Portrait of Julien Cohen-Adad

Julien Cohen-Adad

Associate Academic Member
Associate Professor, Polytechnique Montréal, Electrical Engineering Department
Adjunct Professor, Université de Montréal, Department of Neuroscience
Research Topics
Medical Machine Learning

Biography

Julien Cohen-Adad is a professor at Polytechnique Montréal and the associate director of the Neuroimaging Functional Unit at Université de Montréal. He is also the Canada Research Chair in Quantitative Magnetic Resonance Imaging.

His research focuses on advancing neuroimaging methods with the help of AI. Some examples of projects are:

- Multi-modal training for medical imaging tasks (segmentation of pathologies, diagnosis, etc.)

- Adding prior from MRI physics to improve model generalization

- Incorporating uncertainty measures to deal with inter-rater variability

- Continuous learning strategies when data sharing is restricted

- Bringing AI methods into clinical radiology routine via user-friendly software solutions

Cohen-Adad also leads multiple open-source software projects that are benefiting the research and clinical community (see neuro.polymtl.ca/software.html). In short, he loves MRI with strong magnets, neuroimaging, programming and open science!

Current Students

Research Intern - Polytechnique Montréal
PhD - Polytechnique Montréal
Co-supervisor :
PhD - Polytechnique Montréal
Master's Research - Polytechnique Montréal
PhD - Polytechnique Montréal
Co-supervisor :
Master's Research - Polytechnique Montréal
Master's Research - Polytechnique Montréal
Research Intern - Polytechnique Montréal
PhD - Polytechnique Montréal
PhD - Polytechnique Montréal
Master's Research - Polytechnique Montréal

