Skip to main content
×
Home
    • Aa
    • Aa

Cognitive reserve moderates decline in information processing speed in multiple sclerosis patients

  • RALPH H.B. BENEDICT (a1) (a2), SARAH A. MORROW (a1) (a2), BIANCA WEINSTOCK GUTTMAN (a1) (a2), DIANE COOKFAIR (a1) (a2) and DAVID J. SCHRETLEN (a3)...
Abstract
Abstract

Cognitive reserve is widely recognized as a moderator of cognitive decline in patients with senile dementias such as Alzheimer’s disease. The same effect may occur in multiple sclerosis (MS), an immunologic disorder affecting the central nervous system. While MS is traditionally considered an inflammatory, white matter disease, degeneration of gray matter is increasingly recognized as the primary contributor to progressive cognitive decline. Our aim was to determine if individual differences in estimated cognitive reserve protect against the progression of cognitive dysfunction in MS. Ninety-one patients assessed twice roughly 5 years apart were identified retrospectively. Cognitive testing emphasized mental processing speed. Cognitive reserve was estimated by years of education and by performance on the North American Adult Reading Test (NAART). After controlling for baseline characteristics, both years of education (p = .013) and NAART scores (p = .049) significantly improved regression models predicting cognitive decline. Symbol Digit Modalities Test (SDMT) performance showed no significant change in patients with > 14 years of education, whereas it declined significantly in patients with ≤ 14 years of education. We conclude that greater cognitive reserve as indexed by either higher premorbid intelligence or more years of education protects against the progression of cognitive dysfunction in MS. (JINS, 2010, 16, 829–835.)

Copyright
Corresponding author
*Correspondence and reprint requests to: Ralph H.B. Benedict, Department of Neurology, 100 High Street (D-6), Buffalo, New York 14203. E-mail: benedict@buffalo.edu
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

S.M. Albert , & J.A. Teresi (1999). Reading ability, education, and cognitive status assessment among older adults in Harlem, New York City. American Journal of Public Health, 89, 9597.

M.P. Amato , M.L. Bartolozzi , V. Zipoli , E. Portaccio , M. Mortilla , L. Guidi , . (2004). Neocortical volume decrease in relapsing-remitting MS patients with mild cognitive impairment. Neurology, 63, 8993.

M.P. Amato , G. Ponziani , G. Siracusa , & S. Sorbi (2001). Cognitive dysfunction in early-onset multiple sclerosis: A reappraisal after 10 years. Archives of Neurology, 58, 16021606.

R.H.B. Benedict , J.M. Bruce , M.G. Dwyer , N. Abdelrahman , S. Hussein , B. Weinstock-Guttman , . (2006). Neocortical atrophy, third ventricular width, and cognitive dysfunciton in multiple sclerosis. Archives of Neurology, 63, 13011306.

R.H.B. Benedict , J.S. Fischer , C.J. Archibald , P.A. Arnett , W.W. Beatty , J. Bobholz , . (2002). Minimal Neuropsychological Assessment of MS Patients: A Consensus Approach. Clinical Neuropsychologist, 16, 381397.

R.H.B. Benedict , D. Ramasamy , F. Munschauer , B. Weinstock-Guttman , & R. Zivadinov (2009). Memory impairment in multiple sclerosis: Correlation with deep grey matter and mesial temporal atrophy. Journal of Neurology, Neurosurgery, and Psychiatry, 80, 201206.

R.H.B. Benedict , B. Weinstock-Guttman , I. Fishman , J. Sharma , C.W. Tjoa , & R. Bakshi (2004). Prediction of neuropsychological impairment in multiple sclerosis: Comparison of conventional magnetic resonance imaging measures of atrophy and lesion burden. Archives of Neurology, 61, 226230.

J.R. Blair , & O. Spreen (1989). Predicting premorbid IQ: A revision of the National Adult Reading Test. Clinical Neuropsychologist, 3, 129136.

L. Bo , C.A. Vedeler , H. Nyland , B.D. Trapp , & S.J. Mork (2003a). Intracortical multiple sclerosis lesions are not associated with increased lymphocyte infiltration. Multiple Sclerosis, 9, 323331.

L. Bo , C.A. Vedeler , H.I. Nyland , B.D. Trapp , & S.J. Mork (2003b). Subpial demyelination in the cerebral cortex of multiple sclerosis patients. Journal of Neuropathology and Experimental Neurology, 62, 723732.

