Cognitive Reserve Proxies Do Not Differentially Account for Cognitive Performance in Patients with Focal Frontal and Non-Frontal Lesions

MacPherson, Sarah E.; Allerhand, Michael; Gharooni, Sarah; Smirni, Daniela; Shallice, Tim; Chan, Edgar; Cipolotti, Lisa

doi:10.1017/s1355617720000326

Cited by 13 publications

(14 citation statements)

References 88 publications

(95 reference statements)

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“…On the other hand, CR may work via compensatory mechanisms that are supported by alternative neural networks [1], mostly via increased involvement of prefrontal cortex processes and associated executive control processes [3]. However, a very recent study in unilateral frontal and non-frontal stroke patients failed to support this notion, showing that CR similarly influences cognitive performance in both patient groups [15]. The extent to which existing versus compensatory mechanisms are involved in the current study findings as well as in maintaining cognition in aging in general, requires further investigation.…”

Section: Discussionmentioning

confidence: 99%

Cognitive reserve relates to executive functioning in the old–old

et al. 2020

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Cognitive reserve (CR) is known to reduce or even protect against the negative effects of aging on cognitive functioning. Nonetheless, little is known about how CR influences the relationship between different cognitive abilities and age in the old–old. The goal of the present study was, therefore, to test the hypothesis whether, in the old–old, CR still modifies the relationship between age and cognitive functioning. Eighty-three adults (aged 71–94) without mild cognitive impairment or dementia residing in residential care facilities completed a detailed neuropsychological test battery. CR was estimated using a combination of educational attainment and an estimation of verbal intelligence. Moderation analyses revealed a significant effect for fluency and a trend for flexibility, showing that the negative relationship between age and cognitive performance is reduced as the level of CR increases. These results demonstrate that CR still influences the relationship between age and executive functions in adults of advanced age.

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Section: Discussionmentioning

confidence: 99%

Cognitive reserve relates to executive functioning in the old–old

et al. 2020

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“…Previous comparison of a large frontal and non-frontal sample with different aetiologies on the APM and other executive tests showed that aetiology was not a strong predictor of frontal or non-frontal deficits. 9, 108 Hence, different aetiologies do not result in more severe impairments than others and combining across vascular and tumour pathologies is unlikely to significantly distort neuropsychological performance. 76 Instead, focal lesions may relate more closely to the region of damage rather than aetiology.…”

Section: Discussionmentioning

confidence: 99%

Graph lesion-deficit mapping of fluid intelligence

Cipolotti

Ruffle

Mole

et al. 2022

Preprint

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Fluid intelligence is arguably the defining feature of human cognition. Yet the nature of its relationship with the brain remains a contentious topic. Influential proposals drawing primarily on functional imaging data have implicated "multiple demand" frontoparietal and more widely distributed cortical networks, but extant lesion-deficit studies with greater causal power are almost all small, methodologically constrained, and inconclusive. The task demands large samples of patients, comprehensive investigation of performance, fine-grained anatomical mapping, and robust lesion-deficit inference, yet to be brought to bear on it. We assessed 165 healthy controls and 227 frontal or non-frontal patients with unilateral brain lesions on the best-established test of fluid intelligence, Raven's Advanced Progressive Matrices, employing an array of lesion-deficit inferential models responsive to the potentially distributed nature of fluid intelligence. Non-parametric Bayesian stochastic block models were used to reveal the community structure of lesion deficit networks, disentangling functional from confounding pathological distributed effects. Impaired performance was confined to patients with frontal lesions (F(2,387) = 18.491; p < .001; frontal worse than non-frontal and healthy participants p < .01; p <.001), more marked on the right than left (F(4,385) = 12.237; p < .001; right worse than left and healthy participants p<.01; p<.001). Patients with non-frontal lesions were indistinguishable from controls and showed no modulation by laterality. Neither the presence nor the extent of multiple demand network involvement affected performance. Both conventional network-based statistics and non-parametric Bayesian stochastic block modelling heavily implicated the right frontal lobe. Crucially, this localisation was confirmed on explicitly disentangling functional from pathology-driven effects within a layered stochastic block model, prominently highlighting a right frontal network involving middle and inferior frontal gyrus, pre- and post-central gyri, with a weak contribution from right superior parietal lobule. Similar results were obtained with standard lesion-deficit analyses. Our study represents the first large-scale investigation of the distributed neural substrates of fluid intelligence in the focally injured brain. Combining novel graph-based lesion-deficit mapping with detailed investigation of cognitive performance in a large sample of patients provides crucial information about the neural basis of intelligence. Our findings indicate that a set of predominantly right frontal regions, rather than a more widely distributed network, is critical to the high-level functions involved in fluid intelligence. Further they suggest that Raven's Advanced Progressive Matrices is a useful clinical index of fluid intelligence and a sensitive marker of right frontal lobe dysfunction.

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“…Furthermore, we found that the occupational complexity "data" domain predicts verbal working memory scores. In recent years, the effects of CR have been investigated not only in dementia or aging, but also in a broader range of disorders, such as traumatic brain injury and stroke [28], [30], [33] ; however, no study had focused on occupational complexity as a CR in patients with frontal lobe tumors. To our knowledge, this is the rst study to demonstrate that occupational complexity, as a CR, predicts working memory after tumor resection in patients with frontal lobe tumors.…”

Section: Discussionmentioning

confidence: 99%

“…In studies on patients with traumatic brain injuries, a higher premorbid IQ as a CR proxy was associated with less cognitive decline after injury [31], [32] . Further, CR has been shown to have a protective effect against working memory impairments from traumatic brain injury and stroke [28], [32], [33], [34] . Considering the above evidence, CR should have protective effects against cognitive impairments, including working memory, in patients who have undergone brain tumor resection [35] .…”

Section: Introductionmentioning

confidence: 99%

Protective Effect of Occupational Complexity on Working Memory in Patients with Frontal Lobe Tumors

Ebina

Matsui

Kinoshita

et al. 2021

Preprint

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Cognitive reserve (CR) is the capacity to cope with cognitive impairments due to brain damage by neurological disease. CR is increased by intellectually enriching activities, such as education, occupation, and leisure. After brain tumor resection, patients show working memory impairment because of damage to fronto-parietal networks, such as the superior longitudinal fascicle (SLF). To date, whether occupational experience represented as CR impacts postoperative working memory impairment in patients with frontal lobe tumors remains unknown. We hypothesized that occupational experience predicted postoperative working memory and that higher damage in the SLF was associated with poorer working memory. We enrolled 27 patients who had undergone tumor resection. Patient's occupational experience was estimated using an occupational complexity index based on a dictionary of occupational titles. Working memory was measured using verbal and spatial working memory tasks. Our results showed that patients who had engaged in more complex occupations showed higher performance of postoperative working memory, which supported the previous CR hypothesis. In conclusion, CR has protective effects against working memory impairment in patients with frontal lobe tumors. CR measures, such as occupational experience, will help more accurately predict the severity of working memory deficits and the likelihood of recovery in the postoperative period.

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Cognitive Reserve Proxies Do Not Differentially Account for Cognitive Performance in Patients with Focal Frontal and Non-Frontal Lesions

Cited by 13 publications

References 88 publications

Cognitive reserve relates to executive functioning in the old–old

Cognitive reserve relates to executive functioning in the old–old

Graph lesion-deficit mapping of fluid intelligence

Protective Effect of Occupational Complexity on Working Memory in Patients with Frontal Lobe Tumors

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