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Active Cognitive Reserve Influences the Regional Atrophy to Cognition Link in Multiple Sclerosis

  • Adam J. Booth (a1), Jonathan D. Rodgers (a1), Carolyn E. Schwartz (a2) (a3), Brian R. Quaranto (a2), Bianca Weinstock-Guttman (a1), Robert Zivadinov (a1) and Ralph H.B. Benedict (a1)...


Recent research indicates that cognitive reserve mitigates the clinical expression of neuropsychological impairment in multiple sclerosis (MS). This literature primarily uses premorbid intelligence and lifetime experiences as indicators. However, changes in current recreational activities may also contribute to the maintenance of neural function despite brain atrophy. We examined the moderation effects of current changes in recreational activity on the relationship between brain atrophy and information processing speed in 57 relapsing-remitting MS patients. Current enrichment was assessed using the Recreation and Pastimes subscale from the Sickness Impact Profile. In patients reporting current declines in recreational activities, brain atrophy was negatively associated with cognition, but there was no such association in participants reporting stable participation. The MRI metric-by-recreational activity interaction was significant in separate hierarchical regression analyses conducted using third ventricle width, neocortical volume, T2 lesion volume, and thalamic volume as brain measures. Results suggest that recreational activities protect against brain atrophy's detrimental influence on cognition. (JINS, 2013, 19, 1–6)


Corresponding author

Correspondence and reprint requests to: Ralph H.B. Benedict, Neurology, E-2, Buffalo General Hospital, 100 High Street, Buffalo, New York, 14203. E-mail:


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