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Abstract Details

Evidence for Brain Reserve and Cognitive Reserve in Multiple Sclerosis: Lifetime Maximal Brain Growth and Early Life Cognitive Leisure Independently but Differentially Protect Against Disease-Related Cognitive Decline
MS and Related Diseases
P04 - (-)
109
BACKGROUND: The BR hypothesis states that larger lifetime brain growth/size (estimated with intracranial volume [ICV]) protects against disease-related cognitive impairment. BR is supported in aging/Alzheimer's disease (AD), but is untested in multiple sclerosis (MS). The CR hypothesis states that greater lifetime enrichment (i.e., cognitive leisure) protects against disease-related cognitive impairment. Although supported in AD and MS, it is unknown whether CR (acquired through experience) protects against cognitive impairment independently of BR (determined by genetics).
DESIGN/METHODS: Cognitive status was assessed in 62 MS patients (SDMT, PASAT, SRT, SPART). MRI was used to measure neuropathological burden (T2 lesion load [T2LL]) and BR (ICV). CR was estimated with survey of early life cognitive leisure (e.g., hobbies). BR hypothesis: hierarchical regression predicting cognitive status (step one: demographics; step two: T2LL; step three: ICV, step four: T2LLxICV). CR hypothesis: hierarchical regression predicting cognitive status (step one: all predictors in BR analysis; step two: education; step three: cognitive leisure; step four: T2LLxleisure interaction). Analyses repeated to predict cognitive efficiency (SDMT, PASAT) and memory (SRT, SPART) separately.
RESULTS: T2LLxICV interaction (R[sup2]=.05, p=.030) showed that greater ICV reduced/moderated the negative impact of T2LL on cognitive status. BR protected against cognitive inefficiency, not memory decline. T2LLxleisure interaction (R[sup2]=.037, p=.037) revealed that higher leisure independently reduced/moderated the negative impact ofT2LL on cognitive status. CR was more protective against memory decline than cognitive inefficiency.
CONCLUSIONS: BR was supported in MS, with larger lifetime brain growth/size protecting against cognitive decline. Cognitive leisure provided independent protection against cognitive impairment over-and-above BR. Voluntary lifestyle choices are protective over-and-above genetic sources of reserve.
Authors/Disclosures
James F. Sumowski (Icahn School of Medicine At Mount Sinai)
PRESENTER
Mr. Sumowski has nothing to disclose.
Maria A. Rocca (Neuroimaging Research Unit) Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen, Bristol Myers Squibb, Eli Lilly, Janssen, Roche. Maria Assunta Rocca has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for AstraZaneca, Biogen, Bristol Myers Squibb, Bromatech, Celgene, Genzyme, Horizon Therapeutics Italy, Merck Serono SpA, Novartis, Roche, Sanofi and Teva. The institution of Maria Assunta Rocca has received research support from MS Society of Canada, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Victoria Leavitt, PhD, FAAN (Columbia University Irving Medical Center) Dr. Leavitt has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Leavitt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. The institution of Dr. Leavitt has received research support from National Institutes of Health. The institution of Dr. Leavitt has received research support from National Multiple Sclerosis Society. The institution of Dr. Leavitt has received research support from Department of Defense. Dr. Leavitt has received intellectual property interests from a discovery or technology relating to health care.
Gianna Carla Riccitelli (San Raffaele) No disclosure on file
Argye E. Hillis, MD, MA (Johns Hopkins Hospital) Dr. Hillis has received personal compensation for serving as an employee of Johns Hopkins University. Dr. Hillis has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Hillis has received research support from NIH. Dr. Hillis has received publishing royalties from a publication relating to health care. Dr. Hillis has received personal compensation in the range of $500-$4,999 for serving as a NIDCD Council Member with NIH.
Giancarlo Comi, MD (University Vita-Salute) Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.
John DeLuca, PhD, ABPP (Kessler Foundation) Dr. DeLuca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. DeLuca has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. DeLuca has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Celgene. Dr. DeLuca has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. DeLuca has received research support from Biogen.
Massimo Filippi, MD, FAAN (Ospedale San Raffaele, Neuroimaging Research Unit) Dr. Filippi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion, Almirall, Biogen, Merck, Novartis, Roche, Sanofi. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion, Biogen, Bristol-Myers Squibb, Merck, Novartis, Roche, Sanofi, Sanofi-Aventis, Sanofi-Genzyme, Takeda. Dr. Filippi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bayer, Biogen, Celgene, Chiesi Italia SpA, Eli Lilly, Genzyme, Janssen, Merck-Serono, Neopharmed Gentili, Novartis, Novo Nordisk, Roche, Sanofi, Takeda, and TEVA. Dr. Filippi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer Nature. The institution of Dr. Filippi has received research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.
Teri Schreiner, MD, MPH, FAAN (University of Colorado/ Children's Hospital of Colorado) The institution of Dr. Schreiner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CDC. Dr. Schreiner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. The institution of Dr. Schreiner has received research support from Roche Genentech.