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BMC Neurology
Published in: BMC Neurology 1/2021

01-12-2021 | Alzheimer's Disease | Research article

The protective impact of education on brain structure and function in Alzheimer’s disease

Authors: Wanqiu Zhu, Xiaoshu Li, Xiaohu Li, Haibao Wang, Meiqin Li, Ziwen Gao, Xingqi Wu, Yanghua Tian, Shanshan Zhou, Kai Wang, Yongqiang Yu

Published in: BMC Neurology | Issue 1/2021

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Abstract

Background

The Cognitive Reserve (CR) theory posits that brains with higher reserve can cope with more cerebral damage to minimize clinical manifestations. The aim of this study was to examine the effect of education (CR proxy) on brain structure and function in Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI) patients and in cognitively healthy elderly (HC) individuals.

Methods

Fifty-seven AD patients, 57 aMCI patients and 48 HCs were included to investigate the relationships between education years and gray matter volume (GMV), regional homogeneity (ReHo) and functional connectivity (FC) in brain regions to show associations with both structure and function. Taking the severity of the disease into account, we further assessed the relationships in AD stratified analyses.

Results

In AD group, the GMV of the dorsal anterior cingulate cortex (dACC) and ReHo in the left inferior temporal cortex (ITC) were inversely associated with education years, after adjustment for age, sex, Mini-Mental State Examination (MMSE), and total intracranial volume or head motion parameters. Seed-based FC analyses revealed that education years were negatively correlated with the FC between the left anterior ITC and left mid frontal cortex as well as right superior frontal cortex and right angular gyrus. Stratified analyses results indicated that this negative relation between education and GMV, ReHo, FC was mainly present in mild AD, which was attenuated in moderate AD and aMCI groups.

Conclusions

Our results support the CR theory, and suggest that CR may be protective against AD related brain pathology at the early stage of clinical dementia. These findings could provide the locus of CR-related functional brain mechanisms and a specific time-window for therapeutic interventions to help AD patients to cope better with the brain pathological damage by increasing CR.
Appendix
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Metadata
Title
The protective impact of education on brain structure and function in Alzheimer’s disease
Authors
Wanqiu Zhu
Xiaoshu Li
Xiaohu Li
Haibao Wang
Meiqin Li
Ziwen Gao
Xingqi Wu
Yanghua Tian
Shanshan Zhou
Kai Wang
Yongqiang Yu
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2021
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-021-02445-9

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