The Impact of Cognitive Reserve on Neuroplastic Changes among Complicated Mild Traumatic Brain Injury Patients
Main Article Content
Abstract
Background: Cognitive reserve may influence how individuals tolerate or clinically express neurological injury, but its relationship with structural imaging patterns in complicated mild traumatic brain injury remains insufficiently characterized. Objective: To determine the association between cognitive reserve and MRI-defined structural injury patterns among adults with complicated mild traumatic brain injury. Methods: This analytical cross-sectional study included 64 patients aged 20–40 years recruited through convenience sampling from three tertiary-care hospitals in Lahore, Pakistan, between August 2024 and January 2025. Cognitive reserve was assessed using the Cognitive Reserve Assessment Scale in Health, while structural injury patterns were classified from MRI findings. Categorical variables were summarized as frequencies and percentages, and the association between cognitive-reserve category and MRI pattern was assessed using the chi-square test. Results: The mean age was 29.27 ± 6.08 years, and 34 (53.1%) participants were female. Higher cognitive reserve was identified in 34 (53.1%) participants, while 30 (46.9%) had lower reserve. Less-pronounced MRI lesions were observed in 34 (53.1%) participants and more extensive lesions in 30 (46.9%). Higher reserve corresponded completely with the less-pronounced MRI category, while lower reserve corresponded with the more extensive category (χ² = 64.000, df = 1, p < 0.001; Phi = 1.000). Conclusion: Cognitive-reserve classification was strongly associated with MRI-defined structural injury pattern, although the cross-sectional design did not establish causality or longitudinal neuroplastic change
Article Details
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Maas AI, Menon DK, Manley GT, Abrams M, Åkerlund C, Andelic N, et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022;21:1004–60.
2. Tenovuo O, Diaz-Arrastia R, Goldstein LE, Sharp DJ, Van der Naalt J, Zasler ND. Assessing the severity of traumatic brain injury—time for a change? J Clin Med. 2021;10:148.
3. Lange RT, Iverson GL, Franzen MD. Neuropsychological functioning following complicated versus uncomplicated mild traumatic brain injury. Brain Inj. 2009;23:83–91.
4. Ghaith HS, Nawar AA, Gabra MD, Abdelrahman ME, Nafady MH, Bahbah EI, et al. A literature review of traumatic brain injury biomarkers. Mol Neurobiol. 2022;59:4141–58.
5. Freire MAM, Rocha GS, Bittencourt LO, Falcao D, Lima RR, Cavalcanti JRLP. Cellular and molecular pathophysiology of traumatic brain injury: what have we learned so far? Biology. 2023;12:1139.
6. Mira RG, Lira M, Cerpa W. Traumatic brain injury: mechanisms of glial response. Front Physiol. 2021;12:740939.
7. Fuchs E, Flügge G. Adult neuroplasticity: more than 40 years of research. Neural Plast. 2014;2014:541870.
8. Cramer SC, Sur M, Dobkin BH, O’Brien C, Sanger TD, Trojanowski JQ, et al. Harnessing neuroplasticity for clinical applications. Brain. 2011;134:1591–609.
9. Dąbrowski J, Czajka A, Zielińska-Turek J, Jaroszyński J, Furtak-Niczyporuk M, Mela A, et al. Brain functional reserve in the context of neuroplasticity after stroke. Neural Plast. 2019;2019:9708905.
10. Naro A, Calabrò RS. Brain injury, neural plasticity, and neuromodulation. In: Translational Neurorehabilitation: Brain, Behavior and Technology. Springer; 2024.
11. Vance DE, Roberson AJ, McGuinness TM, Fazeli PL. How neuroplasticity and cognitive reserve protect cognitive functioning. J Psychosoc Nurs Ment Health Serv. 2010;48:23–30.
12. Nunes I, Silva Nunes MV. The influence of cognitive reserve in the protection of cognitive status after an acquired brain injury: a systematic review. J Clin Exp Neuropsychol. 2021;43:839–60.
13. Manrique-Gutierrez G, Rodriguez-Cayetano Q, Samudio-Cruz MA, Carrillo-Mora P. The role of cognitive reserve in traumatic brain injury: a systematic review of observational studies. Brain Inj. 2024;38:45–60.
14. Steward KA, Kennedy R, Novack TA, Crowe M, Marson DC, Triebel KL. The role of cognitive reserve in recovery from traumatic brain injury. J Head Trauma Rehabil. 2018;33:E18–27.
15. Contador I, Alzola P, Stern Y, de la Torre-Luque A, Bermejo-Pareja F, Fernandez-Calvo B. Is cognitive reserve associated with the prevention of cognitive decline after stroke? A systematic review and meta-analysis. Ageing Res Rev. 2023;84:101814.
16. Eliason M, Kalbande PP, Saleem GT. Is non-invasive neuromodulation a viable technique to improve neuroplasticity in individuals with acquired brain injury? A review. Front Hum Neurosci. 2024;18:1341707.
17. Mahncke HW, DeGutis J, Levin H, Newsome MR, Bell MD, Grills C, et al. A randomized clinical trial of plasticity-based cognitive training in mild traumatic brain injury. Brain. 2021;144:1994–2008.