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White matter hyperintensities and cognition: testing the reserve hypothesis.
Adam M Brickman1, Karen L Siedlecki, Jordan Muraskin
1Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. amb2139@columbia.edu
Higher brain and cognitive reserve allow individuals to tolerate more white matter hyperintensities (WMH) before impacting cognition. This suggests reserve mitigates the effects of brain pathology.
Area of Science:
- Neuroimaging
- Cognitive Neuroscience
- Vascular Neurology
Background:
- White matter hyperintensities (WMH) on MRI are markers of small-vessel disease.
- The relationship between WMH and cognitive function is often imperfect.
- The concept of 'reserve' may explain this imperfect association.
Purpose of the Study:
- To investigate the reserve hypothesis regarding WMH and cognition.
- To determine if higher reserve protects against WMH-related cognitive decline.
Main Methods:
- Studied 717 healthy older adults using MRI and neuropsychological tests.
- Quantified WMH volume algorithmically.
- Derived measures for cognitive and brain reserve from psychosocial and anthropometric data.
Main Results:
- Increased WMH volume correlated with poorer cognition.
- Higher cognitive and brain reserve were linked to better cognition.
- Greater WMH volume was observed in individuals with higher reserve, especially women, when controlling for cognitive function.
Conclusions:
- Individuals with higher reserve tolerate more WMH pathology for a given cognitive level.
- Both brain and cognitive reserve appear to buffer the negative impact of WMH on cognition.
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