Cognition and obstructive sleep apnea in Parkinson’s disease: randomized controlled trial of positive airway pressure
Bibliographic record
Abstract
STUDY OBJECTIVES: This randomized controlled trial assessed the effects of positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) on cognition in patients with Parkinson's disease (PD). METHODS: Individuals with PD with Montreal Cognitive Assessment (MoCA) ≤ 27 and OSA were randomized to PAP or nasal dilator strips (placebo) for 6 months. The primary outcome was the change in MoCA from baseline to 6 months compared by t-test between groups by intention to treat (ITT). Sensitivity and per protocol (PP) analyses were performed, adjusting for potential confounders. Secondary outcomes included patient-reported and motor outcomes. Exploratory outcomes comprised detailed neurocognitive tests. FINDINGS: We randomized 94 participants (31% female) with a mean age of 67.3 (standard deviation 10.5) years, body mass index of 28.1 (4.7) kg/m2, and MoCA of 22.7 (3.5). The change in MoCA in the PAP group (n = 48) was 0.60, 95% CI [-0.08, 1.29] and in the control group (n = 46) -0.39, 95% CI [-1.21, 0.43]; between-group difference 1.00, 95% CI [-0.06, 2.05] (ITT). Adjusted ITT analyses showed improved MoCA by 1.44, 95% CI [0.09, 2.79], in treated versus control groups. In PP analyses, the adjusted between-group difference was 1.43, 95% CI [0.054, 2.81] between PAP (n = 33) versus control (n = 41) groups. Nonmotor symptoms, depression and sleep quality scores, and performance on certain executive and psychomotor tasks improved with PAP. PP analyses also showed significant improvement in motor function in PAP compared to control groups. CONCLUSIONS: Evaluation for OSA in PD patients with reduced cognition should be considered as OSA treatment may improve cognitive function, and possibly patient-reported and motor outcomes. CLINICAL TRIAL INFORMATION: Registered as "Cognition and Obstructive Sleep Apnea in Parkinson's Disease, Effect of Positive Airway Pressure Therapy (COPE-PAP)" at ClinicalTrials.gov. ID: NCT02209363. https://clinicaltrials.gov/study/NCT02209363?term=kaminska&rank=4.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 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".