Educational attainment and motor burden in Parkinson's disease

Abstract

OBJECTIVE Greater educational attainment is a protective factor for neurodegenerative dementias. If education earlier in life leads to greater cerebral reserve, it may play a similar protective role in Parkinson disease (PD). METHODS We conducted a cross-sectional clinical-imaging study of 142 subjects with PD. All subjects underwent [11C]dihydrotetrabenazine PET to confirm nigrostriatal dopaminergic denervation and brain MRI to estimate adjusted cortical grey matter volume. RESULTS After adjusting for possible confounders including cognitive and dopaminergic covariates, as well as non-specific neurodegeneration covariates (age, disease duration, and total adjusted cortical gray matter volume), lower years of education remained a significant predictor of higher total MDS-UPDRS motor score (t=−3.28, p=0.001). Education level associated inversely with white matter hyperintensities in a post-hoc analysis (n=83). CONCLUSIONS Higher educational attainment is associated with lower severity of motor impairment in PD. This association may reflect an extranigral protective effect upon white matter integrity.

The effects of lifelong cognitive lifestyle on executive function in older people with Parkinson's disease

“…The finding that high cognitive reserve was associated with better motor function fits with previous studies showing that higher education is associated with better motor performance (Kotagal et al, ). Although the effect of cognitive reserve on design fluency was non‐significant after correction, it may be that in a larger sample with greater power, this result would be positive.…”

“…A recent study has shown that higher education may protect cognition through an association with reduced cortical Lewy body pathology in PD (Lucero et al, ). Higher educational attainment may also be associated with lower motor impairment, possibly mediated through an extra‐nigral effect on white matter integrity (Kotagal et al, ).…”

Risky behaviors and Parkinson disease

“…We first used genetic instruments for different traits representative of the smoking phenotype (ever smoker vs never been a regular smoker, former vs current smoker, and cigarettes per day). [42][43][44][45][46] A previous meta-analysis of GWAS on the ever smoker phenotype in 143,023 individuals of European ancestry identified genetic variants from the BDNF gene to be associated with the ever smoker phenotype. 22 Because all the variants were in high LD with each other, we used rs6265, a nonsynonymous variant with a functional effect on gene expression, as a proxy for all other variants for the MR analysis.…”

Beyond Alzheimer’s Disease: Bilingualism and Other Types of Neurodegeneration

“…Perhaps unexpectedly, a link has also been identified between cognitive reserve and motor outcomes. Low educational attainment and low scores in the Cognitive Reserve Index questionnaire (CRIq)-a questionnaire that permits a quantification of a Cognitive Reserve Index, by taking into account education, working activities and leisure activities-are associated with more severe motor impairment in PD after controlling for age and disease duration (Guzzetti et al, 2019;Kotagal et al, 2015).…”