P1‐185: White matter disease adversely influences cognition in idiopathic Parkinson's disease
Bibliographic record
Abstract
Cross sectional MR data have demonstrated white matter hyperintensity to independently contribute to cognitive impairment in MCI, AD and VaD. The influence of WMH on the cognitive status of PD patients has not been adequately studied. We aim to investigate the relationship between cognitive scores and WMH in Idiopathic Parkinson's disease. Cross-sectional analysis of a longitudinal study cohort. Patients diagnosed with Parkinson's disease using UK brain bank criteria, who fulfilled inclusion/exclusion criteria, were recruited from NNI Outpatient clinic between April and Dec 2011. Demographics, clinical information and scores on cognitive tests were collected. All patients underwent a 3T MRI scan, and Axial FLAIR sequences were scored for WMH using the modified Fazeka's scale (0-12). 66 PD patients - 33 Low WMH (Fazeka's score<4), 33 Mod-High WMH (Fazeka's ≥4) were identified. Both groups were comparable on age (Mean = 63.58years vs 66.64, P = 0.10), gender (66.67% Male vs 69.7%, P = 0.79), race (81.82% Chinese vs 90.91%, P = 0.28), years of education (10.64 vs 9.87, P = 0.32) and vascular risk factors (diabetes, hypertension, hyperlipidemia, smoking). Cognitive scores were poorer in the Mod-High group compared to low WMH group, even though they had shorter disease duration (4.47yrs vs 7.01yrs), less motor symptoms (UPDRS motor sub-score 16.25 vs 20.32) and were in the milder stage of disease (Hoehn & Yahr 1.82 vs 2.03). The Mod-High WMH group had lower scores on the Mini-Mental State Examination (27.45 vs 28.3), Montreal Cognitive Assessment (25.42 vs 27.03), Frontal Assessment Battery (16.12 vs 17.03) and Digit Span (16.16 vs 17.25), but the differences were significant, or approaching significance, only in the MoCA (P = 0.06) and FAB (P = 0.01) The Mod-High group were also consistently slower, albeit not statistically significant, on timed tasks - 100.81s vs 92.81s on Colour Trail 1, 162.23 vs 152.03 on Colour Trail 2, and 22.16s vs 19.19s on Maze. Further analysis showed that MoCA and FAB were negatively correlated with periventricular WMH (R = -0.266, P = 0.042 and R = -0.285, P = 0.029 respectively), but not with deep subcortical WMH. PD patients with Mod-High WMH have poorer cognitive scores, especially in executive functioning (e.g. FAB and Maze). Periventricular WMH appears to adversely influence cognition in idiopathic PD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".