Abstract TP33: Microhemorrhages and Cortical Superficial Siderosis in Cognitively Impaired Patients: Prevalence and Risk Factors
Bibliographic record
Abstract
(1) Background: Cerebral microbleeds (MBs) and cortical superficial siderosis (cSS) can be seen in a multitude of etiologies. The risk factors for cerebral MB and cSS and their relationship with cognitive decline are not well known. (2) Objective: This study aimed to explore the risk factors for cerebral MBs and cSS and to examine their impact on cognitive function in a cohort of cognitively impaired patients. (3) Methods: We conducted a case-control study involving 415 patients who underwent a brain magnetic resonance imaging (MRI) with a dementia protocol and cognitive assessments at the University Health Network, Mount Sinai Hospital, and Women's College Hospital in Toronto from 2014 to 2022. Cognition was assessed using the Mini-Mental State Examination (MMSE) and/ or the Montreal Cognitive Assessment (MoCA) The case group (n=137) included patients with cerebral MBs and/or cSS, while the control group (n=278) was comprised of randomly selected patients for cognitive impairment and underwent the same MRI protocol. We also evaluated the location of the MB including if deep, lobar or mixed MB. White matter hyperintensities (WMH) were graded using the Fazekas scale, wherein severity is assessed from 0 to 3. We performed Multivariate logistic regression to identify risk factors associated with cerebral MBs and cSS. (4) Results: Patients with MBs and/or cSS were older and had a higher prevalence of hypertension compared to the control group. In the multivariate analysis, age (OR = 1.05, 95% CI: 1.02-1.08, p = 0.002), hypertension (OR = 2.67, 95% CI: 1.75-4.08, p < 0.001), and higher Fazekas scores (OR = 1.58, 95% CI: 1.22-2.06, p < 0.001) were associated with cerebral MBs and cSS. Cognitive scores were significantly lower in the group with MB and cSS (MMSE: 22.3 vs. 26.1; MoCA: 19.7 vs. 24.8, both p < 0.001). Regression analysis showed that MB location did not significantly affect cognitive scores. The estimates for deep (0.45, 95% CI: -0.38 to 1.27; p < 0.286), lobar (-0.17, 95% CI: -0.55 to 0.21; p < 0.379), and mixed (-0.12, 95% CI: -0.47 to 0.24; p < 0.522) (5) Conclusions: Age, hypertension, and small vessel disease as measured by Fazekas scale are significant risk factors for cerebral MBs and cSS. Cognitive impairment was more severe in those with MBs and cSS and not related to their location. It is essential to manage vascular risk factors, such as hypertension,as this is ssociated with MBs and cSS , which are associated with worse cognitive impairment
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| 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) | 0.003 | 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".