J.A. Bobholz , & S.M. Rao (2003). Cognitive dysfunction in multiple sclerosis: A review of recent developments. Current Opinion in Neurology, 16, 283288.

B. Borroni , E. Premi , C. Agosti , A. Alberici , V. Garibotto , G. Bellelli , . (2009). Revisiting brain reserve hypothesis in frontotemporal dementia: Evidence from a brain perfusion study. Dementia and Geriatric Cognitive Disorders, 28, 130135.

N.D. Chiaravalloti , & J. DeLuca (2008). Cognitive impairment in multiple sclerosis. Lancet Neurology, 7, 11391151.

C. Christodoulou , L.B. Krupp , Z. Liang , W. Huang , P. Melville , C. Roque , . (2003). Cognitive performance and MR markers of cerebral injury in cognitively impaired MS patients. Neurology, 60, 17931798.

G.R. Cutter , M.L. Baier , R.A. Rudick , D.L. Cookfair , J.S. Fischer , J. Petkau , . (1999). Development of a multiple sclerosis funcitonal composite as a clinical trial outcome measure. Brain, 122, 871882.

A. Dal Bianco , M. Bradl , J. Frischer , A. Kutzelnigg , K. Jellinger , & H. Lassmann (2008). Multiple sclerosis and Alzheimer’s disease. Annals of Neurology, 63, 174183.

C. Dufouil , A. Alperovitch , & C. Tzourio (2003). Influence of education on the relationship between white matter lesions and cognition. Neurology, 60, 831836.

J.S. Elkins , W.T. Longstreth Jr., T.A. Manolio , A.B. Newman , R.A. Bhadelia , & S.C. Johnston (2006). Education and the cognitive decline associated with MRI-defined brain infarct. Neurology, 67, 435440.

K.B. Friend , & L. Grattan (2000). Use of the North American Adult Reading Test to estimate premorbid intellectual function in patients with multiple sclerosis. Journal of Clinical & Experimental Neuropsychology, 20, 846851.

S.L. Glatt , J.P. Hubble , K. Lyons , A. Paolo , A.I. Troster , R.E. Hassanein , . (1996). Risk factors for dementia in Parkinson’s disease: Effect of education. Neuroepidemiology, 15, 2025.

D.M.A. Gronwall (1977). Paced auditory serial addition task: A measure of recovery from concussion. Perceptual and Motor Skills, 44, 367373.

M.K. Houtchens , R.H.B. Benedict , R. Killiany , J. Sharma , Z. Jaisani , B. Singh , . (2007). Thalamic atrophy and cognition in multiple sclerosis. Neurology, 69, 113123.

D. Jacobs , M. Sano , K. Marder , K. Bell , F. Bylsma , G. Lafleche , . (1994). Age at onset of Alzheimer’s disease: Relation to pattern of cognitive dysfunction and rate of decline. Neurology, 44, 12151220.

L.D. Jacobs , K.E. Wende , C.M. Brownscheidle , B. Apatoff , P.K. Coyle , A. Goodman , . (1999). A profile of multiple sclerosis: The New York State Multiple Sclerosis Consortium. Multiple Sclerosis, 5, 369376.

P. Kujala , R. Portin , & J. Ruutiainen (1997). The progress of cognitive decline in multiple sclerosis. Brain, 120, 289297.

R. Lynn , & J. Mikk (2007). National differences in intelligence and educational attainment. Intelligence, 35, 115121.

F.M. McCarthy , A.H. Sellers , & W.J. Burns (2003). Prediction of IQ in the Mayo older adult normative sample using multiple methods. Journal of Clinical Psychology, 59, 457463.

B.A. Parmenter , B. Weinstock-Guttman , N. Garg , F. Munschauer , & R.H.B. Benedict (2007). Screening for cognitive impairment in MS using the Symbol Digit Modalities Test. Multiple Sclerosis, 13, 5257.

B.A. Parmenter , R. Zivadinov , L. Kerenyi , R. Gavett , B. Weinstock-Guttman , M. Dwyer , . (2007). Validity of the Wisconsin Card Sorting and Delis-Kaplan Executive Function System (DKEFS) Sorting Tests in Multiple Sclerosis. Journal of Clinical & Experimental Neuropsychology, 29, 215223.