Publications

Impact of through‐slice gradient optimization for dynamic slice‐wise shimming in the cervico‐thoracic spinal cord
Arnaud Breheret
Alexandre D'Astous
Yixin Ma
Jason P. Stockmann
Julien Cohen‐Adad
This study investigates the effectiveness of through‐slice gradient optimization in dynamic slice‐wise B0 shimming of the cervico‐thor… (see more)acic spinal cord to enhance signal recovery in gradient‐echo (GRE) EPI sequences commonly used in functional MRI studies. Six volunteers underwent MRI acquisitions with dynamic shim updating (DSU) using a custom‐built 15‐channel AC/DC coil at 3 T. A magnetization‐prepared rapid gradient echo was acquired to segment the spine and to provide a clear image of the anatomical region of interest in the figures. GRE B0 field maps were used to measure field homogeneity before and after shimming; the pre‐shimming field map was used for optimization. Shimmed fields were dynamically applied to GRE–echo planar imaging acquisitions simulating functional MRI acquisitions under two shimming conditions: DSU with and without through‐slice gradient consideration. DSU with through‐slice gradient optimization increased the temporal signal‐to‐noise ratio at the T2 vertebral level by 201% compared with volume‐wise shim and by 28% compared with DSU without through‐slice. The residual geometric distortions were similar between DSU with and without through‐slice gradient optimization. A high signal loss penalty parameter was effective in simulations for reducing through‐slice gradient‐induced signal loss but led to instability and reduced image quality in actual acquisitions due to excessive in‐plane B0 inhomogeneities. Introducing a carefully balanced through‐slice gradient parameter in slice‐wise shimming substantially improves signal recovery in axial GRE images of the spinal cord, without compromising in‐plane homogeneity. This effective approach can advance spinal cord functional MRI applications at high field strengths.
Spinal Cord Tract Integrity in Degenerative Cervical Myelopathy
Newton Cho
Abdul Al-Shawwa
W. Bradley Jacobs
Nathan Evaniew
Jacques Bouchard
Steve Casha
Stephan duPlessis
Peter Lewkonia
Fred Nicholls
Alex Soroceanu
Ganesh Swamy
Kenneth C. Thomas
Michael M. H. Yang
David W. Cadotte
Degenerative cervical myelopathy (DCM) is the most common cause of spinal dysfunction globally. Despite surgical intervention, motor dysfunc… (see more)tion may persist in many patients. The purpose of this study was to comprehensively examine specific spinal cord tract changes in patients with DCM, to better understand potential substrates for compensatory recovery of function. Cervical spinal cord MRI scans with diffusion tensor imaging were performed in patients with DCM and in healthy volunteers. Spinal Cord Toolbox was used to register the PAM50 template, which includes a probabilistic atlas of the white matter tracts of the spinal cord, to the imaging data. Fractional anisotropy (FA) was extracted for each tract at C3 above the level of maximal compression and compared between patients with DCM and healthy volunteers and between patients with mild vs moderate to severe DCM. We included 25 patients with DCM (13 mild and 12 moderate to severe) and 6 healthy volunteers. FA was significantly reduced in DCM subjects relative to healthy volunteers for the lateral corticospinal tract (mild DCM vs healthy ∆ = −0.13, P = .018; moderate to severe DCM vs healthy ∆ = −0.11, P = .047), fasciculus gracilis (mild DCM vs healthy ∆ = −0.16, P = .010; moderate to severe DCM vs healthy ∆ = −0.13, P = .039), and fasciculus cuneatus (mild DCM vs healthy ∆ = −0.16, P = .007; moderate to severe DCM vs healthy ∆ = −0.15, P = .012). There were no differences in FA for all tracts between mild and moderate-to-severe DCM subjects. Patients with DCM had altered diffusion tensor imaging signal in their lateral corticospinal tract, fasciculus gracilis, and fasciculus cuneatus in comparison with healthy volunteers. These findings indicate that DCM is characterized by injury to these structures, which suggests that other tracts within the cord could potentially act as substrates for compensatory motor recovery.
Addressing Missing Modality Challenges in MRI Images: A Comprehensive Review
Reza Azad
Mohammad Dehghanmanshadi
Nika Khosravi
Dorit Merhof
Considerations and recommendations from the ISMRM Diffusion Study Group for preclinical diffusion MRI: Part 2 - Ex vivo imaging: added value and acquisition
Kurt G Schilling
Francesco Grussu
Andrada Ianus
Brian Hansen
Manisha Aggarwal
Amy FD Howard
Rachel L C Barrett
Stijn Michielse
Fatima Nasrallah
Warda Syeda
Nian Wang
Jelle Veraart
Alard Roebroeck
Andrew F Bagdasarian
Cornelius Eichner
Farshid Sepehrband
Jan Zimmermann
Ben Jeurissen
Lucio Frydman
Yohan van de Looij … (see 38 more)
Lucas Soustelle
Christien Bowman
David Hike
Benjamin C Tendler
Jeff F Dunn
Andrada Ianus
Karla Miller
Bennett A Landman
Noam Shemesh
Marleen Verhoye
Adam Anderson
Emilie McKinnon
Shawna Farquharson
Flavio Dell' Acqua
Carlo Pierpaoli
Ivana Drobnjak
Alexander Leemans
Kevin D Harkins
Maxime Descoteaux
Duan Xu
Mathieu D Santin
Samuel C. Grant
Andre Obenaus
Gene S Kim
Dan Wu
Denis Le Bihan
Stephen J Blackband
Nian Wang
Luisa Ciobanu
Els Fieremans
Ruiliang Bai
Trygve B Leergaard
Jiangyang Zhang
Tim B Dyrby
G Allan Johnson
Matthew D Budde
Ileana O Jelescu
The value of preclinical diffusion MRI (dMRI) is substantial. While dMRI enables in vivo non-invasive characterization of tissue, ex vivo dM… (see more)RI is increasingly used to probe tissue microstructure and brain connectivity. Ex vivo dMRI has several experimental advantages including higher signal-to-noise ratio and spatial resolution compared to in vivo studies, and enabling more advanced diffusion contrasts. Another major advantage of ex vivo dMRI is the direct comparison with histological data as a methodological validation. However, there are a number of considerations that must be made when performing ex vivo experiments. The steps from tissue preparation, image acquisition and processing, and interpretation of results are complex, with decisions that not only differ dramatically from in vivo imaging of small animals, but ultimately affect what questions can be answered using the data. This work represents "Part 2" of a 3-part series of recommendations and considerations for preclinical dMRI. We describe best practices for dMRI of ex vivo tissue, with a focus on the value that ex vivo imaging adds to the field of dMRI and considerations in ex vivo image acquisition. We give general considerations and foundational knowledge that must be considered when designing experiments. We describe differences in specimens and models and discuss why some may be more or less appropriate for different studies. We then give guidelines for ex vivo protocols, including tissue fixation, sample preparation, and MR scanning. In each section, we attempt to provide guidelines and recommendations, but also highlight areas for which no guidelines exist (and why), and where future work should lie. An overarching goal herein is to enhance the rigor and reproducibility of ex vivo dMRI acquisitions and analyses, and thereby advance biomedical knowledge.
Normalizing Spinal Cord Compression Measures in Degenerative Cervical Myelopathy.
Maryam Seif
Armin Curt
Simon Schading-Sassenhausen
Nikolai Pfender
P. Freund
Markus Hupp
Considerations and recommendations from the ISMRM Diffusion Study Group for preclinical diffusion MRI: Part 3 -- Ex vivo imaging: data processing, comparisons with microscopy, and tractography
Kurt G Schilling
Amy F. D. Howard
Francesco Grussu
Andrada Ianus
Brian Hansen
Rachel L. C. Barrett
Manisha Aggarwal
Stijn Michielse
Fatima Nasrallah
Warda Syeda
Nian Wang
Jelle Veraart
Alard Roebroeck
Andrew F. Bagdasarian
Cornelius Eichner
Farshid Sepehrband
Jan Zimmermann
Lucas Soustelle
Christien Bowman
Benjamin C. Tendler … (see 38 more)
Andreea Hertanu
Ben Jeurissen
Marleen Verhoye
Lucio Frydman
Yohan van de Looij
David Hike
Jeff F. Dunn
Karla Miller
Bennett Landman
Noam Shemesh
Arthur Anderson
Emilie McKinnon
Shawna Farquharson
Flavio Dell’Acqua
Carlo Pierpaoli
Ivana Drobnjak
Alexander Leemans
Kevin D. Harkins
Maxime Descoteaux
Duan Xu
Hao Huang
Mathieu D. Santin
Samuel C. Grant
Andre Obenaus
Gene S. Kim
Dan Wu
Denis Le Bihan
Stephen J. Blackband
Luisa Ciobanu
Els Fieremans
Ruiliang Bai
Trygve B. Leergaard
Jiangyang Zhang
Tim B. Dyrby
G. Allan Johnson
Matthew D. Budde
Ileana O. Jelescu
Considerations and recommendations from the <scp>ISMRM</scp> diffusion study group for preclinical diffusion <scp>MRI</scp>: Part 1: In vivo small‐animal imaging
Ileana O. Jelescu
Francesco Grussu
Andrada Ianus
Brian Hansen
Rachel L. C. Barrett
Manisha Aggarwal
Stijn Michielse
Fatima Nasrallah
Warda Syeda
Nian Wang
Jelle Veraart
Alard Roebroeck
Andrew F. Bagdasarian
Cornelius Eichner
Farshid Sepehrband
Jan Zimmermann
Lucas Soustelle
Christien Bowman
Benjamin C. Tendler
Andreea Hertanu … (see 37 more)
Ben Jeurissen
Marleen Verhoye
Lucio Frydman
Yohan van de Looij
David Hike
Jeff F. Dunn
Karla Miller
Bennett Landman
Noam Shemesh
Arthur Anderson
Emilie McKinnon
Shawna Farquharson
Flavio Dell’Acqua
Carlo Pierpaoli
Ivana Drobnjak
Alexander Leemans
Kevin D. Harkins
Maxime Descoteaux
Duan Xu
Hao Huang
Mathieu D. Santin
Samuel C. Grant
Andre Obenaus
Gene S. Kim
Dan Wu
Denis Le Bihan
Stephen J. Blackband
Luisa Ciobanu
Els Fieremans
Ruiliang Bai
Trygve B. Leergaard
Jiangyang Zhang
Tim B. Dyrby
G. Allan Johnson
Matthew D. Budde
Kurt G Schilling
Recommendations and guidelines from the ISMRM Diffusion Study Group for preclinical diffusion MRI: Part 1 -- In vivo small-animal imaging
Ileana O. Jelescu
Francesco Grussu
Andrada Ianus
Brian Hansen
Rachel L. C. Barrett
Manisha Aggarwal
Stijn Michielse
Fatima Nasrallah
Warda Syeda
Nian Wang
Jelle Veraart
Alard Roebroeck
Andrew F. Bagdasarian
Cornelius Eichner
Farshid Sepehrband
Jan Zimmermann
Ben Jeurissen
Lucio Frydman
Lucas Soustelle
Christien Bowman … (see 37 more)
Yohan van de Looij
Benjamin C. Tendler
David Hike
Jeff F. Dunn
Andrada Ianus
Karla Miller
Bennett Landman
Marleen Verhoye
Noam Shemesh
Arthur Anderson
Emilie McKinnon
Shawna Farquharson
Flavio Dell’Acqua
Carlo Pierpaoli
Ivana Drobnjak
Alexander Leemans
Kevin D. Harkins
Maxime Descoteaux
Duan Xu
Mathieu D. Santin
Samuel C. Grant
Andre Obenaus
Gene S. Kim
Dan Wu
Denis Le Bihan
Stephen J. Blackband
Nian Wang
Luisa Ciobanu
Els Fieremans
Ruiliang Bai
Trygve B. Leergaard
Jiangyang Zhang
Tim B. Dyrby
G. Allan Johnson
Matthew D. Budde
Kurt G Schilling
The value of in vivo preclinical diffusion MRI (dMRI) is substantial. Small-animal dMRI has been used for methodological development and val… (see more)idation, characterizing the biological basis of diffusion phenomena, and comparative anatomy. Many of the influential works in this field were first performed in small animals or ex vivo samples. The steps from animal setup and monitoring, to acquisition, analysis, and interpretation are complex, with many decisions that may ultimately affect what questions can be answered using the data. This work aims to serve as a reference, presenting selected recommendations and guidelines from the diffusion community, on best practices for preclinical dMRI of in vivo animals. In each section, we also highlight areas for which no guidelines exist (and why), and where future work should focus. We first describe the value that small animal imaging adds to the field of dMRI, followed by general considerations and foundational knowledge that must be considered when designing experiments. We briefly describe differences in animal species and disease models and discuss how they are appropriate for different studies. We then give guidelines for in vivo acquisition protocols, including decisions on hardware, animal preparation, imaging sequences and data processing, including pre-processing, model-fitting, and tractography. Finally, we provide an online resource which lists publicly available preclinical dMRI datasets and software packages, to promote responsible and reproducible research. An overarching goal herein is to enhance the rigor and reproducibility of small animal dMRI acquisitions and analyses, and thereby advance biomedical knowledge.
