Cognitive reserve as a moderating factor between EDSS and cognition in multiple sclerosis

Area of Science:

• Neuroscience
• Neurology
• Cognitive Science

Background:

• Brain damage on MRI correlates moderately with cognitive function in multiple sclerosis (MS).
• The cognitive reserve (CR) hypothesis explains this functional heterogeneity but is understudied in MS.
• Investigating CR's protective role is crucial for understanding cognitive resilience in MS.

Purpose of the Study:

• To examine the protective role of cognitive reserve (CR) in cognition.
• To utilize a standardized CR tool in a diverse MS population (age 27-78).
• To assess the relationship between CR, disease burden (EDSS), and cognitive performance.

Main Methods:

• Neuropsychological evaluation of 84 people with MS (pwMS).
• Assessed CR using the CR Index questionnaire (CRIq).
• Measured neurological impairment with the Expanded Disability Status Scale (EDSS).

Main Results:

• CR significantly moderated the relationship between EDSS and cognitive domains: processing efficiency, visuospatial learning/memory.
• A trend was observed for CR's effect on verbal memory.
• High CR levels eliminated the negative association between EDSS and these cognitive functions.

Conclusions:

• Cognitive reserve (CR) demonstrates a protective effect in pwMS across a wide age range.
• This protective role appears specific to cognitively demanding tasks requiring adaptability.
• Findings support CR as a key factor in maintaining cognitive function despite MS-related neurological impairment.