P3‐010: MULTIPLE SCLEROSIS MASQUERADING AS ALZHEIMER'S TYPE DEMENTIA: CLINICAL, RADIOLOGICAL, AND PATHOLOGICAL FINDINGS
Bibliographic record
Abstract
We aim to report clinical, radiological and pathological findings on a patient with clinical features of Alzheimer's disease (AD), but with cortical demyelination as the primary pathological diagnosis. We shall demonstrate that cortical demyelination can mimic neurodegenerative disease. This 57-year-old woman presented with progressive cognitive decline and a background of a single episode of optic neuritis. Examination demonstrated a subtle left internuclear ophthalmoplegia, with no other focal neurological signs. T2-weighted brain MRI demonstrated periventricular and corpus callosum high signal. Spinal fluid oligoclonal band testing and IgG synthesis rate were normal. Cognitive decline was associated with cortical atrophy on serial MRI scans, without accumulation of T2 weighted white matter lesions over 13 years. The rate of increase in her ventricular volume (5.5 cm3/year; 95% CI, 5.0-6.0 cm3/year) was comparable to that of 46 subjects with amnestic mild cognitive impairment who progressed to AD. Progressive impairment in frontal and subcortical domains was demonstrated on neuropsychometric testing. Fluorodeoxyglucose positron emission tomography (FDG-PET) revealed temporal lobe hypometabolism. She was diagnosed with Alzheimer type dementia antemortem. Autopsy demonstrated chronic inactive-type demyelinated white matter lesions, with mild infiltration by activated microglia and lymphocytes, and fibrillary gliosis. Neurofibrillary tangles were moderate in the entorhinal cortex and hippocampus, and rare in the amygdala. Beta-amyloid deposits and TDP43 inclusion were absent, a finding inconsistent with the pathologic diagnosis of Alzheimer's or frontotemporal dementia. Myelin immunohistochemistry showed the presence of widespread and extensive cortical subpial demyelination (Figure 1). Subpial lesions affected the upper cortical layers and often extended to the entire width of the cortex, and involved multiple adjacent gyri of all cerebral lobes and type of cortices, but not the cerebellar cortex. Demyelinated lesions also involved the deep grey structures, the brainstem grey matter nuclei and the anterior horns of the spinal cord bilaterally.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".