Sandroff Brian M, Schwartz Carolyn E, DeLuca John
Kessler Foundation, 1199 Pleasant Valley Way, West Orange, NJ, 07052, USA.
DeltaQuest Foundation, Inc., Concord, MA, USA.
J Neurol. 2016 Nov;263(11):2158-2169. doi: 10.1007/s00415-016-8104-5. Epub 2016 Apr 12.
Cognitive dysfunction is highly prevalent, disabling, and poorly managed in persons with multiple sclerosis (MS). However, not all persons with MS present with cognitive impairment despite having grey and white matter pathology. To explain such an observation, much attention has been drawn to other factors, namely the concept of reserve (i.e., protection against clinical manifestations of neurological damage). There is a growing body of evidence supporting brain reserve and cognitive reserve for mitigating the deleterious effects of MS pathology on cognition in MS. Measurement and maintenance of reserve is paramount. The current review addresses measures of brain and cognitive reserve, separately, that have been adopted in MS research. These measures are largely based on genetics and premorbid behavior. We propose that reserve may not be limited to premorbid factors that are not highly amenable to change. Rather, reserve can be built and maintained over time based on ongoing participation in cognitively stimulating activities. We conclude with recommendations for future research on reserve in MS samples. This will provide keen insight into potential applications for building reserve and ultimately improving the well-being of those with MS across multiple domains.
认知功能障碍在多发性硬化症（MS）患者中非常普遍，会导致残疾，且治疗效果不佳。然而，并非所有MS患者尽管存在灰质和白质病变，但都会出现认知障碍。为了解释这一现象，人们将更多注意力投向了其他因素，即储备概念（即预防神经损伤临床表现的能力）。越来越多的证据支持大脑储备和认知储备在减轻MS病理对MS患者认知的有害影响方面的作用。储备的测量和维持至关重要。本综述分别阐述了MS研究中采用的大脑储备和认知储备的测量方法。这些方法主要基于遗传学和病前行为。我们认为，储备可能不限于那些不太容易改变的病前因素。相反，通过持续参与认知刺激活动，储备可以随着时间的推移而建立和维持。我们最后对MS样本中储备的未来研究提出了建议。这将为建立储备的潜在应用以及最终改善MS患者在多个领域的福祉提供深刻见解。
