Peripheral inflammatory state in idiopathic normal pressure hydrocephalus patients: a cross-sectional study
Bibliographic record
Abstract
BACKGROUND: Neuroinflammation may be involved in the pathogenesis of idiopathic normal pressure hydrocephalus (iNPH). However, the specific changes in the peripheral inflammatory state of patients with iNPH remain unclear. OBJECTIVE: To explore the changes in the peripheral inflammatory state of patients with iNPH and their potential value as biomarkers of clinical diagnosis and disease severity. METHODS: In this cross-sectional study, 119 iNPH patients with AD-negative pathology and 200 healthy controls (HCs) were enrolled. Clinical characteristics, including the Idiopathic Normal Pressure Hydrocephalus Grading Scale (iNPHGS), Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), were collected along with inflammatory parameters in the peripheral blood. Logistic regression was applied to evaluate differences in peripheral inflammatory indicators, adjusting for age, sex, and comorbidities. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the inflammatory markers. Correlations between inflammatory parameters and clinical characteristics were assessed. RESULTS: Significant differences in inflammatory parameters, such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and prognostic nutritional index (PNI), were observed between iNPH patients and HCs after adjusting for age, sex and comorbidities. The combination of PNI and platelet-to-high-density lipoprotein ratio (PHR) distinguished iNPH patients from HCs most significantly (area under the curve [AUC] = 0.820). Neutrophil ratio and lymphocyte ratio were associated with clinical severity and cognitive impairment of patients with iNPH. CONCLUSIONS: iNPH patients exhibit an elevated peripheral inflammatory state. Peripheral inflammatory parameters, especially neutrophil ratio and lymphocyte ratio, are associated with disease severity and cognitive impairment, suggesting their potential as therapeutic targets and offering new insights into the pathophysiology of iNPH. Additionally, the inflammatory peripheral parameters may serve as valuable and convenient method in assisting clinical diagnosis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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) | 0.000 | 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 teacher head, 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".