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Cognitive reserve as a moderating factor between EDSS and cognition in multiple sclerosis
Alexandra Tremblay1, Kim Charest1, Estefan Brando1
1Department of Psychology, Université du Québec à Montréal, CP 8888, succ. Centre-ville, QC, Montreal H3C 3P8, Canada.
Objectives:
It is now well recognized that brain damage and/or atrophy apparent on MRI is only moderately correlated to cognitive functioning. The cognitive reserve (CR) hypothesis has been proposed to explain this functional heterogeneity, but it has only been addressed recently in the MS literature and has not yet been thoroughly investigated. The objective of this study is to examine the protective role of CR in cognition using a standardized CR tool in a population with a wide age range.
Methods:
A neuropsychological evaluation was performed on 84 pwMS aged between 27 and 78 years old and the CR Index questionnaire (CRIq) was used to estimate CR. The EDSS scale was used to assess the degree of neurologic impairment and estimate the disease burden.
Results:
A moderating effect of CR was observed in the relationship between EDSS score and specific cognitive domains: processing efficiency, visuospatial learning and memory, as well as a tendency for verbal memory. In pwMS with a high level of CR, there was no negative relationship between these cognitive domains and EDSS.
Conclusion:
The results support the protective role of CR in a sample of pwMS with a wide age range. This role seems to be limited to specific cognitive tasks that pose a greater challenge and therefore require greater adaptability.
Insights
Cognitive reserve (CR) protects against cognitive decline in people with multiple sclerosis (MS). High CR shielded individuals from the negative effects of MS disease burden on cognitive functions, particularly challenging tasks.
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.
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