Evidence of cognitive compensation associated with educational level in early relapsing–remitting multiple sclerosis

Cognitive compensatory mechanisms may limit the cognitive dysfunction due to cerebral tissue destruction in multiple sclerosis (MS). To explore the effect of educational status on cognitive performances in early relapsing–remitting (RR) MS. 43 RRMS patients were individually matched for age, sex and educational level with 43 healthy controls. Each patient underwent neuropsychological tests, clinical assessment and magnetic resonance imaging (MRI). Cognitive scores of MS patients were compared to those of their paired controls according to educational level. Less educated patients had low performances on all but two neuropsychological tests, while more educated patients had low scores only for three tests. Cognitive performances of more educated patients but not those of less educated ones were strongly correlated with MRI parameters and decreased with the severity of cerebral tissue destruction. These different cognitive patterns suggest the existence of a cognitive compensation in more educated patients which is limited by the accumulation of tissue damage.