0888 Individuals with REM sleep behavior disorder show increased parkinsonism with comorbid neurotrauma: A NAPS Consortium substudy
Bibliographic record
Abstract
Abstract Introduction Introduction: Rapid eye movement (REM) sleep behavior disorder (RBD) is strongly associated with progressive phenoconversion to an overt synucleinopathy (e.g., parkinsonism). Neurotrauma [i.e., traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD)], increases the odds of RBD diagnosis by ~2.5-fold and is associated with an increased later diagnosis of Parkinson’s Disease (PD), a service-connected illness in Veterans. Thus, RBD and neurotrauma are both independently associated with parkinsonism; however, it is unclear how neurotrauma influences neurological symptoms and exam findings in patients with RBD. Methods Methods: Participants ≥18 years of age with overnight polysomnogram-confirmed RBD were enrolled between 8/2018 to 4/2021 as part of the North American Prodromal Synucleinopathy (NAPS) Consortium. Standardized assessments for RBD, TBI, and PTSD history, as well as cognitive, motor, sensory and autonomic function were completed. This sub-study applied a cross-sectional, case-control (1:4 ratio) analysis comparing cases (n=24; RBD+TBI+PTSD) to controls (n=96; RBD) matched for age (±2 years), sex, and years of education (±2 years). Results Results: Participants with neurotrauma reported an earlier age of RBD symptom onset and more severe RBD phenotype, more severe anxiety and depression, greater frequency of hypertension, and significantly worse cognitive, motor, and autonomic function compared to participants without neurotrauma. Conclusion Conclusion: This cross-sectional, matched case:control study showed that individuals with comorbid neurotrauma and RBD have significantly worse neurological outcomes related to common features of early parkinsonism. Although confirmatory longitudinal studies are still ongoing, these results may be a sign of further/faster progression of synucleinopathy in those with comorbid neurotrauma and RBD. Support (if any) Support: NIH R34 AG056639, NIH U19 AG071754, VA RRD 1K2 RX002947, Parkinsons Center of Oregon
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".