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Cognitive reserve lessens the burden of white matter lesions on executive functions in bipolar disorder

Journal article
Authors Sindre Rolstad
C. Abe
E. Olsson
Carl Eckerström
Mikael Landén
Published in Psychological Medicine
Volume 46
Issue 15
Pages 3095-3104
ISSN 0033-2917
Publication year 2016
Published at Institute of Neuroscience and Physiology
Pages 3095-3104
Language en
Links https://doi.org/10.1017/s0033291716...
Keywords Bipolar disorder, cognition, cognitive reserve, magnetic resonance imaging, human cerebral-cortex, magnetic-resonance images, surface-based, analysis, alzheimers-disease, brain reserve, cortical thickness, prefrontal cortex, follow-up, step-bd, education, Psychology, Psychiatry
Subject categories Neurology

Abstract

Background. The concept of cognitive reserve (CR) hypothesizes that intellectually stimulating activities provide resilience against brain pathology/disease. Whereas brain abnormalities and cognitive impairment are frequently reported in bipolar disorder (BD), it is unknown whether the impact of brain alterations can be lessened by higher CR in BD. Method. We tested if higher CR would reduce the influence of total volumes of deep white matter hypointensities (WMH), ventricular cerebrospinal fluid (CSF), and prefrontal cortex on memory, executive, and attention/speed functions in patients with BD (n = 75). Linear regression models with interaction terms for CR and brain volumes were applied to directly test if CR reduces the influence of brain pathology on cognitive domains. Results. CR reduced the influence of total volumes of deep WMH (beta=-0.38, Q = 0.003) and ventricular CSF (beta = -41, Q = 006) on executive functions. Conclusions. The interactions between CR and total volumes of deep WMH/ventricular CSF appear to account for executive functioning in BD. The results suggest that the concept of CR is applicable in BD. Higher reserve capacity in BD alters the relationship between brain pathology and clinical presentation.

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