MRI-based brain age gap tied to disability in MS, not serum biomarkers

In relapsing MS, brain-predicted age gap (BrainAGE) on MRI was 6.48 yrs vs controls' 0.69 yrs, correlating with worse hand dexterity (9HPT) and walking speed (T25FW) but not with serum NfL or GFAP. Suggests complementary disability markers.

• Cross-sectional analysis of 82 relapsing MS patients (mean age 39.2) and 30 healthy controls from three prospective trials.
• BrainAGE increased stepwise with disability (EDSS <3 vs ≥3), and remained associated with EDSS, 9HPT, and T25FW after multivariable adjustment (p<0.05).
• Limitations include small sample size and lack of external validation for the brain age prediction model.

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