title: Education increases reserve against Alzheimer's disease--evidence from structural MRI analysis.
abstract: BACKGROUND
  The aim of this study was to determine whether years of schooling influences regional cortical thicknesses and volumes in Alzheimer's disease (AD), mild cognitive impairment (MCI), and healthy age-matched controls.
  
  
  METHODS
  Using an automated image analysis pipeline, 33 regional cortical thickness and 15 regional volumes measures from MRI images were determined in 121 subjects with MCI, 121 patients with AD, and 113 controls from AddNeuroMed study. Correlations with years of schooling were determined and more highly and less highly educated subjects compared, controlling for intracranial volume, age, gender, country of origin, cognitive status, and multiple testing.
  
  
  RESULTS
  After controlling for confounding factors and multiple testing, in the control group, subjects with more education had larger regional cortical thickness in transverse temporal cortex, insula, and isthmus of cingulate cortex than subjects with less education. However, in the AD group, the subjects with more education had smaller regional cortical thickness in temporal gyrus, inferior and superior parietal gyri, and lateral occipital cortex than the subjects with less education. No significant difference was found in the MCI group.
  
  
  CONCLUSIONS
  Education may increase regional cortical thickness in healthy controls, leading to increased brain reserve, as well as helping AD patients to cope better with the effects of brain atrophy by increasing cognitive reserve.
authors.affiliation: Department of Neurology, University of Eastern Finland, Kuopio University Hospital, P.O.Box 1627, 70211 Kuopio, Finland.
authors.forename: Yawu
authors.initials: Y
authors.lastname: Liu
authors.forename: Valtteri
authors.initials: V
authors.lastname: Julkunen
authors.forename: Teemu
authors.initials: T
authors.lastname: Paajanen
authors.forename: Eric
authors.initials: E
authors.lastname: Westman
authors.forename: Lars-Olof
authors.initials: LO
authors.lastname: Wahlund
authors.forename: Andrew
authors.initials: A
authors.lastname: Aitken
authors.forename: Tomasz
authors.initials: T
authors.lastname: Sobow
authors.forename: Patrizia
authors.initials: P
authors.lastname: Mecocci
authors.forename: Magda
authors.initials: M
authors.lastname: Tsolaki
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.forename: Sebastian
authors.initials: S
authors.lastname: Muehlboeck
authors.forename: Christian
authors.initials: C
authors.lastname: Spenger
authors.forename: Simon
authors.initials: S
authors.lastname: Lovestone
authors.forename: Andrew
authors.initials: A
authors.lastname: Simmons
authors.forename: Hilkka
authors.initials: H
authors.lastname: Soininen
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000473:pathology*; D000704:Analysis of Variance; D001284:Atrophy / Q000473:pathology; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D019047:Phantoms, Imaging; D011446:Prospective Studies