Hypothalamic structure and function in Alzheimer’s disease and Lewy-body dementia: a systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Background Changes to sleep, weight, and endocrine function are common in Alzheimer’s disease (AD) and Lewy-body dementia (LBD). The cause of these is not known, but they may be related to hypothalamic neurodegeneration. Methods We performed a systematic search of MEDLINE and EMBASE of studies using structural magnetic resonance imaging to examine hypothalamic volume in people with AD or LBD. The Newcastle-Ottawa scale was used to assess the risk of bias. A random-effects meta-analysis was conducted using the standardised mean difference (SMD) in hypothalamic volume as the effect measure, and a narrative synthesis was used to examine the relationship between hypothalamic volume and sleep, eating, and endocrine function. Results We identified 6542 articles which resulted in 12 included studies, most which had a low to moderate risk of bias. The meta-analysis included 454 people with mild-moderate AD (Mini-Mental State (MMSE) range: 19.2-26.1) and 715 controls. We found that people with AD had a significantly smaller hypothalamus (pooled SMD: -0.49, t=-3.47, p=0.018, 95%CI: -0.86 to - 0.13). There was significant heterogeneity of a moderate degree (Tau 2 =0.0665, 95%CI:0.005-0.8090; I 2 =67%, 95%CI:21.5%-86.1%; Q=15.16, p<0.01), but no evidence of publication bias. Only one study examined people with LBD, finding qualitative evidence of lower hypothalamic volume compared to controls. Hypothalamic volume loss in AD was more marked in men and may be associated with plasma levels of sex hormones and decreased bone mineral density. Conclusion Reduced hypothalamic volume is seen early in AD and LBD and this may influence endocrine function. A better understanding of hypothalamic degeneration in dementia may help elucidate how pathology relates to symptoms in AD and LBD and reveal new targets for intervention.
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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 | 0.012 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.020 | 0.032 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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 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".