Chronic Neurological Impairment in Patients with Thrombotic Thrombocytopenic Purpura: Preliminary Findings in a Comprehensive MRI Protocol
Bibliographic record
Abstract
Background: Thrombotic thrombocytopenic purpura (TTP) is a life-threating blood disorder characterized by insufficient activity in ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13). This protein prevents blood clotting, so in TTP there is spontaneous clotting throughout the microvasculature. Treatment includes plasma exchange therapy and immunosuppressants to improve fever, thrombocytopenia, and kidney failure. However, neurological changes, such as seizures and confusion, persist. There is limited research on TTP on the brain but it is known that TTP presents similar pathology to stroke. This study aims to better understand the longterm impact of TTP on the brain using a comprehensive magnetic resonance imaging (MRI) protocol and cognitive testing. Methods: 13 patients (5 male, mean age 44.5) in hematological remission were recruited. Participants had a 65-minute MRI scan (Siemens mMR Biograph 3T) based on best-practice guidelines for imaging stroke. The protocol included five qualitative acqusitions and three quantitative acquisitions. Participants also completed a 40-minute cognitive test (Cambridge Brain Sciences) to assess cognitive impairment. Results: Table 1 summarizes the findings across qualitative acquisitions. The most salient findings were the white matter hyperintensities seen in the T2 FLAIR in Image 1. 12 participants completed the cognitive testing and there is evidence of cognitive impairment. Conclusions: Patients will be scanned again at six and twelve months. Agematched healthy controls will be recruited before drawing conclusions on quantitative metrics, namely the amount of white matter. These early results are promising for better understanding the implications of TTP on the brain. Funding: Private Foundation SupportSummary of qualitative findings
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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 | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.002 |
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".