Distinct cerebral amyloid angiopathy patterns in adult Down syndrome
Bibliographic record
Abstract
INTRODUCTION: Cerebral amyloid angiopathy (CAA) is an important component of the neuropathology of adult Down syndrome (DS); however, there is a paucity of its systematic in-depth analysis. MATERIALS AND METHODS: Eleven adult DS cases were analyzed for the presence, type, severity (Vonsattel grade), extension (Love grade), and advancement (Thal stage) of CAA using amyloid-beta immunohistochemistry. Hemorrhagic and iron pathologies were assessed by Perls staining, with double-stainings for co-localization. Descriptive/associative analyses were performed. RESULTS: 10/11 cases had CAA (DS-CAA), all reaching stage 3. 10/10 demonstrated severe/extensive leptomeningeal-predominant neocortical CAA. 7/10 had neocortical capillary involvement (Type 1), accompanying more extensive CAA. Cerebellar CAA was ubiquitous and severe, with lowering frequencies/grades in other stage 2-3 regions. Hemorrhagic alterations were found only in 5/10 patients, without gross hematomas. One patient had extreme cerebellar glial iron pathology, with scattered iron-containing glia being common in the cerebellum and neocortex of all DS-CAA cases, likely reflecting hypoperfusion. CONCLUSION: In this study unique in its depth and scale of analysis, CAA was found to be frequent, severe, and extensive in adult DS. Distinguishing features include the remarkable involvement of the cerebellum, the deep regions, and capillaries. The paucity of hemorrhages implies a complex mechanism for hemorrhage formation in CAA beyond vasculopathic severity. The observed iron pathology suggests the relevance of chronic hypoperfusion in DS-CAA.
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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) | 0.001 | 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".