Carotid Artery Disease in Cerebral Small Vessel Disease and Dementia
Bibliographic record
Abstract
Introduction Carotid artery disease (CAD) is a recognised important cause of stroke. However, its relationship with cerebral small vessel disease (SVD) and dementia remains unclear. We hypothesized that CAD in older individuals significantly affects cerebral perfusion, and leads to cerebral SVD. Methods We performed a clinicopathological study in patients from the Cognitive Function After Stroke (CogFAST) study and prospectively recruited dementia patients with evidence of cerebral SVD. In addition to brain tissues, we collected postmortem samples of the internal carotid arteries (ICA) from these cohorts in the Newcastle Brain Tissue Resource. Standard neuropathological examination was performed for diagnosis and assignment of the cases per current diagnostic criteria for vascular and neurodegenerative dementias and assessed for presence of types of vascular pathology including the degree of stenosis and sclerosis in vascular tissues. Results We evaluated a total of 159 ICA samples and brain tissues from all cases with evidence of SVD. Severity of ICA stenosis and sclerotic index correlated strongly with both clinical stroke and brain infarction (P<0.0001). More than 90% of the subjects had one subtype of ICA lesion in the order: intimal thickening >fibrocalcific >fibrous cap (thick) >fibrous cap (thin) >thrombus group with a strong inflammatory reaction in fibrocalcific atheromas. Linear regression analysis showed that ICA stenosis was positively correlated to both SVD pathology scores and total number of vascular lesions (P<0.034). We found that severity of stenosis was related to anterior circulation involvement and small infarcts in the subcortical structures including the white matter (WM) rather than the cortex. Total intracranial artery scores were correlated with ICA stenosis and sclerosis (P<0.001). In the CogFAST group analysis, the smallest lesions in the WM but not in the cortex or basal ganglia, and thalamus were associated with severity of ICA stenosis (P<0.05) Conclusions Carotid atherosclerosis promotes cerebral SVD types of changes and influences the cerebral arterial system. Our observations also suggest extracranial ICA athology impacts on the perfusion and integrity of the deep WM.
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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".