The age of violence: Mapping brain age in psychosis and psychopathy

Natalia Tesli; Christina Bell; Gabriela Hjell; Thomas Fischer-Vieler; Ivan I Maximov; Genevieve Richard; Martin Tesli; Ingrid Melle; Ole A Andreassen; Ingrid Agartz; Lars T Westlye; Christine Friestad; Unn K Haukvik; Jaroslav Rokicki

doi:10.1016/j.nicl.2022.103181

The age of violence: Mapping brain age in psychosis and psychopathy

Neuroimage Clin. 2022:36:103181. doi: 10.1016/j.nicl.2022.103181. Epub 2022 Sep 6.

Authors

Affiliations

¹ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
² Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Oslo University Hospital, Oslo, Norway.
³ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry, Østfold Hospital Trust, Graalum, Norway.
⁴ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Drammen, Norway.
⁵ Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.
⁶ Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway; Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway.
⁷ Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Adult Psychiatry, Institute of Clinical Medicine, University of Oslo, Norway.
⁸ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden.
⁹ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway.
¹⁰ Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway; University College of Norwegian Correctional Service, Oslo, Norway.
¹¹ Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychiatry, Oslo University Hospital, Oslo, Norway; Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway.
¹² Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Centre of Research and Education in Forensic Psychiatry, Oslo University Hospital, Oslo, Norway. Electronic address: jarrok@ous-hf.no.

Abstract

Young chronological age is one of the strongest predictors for antisocial behaviour in the general population and for violent offending in individuals with psychotic disorders. An individual's age can be predicted with high accuracy using neuroimaging and machine-learning. The deviation between predicted and chronological age, i.e., brain age gap (BAG) has been suggested to reflect brain health, likely relating partly to neurodevelopmental and aging-related processes and specific disease mechanisms. Higher BAG has been demonstrated in patients with psychotic disorders. However, little is known about the brain-age in violent offenders with psychosis and the possible associations with psychopathy traits. We estimated brain-age in 782 male individuals using T1-weighted MRI scans. Three machine learning models (random forest, extreme gradient boosting with and without hyper parameter tuning) were first trained and tested on healthy controls (HC, n = 586). The obtained BAGs were compared between HC and age matched violent offenders with psychosis (PSY-V, n = 38), violent offenders without psychosis (NPV, n = 20) and non-violent psychosis patients (PSY-NV, n = 138). We ran additional comparisons between BAG of PSY-V and PSY-NV and associations with Positive and Negative Syndrome Scale (PANSS) total score as a measure of psychosis symptoms. Psychopathy traits in the violence groups were assessed with Psychopathy Checklist-revised (PCL-R) and investigated for associations with BAG. We found significantly higher BAG in PSY-V compared with HC (4.9 years, Cohen'sd = 0.87) and in PSY-NV compared with HC (2.7 years, d = 0.41). Total PCL-R scores were negatively associated with BAG in the violence groups (d = 1.17, p < 0.05). Additionally, there was a positive association between psychosis symptoms and BAG in the psychosis groups (d = 1.12, p < 0.05). While the significant BAG differences related to psychosis and not violence suggest larger BAG for psychosis, the negative associations between BAG and psychopathy suggest a complex interplay with psychopathy traits. This proof-of-concept application of brain age prediction in severe mental disorders with a history of violence and psychopathy traits should be tested and replicated in larger samples.

Keywords: Antisocial behaviour; Brain age; Forensic psychiatry; Neuroimaging; Psychosis.

MeSH terms

Antisocial Personality Disorder / diagnostic imaging
Brain / diagnostic imaging
Criminals*
Humans
Male
Psychotic Disorders* / diagnostic imaging
Violence