and brainstem, and the ventricles in juvenile and late-infantile GM1 patients compared to NC, reflecting neurodegeneration from disease progression. Cross-sectional evaluations of BSAGE for the whole brain show an average BSAGE = 35.50 years in the late-infantile cohort, 21.19 years in the juvenile cohort, and 0.03 years in NC. Predicted brain age and BSAGE both correlate with cross-sectional and longitudinal clinical outcome assessments.

Conclusions

Predicted brain age accurately reflects the neurodegenerative clinical trajectories of the Type II GM1 disease subtypes. Correlations with clinical outcome assessments indicate evaluations of predicted brain aging may be an important candidate neuroimaging outcome measure for clinical trials in GM1 gangliosidosis.