Balart-Sánchez Sebastián A, Bittencourt Mayra, Jalili Seyedehzahra, van der Naalt Joukje, Maurits Natasha M
Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
PLoS One. 2025 Jan 6;20(1):e0316673. doi: 10.1371/journal.pone.0316673. eCollection 2025.
Older adults have an increased risk of developing persistent cognitive complaints after mild traumatic brain injury (mTBI). Yet, studies exploring which factors protect older adults with mTBI from developing such complaints are rare. It has been suggested that one such factor may be cognitive reserve (CR), but it is unknown how CR influences cognition in this patient category. Here, we therefore study how CR influences brain processes during a task that taps into attention, an important cognitive function.
We studied 17 older adults (13 males, mean 68.18 (SD 5.08) years old) at the subacute stage after mTBI and 19 age- and CR-matched participants without mTBI; 9 males, mean 67.79 (SD 5.36) years old) performing a selective visual attentional processing task while recording EEG. The P2 brain event-related potential component was obtained by averaging over electrodes in the fronto-central region of interest and its amplitude and latency were derived as neural correlates of attentional processing. The inverse efficiency score (IES) was derived from accuracy and reaction times as a measure of performance. To investigate the effect of CR on performance and P2 component characteristics, three separate mixed model repeated measures analyses of covariance (RM-ANCOVA) were performed.
Performance did not significantly differ across groups or task conditions, nor was it significantly influenced by CR. Main effects of CR illustrated that the P2 latency was delayed (p = .03) and the P2 amplitude increased (p = .02) with higher CR across groups. Furthermore, CR correlated positively with P2 latency in both groups (older adults without mTBI: r = .370, p = .005, older adults with mTBI: r = .287, p = 0.041), and with P2 amplitude in the older adults with mTBI (r = .595-.636, p<0.001-.011). We found no main or interaction effects of group or task condition on P2 characteristics.
Older adults with mTBI with higher CR employ more brain resources than older adults with mTBI with lower CR, accompanied by slower processing, suggesting that it may have resulted in similar performance at a selective visual attentional processing task. To better interpret these findings in the context of persistent complaints and establish that higher CR in these patients may result in better performance, our study needs to be repeated with more participants.
老年人在轻度创伤性脑损伤（mTBI）后出现持续性认知主诉的风险增加。然而，探索哪些因素可保护患有mTBI的老年人不出现此类主诉的研究很少。有人提出，认知储备（CR）可能是其中一个因素，但尚不清楚CR如何影响这类患者的认知。因此，我们在此研究CR在一项涉及注意力（一种重要认知功能）的任务中如何影响大脑过程。
我们研究了17名mTBI亚急性期的老年人（13名男性，平均年龄68.18岁（标准差5.08岁））和19名年龄及CR匹配的无mTBI参与者（9名男性，平均年龄67.79岁（标准差5.36岁）），他们在记录脑电图的同时执行选择性视觉注意加工任务。通过对感兴趣的额中央区域的电极进行平均获得P2脑事件相关电位成分，并得出其幅度和潜伏期作为注意加工的神经相关指标。逆效率得分（IES）从准确性和反应时间得出，作为表现的一种度量。为了研究CR对表现和P2成分特征的影响，进行了三项单独的混合模型重复测量协方差分析（RM-ANCOVA）。
各组或任务条件下的表现无显著差异，CR也未对其产生显著影响。CR的主效应表明，各组中CR越高，P2潜伏期延迟（p = 0.03）且P2幅度增加（p = 0.02）。此外，两组中CR均与P2潜伏期呈正相关（无mTBI的老年人：r = 0.370，p = 0.005；有mTBI的老年人：r = 0.287，p = 0.041），在有mTBI的老年人中CR与P2幅度呈正相关（r = 0.595 - 0.636，p < 0.001 - 0.011）。我们未发现组或任务条件对P2特征有主效应或交互效应。
与CR较低的mTBI老年人相比，CR较高的mTBI老年人在执行选择性视觉注意加工任务时会动用更多大脑资源，且加工速度较慢，这表明这可能导致了相似的表现。为了在持续性主诉的背景下更好地解释这些发现，并确定这些患者中较高的CR可能导致更好的表现，我们的研究需要增加更多参与者后重复进行。
