Chronic Cortical Stimulation for Amyotropic Lateral Sclerosis: A Report of Four Consecutive Operated Cases after a 2-Year Follow-up: Technical Case Report
Bibliographic record
Abstract
OBJECTIVE AND IMPORTANCE: From April to July 2002, four consecutive patients affected by amyotrophic lateral sclerosis (ALS) were surgically treated with bilateral chronic cortical stimulation.. CLINICAL PRESENTATION: The preoperative diagnostic assessment was based on the results of a neurological examination, integrated by the ALS functional rating scale, electromyography, magnetic resonance imaging, and single-photon emission computed tomography (SPECT). In particular, SPECT provided a remarkable contribution in terms of its ability to demonstrate specific morphological and metabolic ALS lesions of the brain. INTERVENTION: The postoperative neurological follow-up was based mainly on the assessment of neurological status and the ALS functional rating scale, together with SPECT. Two years after surgery, at clinical examination, two patients demonstrated mild progression of their illness, and SPECT findings disclosed complete disappearance of ALS cerebral lesions, with apparent recovery of brain anatomic integrity. The third patient committed suicide. In the fourth patient, the disease seemed to have progressed inexorably at the time of clinical and SPECT monitoring, after transient improvement during the first 3 months after surgery.. CONCLUSION: These preliminary results are surprising, because they suggest that chronic cortical stimulation can play a role against ALS and deserve confirmation in larger numbers of patients and for a longer follow-up. We present the theoretical grounds for these findings, as well as the diagnostic and surgical procedures and results..
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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 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".