C.H. Polman , S.C. Reingold , G. Edan , M. Filippi , H.P. Hartung , L. Kappos , . (2005). Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria”. [Review]. Annals of Neurology, 58, 840846.

S.M. Rao , G.J. Leo , L. Bernardin , & F. Unverzagt (1991). Cognitive dysfunction in multiple sclerosis. I. Frequency, patterns, and prediction. Neurology, 41, 685691.

C.M. Roe , C. Xiong , J.P. Miller , & J.C. Morris (2007). Education and Alzheimer disease without dementia: Support for the cognitive reserve hypothesis. Neurology, 68, 223228.

M.T. Ropacki , & J.W. Elias (2003). Preliminary examination of cognitive reserve theory in closed head injury. Archives of Clinical Neuropsychology, 18, 643654.

R.A. Rudick , G. Cutter , M. Baier , E. Fisher , D. Dougherty , B. Weinstock-Guttman , . (2001). Use of the multiple sclerosis functional composite to predict disability in relapsing MS. Neurology, 56, 13241330.

M.P. Sanfilipo , R.H.B. Benedict , B. Weinstock-Guttman , & R. Bakshi (2006). Gray and white matter brain atrophy and neuropsychological impairment in multiple sclerosis. Neurology, 66, 685692.

P. Satz , H. Morgenstern , E.N. Miller , O.A. Selnes , J.C. McArthur , B.A. Cohen , . (1993). Low education as a possible risk factor for cognitive abnormalities in HIV-1: Findings from the multicenter AIDS Cohort Study (MACS). Journal of Acquired Immune Deficiency Syndromes, 6, 503511.

R.A. Sperling , C.R. Guttmann , M.J. Hohol , S.K. Warfield , M. Jakab , M. Parente , . (2001). Regional magnetic resonance imaging lesion burden and cognitive function in multiple sclerosis: A longitudinal study. Archives of Neurology, 58, 115121.

Y. Stern (2006). Cognitive reserve and Alzheimer disease. Alzheimer Disease and Associated Disorders, 20(Suppl. 2), S69S74.

Y. Stern (2009). Cognitive reserve. Neuropsychologia, 47, 20152028.

Y. Stern , B. Gurland , T.K. Tatemichi , M.X. Tang , D. Wilder , & R. Mayeux (1994). Influence of education and occupation on the incidence of Alzheimer’s disease. JAMA, 271, 10041010.

L. Strober , J. Englert , F. Munschauer , B. Weinstock-Guttman , S. Rao , & R.H.B. Benedict (2009). Sensitivity of conventional memory tests in multiple sclerosis: Comparing the Rao Brief Repeatable Neuropsychological Battery and the Minimal Assessment of Cognitive Function in MS. Multiple Sclerosis, 15, 10771084.

J.F. Sumowski , G.R. Wylie , J. Deluca , & N. Chiaravalloti (2010). Intellectual enrichment is linked to cerebral efficiency in multiple sclerosis: Functional magnetic resonance imaging evidence for cognitive reserve. Brain, 133(Pt 2), 362374.

M.H. Tabert , S.M. Albert , L. Borukhova-Milov , Y. Camacho , G. Pelton , X. Liu , . (2002). Functional deficits in patients with mild cognitive impairment: Prediction of AD. Neurology, 58, 758764.

A. Tekok-Kilic , R.H.B. Benedict , B. Weinstock-Guttman , M. Dwyer , D. Carone , B. Srinivasaraghavan , . (2007). Independent contributions of cortical gray matter atrophy and ventricle enlargement for predicting neuropsychological impairment in multiple sclerosis. Neuroimage, 36, 12941300.

B.D. Trapp , & K.A. Nave (2008). Multiple sclerosis: An immune or neurodegenerative disorder? Annual Review of Neuroscience, 31, 247269.

E.A. Yeh , B. Weinstock-Guttman , M. Ramanathan , D.P. Ramasamy , L. Willis , J.L. Cox , . (2009). Magnetic resonance imaging characteristics of children and adults with paediatric-onset multiple sclerosis. Brain, 132(Pt 12), 33923400.

R. Zivadinov , J. Sepcic , D. Nasuelli , R. De Masi , L.M. Bragadin , M.A. Tommasi , . (2001). A longitudinal study of brain atrophy and cognitive disturbances in the early phase of relapsing-remitting multiple sclerosis. Journal of Neurology, Neurosurgery, & Psychiatry, 70, 773780.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords: