Notice bibliographique
Résumé
Cardiovascular disease is a major health problem worldwide. However, the mortality risk in patients with cardiovascular disease has decreased due to early detection of the disease and improved treatment possibilities. The downside of increased survival rates are higher rates of long-term functional disability. Cardiovascular disease and an increased cardiovascular risk are associated with loss of function such as cognitive dysfunction, motor dysfunction, and depression. Vascular damage on brain MRI, reflected in markers of small vessel disease, is increasingly recognized as potential underlying factor for age-related function loss that is frequently found in patients with cardiovascular disease. The present thesis aimed to gain more insight in the cross-sectional, but particularly in the longitudinal relationship between risk factors, MRI markers of small vessel disease, and functional disability. In the first part of the thesis we investigated the association between risk factors, MRI markers of small vessel disease, and cognitive decline. We found that potentially modifiable risk factors (e.g. diabetes mellitus and physical activity) may have small impact on slowing down cerebral vascular damage and cognitive dysfunction in middle-aged patients already burdened with vascular disease. Cognitive dysfunction is a slowly developing process that may follow a stepwise progression over time. MRI markers of small vessel disease may be more sensitive to detect the influence of modifiable risk factors and may precede differences in cognitive decline. In part II of the thesis we were interested in the relationship of subclinical features of small vessel disease on brain MRI with motor dysfunction. We performed an explorative study to examine the association of microstructural abnormalities in specific white matter tracts with motor dysfunction in patients with type 2 diabetes mellitus with and without cognitive impairment. We found that in a small group of older patients with type 2 diabetes mellitus with slightly impaired motor performance scores, microstructural abnormalities in the corpus callosum were associated with motor performance scores in the expected directions, although the results were not statistically significant. In part III of the thesis we investigated the course of depression in patients with cardiovascular disease. 30% of these patients had an intermittent or chronic course of depression. Furthermore, of the patients with a history of vascular disease, those with cerebrovascular disease most often showed a chronic course of depression. Cerebral small vessel disease, on top of existing cardiovascular disease contributes to depression. Depression is therefore an important clinical manifestation of both large (e.g. stroke) and small vessel disease in patients with high vascular burden. Patients with cardiovascular disease may require more careful clinical monitoring and management of depressive symptoms.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».