We tested the Cognitive Reserve (CR) hypothesis in Amyotrophic Lateral Sclerosis (ALS), enrolling 111 patients, using education as CR proxy, 18F-FDG-PET to assess brain damage, and ECAS to measure cognition. Education was regressed out against brain metabolism, including age, sex, spinal/bulbar onset, ALSFRS-R, and ECAS as covariates. Clusters showing a significant correlation were used as seed regions in an interregional correlation analysis (IRCA) in the ALS group and in 40 controls. In the ALS group, we found a negative correlation between brain metabolism and education in the right anterior cingulate and bilateral medial frontal gyrus. In the IRCA in the ALS group, the medial frontal cluster metabolism positively correlated with that of frontotemporal regions (right > left), bilateral caudate nuclei, and right insula, and negatively correlated with that of corticospinal tracts, cerebellum, and pons. In controls, the IRCA showed significant positive correlations in the same regions but less extended. Our results agree with the CR hypothesis. The negative correlation between the medial frontal cluster and the cerebellum found only in ALS patients might reflect cerebellar compensation.

中文翻译：

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教育、脑代谢和认知障碍之间的相互作用表明认知储备在肌萎缩侧索硬化中的作用

我们在肌萎缩侧索硬化症 (ALS) 中测试了认知储备 (CR) 假设，招募了 111 名患者，使用教育作为 CR 代理，使用 18F-FDG-PET 评估脑损伤，并使用 ECAS 测量认知。教育对大脑代谢进行了回归，包括年龄、性别、脊髓/延髓发病、ALSFRS-R 和 ECAS 作为协变量。在 ALS 组和 40 个对照的区域间相关性分析 (IRCA) 中，显示显着相关性的集群被用作种子区域。在 ALS 组中，我们发现右前扣带回和双侧内侧额叶回的大脑代谢与教育之间呈负相关。在ALS组的IRCA中，内侧额叶簇代谢与额颞区（右>左）、双侧尾状核和右脑岛的代谢呈正相关，与皮质脊髓束、小脑和脑桥负相关。在对照中，IRCA 在相同区域显示出显着的正相关，但范围较小。我们的结果与 CR 假设一致。仅在 ALS 患者中发现的内侧额叶簇和小脑之间的负相关可能反映了小脑代偿。