MRI Predictors of Cognitive Function After Lacunar Infarction
Bibliographic record
Abstract
BACKGROUND: Poststroke cognitive impairment is associated with disability and decreased quality of life. We assessed whether individual or collective magnetic resonance imaging (MRI) biomarkers can aid in predicting cognitive impairment after lacunar infarction (LACI). METHODS: We conducted a retrospective analysis of data from the American Stroke Association Bugher Small Vessel Study, which included 134 patients within 2 years of an acute LACI, enrolled between 2007 and 2012 at 4 North Carolina hospitals. MRI brain measures at the time of the stroke included as follows: 1, total number of LACIs (index LACI and nonindex radiographic lacunes); 2, size of the largest lacune; 3, ventricular size; 4, cerebral atrophy; 5, radiographic locations (supratentorial, infratentorial, or both); and 6, white matter disease (WMD) extent. WMD extent, cerebral atrophy, and ventricular size were graded using the CHS (Cardiovascular Health Study) scores. The primary outcomes were as follows: 1, total score on Short-Form Montreal Cognitive Assessment to assess global cognition; and 2, time to complete TRAIL Making Test Part B (TMT-B) to evaluate executive function. Regression analyses were used to assess the association between the 6 MRI measures and cognitive function adjusting for demographic and clinical variables. RESULTS: One hundred thirty-four participants completed Short-Form Montreal Cognitive Assessment testing and 100 completed TMT-B at a mean of 76.5 (SD, 172.7) days from the index LACI. There were no associations between MRI characteristics and Short-Form Montreal Cognitive Assessment. On univariable analyses, cerebral atrophy (β=35 [95% CI, 14.17–55.83]; P =0.0010), ventricular size (β=40.1 [95% CI, 22.24–57.96]; P <0.0001), and WMD extent (β=55.25 [95% CI, 38.52–71.98]; P <0.0001) were each associated with TMT-B time. Extent of WMD was the only MRI measure associated with TMT-B time (β=37.74 [95% CI, 19.04–56.44]; P <0.0001). In adjusted models after performing variable selection, the extent of WMD remained the only MRI measure associated with TMT-B time. CONCLUSIONS: Among the assessed MRI measures, only the extent of WMD was independently associated with executive function after LACI.
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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 | 0.004 |
| 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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".