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Enriching Experiences May Protect Against Cognitive Decline in MS

September 26, 2016

Enriching experiences may have a protective role in cognitive performance in multiple sclerosis, reducing the effect that gray matter atrophy has on cognitive functions. These findings were presented at the 32nd Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) in London, September 14-17, 2016.

The researchers, led by Maria Assunta Rocca, MD, PhD, of the Division of Neuroscience at Vita-Salute San Raffaele University in Milan, Italy, aimed to examine whether the cognitive reserve (CR) hypothesis – in which enriching experiences protect against cognitive decline and dementia – could  predict cognitive decline as well as gray matter (GM) and white matter (WM) volume changes in MS patients. The role of CR in protecting against cognitive decline over time in patients with MS has remained unclear.

The researchers obtained 3D T1-weighted scans and Rao's Brief Repeatable Battery from 54 patients with MS and 20 healthy controls at baseline and at 2 years (median 2.2 years) follow-up. To assess cognitive decline, the researchers calculated a reliable change index (RCI); education, intelligence quotient, and leisure activities were included in a cognitive reserve index (CRI) calculation. Regional GM atrophy was estimated with voxel-based-morphometry and longitudinal GM changes were examined using tensor-based morphometry analysis.

Compared with healthy controls, MS patients had GM atrophy of the deep GM nuclei, fronto-temporal-parietal-occipital regions, and left (L) cerebellum. Controlling for atrophy within these regions, higher CRI predicted better performances at verbal memory.

At follow-up, GM atrophy predicted cognitive decline in several fronto-temporal areas and in the left cerebellum. The researchers found no effect of CRI on cognitive and longitudinal structural changes.

“CR in MS patients has a protective role on cognitive performance, reducing the effect of GM atrophy on cognitive functions,” the authors concluded. However, “this protective role might lose his efficacy with the progression of disease.”