Predictive value of the combined DTI-ALPS index and serum creatinine levels in mild cognitive impairment in Parkinson’s disease
Bibliographic record
Abstract
Objective To identify independent risk factors for Parkinson disease mild cognitive impairment (PD-MCI) and develop a prediction model integrating clinical indicators, blood biomarker, and neuroimaging data, aiding in detection and intervention. Methods A retrospective study was conducted with 150 PD patients. The PD-MCI group (n = 64) and PD with normal cognition (PD-NC, n = 86) were identified using the Montreal Cognitive Assessment scale. Data on demographics, motor symptoms, cognitive function, quality of life, blood markers, and diffusion tensor imaging along perivascular spaces (DTI-ALPS) were collected. Univariate analysis identified significant variables, and multivariate logistic regression identified independent risk factors. A nomogram prediction model was developed using R software. Model performance was evaluated using Receiver Operating Characteristic (ROC) curves, bootstrap resampling calibration curves, and decision curve analysis (DCA). Results Significant differences between the groups were found in levodopa equivalent daily dose (LEDD), PD Quality of Life Questionnaire, creatinine, cystatin C, and ALPS index. Multivariate regression identified higher LEDD (OR = 1.01, 95%CI 1.00–1.03, p = 0.005) and creatinine levels (OR = 1.34, 95%CI 1.10–1.66, p = 0.005) as independent risk factors. The nomogram model demonstrated strong discriminatory ability (AUC = 0.864, 95%CI 0.807–0.922) and good calibration. DCA showed a significant net benefit within clinical threshold ranges. Conclusion This study developed a PD-MCI prediction model incorporating DTI-ALPS and clinical blood biomarkers. It confirmed that LEDD and creatinine levels are independent risk factors, with high clinical value for early screening and individualized treatment.
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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 | 0.003 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".