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Does cognitive reserve play any role in multiple sclerosis? A meta-analytic study.

Gabriella Santangelo1, Manuela Altieri1, Antonio Gallo2

  • 1Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.

Multiple Sclerosis and Related Disorders
|March 11, 2019
PubMed
Summary

Cognitive reserve (CR) partially protects cognition from brain damage in Multiple Sclerosis (MS), particularly verbal fluency. However, CR does not mitigate the impact of physical disability on cognitive function in MS patients.

Keywords:
Cognitive reserveEDSSMRIMeta-analysisMultiple sclerosis

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Inconsistent evidence exists regarding cognitive reserve's (CR) moderating effect on Multiple Sclerosis (MS) progression and cognition.
  • MS disease progression is assessed via MRI biomarkers and physical disability scales (e.g., EDSS).

Purpose of the Study:

  • To meta-analytically investigate CR's role in moderating the impact of brain damage and physical disability on cognition in MS.
  • To explore how MRI biomarkers and physical disability influence cognitive function in MS patients.

Main Methods:

  • Conducted two literature searches for studies on MRI biomarkers, physical disability, and cognition in MS.
  • Performed meta-analyses using random effect models and meta-regression with CR as a numerical moderator.

Main Results:

  • Significant impact of lesion load and gray matter abnormalities on most cognitive domains in MS.
  • CR significantly moderated the relationship between brain damage and verbal fluency.
  • Physical disability significantly impacted cognitive functioning, but CR did not mitigate this relationship.

Conclusions:

  • CR offers a limited protective role against brain damage's cognitive impact in MS, specifically for lexical access and cognitive flexibility.
  • Findings highlight the need for longitudinal studies to further explore CR's moderator effect throughout MS progression.