Cognitive reserve,cognition,and regional brain damage in MS: A 2 -year longitudinal study

Abstract

Background:

According to the cognitive reserve (CR) theory, enriching experiences protect against cognitive decline.

Objectives:

To investigate the dynamic interaction between CR and global/regional measures of brain white matter (WM) and gray matter (GM) damage and their effect on cognitive performance in multiple sclerosis (MS).

Methods:

Baseline and 2 -year three-dimensional (3D) T1-weighted scans were obtained from 54 MS patients and 20 healthy controls. Patients’ cognitive functions were tested and a cognitive reserve index (CRI) was calculated. Baseline regional atrophy and longitudinal volume changes were investigated using voxel-wise methods. Structural damage and CRI effects on cognitive performance were explored with linear models.

Results:

At baseline, MS patients showed atrophy of the deep GM nuclei, GM/WM frontal–temporal–parietal–occipital regions, and left cerebellum. Controlling for atrophy, higher CRI explained significant portions of variance in verbal memory and verbal fluency (∆R² = 0.07–0.16; p < 0.03). The interaction between thalamic volume and CRI was significant (∆R² = 0.05; p = 0.03). Longitudinal changes in memory and attention performance were associated with local/global variations of GM/WM and T2 lesions. CRI had no effect on longitudinal cognitive changes.

Conclusion:

In MS, CR may have a protective role in preserving cognitive functions, moderating the effect of structural damage on cognitive performance. This protective role may diminish with disease progression.

Keywords

MS cognitive reserve cognitive impairment gray matter white matter lesions

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