Significance of cerebrovascular reactivity in patients with systemic lupus erythematosus
Bibliographic record
Abstract
There is growing recognition and concern regarding cognitive dysfunction in patients with systemic lupus erythematosus (SLE). SLE patients have accelerated atherosclerosis, which is known to contribute to cognitive dysfunction in other disease states. Impaired cerebrovascular reactivity (CVR) is a vascular measure linked to cognitive dysfunction, but this has not been well studied in the setting of SLE. The objectives of this study are to determine whether CVR is impaired in patients with SLE and to determine the significance of CVR impairment. Right middle cerebral artery CVR was assessed by the breath holding index (BHI), which combines transcranial Doppler recording and passive breath holding. This technique evaluates changes in middle cerebral artery Doppler velocities upon permissive hypercapnea. We measured the BHI in nine female patients with SLE (age 38 ± 13 years) and 12 age-matched controls. Cognitive function was assessed using the color Stroop block time test (SBT) and the Stroop black/white test (SBWT). The augmentation index, a measure of arterial wave reflection, was assessed by applanation tonometry of the radial artery. Carotid intimal media thickness measurements were obtained with high-resolution ultrasound. Completion times for the SBT (38.4 ± 8.7 vs. 29.5 ± 6.6) and the SBWT (29.7 ± 5.4 vs. 22.9 ± 5.8) were significantly higher in SLE patients versus controls ( P = 0.005 and P = 0.004 respectively). On CVR testing, right middle cerebral artery BHI responses were significantly different between SLE and NLS (0.91 ± 1.10 vs. -0.99 ± 1.7, P = 0.001). There was a trend towards higher CIMT (0.634 ± 0.130 cm vs. 0.549 ± 0.116 cm, P = 0.10) and towards higher AI (27 ± 16% vs. 18 ± 9%, P = 0.10) in the SLE group. CVR was significantly correlated with AI (0.68, P = 0.003), and a trend with SBT ( r = 0.42, P = 0.07) and CIMT ( r = 0.45, P = 0.08). On multivariate analysis (with age and SLE), SLE was a significant predictor of BHI ( B = 1.84, P = 0.033). SLE is associated with impaired CVR. Impaired CVR appears related to higher wave reflection as measured by the AI. This ongoing study will help define the relations between CVR and other vascular parameters as well as potential relations with cognitive dysfunction in SLE patients.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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".