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
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
Authors: Sumowski JF, Rocca MA
Source: Neurology. 2013 May 10. [Epub ahead of print]
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