The cognitive reserve theory in the setting of pediatric-onset multiple sclerosis

Luisa Pastò, Emilio Portaccio, Benedetta Goretti, Angelo Ghezzi, Silvia Lori, Bahia Hakiki, Marta Giannini, Isabella Righini, Lorenzo Razzolini, Claudia Niccolai, Lucia Moiola, Monica Falautano, Marta Simone, Rosa Gemma Viterbo, Francesco Patti, Sabina Cilia, Carlo Pozzilli, Valentina Bianchi, Marco Roscio, Vittorio MartinelliGiancarlo Comi, Maria Trojano, Maria Pia Amato

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The study of cognitive reserve (CR) in relationship with cognitive impairment (CI) in pediatric-onset multiple sclerosis (POMS) may provide cues to identifying subjects at higher risk of impairment and scope for therapeutic strategies. Objectives: To assess the potential impact of CR on cognition in a cohort of POMS patients. Methods: In all, 48 POMS patients were followed up for 4.7 ± 0.4 years. CI was defined as the failure of ≥3 tests on an extensive neuropsychological battery. Change of neuropsychological performance was assessed through the Reliable Change Index (RCI) method. At baseline, CR was estimated by measuring the intelligence quotient (IQ). The relationships were assessed through multivariable regression analyses. Results: At baseline, CI was detected in 14/48 (29.2%) patients. Two out of 57 healthy control (HC; 3.5%) met the same criteria of CI (p < 0.001). A deteriorating cognitive performance using the RCI method was observed in 18/48 patients (37.6%). Among the 34 cases who were cognitively preserved at baseline, a higher reserve predicted stable/improving performance (odds ratio (OR) = 1.11; 95% confidence interval (CI): 1.03-1.20; p = 0.006). Conclusion: Our results suggest that higher CR in POMS patients may protect from CI, particularly in subjects with initial cognitive preservation, providing relevant implications for counseling and rehabilitation strategies.

Original languageEnglish
Pages (from-to)1741-1749
Number of pages9
JournalMultiple Sclerosis
Volume22
Issue number13
DOIs
Publication statusPublished - Nov 1 2016

Keywords

  • cognitive impairment
  • cognitive reserve
  • intelligence quotient
  • Pediatric-onset multiple sclerosis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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