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Record W2952824507 · doi:10.33805/2641-8991.120

Double Hit Theory for the Development of Vascular Parkinsonism

2019· article· en· W2952824507 on OpenAlexaffabout
Herbert Manosalva

Bibliographic record

VenueNeurophysiology and Rehabilitation · 2019
Typearticle
Languageen
FieldMedicine
TopicParkinson's Disease Mechanisms and Treatments
Canadian institutionsSunnybrook HospitalUniversity of Toronto
Fundersnot available
KeywordsParkinsonismMedicineStroke (engine)Basal gangliaCohortPhysical medicine and rehabilitationPhysical therapyPediatricsInternal medicinePsychologyCardiologyDiseaseCentral nervous system

Abstract

fetched live from OpenAlex

Introduction: Identify the non-decoded network in Vascular Parkinsonism (VasP). Objective: To determine what pattern of stroke lesions is responsible for VasP, as compared to those patients who had stroke, gait and balance problems, but absence of a hypokinetic rigid syndrome also called Vascular Pseudo Parkinsonism-V PSeuP. Materials and Methods: Design: prospective cohort study. Participants were consecutively screened for parkinsonian symptoms during a year as according to our previous study. Validated questionnaire (Tanner Questionnaire-TQ) was used, and a new scale operationalizing the criteria for VasP (FMAS score). All participants in the original study had a clinical exam to identify if presence of a hypokinetic rigid syndrome. Lesion patterns were analyzed. Setting: tertiary care stroke prevention clinic at the University of Alberta Hospital. Participants: Eligible participants attained a score of ≥ 4 on the TQ, high risk for parkinsonism. Four groups were considered: V PseuP, VasP (onset of parkinsonism within a year of the stroke -FMAS score of 4), Pseudo Vascular Parkinsonism-PseuVP (hypokinetic rigid syndrome not related to stroke), and Pseudo Vascular Pseudo Parkinsonism-PseuV PseuP (no stroke and no extrapyramidal syndrome), but with gait and balance problems. Baseline demographic information and clinical characteristics were recorded including vascular risk factors, and stroke subtype. All participants had a Holter, CT head and/or brain MRI, and CTA. Medications that produce drug-induced-parkinsonism were recorded for every participant. The primary outcome was to find the pattern of anatomical lesions particularly involved in the VasP subgroup considering the Basal Ganglia Motor Output Circuit-BGMO, the Thalamo Cortical Drive Loop-TCD and connections to frontal cortex. Results: 240 consecutive participants were screened during 12 months. We found 46 patients with potential Parkinsonism (TQ>4). VPseuP was found in 25/46 (54%), VasP in 8/46 (17%), PseuVP in 7/46 (15%), and PseuV PseuP in 6/46 (14%). VasP were older (p<0.0007) and had a higher risk for cardio embolism due to atrial fibrillation (p=0.02, odd ratio 6.6 CI 95% (1.2 – 35.2)). Neuro images showed that only the pattern involving the BGMO and frontal cortex was significantly associated to the group of VasP (X2 Fisher exact test p<0.0005 Odds ratio 32 CI 95% (9.6-108)); whereas the pattern TCD was not significantly different between the groups (X2 Fisher exact test p=0.828 Odds ratio 1.2 CI 95% (0.5-2.8)). Discussion and Conclusion: A two strategic location hit within the BGMO circuit and frontal cortex is required, so a phenotype of VasP may occur.

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 distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.928
Threshold uncertainty score0.176

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.011
GPT teacher head0.257
Teacher spread0.246 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

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Citations0
Published2019
Admission routes2
Has abstractyes

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