Brain and Cognitive Reserve

      The concept of reserve is well-recognized in medicine. Various organs of the body, for example the kidney and the liver, manifest reserve such that significant damage can occur to the organ without impacting on clinical function. The very fact that an individual can donate one kidney and yet remain healthy attests to this fact. The glomerular filtration rate (GFR) is generally considered to be a measure of the excretory function of the kidney, with the normal GFR being >90 mL/min/1.73 m2. Significant kidney damage can occur without affecting GFR, and the GFR is generally <30 mL/min/1.73 m2 before features of chronic renal failure are manifest.
      • National Kidney Foundation
      K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification.
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        • National Kidney Foundation
        K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification.
        Am J Kidney Dis. 2002; 39: S1-S266
        • Pakkenberg B
        • Møller A
        • Gundersen HJ
        • et al.
        The absolute number of nerve cells in substantia nigra in normal subjects and in patients with Parkinson's disease estimated with an unbiased stereological method.
        J Neurol Neurosurg Psychiatry. 1991; 54: 30-33
        • Katzman R
        • Terry R
        • DeTeresa R
        • et al.
        Clinical, pathological, and neurochemical changes in dementia: a subgroup with preserved mental status and numerous neocortical plaques.
        Ann Neurol. 1988; 23: 138-144
        • Graves AB
        • Mortimer JA
        • Larson EB
        • et al.
        Head circumference as a measure of cognitive reserve. Association with severity of impairment in Alzheimer's disease.
        Br J Psychiatry. 1996; 169: 86-92
        • Schofield PW
        • Logroscino G
        • Andrews HF
        • et al.
        An association between head circumference and Alzheimer's disease in a population-based study of aging and dementia.
        Neurology. 1997; 49: 30-37
        • Borenstein Graves A
        • Mortimer JA
        • Bowen JD
        • et al.
        Head circumference and incident Alzheimer's disease: modification by apolipoprotein E.
        Neurology. 2001; 57: 1453-1460
        • Perneczky R
        • Drzezga A
        • Boecker H
        • et al.
        FDG PET correlates of impaired activities of daily living in dementia with Lewy bodies: implications for cognitive reserve.
        Am J Ger Psychiatry. 2009; 17: 188-195
        • Salmon E
        • Lespagnard S
        • Marique P
        • et al.
        Cerebral metabolic correlates of four dementia scales in Alzheimer's disease.
        J Neurol. 2005; 252: 283-290
        • Nithianantharajah J
        • Barkus C
        • Vijiaratnam N
        • et al.
        Modeling brain reserve: experience-dependent neuronal plasticity in healthy and Huntington's disease transgenic mice.
        Am J Ger Psychiatry. 2009; 17: 196-209
        • Nithianantharajah J
        • Hannan AJ
        Enriched environments, experience dependent plasticity and disorders of the nervous system.
        Nat Rev Neurosci. 2006; 7: 697-709
        • van Dellen A
        • Blakemore C
        • Deacon R
        • et al.
        Delaying the onset of Huntington's in mice.
        Nature. 2000; 404: 721-722
        • Fischer A
        • Sananbenesi F
        • Wang X
        • et al.
        Recovery of learning and memory is associated with chromatin remodelling.
        Nature. 2007; 447: 178-182
        • Rubinov M
        • McIntosh AR
        • Valenzuela MJ
        • et al.
        Simulation of neuronal death and network recovery in a comutational model of distributed cortical activity.
        Am J Ger Psychiatry. 2009; 17: 210-217
        • Stern Y
        What is cognitive reserve? Theory and research application of the reserve concept.
        J Int Neuropsychol Soc. 2002; 8: 448-460
        • Mortimer J
        Brain reserve and the clinical expression of Alzheimer's disease.
        Geriatrics. 1997; 52: S50-S53
        • Valenzuela M
        • Breakspear M
        • Sachdev P
        Complex mental activity and the aging brain: molecular, cellular and cortical network mechanisms.
        Brain Res Rev. 2007; 56: 198-213
        • Valenzuela MJ
        Brain reserve and the prevention of dementia.
        Curr Opin Psychiatr. 2008; 21: 296-302
        • Valenzuela M
        • Sachdev P
        Brain reserve and dementia: a systematic review.
        Psychol Med. 2006; 36: 441-454
        • Christensen H
        • Batterham PJ
        • Mackinnon AJ
        • et al.
        Education, atrophy and cognitive change in an epidemiological sample of early old age.
        Am J Ger Psychiatry. 2009; 17: 218-226
        • Karp A
        • Andel R
        • Parker MG
        • et al.
        Mentally stimulating activities at work during midlife and dementia risk after age 75: a follow up study from the Kungsholmen Project.
        Am J Ger Psychiatry. 2009; 17: 227-236
        • Valenzuela MJ
        • Sachdev P
        Can cognitive exercise prevent the onset of dementia? A systematic review of randomized clinical trials with longitudinal follow-up.
        Am J Ger Psychiatry. 2009; 17: 179-187
        • Valenzuela MJ
        • Sachdev P
        Brain reserve and cognitive decline: a non-parametric systematic review.
        Psychol Med. 2006; 36: 1065-1073
        • Mohammed AH
        • Zhu S
        • Darmopil S
        • et al.
        Environmental enrichment and the brain.
        Prog Brain Res. 2002; 138: 109-133
        • Kempermann G
        • Gast D
        • Gage FH
        Neuroplasticity in old age: sustained fivefold induction of hippocampal neurogenesis by long-term environmental enrichment.
        Ann Neurol. 2002; 52: 135-143
        • Frick K
        • Fernandez S
        Enrichment enhances spatial memory and increases synaptophysin levels in aged female mice.
        Neurobiol Aging. 2003; 24: 615-626
        • Black J
        • Isaacs K
        • Anderson B
        • et al.
        Learning causes synaptogenesis, whereas motor activity causes angiogenesis, in cerebellar cortex of adult rats.
        Proc Natl Acad Sci USA. 1990; 87: 5568-5572