The protective effects of high-education levels on cognition in different stages of multiple sclerosis
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Citações na Scopus
27
Tipo de produção
article
Data de publicação
2018
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCI LTD
Autores
Citação
MULTIPLE SCLEROSIS AND RELATED DISORDERS, v.22, p.41-48, 2018
Resumo
Background: Low-education attainment is associated with worse cognitive performance in multiple sclerosis (MS) patients, and possibly with a lower cognitive reserve and/or increased inflammatory activity. Cognitive reserve refers to the capability of a source of intellectual enrichment in attenuating a negative effect of a diseaserelated factor; while the inflammatory activity is often related to T2-lesion load (T2-LL) increase. Objective: To disentangle the effects of cognitive reserve and an increased T2-LL in MS-patients with low-education levels. Methods: The study included 136 MS patients and 65 healthy-controls, divided in low-education (12 years or less of school education without obtaining any technical superior degree) and high-education (more than 12 years of school education with technical or superior degree) groups. An extensive battery of neuropsychological tests was applied examining intelligence quotient and six cognitive domains. Test results were z-scored and subjects with z-scores <= -1.5 in two or more domains were considered cognitively impaired. To test the factors associated with worse cognitive performance, regression models were applied using average cognition as target; education level, Expanded Disability Status Scale (EDSS), T2-LL, disease duration, age of disease onset, age and gender as predictors. We also tested the correlation between T2-LL and cognition in the groups. To investigate the role of education level as a source of intellectual enrichment/cognitive reserve in different stages of MS, we sub-divided the MS patients in three groups according to the disease duration (less than 5 years, between 5 and 10 years and more than 10 years). Results: Worse average cognition was associated with low-education level, higher T2-LL and male gender. A higher frequency of cognitively impaired patients was observed in MS patients with low-education level, in all stages of the disease. In patients with a disease duration shorter than five years, there was a lower correlation between worse average cognition and T2-LL in the high-education level group, compared to the patients with low-education level; in MS patients with longer disease duration, we observed a stronger correlation between lesion burden and cognitive impairment in both groups. Conclusion: Education attainment is a source of intellectual enrichment and can enhance the cognitive reserve in MS patients. The protective effect of a high-education level was stronger in patients with less than five years of disease, suggesting a stronger role of cognitive reserve in short-term disease. In long-term disease we observed a greater impact of increased inflammatory activity on cognition.
Palavras-chave
Multiple sclerosis, Cognition, Education, Cognitive reserve, Demyelinating diseases, Neuropsychology
Referências
- Almeida L, 2012, INT J ENV RES PUB HE, V9, P2520, DOI 10.3390/ijerph9072520
- Benedict RHB, 2010, J INT NEUROPSYCH SOC, V16, P829, DOI 10.1017/S1355617710000688
- Benedict RH., 1997, BRIEF VISUOSPATIAL M
- Bjornevik K, 2016, MULT SCLER J, V22, P104, DOI 10.1177/1352458515579444
- Boylan JM, 2013, PSYCHOSOM MED, V75, P566, DOI 10.1097/PSY.0b013e31829683bd
