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Alzheimers Res Ther. 2018 Sep 27;10(1):103. doi: 10.1186/s13195-018-0432-5.

The impact of education on cortical thickness in amyloid-negative subcortical vascular dementia: cognitive reserve hypothesis.

Jung NY1,2,3, Cho H4, Kim YJ5, Kim HJ2,3, Lee JM6, Park S2,3, Kim ST7, Kim EJ8, Kim JS9, Moon SH10, Lee JH11, Ewers M12, Na DL2,3, Seo SW13,14.

Author information

1
Pusan National University Yangsan Hospital, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, Korea.
2
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3
Neuroscience Center, Samsung Medical Center, Seoul, Korea.
4
Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
5
Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
6
Department of Biomedical Engineering, Hanyang University, Seoul, Korea.
7
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
8
Department of Neurology, Pusan National University Hospital, Busan, Korea.
9
Department of Nuclear Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
10
Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
11
Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
12
Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany.
13
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. sw72.seo@samsung.com.
14
Neuroscience Center, Samsung Medical Center, Seoul, Korea. sw72.seo@samsung.com.

Abstract

BACKGROUND:

The protective effect of education has been well established in Alzheimer's disease, whereas its role in patients with isolated cerebrovascular diseases remains unclear. We examined the correlation of education with cortical thickness and cerebral small vessel disease markers in patients with pure subcortical vascular mild cognitive impairment (svMCI) and patients with pure subcortical vascular dementia (SVaD).

METHODS:

We analyzed 45 patients with svMCI and 47 patients with SVaD with negative results on Pittsburgh compound B positron emission tomographic imaging who underwent structural brain magnetic resonance imaging. The main outcome was cortical thickness measured using surface-based morphometric analysis. We also assessed the volumes of white matter hyperintensities (WMH) and numbers of lacunes as other outcomes. To investigate the correlation of education with cortical thickness, WMH volume, and number of lacunes, multiple linear regression analyses were performed after controlling for covariates, including Mini Mental State Examination, in the svMCI and SVaD groups.

RESULTS:

In the SVaD group, higher education was correlated with more severe cortical thinning in the bilateral dorsolateral frontal, left medial frontal, and parahippocampal areas, whereas there was no correlation of education with cortical thickness in the svMCI group. There was no correlation between education and cerebral small vessel disease, including WMH and lacunes, in both patients with svMCI and patients with SVaD.

CONCLUSIONS:

Our findings suggest that the compensatory effects of education on cortical thinning apply to patients with SVaD, which might be explained by the cognitive reserve hypothesis.

KEYWORDS:

Cognitive reserve; Education; Gray matter atrophy; Subcortical vascular dementia

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