Acute weight loss and alexythymia after stroke in the right caudate nucleus
Bibliographic record
Abstract
Case presentation: 78-year-old woman, admitted to a neurology outpatient clinic complaining of weight loss of 30 kg after an ischemic stroke 6 months ago. Refers to a patient who had chest pain 6 months ago and underwent cardiac catheterization in the emergency room with normal results. Immediately after the procedure, she presented left hemiparesis, followed by hyporexia and adipsia. She reported not feeling hungry or thirsty and when she ate felt disgust and a sensation of change in the texture and flavor of the food (as if she were drinking oil). Her behavior from extroverted and communicative changed to reclusive with a feeling of social inadequacy and difficulty identifying and expressing what she felt, her mood became depressed. The neurological examination showed left hemiparesis with hyperreflexia and the presence of striatal hand (Fig.1). Mini-Mental State Examination1 23/30, Montreal Cognitive Assessment2 13/30, Depression Scale3 (Zung) 46/80, Toronto Alexithymia Scale4 73/100. Brain magnetic resonance imaging (MRI) showed hyperacute ischemic insult in the right caudate nucleus (Fig. 2). Discussion: The Caudate Nucleus (CN) contains several neuronal clusters that are functionally connected to cortical areas that are part of networks involved in the cognitive and emotional process, whose lesions compromise multiple cognitive and behavioral domains. Personality change, psychiatric disorders, and cognition symptoms can do clinical syndrome. Lesions located in the right CN through their interconnections, with the orbitofrontal, medial and anterior prefrontal, and cingulate cortical areas, are involved in these behaviors. We report the case of a 78-year-old woman, who, in addition to the motor deficit, developed acute weight loss, mood changes, hyporexia, adipsia, bizarre taste perceptions, and alexithymia, which we infer as possible disconnection of networks with the right insula and hypothalamus. The cognitive and emotional consequences of CN lesions, as illustrated in the patient, emphasize the concept of network disturbance as a cause of cognition and behavioral manifestations of vascular disorders. Final comments: There are few studies on cognition and behavioral disorders caused by unilateral CN injury. Although these syndromes present strong similarities, there are subtle differences, which likely reflect the specific contribution of neuronal processing within each cognition and emotional network.
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".