Abstract
Late-life depression (LLD) is an affective disorder that is highly prevalent among older people. Cognitive reserve (CR) refers to an active process that facilitates the flexibility and efficiency of the neural networks to compensate for impairments that emerge in consequence of brain pathology. The current functional magnetic resonance imaging study investigated whether and how CR affects emotional regulation, level of depression severity and neural activity associated with affective control during emotional Stroop (eStroop) task. Altogether, 90 older people participated in this study, 50 of whom suffered from LLD. We used years of education and verbal fluency capacity as proxies for CR. Clinical participants with relatively higher CR presented with milder degrees of depression, better eStroop performance and stronger neural activity in the middle frontal gyrus (MFG) involved with exercising affective control. Results of the mediation analysis indicated that both education and verbal fluency significantly mediated the association between the depression severity and MEG activity. These results suggest a negative association between CR and age-related clinical symptoms of emotional dysregulation. Our neurobehavioral findings provide supportive evidence that CR implies efficiency of top-down emotional regulation and operates as a protective factor against emotional and cognitive vulnerability in the aging brain.
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1 College of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan; Center for Intelligent Drug Systems and Smart Bio-devices (IDS 2 B), National Chiao Tung University, Hsinchu, Taiwan
2 College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
3 Department of Imaging Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA
4 College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan, Taiwan
5 College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Keelung, Taiwan
6 State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, PR China; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong, PR China