A cross-sectional and longitudinal study on the protective effect of bilingualism against dementia using brain atrophy and cognitive measures

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Abstract

Background

Evidence from previous studies suggests that bilingualism contributes to cognitive reserve because bilinguals manifest the first symptoms of Alzheimer’s disease (AD) up to 5 years later than monolinguals. Other cross-sectional studies demonstrate that bilinguals show greater amounts of brain atrophy and hypometabolism than monolinguals, despite sharing the same diagnosis and suffering from the same symptoms. However, these studies may be biased by possible pre-existing between-group differences.

Methods

In this study, we used global parenchymal measures of atrophy and cognitive tests to investigate the protective effect of bilingualism against dementia cross-sectionally and prospectively, using a sample of bilinguals and monolinguals in the same clinical stage and matched on sociodemographic variables.

Results

Our results suggest that the two groups did not differ in their cognitive status at baseline, but bilinguals had less parenchymal volume than monolinguals, especially in areas related to brain atrophy in dementia. In addition, a longitudinal prospective analysis revealed that monolinguals lost more parenchyma and had more cognitive decline than bilinguals in a mean follow-up period of 7 months.

Conclusion

These results provide the first prospective evidence that bilingualism may act as a neuroprotective factor against dementia and could be considered a factor in cognitive reserve.

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Most cited references 29

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Construction of a 3D probabilistic atlas of human cortical structures.

David W. Shattuck, Mubeena Mirza, Vitria Adisetiyo … (2008)

We describe the construction of a digital brain atlas composed of data from manually delineated MRI data. A total of 56 structures were labeled in MRI of 40 healthy, normal volunteers. This labeling was performed according to a set of protocols developed for this project. Pairs of raters were assigned to each structure and trained on the protocol for that structure. Each rater pair was tested for concordance on 6 of the 40 brains; once they had achieved reliability standards, they divided the task of delineating the remaining 34 brains. The data were then spatially normalized to well-known templates using 3 popular algorithms: AIR5.2.5's nonlinear warp (Woods et al., 1998) paired with the ICBM452 Warp 5 atlas (Rex et al., 2003), FSL's FLIRT (Smith et al., 2004) was paired with its own template, a skull-stripped version of the ICBM152 T1 average; and SPM5's unified segmentation method (Ashburner and Friston, 2005) was paired with its canonical brain, the whole head ICBM152 T1 average. We thus produced 3 variants of our atlas, where each was constructed from 40 representative samples of a data processing stream that one might use for analysis. For each normalization algorithm, the individual structure delineations were then resampled according to the computed transformations. We next computed averages at each voxel location to estimate the probability of that voxel belonging to each of the 56 structures. Each version of the atlas contains, for every voxel, probability densities for each region, thus providing a resource for automated probabilistic labeling of external data types registered into standard spaces; we also computed average intensity images and tissue density maps based on the three methods and target spaces. These atlases will serve as a resource for diverse applications including meta-analysis of functional and structural imaging data and other bioinformatics applications where display of arbitrary labels in probabilistically defined anatomic space will facilitate both knowledge-based development and visualization of findings from multiple disciplines.

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Understanding the Consequences of Bilingualism for Language Processing and Cognition.

Judith F. Kroll, Ellen Bialystok (2012)

Contemporary research on bilingualism has been framed by two major discoveries. In the realm of language processing, studies of comprehension and production show that bilinguals activate information about both languages when using one language alone. Parallel activation of the two languages has been demonstrated for highly proficient bilinguals as well as second language learners and appears to be present even when distinct properties of the languages themselves might be sufficient to bias attention towards the language in use. In the realm of cognitive processing, studies of executive function have demonstrated a bilingual advantage, with bilinguals outperforming their monolingual counterparts on tasks that require ignoring irrelevant information, task switching, and resolving conflict. Our claim is that these outcomes are related and have the overall effect of changing the way that both cognitive and linguistic processing are carried out for bilinguals. In this article we consider each of these domains of bilingual performance and consider the kinds of evidence needed to support this view. We argue that the tendency to consider bilingualism as a unitary phenomenon explained in terms of simple component processes has created a set of apparent controversies that masks the richness of the central finding in this work: the adult mind and brain are open to experience in ways that create profound consequences for both language and cognition.

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Lifelong bilingualism maintains white matter integrity in older adults.

