Brain reserve and cognitive reserve protect against cognitive decline over 4.5 years in MS

Objective: Based on the theories of brain reserve and cognitive reserve, we investigated whether larger maximal lifetime brain growth (MLBG) and/or greater lifetime intellectual enrichment protect against cognitive decline over time. Methods: Forty patients with multiple sclerosis (MS) underwent baseline and 4.5-year follow-up evaluations of cognitive efficiency (Symbol Digit Modalities Test, Paced Auditory Serial Addition Task) and memory (Selective Reminding Test, Spatial Recall Test). Baseline and follow-up MRIs quantified disease progression: percentage brain volume change (cerebral atrophy), percentage change in T2 lesion volume. MLBG (brain reserve) was estimated with intracranial volume; intellectual enrichment (cognitive reserve) was estimated with vocabulary. We performed repeated-measures analyses of covariance to investigate whether larger MLBG and/or greater intellectual enrichment moderate/attenuate cognitive decline over time, controlling for disease progression. Results: Patients with MS declined in cognitive efficiency and memory (p < 0.001). MLBG moderated decline in cognitive efficiency (p = 0.031, ηp2 = 0.122), with larger MLBG protecting against decline. MLBG did not moderate memory decline (p = 0.234, ηp2 = 0.039). Intellectual enrichment moderated decline in cognitive efficiency (p = 0.031, ηp2 = 0.126) and memory (p = 0.037, ηp2 = 0.115), with greater intellectual enrichment protecting against decline. MS disease progression was more negatively associated with change in cognitive efficiency and memory among patients with lower vs higher MLBG and intellectual enrichment. Conclusion: We provide longitudinal support for theories of brain reserve and cognitive reserve in MS. Larger MLBG protects against decline in cognitive efficiency, and greater intellectual enrichment protects against decline in cognitive efficiency and memory. Consideration of these protective factors should improve prediction of future cognitive decline in patients with MS.

[1]  Julie D. Henry,et al.  Verbal fluency deficits in multiple sclerosis , 2006, Neuropsychologia.

[2]  David H. Miller,et al.  Reducing the impact of white matter lesions on automated measures of brain gray and white matter volumes , 2010, Journal of magnetic resonance imaging : JMRI.

[3]  P. Rabbitt,et al.  Effects of global atrophy, white matter lesions, and cerebral blood flow on age-related changes in speed, memory, intelligence, vocabulary, and frontal function. , 2007, Neuropsychology.

[4]  Keith E. Stanovich,et al.  Where does knowledge come from? Specific associations between print exposure and information acquisition. , 1993 .

[5]  Marcus Richards,et al.  Lifetime Antecedents of Cognitive Reserve , 2003, Journal of clinical and experimental neuropsychology.

[6]  Charles DeCarli,et al.  Maximal brain size remains an important predictor of cognition in old age, independent of current brain pathology , 2012, Neurobiology of Aging.

[7]  S. Rombouts,et al.  The contribution of MRI in assessing cognitive impairment in multiple sclerosis , 2010, Neurology.

[8]  Karen J. Ferguson,et al.  Intracranial capacity and brain volumes are associated with cognition in healthy elderly men , 2002, Neurology.

[9]  M. Deloire,et al.  An unusual cause of isolated vomiting , 2011, Neurology.

[10]  I. Steiner,et al.  Head size and cognitive ability in nondemented older adults are related. , 2001 .

[11]  A. Giorgio,et al.  Cognitive reserve and cortical atrophy in multiple sclerosis , 2013, Neurology.

[12]  G. Wylie,et al.  Cognitive reserve moderates the negative effect of brain atrophy on cognitive efficiency in multiple sclerosis , 2009, Journal of the International Neuropsychological Society.

[13]  J. Townsend,et al.  Normal brain development and aging: quantitative analysis at in vivo MR imaging in healthy volunteers. , 2000, Radiology.

[14]  R. Benedict,et al.  Cognitive reserve moderates decline in information processing speed in multiple sclerosis patients , 2010, Journal of the International Neuropsychological Society.

