• Adrià Macias-Gómez, Joan Jiménez-Balado, Isabel Fernández-Pérez, Antoni Suárez-Pérez, Marta Vallverdú-Prats, Leopoldo Guimaraens, Elio Vivas, Jesus Saldaña, Eva Giralt-Steinhauer, Daniel Guisado-Alonso, Gloria Villalba, Maria-Pilar Gracia, Manel Esteller, Ana Rodriguez-Campello, Jordi Jiménez-Conde, Angel Ois, and Elisa Cuadrado-Godia.
• Neurology Department, Hospital del Mar, Barcelona, Catalunya, Spain.
• J. Neurol. Neurosurg. Psychiatr. 2024 Jun 17; 95 (7): 675681675-681.

BackgroundWe aimed to investigate the association between DNA-methylation biological age (B-age) calculated as age acceleration (ageAcc) and key aneurysmal subarachnoid haemorrhage (aSAH) complications such as vasospasm, delayed cerebral ischaemia (DCI), poor outcome, and mortality.MethodsWe conducted a prospective study involving 277 patients with aSAH. B-age was determined in whole blood samples using five epigenetic clocks: Hannum's, Horvath's, Levine's and both versions of Zhang's clocks. Age acceleration was calculated as the residual obtained from regressing out the effect of C-age on the mismatch between C-age and B-age. We then tested the association between ageAcc and vasospasm, DCI and 12-month poor outcome (mRS 3-5) and mortality using linear regression models adjusted for confounders.ResultsAverage C-age was 55.0 years, with 66.8% being female. Vasospasm occurred in 143 cases (51.6%), DCI in 70 (25.3%) and poor outcomes in 99 (35.7%), with a mortality rate of 20.6%. Lower ageAcc was linked to vasospasm in Horvath's and Levine's clocks, whereas increased ageAcc was associated with 12-month mortality in Hannum's clock. No significant differences in ageAcc were found for DCI or poor outcome at 12 months with other clocks.ConclusionsOur study indicates that B-age is independently associated with vasospasm and 12-month mortality in patients with aSAH. These findings underscore the potential role of epigenetics in understanding the pathophysiology of aSAH-related complications and outcomes.© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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