Brain reserve and cognitive reserve in MS

This study group from Italy firstly examined if larger maximal lifetime brain volume (MLBV) protects against disease-related cognitive impairment. They then looked at cognitive reserve (CR), gained through life experience (intellectually enriching leisure activities), to see if this protects against cognitive decline independent of MLBV (brain reserve (BR)).

The study included 41 people with relapsing-remitting MS and 21 with secondary progressive MS who had MRIs to estimate BR (MLBV, estimated with intracranial volume (ICV)) and disease burden (T2 lesion load, grey and white matter atrophy). They assessed cognitive status with tasks of cognitive efficiency and memory. They measured early life cognitive leisure as a source of CR. Results demonstrated that cognitive status was positively associated with ICV.

Controlling for BR, higher education and leisure predicted better cognition.  A leisure by disease burden interaction showed that leisure independently attenuated the impact of disease burden on cognition.

Follow-up analysis showed that BR protected against cognitive inefficiency, not memory deficits, whereas CR was more protective against memory deficits than cognitive inefficiency.

Therefore this study demonstrated that CR independently protects against disease-related cognitive decline over and above BR. So lifestyle choices protect against cognitive impairment independently of genetic factors.

Authors: Sumowski JF, Rocca MA

Source: Neurology. 2013 May 10. [Epub ahead of print]

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