Researchers have developed an artificial intelligence (AI) model capable of identifying a measurable biomarker of chronic stress directly from standard computed tomography (CT) scans. This breakthrough, presented at the Radiological Society of North America (RSNA) meeting, offers a novel way to assess the physiological toll of long-term stress without additional testing or radiation exposure.
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The Hidden Cost of Chronic Stress
Chronic stress is more than just a mental burden. It impacts both physical and mental well-being, contributing to conditions like anxiety, sleep disturbances, muscle pain, hypertension, and weakened immunity. Prolonged stress is also linked to severe health issues including heart disease, depression, and obesity. Identifying this stress physiologically has been difficult until now.
How the AI Works: Measuring Adrenal Glands
The study, led by Dr. Elena Ghotbi at Johns Hopkins University, trained a deep learning tool to measure adrenal gland size from existing CT scans. Given that tens of millions of chest CTs are performed annually in the U.S., this method can leverage vast amounts of data for large-scale stress evaluations. The AI calculates the Adrenal Volume Index (AVI), essentially measuring adrenal volume relative to height.
“Our approach leverages widely available imaging data… to enhance cardiovascular risk stratification and guide preventive care.” – Dr. Elena Ghotbi
Linking Imaging to Real-World Stress
Researchers analyzed data from 2,842 participants in the Multi-Ethnic Study of Atherosclerosis, integrating CT scans, stress questionnaires, cortisol levels, and measures of allostatic load (the cumulative impact of chronic stress). The AI-derived AVI correlated with established stress indicators, cortisol readings, and future cardiovascular events. Higher AVI values linked to greater cortisol exposure, higher peak cortisol levels, and increased allostatic load.
Stress Visible in the Body: A New Measurement
For the first time, researchers can quantify the long-term effects of stress using a readily available scan. Unlike single cortisol tests, which only measure stress at one point in time, adrenal gland size serves as a cumulative gauge. The study found that for every 1 cm3/m2 increase in AVI, the risk of heart failure and death increased.
Implications for Clinical Practice
The findings demonstrate a clear link between chronic stress, physiological changes, and major health outcomes. According to study co-author Dr. Teresa Seeman, this research operationalizes the cumulative impact of stress on health by tying imaging to biological and psychological measures. The biomarker can be obtained from routinely performed CT scans, making it a practical tool for everyday clinical practice.
The ability to identify and quantify chronic stress through routine imaging may lead to more effective preventive care strategies and improved understanding of stress-related diseases. This work marks a significant step toward integrating stress assessment into standard medical diagnostics.