[15]  Y. Stern.  What is cognitive reserve? Theory and research application of the reserve concept , 2002, Journal of the International Neuropsychological Society.

[16]  Yaakov Stern,et al.  Cognitive Reserve: Implications for Assessment and Intervention , 2013, Folia Phoniatrica et Logopaedica.

[17]  J. Sumowski,et al.  Cognitive reserve in multiple sclerosis , 2013, Multiple sclerosis.

[18]  G. Wylie,et al.  Intellectual enrichment is linked to cerebral efficiency in multiple sclerosis: functional magnetic resonance imaging evidence for cognitive reserve , 2009, Brain : a journal of neurology.

[19]  G. Wylie,et al.  Premorbid cognitive leisure independently contributes to cognitive reserve in multiple sclerosis , 2010, Neurology.

[20]  Jeffrey A. Cohen,et al.  Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria , 2011, Annals of neurology.

[21]  G. Wylie,et al.  Aerobic exercise increases hippocampal volume and improves memory in multiple sclerosis: Preliminary findings , 2014, Neurocase.

[22]  E. Mori,et al.  Premorbid brain size as a determinant of reserve capacity against intellectual decline in Alzheimer's disease. , 1997, The American journal of psychiatry.

[23]  I. Deary,et al.  The neuroscience of human intelligence differences , 2010, Nature Reviews Neuroscience.

[24]  V. Dousset,et al.  MRI predictors of cognitive outcome in early multiple sclerosis , 2011, Neurology.

[25]  R. V. Van Heertum,et al.  Brain networks associated with cognitive reserve in healthy young and old adults. , 2005, Cerebral cortex.

[26]  J. Jolles,et al.  Head size and cognitive ability in nondemented older adults are related , 2001, Neurology.

[27]  John DeLuca,et al.  Retrieval practice is a robust memory aid for memory-impaired patients with MS , 2013, Multiple sclerosis.

[28]  J. DeLuca,et al.  L-amphetamine improves memory in MS patients with objective memory impairment , 2011, Multiple sclerosis.

[29]  G. Mcclearn,et al.  A Quantitative Genetic Analysis of Cognitive Abilities during the Second Half of the Life Span , 1992 .

[30]  J. DeLuca,et al.  Treatment of cognitive impairment in multiple sclerosis: position paper , 2013, Journal of Neurology.

[31]  J. DeLuca,et al.  Brain reserve and cognitive reserve in multiple sclerosis , 2013, Neurology.

[32]  A. Thompson,et al.  Magnetic resonance imaging in monitoring the treatment of multiple sclerosis: concerted action guidelines. , 1991, Journal of neurology, neurosurgery, and psychiatry.

[33]  P. Satz.  Brain reserve capacity on symptom onset after brain injury: A formulation and review of evidence for threshold theory. , 1993 .

[34]  D. Weinberger,et al.  Genetic variability of human brain size and cortical gyral patterns. , 1997, Brain : a journal of neurology.

[35]  Arthur F. Kramer,et al.  Aerobic fitness is associated with gray matter volume and white matter integrity in multiple sclerosis , 2010, Brain Research.

[36]  Hirofumi Ochi,et al.  [Cognitive impairment in multiple sclerosis]. , 2014, Brain and nerve = Shinkei kenkyu no shinpo.

[37]  Robert Zivadinov,et al.  Neocortical atrophy, third ventricular width, and cognitive dysfunction in multiple sclerosis. , 2006, Archives of neurology.

[38]  B Johansson,et al.  Substantial genetic influence on cognitive abilities in twins 80 or more years old. , 1997, Science.

[39]  C H Polman,et al.  The Brief Repeatable Battery of Neuropsychological Tests: normative values allow application in multiple sclerosis clinical practice , 2001, Multiple sclerosis.

[40]  Michael W Weiner,et al.  Longitudinal MRI and cognitive change in healthy elderly. , 2007, Neuropsychology.

[41]  Stephen M. Smith,et al.  Accurate, Robust, and Automated Longitudinal and Cross-Sectional Brain Change Analysis , 2002, NeuroImage.