title: Reserve-related activities and MRI metrics in multiple sclerosis patients and healthy controls: an observational study.
abstract: BACKGROUND
  To examine whether past and current reserve-related activities make the brain less susceptible to MS pathology (i.e., lesions or disease-related atrophy).
  
  
  METHODS
  This secondary analysis of a cohort study included 276 healthy controls (HC), and 65 clinically isolated syndrome (CIS), 352 relapsing-remitting MS (RR) and 109 secondary- progressive MS (SPMS) patients. Past reserve-related activities comprised educational and occupational attainment. Current reserve-related activities comprised strenuous and non-strenuous activities. MRI was performed on 3 T scanner. Regression and non-parametric analysis examined relationships between MRI metrics and reserve-related activities.
  
  
  RESULTS
  Multivariate models (HC as referent) revealed significant interactions in predicting strenuous reserve-related activities with chronic lesion burden (for CIS), brain- (for RR & SPMS), subcortical- (for CIS, RR, & SPMS) and amygdala- (for RR) volumes. Maximal Lifetime Brain Growth was higher for RR patients who engaged in running before and after diagnosis, rather than only before or never. Residual Brain Volume was higher in RR patients who did weights-exercise before and after diagnosis, as compared to only before.
  
  
  CONCLUSIONS
  Reserve-related activities are related to brain health cross-sectionally in all MS subgroups, and longitudinally in RR patients. Consistent with reserve theory, RR patients who maintained strenuous activities had higher Maximal Lifetime Brain Growth and Residual Brain Volume. The study's limitations are discussed, including the potential for recall bias and design limitations that preclude causal inference.
authors.affiliation: DeltaQuest Foundation, Inc, 31 Mitchell Road, Concord, MA, 01742, USA. carolyn.schwartz@deltaquest.org.|Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA. carolyn.schwartz@deltaquest.org.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Schwartz
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA.|Department of Biomedical Informatics, University of Buffalo, State University of New York, Buffalo, NY, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Dwyer
authors.affiliation: Department of Neurology, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, Buffalo, NY, USA.
authors.forename: Ralph
authors.initials: R
authors.lastname: Benedict
authors.affiliation: Department of Neurology, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, Buffalo, NY, USA.
authors.forename: Bianca
authors.initials: B
authors.lastname: Weinstock-Guttman
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA.|Istituto Di Ricovero e Cura a Carattere Scientifico, "S.Maria Nascente", Don Gnocchi Foundation, Milan, Italy.|Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
authors.forename: Niels P
authors.initials: NP
authors.lastname: Bergsland
authors.affiliation: DeltaQuest Foundation, Inc, 31 Mitchell Road, Concord, MA, 01742, USA.|Department of Biostatistics, University of Massachusetts, Amherst, MA, USA.
authors.forename: Jei
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurology, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, Buffalo, NY, USA.|Department of Pharmaceutical Sciences, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA.
authors.forename: Murali
authors.initials: M
authors.lastname: Ramanathan
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY, USA.|Department of Neurology, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, Buffalo, NY, USA.|MR Imaging Clinical Translational Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Zivadinov
mesh_terms: D000328:Adult; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D015331:Cohort Studies; D003711:Demyelinating Diseases / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*