Interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome

Abstract The concepts of brain reserve and cognitive reserve were recently suggested as valuable predictors of stroke outcome. To test this hypothesis, we used age, years of education and lesion size as clinically feasible coarse proxies of brain reserve, cognitive reserve, and the extent of stroke...

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Autores principales:	Roza M. Umarova, Lena V. Schumacher, Charlotte S. M. Schmidt, Markus Martin, Karl Egger, Horst Urbach, Jürgen Hennig, Stefan Klöppel, Christoph P. Kaller
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d27887ef5b3d43158381cc5cefd7e2b6
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spelling	oai:doaj.org-article:d27887ef5b3d43158381cc5cefd7e2b62021-12-02T13:20:22ZInteraction between cognitive reserve and age moderates effect of lesion load on stroke outcome10.1038/s41598-021-83927-12045-2322https://doaj.org/article/d27887ef5b3d43158381cc5cefd7e2b62021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83927-1https://doaj.org/toc/2045-2322Abstract The concepts of brain reserve and cognitive reserve were recently suggested as valuable predictors of stroke outcome. To test this hypothesis, we used age, years of education and lesion size as clinically feasible coarse proxies of brain reserve, cognitive reserve, and the extent of stroke pathology correspondingly. Linear and logistic regression models were used to predict cognitive outcome (Montreal Cognitive Assessment) and stroke-induced impairment and disability (NIH Stroke Scale; modified Rankin Score) in a sample of 104 chronic stroke patients carefully controlled for potential confounds. Results revealed 46% of explained variance for cognitive outcome (p < 0.001) and yielded a significant three-way interaction: Larger lesions did not lead to cognitive impairment in younger patients with higher education, but did so in younger patients with lower education. Conversely, even small lesions led to poor cognitive outcome in older patients with lower education, but didn’t in older patients with higher education. We observed comparable three-way interactions for clinical scores of stroke-induced impairment and disability both in the acute and chronic stroke phase. In line with the hypothesis, years of education conjointly with age moderated effects of lesion on stroke outcome. This non-additive effect of cognitive reserve suggests its post-stroke protective impact on stroke outcome.Roza M. UmarovaLena V. SchumacherCharlotte S. M. SchmidtMarkus MartinKarl EggerHorst UrbachJürgen HennigStefan KlöppelChristoph P. KallerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Roza M. Umarova Lena V. Schumacher Charlotte S. M. Schmidt Markus Martin Karl Egger Horst Urbach Jürgen Hennig Stefan Klöppel Christoph P. Kaller Interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome
description	Abstract The concepts of brain reserve and cognitive reserve were recently suggested as valuable predictors of stroke outcome. To test this hypothesis, we used age, years of education and lesion size as clinically feasible coarse proxies of brain reserve, cognitive reserve, and the extent of stroke pathology correspondingly. Linear and logistic regression models were used to predict cognitive outcome (Montreal Cognitive Assessment) and stroke-induced impairment and disability (NIH Stroke Scale; modified Rankin Score) in a sample of 104 chronic stroke patients carefully controlled for potential confounds. Results revealed 46% of explained variance for cognitive outcome (p < 0.001) and yielded a significant three-way interaction: Larger lesions did not lead to cognitive impairment in younger patients with higher education, but did so in younger patients with lower education. Conversely, even small lesions led to poor cognitive outcome in older patients with lower education, but didn’t in older patients with higher education. We observed comparable three-way interactions for clinical scores of stroke-induced impairment and disability both in the acute and chronic stroke phase. In line with the hypothesis, years of education conjointly with age moderated effects of lesion on stroke outcome. This non-additive effect of cognitive reserve suggests its post-stroke protective impact on stroke outcome.
format	article
author	Roza M. Umarova Lena V. Schumacher Charlotte S. M. Schmidt Markus Martin Karl Egger Horst Urbach Jürgen Hennig Stefan Klöppel Christoph P. Kaller
author_facet	Roza M. Umarova Lena V. Schumacher Charlotte S. M. Schmidt Markus Martin Karl Egger Horst Urbach Jürgen Hennig Stefan Klöppel Christoph P. Kaller
author_sort	Roza M. Umarova
title	Interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome
title_short	Interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome
title_full	Interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome
title_fullStr	Interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome
title_full_unstemmed	Interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome
title_sort	interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d27887ef5b3d43158381cc5cefd7e2b6
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Interaction between cognitive reserve and age moderates effect of lesion load on stroke outcome

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