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Exploring cognitive reserve in multiple sclerosis: New findings from a cross-sectional study.
J Clin Exp Neuropsychol. 2016 12; 38(10):1158-67.JC

Abstract

INTRODUCTION

The cognitive reserve (CR) hypothesis attempts to explain the discrepancy between brain damage and clinical manifestations in neurodegenerative diseases. Recently the concept of CR was applied to the multiple sclerosis (MS) model. Our aim is to investigate the impact of demographic and clinical variables on cognitive outcome in MS patients.

METHOD

A total of 72 MS patients were assessed by Rao's Brief Repeatable Battery of Neuropsychological Tests (BRB-N), Cognitive Reserve Index Questionnaire (CRIq), and high field magnetic resonance examination. We performed a multivariate linear regression analysis, including each cognitive test scores as dependent variables and CRI together with age, normalized brain volume (NBV), normalized cortical volume (NCV), expanded disability severity scale (EDSS) score, and disease duration as independent variables. Moreover, we assessed whether one of the CRI subscores (CRI-Education, CRI-WorkingActivity, CRI-LeisureTime) predicted cognitive performance more than the other. Finally, to assess the CR hypothesis in our sample, we conducted the same analyses including the interaction term CRI × NCV.

RESULTS

From the multiple regression analysis, it emerged that the CRI total score influenced sustained attention, concentration, information processing speed, and verbal learning. Among the three CRI subscores, CRI-Education and CRI-WorkingActivity had the most influence. Age and EDSS score were the other significant predictors. We did not find evidence for a moderation effect of CR on negative influence of atrophy on cognitive status.

CONCLUSIONS

This study focused on the contribution of CR to predict neuropsychological outcome in MS. We used a new standardized questionnaire to provide a global index including three main source of CR: education, working activity, and leisure time activities. Our preliminary findings suggest that the CR is an important predictor of better performance on cognitive tests in MS patients. However, at this stage of the study, we are unable to confirm the CR hypothesis.

Authors+Show Affiliations

a Neurobioimaging Laboratory , IRCCS Centro Neurolesi Bonino Pulejo , Messina , Italy.a Neurobioimaging Laboratory , IRCCS Centro Neurolesi Bonino Pulejo , Messina , Italy.a Neurobioimaging Laboratory , IRCCS Centro Neurolesi Bonino Pulejo , Messina , Italy.a Neurobioimaging Laboratory , IRCCS Centro Neurolesi Bonino Pulejo , Messina , Italy.a Neurobioimaging Laboratory , IRCCS Centro Neurolesi Bonino Pulejo , Messina , Italy.a Neurobioimaging Laboratory , IRCCS Centro Neurolesi Bonino Pulejo , Messina , Italy. b Department of Biomedical and Dental Sciences and Morphofunctional Imaging , University of Messina , Messina , Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27410680

Citation

Nunnari, Domenica, et al. "Exploring Cognitive Reserve in Multiple Sclerosis: New Findings From a Cross-sectional Study." Journal of Clinical and Experimental Neuropsychology, vol. 38, no. 10, 2016, pp. 1158-67.
Nunnari D, De Cola MC, Costa A, et al. Exploring cognitive reserve in multiple sclerosis: New findings from a cross-sectional study. J Clin Exp Neuropsychol. 2016;38(10):1158-67.
Nunnari, D., De Cola, M. C., Costa, A., Rifici, C., Bramanti, P., & Marino, S. (2016). Exploring cognitive reserve in multiple sclerosis: New findings from a cross-sectional study. Journal of Clinical and Experimental Neuropsychology, 38(10), 1158-67. https://doi.org/10.1080/13803395.2016.1200538
Nunnari D, et al. Exploring Cognitive Reserve in Multiple Sclerosis: New Findings From a Cross-sectional Study. J Clin Exp Neuropsychol. 2016;38(10):1158-67. PubMed PMID: 27410680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exploring cognitive reserve in multiple sclerosis: New findings from a cross-sectional study. AU - Nunnari,Domenica, AU - De Cola,Maria Cristina, AU - Costa,Antonio, AU - Rifici,Carmela, AU - Bramanti,Placido, AU - Marino,Silvia, Y1 - 2016/07/13/ PY - 2016/7/14/entrez PY - 2016/7/14/pubmed PY - 2018/2/1/medline KW - Cognitive Reserve Index Questionnaire KW - Cognitive impairment KW - Cognitive reserve KW - Magnetic resonance imaging KW - Multiple sclerosis KW - Neuropsychological assessment SP - 1158 EP - 67 JF - Journal of clinical and experimental neuropsychology JO - J Clin Exp Neuropsychol VL - 38 IS - 10 N2 - INTRODUCTION: The cognitive reserve (CR) hypothesis attempts to explain the discrepancy between brain damage and clinical manifestations in neurodegenerative diseases. Recently the concept of CR was applied to the multiple sclerosis (MS) model. Our aim is to investigate the impact of demographic and clinical variables on cognitive outcome in MS patients. METHOD: A total of 72 MS patients were assessed by Rao's Brief Repeatable Battery of Neuropsychological Tests (BRB-N), Cognitive Reserve Index Questionnaire (CRIq), and high field magnetic resonance examination. We performed a multivariate linear regression analysis, including each cognitive test scores as dependent variables and CRI together with age, normalized brain volume (NBV), normalized cortical volume (NCV), expanded disability severity scale (EDSS) score, and disease duration as independent variables. Moreover, we assessed whether one of the CRI subscores (CRI-Education, CRI-WorkingActivity, CRI-LeisureTime) predicted cognitive performance more than the other. Finally, to assess the CR hypothesis in our sample, we conducted the same analyses including the interaction term CRI × NCV. RESULTS: From the multiple regression analysis, it emerged that the CRI total score influenced sustained attention, concentration, information processing speed, and verbal learning. Among the three CRI subscores, CRI-Education and CRI-WorkingActivity had the most influence. Age and EDSS score were the other significant predictors. We did not find evidence for a moderation effect of CR on negative influence of atrophy on cognitive status. CONCLUSIONS: This study focused on the contribution of CR to predict neuropsychological outcome in MS. We used a new standardized questionnaire to provide a global index including three main source of CR: education, working activity, and leisure time activities. Our preliminary findings suggest that the CR is an important predictor of better performance on cognitive tests in MS patients. However, at this stage of the study, we are unable to confirm the CR hypothesis. SN - 1744-411X UR - https://www.unboundmedicine.com/medline/citation/27410680/Exploring_cognitive_reserve_in_multiple_sclerosis:_New_findings_from_a_cross_sectional_study_ L2 - http://www.tandfonline.com/doi/full/10.1080/13803395.2016.1200538 DB - PRIME DP - Unbound Medicine ER -