Associations between cerebral small vessel disease and obstructive sleep apnea in patients with ischemic stroke and TIA (S6.006)
Notice bibliographique
Résumé
Objective: (1) To examine the relationship between OSA severity and Small Vessel Disease (SVD) in patients with ischemic stroke/TIA. (1a) To assess whether these associations may be present only in select brain regions with specific types of SVD. (2) To examine the relationship between OSA, SVD and cognition. Background: Cerebral small vessel disease (SVD) is the most common cause of vascular dementia. On MRI SVD manifests as White Matter Hyperintensities (WMH), lacunes, enlarged perivascular spaces and microbleeds. Obstructive Sleep Apnea (OSA) is the most common sleep disorder and meta-analytic data supports a relationship between OSA and SVD. The purpose of this study is to examine relationships between: (1) OSA severity and SVD (2) OSA severity, SVD and cognition. Design/Methods: Patients with ischemic stroke/TIA were prospectively recruited across three independent cohort studies. Years of education, vascular risk factors, stroke severity and Montreal Cognitive Assessment scores were collected. All patients completed MRI and either an in-laboratory polysomnography (PSG) or Home Sleep Apnea Test (HSAT). OSA severity was quantified using the Apnea Hypopnea Index (AHI). The burden of small vessel disease was quantified using validated visual rating scales. Ordinal logistic regression models examined relationships between OSA and SVD, while controlling for covariates. Results: In 237 patients increasing AHI was associated with a greater burden of periventricular WMH (pWMH) OR=1.02 (CI:1.01 to 1.04, p=0.02), deep microbleeds OR=1.03 (CI:1.01 to 1.05, p=0.002) and lobar microbleeds OR=1.02 (CI:1.01 to 1.04, p=0.03). Finally, in an ordinal logistic regression model, lower cognitive scores were related to cerebral microbleeds OR=1.09 (CI:1.01 to 1.18, p = 0.03) while controlling for covariates. Conclusions: OSA severity is associated with greater periventricular WMH and cerebral microbleeds. Cerebral microbleeds are predictive of lower cognitive scores. The relationship between OSA and both lobar and deep microbleeds suggests potential associations with nocturnal hypertension and cerebral amyloid clearance. Disclosure: Dr. Muir has nothing to disclose. Ms. Dharmakulaseelan has nothing to disclose. Dr. Black has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Hoffmann-La Roche. Dr. Black has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Black has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffmann-La Roche. Dr. Black has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Black has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Black has received research support from Hoffmann-La Roche. The institution of Dr. Black has received research support from Biogen. The institution of Dr. Black has received research support from GE Healthcare. The institution of Dr. Black has received research support from Eli Lilly. The institution of Dr. Black has received research support from Genentech. The institution of Dr. Black has received research support from NovoNordisk. The institution of Dr. Black has received research support from UCB Biopharma. The institution of Dr. Black has received research support from Alkahest Inc. The institution of Dr. Black has received research support from University of Southern California - AHEAD 3-45 Study. The institution of Dr. Murray has received research support from Wake Up Narcolepsy. Dr. Murray has received publishing royalties from a publication relating to health care. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Paladin Labs. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. Dr. Boulos has received research support from Interaxon. The institution of Dr. Boulos has received research support from The Mahaffy Family Research Fund. The institution of Dr. Boulos has received research support from Canadian Institutes of Health Research. The institution of Dr. Boulos has received research support from Slamen-Fast New Initiatives in Neurology Award. The institution of Dr. Boulos has received research support from Green Mountain . Dr. Boulos has received personal compensation in the range of $5,000-$9,999 for serving as a speaker with Jazz Pharmaceuticals.
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 | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 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 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
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 ».