Apathy progression is associated with brain atrophy and white matter damage in Parkinson’s disease
Bibliographic record
Abstract
PD patients from the Parkinson's Progression Markers Initiative (PPMI), the present study aims to investigate these relationships. We used T1-weighted magnetic resonance imaging (MRI) and clinical data from 445 participants. Apathy was assessed as part of the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part I. We applied deformation-based morphometry (DBM) to quantify grey matter atrophy and used the Brain tISsue segmentatiON (BISON) algorithm to segment WMHs from T1-weighted images. Using linear regression models, we performed cross-sectional analyses to identify the associations between baseline brain measurements (DBM and WMH) and apathy severity. Longitudinal analyses utilized linear mixed-effects models to investigate whether baseline brain measurements were associated with future apathy progression over time, accounting for covariates such as age, sex, motion artefacts, Hoehn and Yahr stage, levodopa-equivalent daily dose (LEDD), Total Intracranial Volume (TIV) and baseline apathy. Hypothesis-based and exploratory analyses were conducted to confirm the results previously reported in the literature and explore potential new associations. No cross-sectional regional associations survived multiple comparison corrections. Longitudinal hypothesis-based models confirmed that baseline atrophy in regions such as the bilateral nucleus accumbens area, superior parietal, putamen, insula, left precuneus, right precentral and cerebellum grey matter was significantly associated with future apathy progression. Exploratory longitudinal analyses identified additional regions, including the bilateral lingual, parahippocampal, basal forebrain, ventral diencephalon, isthmus cingulate, thalamus, hippocampus, left middle temporal, right inferior temporal, pericalcarine, medial orbitofrontal, cuneus, where baseline atrophy was correlated with progression of apathy severity. Moreover, greater WMH burden, particularly in the frontal lobe, was associated with worsening apathy. These results highlight the influence of both grey matter atrophy and WMHs on apathy progression in PD.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 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".