Kesler Shelli R, Adams Heather F, Blasey Christine M, Bigler Erin D
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California, USA.
Appl Neuropsychol. 2003;10(3):153-62. doi: 10.1207/S15324826AN1003_04.
Cognitive reserve theories have been postulated in an attempt to explain individual differences in functional outcome following cerebral insult or disease. These theories suggest that higher education and psychometric intelligence may preserve functional capacity regardless of injury or disease severity. This study investigated cognitive reserve in 25 participants with traumatic brain injury (TBI) using high-resolution magnetic resonance imaging (MRI) analyses. We examined the relationships between total intracranial volume (TICV), ventricle-tobrain ratio (VBR), education level, and standardized testing obtained prior to injury with post-injury cognitive outcome. Participants with lower post-injury IQ scores had significantly lower TICV values, irrespective of injury severity, and experienced significantly greater change in IQ from pre- to post-injury. TICV and education correctly predicted participants' post-injury IQ category ( Y 90 or < 90). However, premorbid standardized testing (PST) scores did not predict cognitive outcome. The results of this study suggest that larger premorbid brain volume and higher education level may decrease vulnerability to cognitive deficits following TBI, consistent with the notion of a cognitive reserve.
认知储备理论已被提出，试图解释脑损伤或疾病后功能结局的个体差异。这些理论表明，无论损伤或疾病严重程度如何，高等教育和心理测量智力都可能保留功能能力。本研究使用高分辨率磁共振成像（MRI）分析，对25名创伤性脑损伤（TBI）患者的认知储备进行了调查。我们检查了总颅内体积（TICV）、脑室与脑比率（VBR）、教育水平以及损伤前获得的标准化测试与损伤后认知结局之间的关系。损伤后智商得分较低的参与者，无论损伤严重程度如何，其TICV值均显著较低，并且从损伤前到损伤后智商的变化显著更大。TICV和教育水平能够正确预测参与者损伤后的智商类别（≥90或<90）。然而，病前标准化测试（PST）分数并不能预测认知结局。本研究结果表明，较大的病前脑容量和较高的教育水平可能会降低TBI后认知缺陷的易感性，这与认知储备的概念一致。
