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Cognitive reserve in secondary progressive multiple sclerosis.

James F Sumowski1, Nancy Chiaravalloti, Victoria M Leavitt

  • 1Neuropsychology & Neuroscience Laboratory, Kessler Foundation Research Center, USA. jsumowski@kesslerfoundation.org

Multiple Sclerosis (Houndmills, Basingstoke, England)
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Summary

Lifetime intellectual enrichment protects patients with secondary-progressive multiple sclerosis (SPMS) from cognitive impairment. Higher enrichment levels mitigate memory and cognitive efficiency deficits in SPMS patients compared to healthy controls.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Neurology

Background:

  • The cognitive reserve hypothesis suggests lifetime intellectual enrichment protects against cognitive impairment in multiple sclerosis (MS).
  • Previous research primarily focused on relapsing-remitting MS, leaving the effect of enrichment on secondary-progressive MS (SPMS) unclear.

Purpose of the Study:

  • To investigate if greater lifetime intellectual enrichment moderates the negative impact of SPMS on memory and cognitive efficiency.
  • To extend the understanding of cognitive reserve to a more advanced stage of MS.

Main Methods:

  • Twenty-five SPMS patients and 25 healthy controls (HC) underwent neuropsychological testing to assess memory and cognitive efficiency.
  • Lifetime intellectual enrichment was estimated using educational attainment and vocabulary knowledge.
  • Regression analyses examined the interaction between intellectual enrichment and group (SPMS vs. HC) on cognitive outcomes.

Main Results:

  • Significant interactions were found between intellectual enrichment and group for both memory and cognitive efficiency.
  • SPMS patients showed cognitive deficits at lower enrichment levels but not at higher levels.
  • Higher intellectual enrichment appeared to buffer against cognitive decline in SPMS patients.

Conclusions:

  • Lifetime intellectual enrichment protects SPMS patients from cognitive impairment.
  • The findings support and extend the cognitive reserve hypothesis to the SPMS disease course.