Cerebral small vessel disease in memory center patients with dementia with lewy bodies and Alzheimer’s disease
Bibliographic record
Abstract
INTRODUCTION: Cerebral small vessel disease (CSVD) is a common co-pathology in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). A comprehensive characterization of CSVD load in DLB and AD patients referred to a memory center is lacking. METHODS: In this retrospective study, we collected data from patients with a clinical DLB diagnosis or clinico-biological AD diagnosis, evaluated at our memory center. They were assessed for CSVD MRI features, including enlarged perivascular spaces (PVS), presence of cerebral amyloid angiopathy (CAA) and hypertensive arteriopathy (HTNA). Differences in CSVD features between AD and DLB and across clinical stages were investigated. Regression models were used to evaluate the association between (i) cerebrovascular risk factors (CVRF) and HTNA, and (ii) CSVD features and cognition as expressed by Montreal Cognitive Assessment (MoCA). RESULTS: We included 71 DLB (76.8 ± 7.4 years old, 25 females) and 71 age- and sex-matched AD patients (and 75.2 ± 5.3 years old, 27 females). Probable CAA, according to current Boston 2.0 criteria, was observed in 22.5% of DLB and 35.2% of AD patients, while any (probable + possible) CAA rate was higher in the two groups (71.8% and 91.5%, respectively). A moderate/severe HTNA was present in 45% of DLB and 28.2% of AD patients. When comparing the two groups, DLB presented with higher HTNA score (p =.012), while AD patients had higher prevalence of any CAA (p =.002). Patients with DLB had a greater PVS burden in the basal ganglia (p =.011) and centrum semiovale (p =.004) and higher number of deep microbleeds (p =.004). Certain HTNA-related features were more pronounced at dementia stage, with respect to mild cognitive impairment. No association was observed between CVRF and HTNA. Regarding the association between CSVD and cognition, only deep microbleeds count was related to MoCA in DLB patients. DISCUSSION: DLB or AD patients present with high CSVD burden and differ in terms of features and subtype. Patients with DLB present with increased HTNA, PVS load and deep microbleeds, while patients with AD present with a higher any CAA prevalence. CSVD might impact global cognition.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| 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".