Magnetic resonance elastography of the ageing brain in normal and demented populations: A systematic review
Open accessAbstract
The aim of this systematic review was to evaluate the ability of magnetic resonance elastography (MRE) to identify significant changes in brain mechanical properties during normal and pathological aging. PubMed, Web of Science and Scopus were searched for human studies using MRE to assess brain mechanical properties in cognitively healthy individuals, individuals at risk of dementia or patients diagnosed with dementia. Study characteristics, sample demographics, clinical characterization and main MRE outcomes were summarized in a table. A total of 19 studies (nine aging, 10 dementia), comprising 700 participants, were included. The main findings were decreased cerebral stiffness along aging, with rates of annual change ranging from −0.008 to −0.025 kPa per year. Also, there were regional differences in the age effect on brain stiffness. Concerning demented patients, differential patterns of stiffness were found for distinct dementia subtypes. Alzheimer's disease and frontotemporal dementia exhibited decreased brain stiffness in comparison to cognitively healthy controls and significant declines were found in regions known to be affected by the disease. In normal pressure hydrocephalus, the results were not consistent across studies, and in dementia with Lewy bodies no significant differences in brain stiffness were found. In conclusion, aging is characterized by the softening of brain tissue and this event is even more pronounced in pathological aging, such as dementia. MRE technique could be applied as a sensible diagnostic tool to identify deviations from normal aging and develop new brain biomarkers of cognitive decline/dementia that would help promote healthier cognitive aging.
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Regional stiffness maps may provide a mesoscale index of cumulative microstructural failure and of how strongly pathology has destabilized the local tissue environment.
“Regional stiffness maps may thus provide a mesoscale index of cumulative microstructural failure and of how strongly pathology has destabilized the local tissue environment (Coelho & Sousa, 2022; Y. Feng et al., 2024; Le Bihan, 2026).”
From 40 Years of diffusion MRI in the brain: From history to emerging frontiers (2026) · cites this paper as Coelho & Sousa, 2022
The Discussion reports regional stiffness changes in dementia and says that reduced stiffness in Alzheimer’s disease is thought to reflect disease-related microstructural disruption. It does not establish that stiffness maps index cumulative microstructural failure or quantify how strongly pathology has destabilized local tissue; those are more specific interpretations than the review supports. (LLM, conf=0.81)
Experimental — accuracy not yet measuredIn healthy aging, most studies report progressive brain softening, which is associated with lower cognitive performance.
“In healthy aging, most studies report progressive brain softening, which is associated with lower cognitive performance (Coelho & Sousa, 2022; Y. Feng et al., 2024; Hiscox et al., 2018).”
From 40 Years of diffusion MRI in the brain: From history to emerging frontiers (2026) · cites this paper as Coelho & Sousa, 2022
The Results (‘Aging studies’; page unavailable) say that decreased global brain stiffness is the common pattern across the aging studies, supporting progressive softening. They do not establish that this softening is associated with lower cognitive performance in healthy aging. The cognitive-score association reported in Results (‘Dementia studies’; page unavailable) concerns a dementia-related study, not healthy aging. (LLM, conf=0.87)
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- Authors
- Coelho, A., & Sousa, N.
- Affiliations
- Clinical Academic Center of Braga (PT)
- Corresponding author
- Sousa, Nuno
- Venue
- Human Brain Mapping
- Publisher
- Wiley
- Published
- 2022-04-30
- Volume
- 43
- Issue
- 13
- Pages
- 4207-4218
- ISSN
- 1065-9471 (ISSN-L)
- 1097-0193
- PMC
- PMC9374877
- OpenAlex
- W4225131947
- Cited by
- 32
- References
- 65
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 4 · 2023: 7 · 2022: 1
- FWCI
- 1.10
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Human Brain Mapping (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Fundação para a Ciência e a Tecnologia (UIDB/50026/2020, UIDP/50026/2020)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Keywords
- magnetic resonance elastography, brain mechanical properties, brain stiffness, brain aging, dementia, Alzheimer's disease, frontotemporal dementia, normal pressure hydrocephalus, dementia with Lewy bodies, cerebral softening, cognitive decline biomarkers, cognitive aging
- MeSH terms
- Aging, Alzheimer Disease, Brain, Humans, Magnetic Resonance Imaging, Elasticity Imaging Techniques
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