Perfusion and Structural Impairment in Minor Stroke and Transient Ischemic Attack With Intracranial Atherosclerotic Stenosis: Associations With Cognitive Decline
Bibliographic record
Abstract
AIMS: To investigate the characteristics of hypoperfusion and structural impairment in patients with transient ischemic attack (TIA) or minor stroke (MS) with intracranial atherosclerotic stenosis (ICAS) and evaluate its impact on cognitive decline. METHODS: Cognitive function in 47 patients and 33 health controls (HC) was assessed using the Montreal Cognitive Assessment (MoCA) tool. Arterial spin labeling with two distinct postlabeling delays and 3D T1 imaging was conducted to assess cerebral blood flow (CBF), morphometric features, and asymmetry index (AI). RESULTS: Compared with HC, both the left and right involved patients showed reduced scores for total MoCA score. Comparisons of CBF with HC revealed that significant ischemic areas in patients were primarily localized to the perfusion territory of the middle cerebral artery in the affected hemisphere (p < 0.05, family-wise error [FWE] corrected). Despite morphometry abnormality being locally confined, AI exhibits more widespread alterations across a wider range of brain regions (both p < 0.05, FWE corrected). Both hypoperfusion and structural impairment were significantly associated with reduced MoCA score in left-involved patients, whereas only hypoperfusion showed a significant association in those with right-hemisphere involvement (p < 0.05, FWE corrected). Furthermore, the effect of ischemia on cognition was mediated by structural impairment and compensatory CBF simultaneously. CONCLUSION: These findings highlight that hypoperfusion and structural impairment are already concerning and jointly associated with cognitive impairment in MS/TIA patients with ICAS, emphasizing the need for early detection and intervention.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".