The impact of education on cortical thickness in amyloid-negative subcortical vascular dementia: cognitive reserve hypothesis

Abstract

BackgroundThe protective effect of education has been well established in Alzheimer’s disease, whereas its role in patients with isolated cerebrovascular diseases remains unclear. We examined the correlation of education with cortical thickness and cerebral small vessel disease markers in patients with pure subcortical vascular mild cognitive impairment (svMCI) and patients with pure subcortical vascular dementia (SVaD).MethodsWe analyzed 45 patients with svMCI and 47 patients with SVaD with negative results on Pittsburgh compound B positron emission tomographic imaging who underwent structural brain magnetic resonance imaging. The main outcome was cortical thickness measured using surface-based morphometric analysis. We also assessed the volumes of white matter hyperintensities (WMH) and numbers of lacunes as other outcomes. To investigate the correlation of education with cortical thickness, WMH volume, and number of lacunes, multiple linear regression analyses were performed after controlling for covariates, including Mini Mental State Examination, in the svMCI and SVaD groups.ResultsIn the SVaD group, higher education was correlated with more severe cortical thinning in the bilateral dorsolateral frontal, left medial frontal, and parahippocampal areas, whereas there was no correlation of education with cortical thickness in the svMCI group. There was no correlation between education and cerebral small vessel disease, including WMH and lacunes, in both patients with svMCI and patients with SVaD.ConclusionsOur findings suggest that the compensatory effects of education on cortical thinning apply to patients with SVaD, which might be explained by the cognitive reserve hypothesis.

Resistance and resilience to Alzheimer’s disease pathology are associated with reduced cortical pTau and absence of limbic-predominant age-related TDP-43 encephalopathy in a community-based cohort

“…Power to detect differences across these characteristics is low in this stringently-defined group, but there was a trend in the resistant group toward more years of education and toward reduced cerebrovascular pathology (CAA, arteriolosclerosis, and atherosclerosis). Multiple prior studies have demonstrated an inverse association between higher education and cerebrovascular pathology [21, 42, 100]; our results support these prior findings. The literature is mixed on the association between education and AD, with some studies showing a protective effect of education on ADNC and others demonstrating lack of an association [9, 21, 27, 33, 45, 57, 100].…”

Relationship Between Level of Education and Post-Stroke Cognitive Status in Hospital-Based Ischemic Stroke Survivors

“…5 Recent studies have shown that level of education is a representation of the concept of cognitive reserve which has significant relationship with cognitive status in elderly population and Alzheimer's disease patients. 5,32,33,34 The study aimed to investigate the impact of low level of education to cognitive status among stroke survivors regardless to stroke subtype are still very limited and have not been conducted specifically in ischemic stroke subtype patients. A cohort study conducted by Levine et al have shown that low level of education significantly decrease the cognitive status of both ischemic and haemorrhagic stroke survivors, prominently on executive domain.…”

Reserva cognitiva y demencias: Limitaciones del efecto protector en el envejecimiento y el deterioro cognitivoLimited protective effects of cognitive reserve on the progression of cognitive impairment

“…Escolaridad y RC Analizando el impacto de la educación sobre el grosor cortical en pacientes con deterioro cognitivo y demencia vascular subcortical, se observó que, tras correlacionar un alto nivel de escolaridad y alta RC, éstas no logran atenuar el significativo adelgazamiento cortical experimentado en demencia vascular. Esto permitiría inferir que los efectos protectores de la RC sobre la cognición disminuyen frente a una gran atrofia cerebral 33 . Estos hallazgos son consistentes con estudios previos de demencia vascular, donde se observó que las repercusiones cognitivas no logran ser atenuadas debido a una disminución considerable en los volúmenes de sustancia gris 34,35 .…”