Higher Education May Protect Against MS-Related Cognitive Deficits

Multiple sclerosis (MS) is a debilitating disease in which myelin sheaths insulating the axons of the brain and spinal cord are damaged. As the immunologic brain disorder progresses, the inflammation can lead to the loss of myelin and cause potential cognitive impairments.

The neuropsychological deficits can permanently impact one’s daily life as it can hinder a person’s ability to speak or coordinate ambulatory movements.

The scarring caused by MS particularly affects the white matter of the brain. White matter is one of the two components of the central nervous system – the other is grey matter, composed of neurons.

White matter consists mostly of glial cells and myelinated axons that transmit signals from one region of the cerebrum to another, and between the cerebrum and lower brain centers. Actively, white matter has influence over how the brain learns and functions.

Whilst grey matter is primarily associated with processing and cognition, white matter modulates the distribution of action potentials, acting as a relay and coordinating communication between different brain regions.

MS interferes with the ability of nerve cells to communicate.

MS is more common in women, and the manifestation occurs in young adults.

The underlying mechanism thought to encourage the deterioration may have something to do with the immune system or failure of the myelin-producing cells, but the exact cause is still unknown.

There is no cure for MS, according to the Mayo Clinic, and the long term outcome for a patient is difficult to predict. Life expectancy with MS is five to 10 years lower than that of an unaffected population.

A study, published in Restorative Neurology and Neuroscience, suggests one way to combat declined mental acuity associated with MS is to achieve a higher education.

In prior research, neurobiologists have found continued learning promotes brain health. A higher education does not necessarily equate to college, as people can undertake several opportunities to learn a new cognitive skill such as another language, crosswords, or Sudoku, or establish a habit of reading for both education and leisure.

The simple act of stimulating the brain, like working a muscle, can aid in keeping it healthy.

But for the purposes of this study, reports Science Daily, Italian researchers found that patients with high educational levels show less impairment on a neuropsychological evaluation compared with those with low educational levels.

Investigators assessed the role of cognitive reserve (CR), the brain’s active attempt to compensate when processing and performing tasks when damage is present. They evaluated both educational and occupational experience and the influence of fatigue was also considered, as it can lower cognitive performance.

Fifty clinically diagnosed MS patients took part in the study along with a control group of 157 clinically healthy subjects. Individuals in both groups were, on average, of the same age and education level. The mean age was 40.41 years with 12.37 years of education.

Both groups were administered a short neuropsychological battery of standardized tests and cognitive performance was evaluated using a Paced Auditory Serial Addition Test (PASAT).

The researchers found that high speed PASAT versions were more suitable for identifying compensatory capacities compared to low speed PASAT versions. MS patients with low education performed worse than matched healthy controls at faster PASAT speeds.

By contrast, no difference was observed between MS patients with high education and matched healthy controls, regardless of PASAT speed. On the other hand, neither occupational attainment nor fatigue had any impact on cognitive deficits in MS.

Lead investigator Elisabetta Làdavas, PhD – Director of the Center for Studies and Research in Cognitive Neuroscience, Cesena and Professor of Neuropsychology at the Department of Psychology of the University of Bologna, Italy – states:

“These results indicate that low education is a risk factor for cognitive impairment in people with neurological disease such as MS, whereas a high educational level could be considered a protective factor from disease-associated cognitive impairment.”

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