Gray Matter Volume Correlates with Information Processing as Measured by the Symbol Digit Modalities Test (SDMT) but Not with Physical Disability as Measured by the Expanded Disability Status Scale (EDSS) in Patients with Secondary Progressive Multiple Sclerosis (SPMS): Analysis of Baseline Correlations from the ASCEND Natalizumab Study (P6.143)
Bibliographic record
Abstract
OBJECTIVE: To evaluate clinical correlates of brain tissue loss in progressive multiple sclerosis using baseline data from the ASCEND study of patients with SPMS. BACKGROUND: Previous studies showed that most brain tissue loss in SPMS affects gray matter (GM) rather than cerebral white matter. Clinical correlates of GM loss in SPMS are not well understood. DESIGN/METHODS: ASCEND is a phase 3b, randomized, double-blind, placebo-controlled study of natalizumab in SPMS patients. The primary endpoint is a composite of the EDSS, Timed 25-Foot Walk (T25FW), and Nine-Hole Peg Test (9HPT). Additional endpoints measure whole-brain (WB) and GM volumes with MRI and assess cognitive function using the SDMT in all patients and a composite measure (MS-COG) in a substudy. Pairwise correlations between brain volumes and measures of physical disability and cognitive function were evaluated from pooled blinded ASCEND baseline data using Spearman’s rank correlation coefficient (rho). RESULTS: Baseline mean EDSS score was 5.6 (N=889 enrolled patients). Median baseline WB, total GM, and cortical GM volumes were 1426.58 mL, 654.50 mL, and 518.84 mL, respectively. Mean (SD) baseline SDMT score was 38.76 (13.661). GM volumes were moderately correlated with SDMT (rho: total GM, 0.47; cortical GM, 0.45) but not with EDSS (rho: total GM, −0.06; cortical GM, −0.05) or T25FW (rho: total GM, −0.11; cortical GM, −0.11). Correlations between brain volumes and 9HPT ranged from −0.20 to −0.21 (dominant hand) and from −0.21 to −0.22 (nondominant hand). Similar correlation patterns were observed in patient subgroups with higher (蠅6.0) or lower (≤5.5) baseline EDSS scores. Correlations involving additional measures including WB volume and MS-COG results will also be presented. CONCLUSIONS: In ASCEND patients at baseline, GM volumes correlated with measures of information processing but not with EDSS or T25FW, demonstrating the importance of measuring cognitive function in SPMS clinical trials. Study supported by: Biogen Idec.
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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 | 0.001 | 0.002 |
| 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) | 0.001 | 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".