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      Bilingualism as a Contributor to Cognitive Reserve? Evidence from Cerebral Glucose Metabolism in Mild Cognitive Impairment and Alzheimer’s Disease

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          Abstract

          Objective

          Bilingualism is discussed as one factor contributing to “cognitive reserve” (CR), as it enhances executive control functions. To elucidate the underlying cerebral correlates, regional glucose uptake was compared between bilinguals and monolinguals with mild cognitive impairment (MCI) and beginning-stage Alzheimer’s disease (AD) by using [ 18F]fluorodeoxyglucose (FDG) positron emission tomography (PET).

          Methods

          Thirty patients (73.2 ± 7.4) diagnosed with MCI or probable AD received physical and neuropsychological examinations, blood tests, and FDG-PET scans. Sixteen patients were classified as lifelong bilinguals, following the criterion of Bialystok et al., and groups were matched for age, sex, and mini mental state examination scores. Analyses were conducted using statistical parametric mapping version 8. The whole brain was used as reference region for intensity normalization and years of education were controlled for.

          Results

          Bilingual patient groups showed substantially greater impairment of glucose uptake in frontotemporal and parietal regions [including Brodmann areas (BAs) 9, 47, 40, and 21] and in the left cerebellum relative to monolingual patients.

          Conclusion

          Bilingualism is likely to contribute to CR, given that bilingual patients showed more severe brain changes than monolinguals when adjusting for severity of cognitive impairment. The latter did not only comprise BAs relevant to speech and language but also structures typically involved in AD pathology, such as the temporal and the parietal cortices.

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          Most cited references20

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          Bilingualism, aging, and cognitive control: evidence from the Simon task.

          Previous work has shown that bilingualism is associated with more effective controlled processing in children; the assumption is that the constant management of 2 competing languages enhances executive functions (E. Bialystok, 2001). The present research attempted to determine whether this bilingual advantage persists for adults and whether bilingualism attenuates the negative effects of aging on cognitive control in older adults. Three studies are reported that compared the performance of monolingual and bilingual middle-aged and older adults on the Simon task. Bilingualism was associated with smaller Simon effect costs for both age groups; bilingual participants also responded more rapidly to conditions that placed greater demands on working memory. In all cases the bilingual advantage was greater for older participants. It appears, therefore, that controlled processing is carried out more effectively by bilinguals and that bilingualism helps to offset age-related losses in certain executive processes. ((c) 2004 APA, all rights reserved)
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            Cognitive control and lexical access in younger and older bilinguals.

            Ninety-six participants, who were younger (20 years) or older (68 years) adults and either monolingual or bilingual, completed tasks assessing working memory, lexical retrieval, and executive control. Younger participants performed most of the tasks better than older participants, confirming the effect of aging on these processes. The effect of language group was different for each type of task: Monolinguals and bilinguals performed similarly on working memory tasks, monolinguals performed better on lexical retrieval tasks, and bilinguals performed better on executive control tasks, with some evidence for larger language group differences in older participants on the executive control tasks. These results replicate findings from individual studies obtained using only 1 type of task and different participants. The confirmation of this pattern in the same participants is discussed in terms of a suggested explanation of how the need to manage 2 language systems leads to these different outcomes for cognitive and linguistic functions. (c) 2008 APA
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              Are there bilingual advantages on nonlinguistic interference tasks? Implications for the plasticity of executive control processes.

              It has been proposed that the unique need for early bilinguals to manage multiple languages while their executive control mechanisms are developing might result in long-term cognitive advantages on inhibitory control processes that generalize beyond the language domain. We review the empirical data from the literature on nonlinguistic interference tasks to assess the validity of this proposed bilingual inhibitory control advantage. Our review of these findings reveals that the bilingual advantage on conflict resolution, which by hypothesis is mediated by inhibitory control, is sporadic at best, and in some cases conspicuously absent. A robust finding from this review is that bilinguals typically outperform monolinguals on both compatible and incompatible trials, often by similar magnitudes. Together, these findings suggest that bilinguals do enjoy a more widespread cognitive advantage (a bilingual executive processing advantage) that is likely observable on a variety of cognitive assessment tools but that, somewhat ironically, is most often not apparent on traditional assays of nonlinguistic inhibitory control processes.
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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/300775
                URI : http://frontiersin.org/people/u/190185
                URI : http://frontiersin.org/people/u/197274
                URI : http://frontiersin.org/people/u/143542
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                15 April 2016
                2016
                : 7
                : 62
                Affiliations
                [1] 1Section for Geriatric Psychiatry, University Clinic Heidelberg , Heidelberg, Germany
                [2] 2Department of Psychiatry and Psychotherapy, University Hospital Leipzig , Leipzig, Germany
                [3] 3Department of Nuclear Medicine, University Clinic , Heidelberg, Germany
                Author notes

                Edited by: Stefan Borgwardt, University of Basel, Switzerland

                Reviewed by: Ellen Bialystok, York University, Canada; Thomas Leyhe, Universitäre Psychiatrische Kliniken Basel, Switzerland

                *Correspondence: Magdalena Eva Kowoll, magdalena-eva.kowoll@ 123456med.uni-heidelberg.de

                Specialty section: This article was submitted to Neuroimaging and Stimulation, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2016.00062
                4831977
                27148091
                f40db5dd-b73f-4df1-905f-b4c29e32bd67
                Copyright © 2016 Kowoll, Degen, Gorenc, Küntzelmann, Fellhauer, Giesel, Haberkorn and Schröder.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 28 January 2016
                : 29 March 2016
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 39, Pages: 6, Words: 4048
                Categories
                Psychiatry
                Original Research

                Clinical Psychology & Psychiatry
                bilingualism,cognitive reserve,alzheimer’s disease,mild cognitive impairment,fdg-pet

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