Progressive Cognitive Decline in a Patient With Isolated Chronic Neurosarcoidosis
Bibliographic record
Abstract
INTRODUCTION: Central nervous system manifestations of sarcoidosis are diverse. Cognitive decline is a recognized manifestation of neurosarcoidosis, yet detailed descriptions of this topic are limited in the literature. CASE REPORT: A 44-year-old man with long-standing isolated neurosarcoidosis presented with a 7-year history of progressive cognitive decline in multiple domains. Known manifestations of this patient's neurosarcoidosis included panhypopituitarism, seizures, and ventricular loculation, which required shunt placement. He had required ongoing immunosuppression for treatment. The patient's neuropsychological profile confirmed decline in multiple cognitive domains affecting memory, basic and more complex attention skills, processing speed and flexibility, perceptual and constructional skills, and aspects of abstract thinking and problem-solving. His gross cognitive status was borderline, with relative preservation of verbal skills, and significant impairment of visuospatial skills. Overall, this patient's neuropsychological profile was suggestive of diffuse involvement, with frontal/ subcortical mechanisms appearing predominantly affected, perhaps with greater involvement of right hemisphere systems. CONCLUSIONS: This patient's progressive cognitive decline was attributable primarily to ongoing inflammatory disease from neurosarcoidosis. This case is discussed in the context of the existing literature on cognitive impairment and neurosarcoidosis, and adds to the small body of literature surrounding the chronic neurologic manifestations of this disease.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| 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".