Objective: We used whole brain T1-weighted MRIto estimate the age of individuals with medically refractory
focal epilepsy, and compared with individuals with newly diagnosed focal epilepsy and healthy
controls. The difference between neuroanatomical age and chronological age was compared between
the three groups.
Methods: Neuroanatomical age was estimated using a machine learning-based method that was trained
using structural MRI scans from a large independent healthy control sample (N = 2001). The prediction
model was then used to estimate age from MRI scans obtained from newly diagnosed focal epilepsy
patients (N = 42), medically refractory focal epilepsy patients (N = 94) and healthy controls (N = 74).
Results: Individuals with medically refractory epilepsy had a difference between predicted brain age and
chronological age that was on average 4.5 years older than healthy controls (p = 4.6 × 10−5). No significant
differences were observed in newly diagnosed focal epilepsy. Earlier age of onset was associated with an
increased brain age difference in the medically refractory group (p = 0.034).
Significance: Medically refractory focal epilepsy is associated with structural brain changes that resemble
premature brain aging.