Automatic segmentation of spinal cord lesions in MS: A robust tool for axial T2-weighted MRI scans
Enamundram Naga Karthik
Julian McGinnis
Ricarda Wurm
Sebastian Ruehling
Robert Graf
Pierre-Louis Benveniste
Markus Lauerer
Jason Talbott
Rohit Bakshi
Shahamat Tauhid
Timothy Shepherd
Achim Berthele
Claus Zimmer
Bernhard Hemmer
Daniel Rueckert
Benedikt Wiestler
Jan S. Kirschke
Mark Mühlau
Deep learning models have achieved remarkable success in segmenting brain white matter lesions in multiple sclerosis (MS), becoming integral… (see more) to both research and clinical workflows. While brain lesions have gained significant attention in MS research, the involvement of spinal cord lesions in MS is relatively understudied. This is largely owed to the variability in spinal cord magnetic resonance imaging (MRI) acquisition protocols, high individual anatomical differences, the complex morphology and size of spinal cord lesions - and lastly, the scarcity of labeled datasets required to develop robust segmentation tools. As a result, automatic segmentation of spinal cord MS lesions remains a significant challenge. Although some segmentation tools exist for spinal cord lesions, most have been developed using sagittal T2-weighted (T2w) sequences primarily focusing on cervical spines. With the growing importance of spinal cord imaging in MS, axial T2w scans are becoming increasingly relevant due to their superior sensitivity in detecting lesions compared to sagittal acquisition protocols. However, most existing segmentation methods struggle to effectively generalize to axial sequences due to differences in image characteristics caused by the highly anisotropic spinal cord scans. To address these challenges, we developed a robust, open-source lesion segmentation tool tailored specifically for axial T2w scans covering the whole spinal cord. We investigated key factors influencing lesion segmentation, including the impact of stitching together individually acquired spinal regions, straightening the spinal cord, and comparing the effectiveness of 2D and 3D convolutional neural networks (CNNs). Drawing on these insights, we trained a multi-center model using an extensive dataset of 582 MS patients, resulting in a dataset comprising an entirety of 2,167 scans. We empirically evaluated the model’s segmentation performance across various spinal segments for lesions with varying sizes. Our model significantly outperforms the current state-of-the-art methods, providing consistent segmentation across cervical, thoracic and lumbar regions. To support the broader research community, we integrate our model into the widely-used Spinal Cord Toolbox (v7.0 and above), making it accessible via the command sct_deepseg lesion_ms_axial_t2 -i &lt;path-to-image.nii.gz&gt;.
Body size and intracranial volume interact with the structure of the central nervous system: A multi-center in vivo neuroimaging study
René Labounek
Monica T. Bondy
Amy L. Paulson
Mihael Abramovic
Eva Alonso-Ortiz
Nicole T. Atcheson
Laura R. Barlow
Robert L. Barry
Markus Barth
Marco Battiston
Christian Büchel
Matthew D. Budde
Virginie Callot
Anna Combes
Benjamin De Leener
Maxime Descoteaux
Paulo Loureiro de Sousa
Marek Dostál
Julien Doyon … (see 74 more)
Adam V. Dvorak
Falk Eippert
Karla R. Epperson
Kevin S. Epperson
Patrick Freund
Jürgen Finsterbusch
Alexandru Foias
Michela Fratini
Issei Fukunaga
Claudia A.M. Gandini Wheeler-Kingshott
Giancarlo Germani
Guillaume Gilbert
Federico Giove
Francesco Grussu
Akifumi Hagiwara
Pierre-Gilles Henry
Tomáš Horák
Masaaki Hori
James M. Joers
Kouhei Kamiya
Haleh Karbasforoushan
Miloš Keřkovský
Ali Khatibi
Joo-Won Kim
Nawal Kinany
Hagen Kitzler
Shannon Kolind
Yazhuo Kong
Petr Kudlička
Paul Kuntke
Nyoman D. Kurniawan
Slawomir Kusmia
