1021 Cognitive, Motor, and Autonomic Function Impairments in Idiopathic REM Sleep Behavior Disorder
Bibliographic record
Abstract
The majority of patients with idiopathic REM sleep behavior disorder (iRBD) are thought to have prodromal synucleinopathy. 25–60% of iRBD patients have olfactory, orthostatic blood pressure, cognitive, or motor impairments suggestive of underlying neurodegeneration. We describe objective measure impairments in the Mayo Clinic iRBD registry cohort at baseline and one-year follow-up. We included adults diagnosed with iRBD by ICSD-3 criteria, and excluded symptomatic RBD patients with mild cognitive impairment, dementia with Lewy bodies, Parkinson disease, or multiple system atrophy. We considered clinical measures as abnormal when subjects met age-sex defined cut-offs for the brief Smell Identification Test (B-SIT) and neurocognitive assessments (Montreal Cognitive Assessment (MoCA), Kokmen Short Test of Mental Status (STMS), and King-Devick Test (KDT)), orthostatic systolic blood pressure (SBP) drop ≥ 10 mm Hg, or timed up and go (TUG) speed > 7.5 seconds. 59 iRBD subjects participated, with 24 (40.7%) having one-year follow-up. Mean age at baseline was 65.8 (range 21–84) years, and 18 (30.5%) were women. Dream enactment symptom duration was 9.85 ± 13.01 years. 26 (44.1%) were receiving antidepressant medications. Mean (range) measure scores were: B-SIT 8.7 (2–12); MoCA, 26.4 (20–30); STMS, 34.7 (27–38); KDT, 58.4 (39.2–125.6); SBP drop, 15.3 (1–49); and TUG, 8.3 (5.3–12.8) seconds. Patients with abnormal baseline measures included: B-SIT, 24 (33.9%); MoCA, 20 (33.4%); STMS, 2 (3.4%); KDT, 19 (32.2%); SBP drop, 24 (41.4%); and TUG, 39 (69.6%). At least one baseline measure was abnormal in 54 (91.5%) patients, and two or more in 37 (62.7%). There were no significant differences in measures for patients receiving antidepressant medications at baseline, or for serial measures at one-year follow-up. 91.5% of iRBD patients had impairment in at least one baseline characteristic of underlying prodromal synucleinopathy. Further longitudinal analyses of this cohort compared to matched controls is planned. Mayo Clinic CCaTS.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".