Aneurysm Wall Enhancement and Systemic Inflammation Jointly Contribute to Cognitive Dysfunction in Untreated Unruptured Intracranial Aneurysm Patients
Bibliographic record
Abstract
Xiao-Bing Wu,1,* Bin Luo,2,* Xin Guo,2,* Chi-Chen Liu,2 Yi-Ao Liu,2 Jie-Shun Ye,3 Shao-Yi Fan,4 Qing-Jian Li,5 Sheng-Wen Wang1 1Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China; 2Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China; 3School of Civil Engineering and Transportation, South China University of Technology, Guangzhou, People’s Republic of China; 4Department of TCM, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China; 5Department of Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Sheng-Wen Wang, Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yanjiang West Road, Guangzhou, Guangdong, 510120, People’s Republic of China, Email wangshw9@mail.sysu.edu.cn Qing-Jian Li; Department of Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, No. 107, Yanjiang West Road, Guangzhou, Guangdong, 510120, People’s Republic of China, Email liqj33@mail.sysu.edu.cnBackground and Purpose: Peripheral inflammatory markers and aneurysm wall enhancement (AWE) on high-resolution vessel wall MRI (HR-VWI) may reflect inflammation in unruptured intracranial aneurysms (UIAs). We assessed cognitive function and its association with inflammatory markers in UIA patients.Methods: The study included 120 consecutive patients with UIAs diagnosed between September 2018 and December 2023 and a control group of 27 healthy adults at our institution. Neuropsychological function in these patients was evaluated using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAMA), and Self-Rating Depression Scale (SDS). A MoCA score of < 23 was classified as cognitive decline, while scores of ≥ 23 indicated normal cognitive function. The peripheral blood inflammatory markers and radiological characteristics were compared between the patients with cognitive decline and those with normal cognitive function. The presence of AWE and white matter hyperintensities (WMH) in UIA was identified through HR-VWI.Results: UIA patients demonstrated significantly poorer cognitive performance than controls, with lower MMSE (27.0 vs 29.0, P < 0.001) and MoCA scores (23.0 vs 25.0, P = 0.020). Patients with cognitive decline were older and exhibited elevated inflammatory markers (NLR, SII, hsCRP; all P < 0.05), along with higher rates of AWE and white matter hyperintensities (WMH) (both P < 0.001). Multivariate analysis identified AWE (OR = 5.33, 95% CI:1.82– 15.59), WMH (OR = 4.26, 95% CI:1.58– 11.49), and age (OR = 1.07, 95% CI:1.02– 1.12) as independent predictors of cognitive decline (all P ≤ 0.01). Moreover, the cognitive decline group also showed higher SDS and HAMA scores (P < 0.05), suggesting a correlation between emotional distress and cognitive impairment.Conclusion: Untreated UIA patients exhibit cognitive decline associated with systemic inflammation (NLR, SII, hs-CRP). AWE, WMH and age are independent risk factors, suggesting vascular inflammation contributes to cognitive dysfunction.Keywords: unruptured intracranial aneurysm, cognitive function, aneurysm wall enhancement, inflammation
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| 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 | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".