Maria Marcella Laganà
Cornelia Laule
Christine S.W. Law
Christine S.W. Law
Tobias Leutritz
Yaou Liu
Sara Llufriu
Sean Mackey
Allan R. Martin
Eloy Martinez-Heras
Loan Mattera
Kristin P. O'Grady
Nico Papinutto
Daniel Papp
Deborah Pareto
Todd B. Parrish
Anna Pichiecchio
Ferran Prados
Àlex Rovira
Marc J. Ruitenberg
Rebecca S. Samson
Giovanni Savini
Maryam Seif
Alan C. Seifert
Alex K. Smith
Seth A. Smith
Zachary A. Smith
Elisabeth Solana
Yuichi Suzuki
George W Tackley
Alexandra Tinnermann
Dimitri Van De Ville
Marios C. Yiannakas
Kenneth A. Weber II
Nikolaus Weiskopf
Richard G. Wise
Patrik O. Wyss
Junqian Xu
Christophe Lenglet
Igor Nestrasil
Clinical research emphasizes the implementation of rigorous and reproducible study designs that rely on between-group matching or controllin… (see more)g for sources of biological variation such as subject’s sex and age. However, corrections for body size (i.e., height and weight) are mostly lacking in clinical neuroimaging designs. This study investigates the importance of body size parameters in their relationship with spinal cord (SC) and brain magnetic resonance imaging (MRI) metrics. Data were derived from a cosmopolitan population of 267 healthy human adults (age 30.1 ± 6.6 years old, 125 females). We show that body height correlates with brain gray matter (GM) volume, cortical GM volume, total cerebellar volume, brainstem volume, and cross-sectional area (CSA) of cervical SC white matter (CSA-WM; 0.44 ≤ r ≤ 0.62). Intracranial volume (ICV) correlates with body height (r = 0.46) and the brain volumes and CSA-WM (0.37 ≤ r ≤ 0.77). In comparison, age correlates with cortical GM volume, precentral GM volume, and cortical thickness (-0.21 ≥ r ≥ -0.27). Body weight correlates with magnetization transfer ratio in the SC WM, dorsal columns, and lateral corticospinal tracts (-0.20 ≥ r ≥ -0.23). Body weight further correlates with the mean diffusivity derived from diffusion tensor imaging (DTI) in SC WM (r = -0.20) and dorsal columns (-0.21), but only in males. CSA-WM correlates with brain volumes (0.39 ≤ r ≤ 0.64), and with precentral gyrus thickness and DTI-based fractional anisotropy in SC dorsal columns and SC lateral corticospinal tracts (-0.22 ≥ r ≥ -0.25). Linear mixture of age, sex, or sex and age, explained 2 ± 2%, 24 ± 10%, or 26 ± 10%, of data variance in brain volumetry and SC CSA. The amount of explained variance increased to 33 ± 11%, 41 ± 17%, or 46 ± 17%, when body height, ICV, or body height and ICV were added into the mixture model. In females, the explained variances halved suggesting another unidentified biological factor(s) determining females’ central nervous system (CNS) morphology. In conclusion, body size and ICV are significant biological variables. Along with sex and age, body size should therefore be included as a mandatory variable in the design of clinical neuroimaging studies examining SC and brain structure; and body size and ICV should be considered as covariates in statistical analyses. Normalization of different brain regions with ICV diminishes their correlations with body size, but simultaneously amplifies ICV-related variance (r = 0.72 ± 0.07) and suppresses volume variance of the different brain regions (r = 0.12 ± 0.19) in the normalized measurements.
EPISeg: Automated segmentation of the spinal cord on echo planar images using open-access multi-center data
Merve Kaptan
Alexandra Tinnermann
Ali Khatibi
Alice Dabbagh
Christian Büchel
Christian W. Kündig
Christine S.W. Law
Christine S.W. Law
Dario Pfyffer
David J. Lythgoe
Dimitra Tsivaka
Dimitri Van De Ville
Falk Eippert
Fauziyya Muhammad
Gary H. Glover
Gergely David
Grace Haynes
Jan Haakers
Jonathan C.W. Brooks … (see 23 more)
Jürgen Finsterbusch
Katherine T. Martucci
Kimberly J. Hemmerling
Mahdi Mobarak-Abadi
Mark A. Hoggarth
Matthew A. Howard
Molly G. Bright
Nawal Kinany
Olivia S. Kowalczyk
Patrick Freund
Robert L. Barry
Sean Mackey
Shahabeddin Vahdat
Simon Schading
Stephen B. McMahon
Todd Parish
Veronique Marchand-Pauvert
