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Past Life Experiences and Neurological Recovery: The Role of Cognitive Reserve in the Rehabilitation of Severe Post-Anoxic Encephalopathy and Traumatic Brain Injury

Published online by Cambridge University Press:  15 November 2019

Arianna Menardi
Department of Neuroscience, Padova Neuroscience Center, University of Padova, Via Giuseppe Orus, 35131 Padova, PD, Italy
Giannettore Bertagnoni
Division of Physical and Rehabilitative Medicine of the San Bortolo Hospital, Viale Ferdinando Rodolfi, 37, 36100 Vicenza, VI, Italy
Giuseppe Sartori
Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, PD, Italy Human Inspired Research Centre, University of Padova, Via Luzzatti, 4, 35122 Padova, PD, Italy
Massimiliano Pastore
Department of Developmental and Social Psychology, University of Padova, Via Venezia, 8, 35131 Padova, PD, Italy
Sara Mondini*
Human Inspired Research Centre, University of Padova, Via Luzzatti, 4, 35122 Padova, PD, Italy FI.S.P.P.A. Department, University of Padova, Via Venezia 14, 35131 Padova, PD, Italy
*Correspondence and reprint requests to: Sara Mondini, FI.S.P.P.A. Department, University of Padova, Via Venezia 14, 35121 Padova, PD, Italy. E-mail:



Patients with an equivalent clinical background may show unexpected interindividual differences in their outcome. The cognitive reserve (CR) model has been proposed to account for such discrepancies, but its role after acquired severe injuries is still being debated. We hypothesize that inappropriate investigative methods might have been used when dealing with severe patients, which have very likely reduced the possibility of observing meaningful influences in recovery from severe traumas.


To overcome this issue, the potential neuroprotective role of CR was investigated, considering a wider spectrum of clinical symptoms ranging from low-level brain stem functions necessary for life to more complex motor and cognitive skills. In the present study, data from 50 severe patients, 20 suffering from post-anoxic encephalopathy (PAE) and 30 with traumatic brain injury (TBI), were collected and retrospectively analyzed.


We found that CR, diagnosis, time of hospitalization, and their interaction had an effect on the clinical indexes. When the predictive power of CR was investigated by means of two machine learning classifier algorithms, CR, together with age, emerged as the strongest factor in discriminating between patients who reached or did not reach successful recovery.


Overall, the present study highlights a possible role of CR in shaping the recovery of severe patients suffering from either PAE or TBI. The practical implications underlying the need to routinely considered CR in the clinical practice are discussed.

Regular Research
Copyright © INS. Published by Cambridge University Press, 2019

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