ELUCIDATING COGNITIVE IMPAIRMENT IN CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS
Bibliographic record
Abstract
PV158 / #289 Poster Topic: AS18 - Pediatric SLE Background/Purpose Childhood-onset systemic lupus erythematosus (cSLE) is characterized by a more severe disease and a high frequency of neuropsychiatric manifestations. Especially cognitive impairment (CI) is observed in around 40% of cSLE patients and associated with worse outcome in adult life. Here, we aimed to pursue the associations among serum cytokines, anti-P antibodies, the NMDA receptor antibodies, magnetic resonance imaging findings in cSLE patients with or without CI. Methods We did a cross-sectional study including consecutive cSLE patients with well characterized clinical and laboratory data. We evaluated CI through Pediatric-Automated Neuropsychological Assessment Metrics (Ped-ANAM). All included subjects had MRI performed with a 3T Philips Achieva (Best, The Netherlands). Sagittal T1-weighted images (3-dimensional acquisitions obtained in the sagittal T1-weighted gradient echo plane with 1 mm thickness, an angle of excitation of 35, a repetition time of 22 ms, a time to echo of 9 ms, a matrix of 240 × 240 pixels, a field of view of 230 × 250 cm, 1 × 1 pixel). MRI were analyzed using FreeSurfer and volBrain softwares. The concentration of cytokines was determined by Luminex immunoassay (MILLIPLEX map Human High Sensitivity T Cell Panel, Millipore, USA) according to the manufacturer’s protocol. The limit of detection was 0.48pg/mL for IFN-gamma, 1.12pg/mL for IL-4, 0.11pg/mL for IL-6, 0.56pg/mL for IL-10, 0.15pg/mL for IL-12 (p70) and 0.16pg/mL for TNF. When the concentration was undetectable, it was attributed the half of these values for statistical purposes. The concentration of NMDA NR-2 subunit receptor was determined by Enzyme-Linked Immunosorbent Assay (ELISA, Mybiosource, CA, USA) according to the manufacturer’s protocol, with the limit of detection of 0.09 ng/mL. The presence of anti-P was determined by Enzyme-Linked Immunosorbent Assay (ELISA, Quanta Lite™ Ribosome P, Ivona, CA, USA) according to the manufacturer’s protocol, and samples were classified as negative or positive. The Statistical Package for the Social Sciences software (IBM SPSS, version 22) was used for analysis. Results Eighty-five cSLE patients were included. There was no significant difference regarding the dosages of cytokines, NR-2 and anti-P in patients with or without CI. Patients with CI had impaired scores on 8 subtests and 3 indexes from Ped-ANAM. Also, the volumes of Central (p=0.035) and Mid Anterior (p=0.016) Corpus Callosum were significantly lower in the group with CI (p=0.045). NR-2 concentration correlated inversely with SLEDAI scores (p=0.021) and with the Cornu Ammonis 1 (CA1) volume (p=0.029). IL-4 correlated inversely with the Ped-ANAM scores (p=0.033), IL-10 correlated inversely with Total CA2 CA3 (p=0.012) and right CA2 CA3 volumes (p=0.014) and directly with Left Caudate volume (p=0.026). Also, IL-6 correlated inversely with Right CA2 CA3 volume (p=0.047). Conclusions Simple reaction time and procedural reaction time were the cognitive domains more often affected in cSLE patients with CI. We observed a significant reduction of corpus callosum and hippocampal subfields in cSLE associated with the presence of NR2 and inversely with IL6, suggesting that autoantibodies and cytokines may be associated with structural brain abnormalities and CI in cSLE.
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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 | 0.000 |
| 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) | 0.002 | 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".