Yufen Chen
Zachary A. Smith
Kenneth A. Weber II
Kenneth A. Weber II
Benjamin De Leener
Functional magnetic resonance imaging (fMRI) of the spinal cord is relevant for studying sensation, movement, and autonomic function. Prepro… (see more)cessing of spinal cord fMRI data involves segmentation of the spinal cord on gradient-echo echo planar imaging (EPI) images. Current automated segmentation methods do not work well on these data, due to the low spatial resolution, susceptibility artifacts causing distortions and signal drop-out, ghosting, and motion-related artifacts. Consequently, this segmentation task demands a considerable amount of manual effort which takes time and is prone to user bias. In this work, we (i) gathered a multi-center dataset of spinal cord gradient-echo EPI with ground-truth segmentations and shared it on OpenNeuro https://openneuro.org/datasets/ds005143/versions/1.3.1 and (ii) developed a deep learning-based model, EPISeg, for the automatic segmentation of the spinal cord on gradient-echo EPI data. We observe a significant improvement in terms of segmentation quality compared with other available spinal cord segmentation models. Our model is resilient to different acquisition protocols as well as commonly observed artifacts in fMRI data. The training code is available at https://github.com/sct-pipeline/fmri-segmentation/, and the model has been integrated into the Spinal Cord Toolbox as a command-line tool.
Morphometric characteristics of tibial nerve and their relationship with age
Shahram Oveisgharan
Jingyun Yang
Sue E. Leurgans
Veronique VanderHorst
David A. Bennett
Osvaldo Delbono
Aron S. Buchman
Peripheral nerve comprises a crucial component of the distributed motor/sensory system. However, there is a paucity of data on peripheral ne… (see more)rve morphology derived from large numbers of older adults. This study aimed to quantify the morphometric characteristics of myelinated nerve fibres of the tibial nerve obtained from deceased community-dwelling older adults and examine their association with age. The tibial nerves were obtained from consecutive autopsies of older adults without a history of diabetes who were participants of the Rush Memory and Aging Project, an ongoing longitudinal clinical-autopsy study. A nerve fascicle, obtained from a fixed popliteal segment of the tibial nerve, was separated from the blood vessels and adipose tissue for postmortem examination under an optical microscope. Morphometric characteristics of the myelinated nerve fibres were automatically segmented and quantified using our open-source software AxonDeepSeg. The participants (N = 140) had a mean age of 92.0 years (SD = 5.4) at death, and 72.1% (N = 101) were women. We examined 754 247 myelinated nerve fibres, with an average 5387 (SD = 3436) nerve fibres per participant. The average diameter of myelinated nerve fibres was 4.9 µm (SD = 3.1), axon diameter was 2.0 µm (SD = 1.4), myelin thickness was 1.4 µm (SD = 0.96) and the g-ratio (ratio of axon diameter to myelinated nerve fibre diameter) was 0.45 (SD = 0.17). The relationship between axon diameter and myelin thickness was nonlinear. Myelin was thicker in larger axons up to a diameter of 8 µm, beyond which myelin thickness plateaued. Older age at death was associated with smaller myelinated nerve fibres, smaller axons and thinner myelin. However, age at death was not correlated with myelinated nerve fibre density and was not associated with the average of g-ratio. The association between older age and smaller myelinated nerve fibres was largely attributable to a lower percentage of myelinated nerve fibres >8 µm. We conclude that the smaller tibial myelinated nerve fibres observed in older adults may reflect axonal atrophy rather than degeneration and regeneration of the myelinated nerve fibres. Further research is needed to investigate the pathologies and molecular mechanisms underlying these age-related morphometric changes and their clinical implications in older adults.