Predictors of future deep brain stimulation surgery in de novo Parkinson’s disease: analysis of the PPMI cohort
Bibliographic record
Abstract
Abstract Introduction: Deep brain stimulation (DBS) surgery is offered to a subset of Parkinson’s disease (PD) patients. It is unclear if there are features at diagnosis that predict future DBS surgery. Our primary aim was to assess predictors of eventual DBS surgery in de novo PD patients. A secondary aim was to characterize disease progression over four years. Methods: Subjects from the Parkinson’s Progression Marker Initiative (PPMI) database with newly diagnosed, sporadic PD (n=416) were identified and their eventual DBS status was noted (DBS+, n=43; DBS-, n=373). Fifty baseline clinical, imaging, and biospecimen features were extracted for each subject and cross-validated lasso regression was used for feature reduction. The identified features were used in multivariate logistic regression to assess their relationship with DBS status and a receiver operating characteristic curve was constructed to evaluate model performance. Linear mixed effect models were used to explore differences in disease progression over four years. Results: Age at symptom onset, Hoehn and Yahr (H&Y) stage, tremor score, and ratio of CSF Tau to amyloid-beta 1-42 (Tau:Ab) were identified as important baseline features for predicting DBS surgery. A multivariate logistic regression demonstrated age (p < .001), H&Y stage (p = 0.026), tremor score (p <.001), and CSF Tau:Ab (p = .003) independently predicted DBS surgery (area under the curve = 0.83). DBS- patients had faster memory decline (p < .05), while DBS+ patients had faster decline in H&Y stage (p < .001) and motor scores (p<0.05).View Large Image Figure ViewerDownload Hi-res image Download (PPT)View Large Image Figure ViewerDownload Hi-res image Download (PPT) Conclusion: The identified features can be used for early identification of patients who may be surgical candidates during the course of their disease. Disease progression in these groups reflects surgical eligibility criteria, with DBS- patients having more rapid decline in memory while DBS+ patients experienced a faster decline in motor scores. Research Category and Technology and Methods Clinical Research: 17. Epidemiology Keywords: Deep brain stimulation, Parkinson's disease, Predictors
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| 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".