Cognitive reserve (CR) delays cognitive decline due to neurodegeneration. Heterogeneous evidence suggests that education may act as CR in Dementia with Lewy Bodies (DLB). No data, however, are currently available on the role of occupation as proxy of CR in this neuropathology. Thirty-three patients with probable DLB were retrospectively included. We performed regression analyses models (TFCE p < 0.05) and seed-based interregional correlation analyses (p = 0.001, FWE-corrected at cluster-level) with brain metabolism. We aimed at exploring the relationship between brain metabolic connectivity, as assessed by FDG-PET, in the relevant resting-state networks and CR proxies (education, 6-levels occupation, and the specific O*Net occupational profiles). Education modulates executive (ECN), attentive (ATTN) and posterior default mode (PDMN) networks in the highly educated DLB subjects, as shown by an increased metabolic connectivity, acting as a compensatory mechanism. High scores of the 6-levels occupation scale were associated with a decreased connectivity in the anterior default mode (ADMN) and high visual network (HVN), suggesting brain reserve mechanisms. As for the specific O*Net occupational profiles, these modulated ADMN, PDMN, ATTN, ECN, HVN and primary visual network (PVN) connectivity according to different neuroprotection mechanisms, namely neural reserve and compensation against neurodegeneration. This study highlights the relevance of life-long occupational activities at individual level in the neural expression of compensatory and neuroprotective mechanisms in DLB.

认知储备（CR）延迟了由于神经变性引起的认知衰退。各种各样的证据表明，在路易体（DLB）中痴呆症中的教育可能是CR。然而，目前尚无关于职业在该神经病理学中作为CR代理的作用的数据。回顾性纳入33例可能的DLB患者。我们进行了回归分析模型（TFCE p  <0.05）和基于种子的区域间相关分析（p = 0.001，通过脑代谢进行FWE校正（簇级校正）。我们旨在探索由FDG-PET评估的相关静息状态网络中的大脑代谢连通性与CR代理（教育，6级职业和特定O * Net职业概况）之间的关系。教育在受过高等教育的DLB受试者中调节执行（ECN），专心（ATTN）和后默认模式（PDMN）网络，这表现为代谢连接性的增强，是一种补偿机制。6级职业量表的高分与前默认模式（ADMN）和高视觉网络（HVN）的连通性降低相关，表明了大脑储备机制。至于特定的O * Net职业概况，这些经过调制的ADMN，PDMN，ATTN，ECN，HVN和主要视觉网络（PVN）的连接根据不同的神经保护机制，即神经储备和针对神经变性的补偿。这项研究强调了终生职业活动在个体水平上与DLB代偿性和神经保护机制的神经表达的相关性。