Estimation of Threshold Age for Cerebral Decline Using Sigmoidal Growth Model in Cross-Sectional Imaging Study

Backgrounds: Linear association has widely been assumed for prediction of aging-related fractional anisotropy (FA) decline in white matter of the brain. While useful for testing significance of the aging effect, it fails to identify a threshold age before and after which the age-FA association changes. Identification of such a threshold is often of clinical interest for timely intervention. Methods We employed a sigmoidal growth function to test a threshold effect in age triggering onset of cerebral decline in 21 white matter tracts, and compared its fitting performance to those of linear, and power regression. The study sample was a normal healthy cohort of 106 participants with ages in mid-life ranging from 18 to 60 years. Results Of the 21 white matter tracts analyzed, the posterior thalamic radiation showed better fit with sigmoidal curve model, compared to a linear or power regression. The estimated threshold age in years (95% confidence interval) were 47.2 (44.1-48.4). Conclusion While available evidence regarding the presence of a specific age threshold for cerebral decline in mid-life based on FA was limited, the posterior thalamic radiation exhibited a threshold age of 47.2. Beyond this age point, we observed a significant change in the FA risk pattern.