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Cognitive reserve moderates the negative effect of brain atrophy on cognitive efficiency in multiple sclerosis
Abstract
According to the cognitive reserve hypothesis, neuropsychological expression of brain disease is attenuated among persons with higher education or premorbid intelligence. The current research examined cognitive reserve in multiple sclerosis (MS) by investigating whether the negative effect of brain atrophy on information processing (IP) efficiency is moderated by premorbid intelligence. Thirty-eight persons with clinically definite MS completed a vocabulary-based estimate of premorbid intelligence (Wechsler Vocabulary) and a composite measure of IP efficiency (Symbol Digit Modalities Test and Paced Auditory Serial Addition Task). Brain atrophy was estimated from measurements of third ventricle width using high-resolution anatomical brain magnetic resonance imaging (magnetization-prepared rapid gradient echo). In a hierarchical regression analysis controlling for age and depressive symptomatology, brain atrophy predicted worse IP efficiency (R2 = .23, p = .003) and cognitive reserve predicted better IP efficiency (R2 = .13, p = .013), but these effects were moderated by an Atrophy x Cognitive Reserve interaction (R2 = .15, p = .004). The negative effect of brain atrophy on IP efficiency was attenuated at higher levels of reserve, such that MS subjects with higher reserve were better able to withstand MS neuropathology without suffering cognitive impairment. Results help explain the incomplete and inconsistent relationship between brain atrophy and IP efficiency in previous res…
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“This finding is somewhat consistent with previous findings supporting the cognitive reserve hypothesis, that higher education mitigates cognitive problems associated with MS73–75.”
From Ecological momentary assessment of pain, fatigue, depressive, and cognitive symptoms reveals significant daily variability in multiple sclerosis (2017) · cites this paper as [73]
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Self-citation
Metadata
- Authors
- SUMOWSKI, J. F., CHIARAVALLOTI, N., WYLIE, G., & DELUCA, J.
- Affiliations
- Kessler Foundation (US)
- Corresponding author
- SUMOWSKI, JAMES F.
- Venue
- Journal of the International Neuropsychological Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-07
- Volume
- 15
- Issue
- 4
- Pages
- 606-612
- ISSN
- 1355-6177 (ISSN-L)
- 1469-7661
- OpenAlex
- W2090481814
- Cited by
- 132
- References
- 50
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 4 · 2023: 6 · 2022: 4 · 2021: 4 · 2020: 7 · 2019: 6 · 2018: 10 · 2017: 6 · 2016: 15 · 2015: 11 · 2014: 11 · 2013: 16 · 2012: 10
- FWCI
- 6.06
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the International Neuropsychological Society (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Cambridge
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Keywords
- cognitive reserve, multiple sclerosis, brain atrophy, processing efficiency, premorbid intelligence, third ventricle width, cognitive impairment, moderation, Symbol Digit Modalities Test, Paced Auditory Serial Addition Test
- MeSH terms
- Adolescent, Adult, Atrophy, Brain, Cognition Disorders, Female, Humans, Intelligence, Male, Middle Aged, Multiple Sclerosis, Neuropsychological Tests, Regression Analysis, Vocabulary, Models, Statistical, Imaging, Three-Dimensional, Young Adult
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