D.3 Self-reported autonomic nervous system dysfunction among people with drug-resistant focal epilepsy
Bibliographic record
Abstract
Background: Autonomic nervous system (ANS) dysfunction in people with epilepsy (PwE) is a likely contributor to sudden unexpected death in epilepsy (SUDEP). However, the nature of autonomic dysfunction among PwE remains poorly understood. We aimed to delineate self-reported ANS functioning among people with drug-resistant epilepsy, a patient group at increased risk for SUDEP. Methods: People with focal drug-resistant epilepsy undergoing stereoelectroencephalography at the Epilepsy Monitoring Unit in London, Ontario completed the Composite Autonomic Symptom Score (COMPASS-31), a widely used questionnaire for ANS function. Results: The mean total COMPASS-31 score (N=34; 13 females) was 27.36 (SD=13.77). There was no significant correlation between total COMPASS-31 score and current age (mean=32.71 years, SD=10.58; r(32)= -0.04) or age of epilepsy onset (mean=17.31 years, SD=8.26; r(30)=0). Females scored higher than males (t(32)=3.41, p<.05), but scores did not differ between participants with an epileptogenic zone in the temporal lobe(s) (N=20) and participants with multi-focal, extra-temporal or unknown epileptogenic zones (t(32)=0.18). Participants prescribed 2-3 sodium channel blocking anti-seizure medications (cardiotoxic; N=17), scored worse than participants on 0-1 sodium channel blockers (N=17) (t(32)= -2.15, p<.05). Conclusions: Autonomic testing should be a standard component of clinical care for people with drug-resistant epilepsy, especially for females and for those on sodium channel blockers.
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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 | 0.000 | 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) | 0.003 | 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".