Phenotypes and course of restless legs syndrome in acute stroke survivors – a prospective observational cohort study
Bibliographic record
Abstract
STUDY OBJECTIVES: The objective of this study was to determine Restless legs syndrome (RLS) phenotypes and course in patients with recent acute stroke and evaluate the relationship with different cardio-cerebrovascular factors. METHODS: Consecutive acute stroke patients were recruited from the stroke unit of the Kingston Health Sciences Centre, Canada. A pre-determined sleep questionnaire was administered, and details of stroke, brain imaging and hematological investigations were collected from the hospital database for analysis. RLS diagnosis was confirmed in accordance with the criteria determined by the International Restless Legs Syndrome Study Group. RESULTS: Out of 113 acute stroke patients that could be enrolled, 30 patients (26 %) could be diagnosed as RLS, the majority of them being women. Among these, 6 patients (20 %; 5.3 % of entire acute stroke cohort) presented with acute onset symptoms, while 24 (80 %; 21 % of entire stroke cohort) had chronic RLS. Half of these patients showed similar or worsening RLS symptoms upon a three-to-six-month follow-up. RLS diagnosis showed a statistically significant association with subcortical stroke location (p = 0.006; OR3.4 95 % CI1.4-8.1) and cerebral small vessel disease (CSVD)(p = 0.0006; OR4.6 95 %CI 1.9-11.3). CONCLUSION: In this prospective observational follow-up study, we observed three distinct RLS phenotypes - chronic bilateral, chronic unilateral and acute, along with association of RLS with subcortical brain location of the stroke and CSVD. Symptom persistence beyond 6 months post-stroke was observed in almost half of those with an RLS diagnosis. Observations from this study can provide a framework for structured diagnostic and treatment strategies for RLS among stroke survivors.
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| 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".