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Record W4366368052 · doi:10.1212/wnl.0000000000207282

CSF Findings in Relation to Clinical Characteristics, Subtype, and Disease Course in Patients With Guillain-Barré Syndrome

2023· article· en· W4366368052 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueNeurology · 2023
Typearticle
Languageen
FieldMedicine
TopicPeripheral Neuropathies and Disorders
Canadian institutionsUniversity of Calgary
FundersPrinses Beatrix SpierfondsLundbeckfondenUniversity of GlasgowArgenxGenentechGrifolsGBS/CIDP Foundation InternationalBristol-Myers SquibbEli Lilly and CompanyAstraZenecaCSL BehringH. Lundbeck A/SAlnylam PharmaceuticalsMedical Research CouncilBiogenEuropean CommissionDisarm TherapeuticsSanofiJohns Hopkins UniversityPfizer
KeywordsGuillain-Barre syndromeMedicineDiseasePediatricsInternal medicine

Abstract

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<h3>Objective:</h3> To investigate cerebrospinal fluid findings in relation to clinical and electrodiagnostic subtypes, severity, and outcome of Guillain-Barré syndrome based on 1500 patients in the International GBS Outcome Study. <h3>Methods:</h3> Albuminocytological dissociation was defined as an increased protein level (&gt;0.45 g/L) in absence of elevated white cell count (&lt;50 cells/µL). We excluded 124 (8%) patients due to other diagnoses, protocol violation or insufficient data. CSF was examined in 1231 patients (89%). <h3>Results:</h3> In 846 (70%) patients CSF examination showed albuminocytological dissociation, which increased with time from weakness onset: ≤4 days 57%, &gt;4 days 84%. High CSF protein levels were associated with a demyelinating subtype, proximal or global muscle weakness and a reduced likelihood of being able to run at week 2 (OR: 0.42 (95% CI 0.25-0.70; <i>p</i> = 0.001) and week 4 (OR: 0.44 (95% CI 0.27-0.72; <i>p</i> = 0.001). Patients with the Miller Fisher syndrome, distal predominant weakness and normal or equivocal nerve conduction studies were more likely to have lower CSF protein levels. CSF cell count was &lt;5 cells/µL in 1005 patients (83%), 5-49 cells/µL in 200 patients (16%) and ≥50 cells/µL in 13 patients (1%). <h3>Interpretation:</h3> Albuminocytological dissociation is a common finding in Guillain-Barré syndrome, but normal protein levels do not exclude this diagnosis. High CSF protein level is associated with an early severe disease course and a demyelinating subtype. Elevated CSF cell count, rarely ≥50 cells/µL, is compatible with GBS after thorough exclusion of alternative diagnoses. <h3>Classification of evidence:</h3> This study provides Class IV evidence that CSF albuminocytologic dissociation (defined by the Brighton Collaboration) is common in patients with GBS.

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.

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)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.322

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
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 head0.012
GPT teacher head0.272
Teacher spread0.260 · 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