- Brandt J., 2001, HOPKINS VERBAL LEARN
- Bruce JM, 2010, J BEHAV MED, V33, P219, DOI 10.1007/s10865-010-9247-y
- Butler SM, 1996, J AM GERIATR SOC, V44, P675, DOI 10.1111/j.1532-5415.1996.tb01831.x
- Calabrese M, 2015, MULT SCLER J, V21, P580, DOI 10.1177/1352458514542363
- Christensen H, 1997, INT J GERIATR PSYCH, V12, P323, DOI 10.1002/(SICI)1099-1166(199703)12:3<323::AID-GPS492>3.0.CO;2-N
- D'hooghe MB, 2016, ACTA NEUROL SCAND, V134, P414, DOI 10.1111/ane.12555
- Silva AM, 2015, MULT SCLER J, V21, P1312, DOI 10.1177/1352458515581874
- Feinstein A, 2013, J NEUROL, V260, P2256, DOI 10.1007/s00415-013-6952-9
- Fraga S, 2015, PREV MED, V71, P12, DOI 10.1016/j.ypmed.2014.11.031
- Fragoso YD, 2014, ARQ NEURO-PSIQUIAT, V72, P889, DOI 10.1590/0004-282X20140159
- Gold SM, 2003, J NEUROIMMUNOL, V138, P99, DOI 10.1016/S0165-5728(03)00121-8
- Greenaway MC, 2009, CLIN NEUROPSYCHOL, V23, P7, DOI 10.1080/13854040801891686
- Koster A, 2006, J GERONTOL A-BIOL, V61, P284, DOI 10.1093/gerona/61.3.284
- Kuhlmann T, 2002, BRAIN, V125, P2202, DOI 10.1093/brain/awf235
- Langdon DW, 2012, MULT SCLER J, V18, P891, DOI 10.1177/1352458511431076
- Lazeron RHC, 2005, MULT SCLER, V11, P524, DOI 10.1191/1352458505ms1201oa
- Lynch SG, 2005, MULT SCLER, V11, P469, DOI 10.1191/1352458505ms1182oa
- Miotto EC, 2012, ARQ NEURO-PSIQUIAT, V70, P962, DOI 10.1590/S0004-282X2012001200014
- Monteiro CA, 2001, J NUTR, V131, p881S
- Patti F, 2007, MULT SCLER, V13, P783, DOI 10.1177/1352458506073511
- Pinter D, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0087567
- Schmidt P, 2012, NEUROIMAGE, V59, P3774, DOI 10.1016/j.neuroimage.2011.11.032
- Schoonheim MM, 2014, HUM BRAIN MAPP, V35, P2348, DOI 10.1002/hbm.22332
- Schoonheim MM, 2012, NEUROLOGY, V79, P1754, DOI 10.1212/WNL.0b013e3182703f46
- Smith A., 1991, SYMBOL DIGIT MODALIT
- SNOWDON DA, 1989, AM J EPIDEMIOL, V130, P999, DOI 10.1093/oxfordjournals.aje.a115433
- SPREEN O., 1998, COMPENDIUM NEUROPSYC
- Stern Y, 2005, CEREB CORTEX, V15, P394, DOI 10.1093/cercor/bhh142
- Stern Y, 2002, J INT NEUROPSYCH SOC, V8, P448, DOI 10.1017/S1355617702813248
- Stern Y, 2009, NEUROPSYCHOLOGIA, V47, P2015, DOI 10.1016/j.neuropsychologia.2009.03.004
- Strauss E., 2006, COMPENDIUM NEUROPSYC
- Strober L, 2009, MULT SCLER, V15, P1077, DOI 10.1177/1352458509106615
- Sumowsk JF, 2015, FRONT NEUROL, V6, DOI 10.3389/fneur.2015.00176
- Sumowski JF, 2010, NEUROLOGY, V75, P1428, DOI 10.1212/WNL.0b013e3181f881a6
- Sumowski JF, 2016, MULT SCLER J, V22, P1621, DOI 10.1177/1352458516630822
- Sumowski JF, 2014, NEUROLOGY, V82, P1776, DOI 10.1212/WNL.0000000000000433
- Sumowski JF, 2010, NEUROLOGY, V74, P1942, DOI 10.1212/WNL.0b013e3181e396be
- Sumowski JF, 2010, BRAIN, V133, P362, DOI 10.1093/brain/awp307
- Sumowski JF, 2009, J INT NEUROPSYCH SOC, V15, P606, DOI 10.1017/S1355617709090912
- Tombaugh TN, 1999, ARCH CLIN NEUROPSYCH, V14, P167, DOI 10.1016/S0887-6177(97)00095-4
- Van Schependom J, 2014, EUR J NEUROL, V21, P1219, DOI 10.1111/ene.12463
- Wechsler D., 2014, WAIS 3 ESCALA INTELI
- Yeh EA, 2009, BRAIN, V132, P3392, DOI 10.1093/brain/awp278
- Zimmermann Nicolle, 2015, Dement. neuropsychol., V9, P120, DOI 10.1590/1980-57642015DN92000006
Coleções
Artigos e Materiais de Revistas Científicas - FM/MDR
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/21
Artigos e Materiais de Revistas Científicas - LIM/44
Artigos e Materiais de Revistas Científicas - LIM/45
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/21
Artigos e Materiais de Revistas Científicas - LIM/44
Artigos e Materiais de Revistas Científicas - LIM/45