Ellen Bialystok, Sarah Grady, Fergus I M Craik … (2011)

Previous research has shown that bilingual speakers have higher levels of cognitive control than comparable monolinguals, especially at older ages. The present study investigates a possible neural correlate of this behavioral effect. Given that white matter (WM) integrity decreases with age in adulthood, we tested the hypothesis that bilingualism is associated with maintenance of WM in older people. Using diffusion tensor imaging, we found higher WM integrity in older people who were lifelong bilinguals than in monolinguals. This maintained integrity was measured by fractional anisotropy (FA) and was found in the corpus callosum extending to the superior and inferior longitudinal fasciculi. We also hypothesized that stronger WM connections would be associated with more widely distributed patterns of functional connectivity in bilinguals. We tested this by assessing the resting-state functional connectivity of frontal lobe regions adjacent to WM areas with group differences in FA. Bilinguals showed stronger anterior to posterior functional connectivity compared to monolinguals. These results are the first evidence that maintained WM integrity is related to lifelong naturally occurring experience; the resulting enhanced structural and functional connectivity may provide a neural basis for "brain reserve."

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Author and article information

Contributors

César Ávila: avila@uji.es

Journal

Journal ID (nlm-ta): Alzheimers Res Ther

Journal ID (iso-abbrev): Alzheimers Res Ther

Title: Alzheimer's Research & Therapy

Publisher: BioMed Central (London )

ISSN (Electronic): 1758-9193

Publication date (Electronic): 10 January 2020

Publication date PMC-release: 10 January 2020

Publication date Collection: 2020

Volume: 12

Electronic Location Identifier: 11

Affiliations

[1 ]ISNI 0000 0001 2172 2676, GRID grid.5612.0, Center for Brain and Cognition, , University Pompeu Fabra, ; Barcelona, Spain

[2 ]ISNI 0000 0001 1957 9153, GRID grid.9612.c, Neuropsychology and Functional Neuroimaging Group, , University Jaume I, ; Castellón, Spain

[3 ]ISNI 0000 0001 2173 938X, GRID grid.5338.d, ERI Lectura, , University of Valencia, ; Valencia, Spain

[4 ]ERESA Medical Group, Valencia, Spain

[5 ]ISNI 0000 0004 1770 977X, GRID grid.106023.6, Department of Neurology, , General Hospital of Valencia, ; Valencia, Spain

[6 ]ISNI 0000 0001 0360 9602, GRID grid.84393.35, Neurology Unit, , University and Polytechnic Hospital La Fe, ; Valencia, Spain

[7 ]ISNI 0000 0004 1937 0247, GRID grid.5841.8, Department of Cognition, Development, and Educational Psychology Section of Cognitive Processes, , University of Barcelona, ; Barcelona, Spain

[8 ]ISNI 0000 0004 0427 2257, GRID grid.418284.3, Cognition and Brain Plasticity Group, , Bellvitge Biomedical Research Institute (IDIBELL), ; L’Hospitalet de Llobregat, Spain

[9 ]ISNI 0000 0001 2096 9837, GRID grid.21507.31, Computer Science Department, , University of Jaén, ; Jaén, Spain

Article

Publisher ID: 581

DOI: 10.1186/s13195-020-0581-1

PMC ID: 6954576

PubMed ID: 31924269

SO-VID: 6f0ed939-85d0-453c-aa89-7d4e77256827

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 24 July 2019

Date accepted : 5 January 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/100008666, Fundació la Marató de TV3;

Award ID: 201410-30-31

Award Recipient : César Ávila

Funded by: FundRef http://dx.doi.org/10.13039/501100003176, Ministerio de Educación, Cultura y Deporte;

Award ID: FPU17/00698

Funded by: FundRef http://dx.doi.org/10.13039/501100003339, Consejo Superior de Investigaciones Científicas;

Award ID: IJCI-2016-29247

Award Recipient : Víctor Costumero

Custom metadata

ScienceOpen disciplines: Neurology

Keywords: bilingualism,cognitive reserve,alzheimer’s disease,mild cognitive impairment,brain atrophy,region-based morphometry

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ScienceOpen disciplines: Neurology

Keywords: bilingualism, cognitive reserve, alzheimer’s disease, mild cognitive impairment, brain atrophy, region-based morphometry

A cross-sectional and longitudinal study on the protective effect of bilingualism against dementia using brain atrophy and cognitive measures

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Abstract

Background

Methods

Results

Conclusion

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Karger: Neurology and Neuroscience

Most cited references 29

Construction of a 3D probabilistic atlas of human cortical structures.

Understanding the Consequences of Bilingualism for Language Processing and Cognition.

Lifelong bilingualism maintains white matter integrity in older adults.

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