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Education May Help Insulate The Brain Against Traumatic Injury

A little education goes a long way toward ensuring you'll recover from a serious traumatic brain injury. In fact, people with lots of education are seven times more likely than high school dropouts to have no measurable disability a year later.

"It's a very dramatic difference," says Eric Schneider, an epidemiologist at Johns Hopkins and the lead author of a new study. The finding suggests that people with more education have brains that are better able to "find ways around the damage" caused by an injury, he says.

The study looked at the medical records of 769 adults who suffered traumatic brain injuries serious enough to require an inpatient hospital stay and rehabilitation. A year after the injury, just 10 percent of people who didn't finish high school had no disability, compared with 39 percent of people with enough years of education to have received a college degree. People with advanced degrees did even better.

One reason for the difference may be something known as "cognitive reserve" in the brain, Schneider says. The concept is a bit like physical fitness, he says, which can help a person recover from a physical injury. Similarly, a person with a lot of cognitive reserve may be better equipped to recover from a brain injury.

The results were reported Tuesday in the journal Neurology.

Scientists don't fully understand what specific brain changes are responsible for cognitive reserve. But research on educational training suggests that it involves strengthening the networks of brain cells involved in learning and memory, according to a commentary by Erin Bigler that accompanies the study. A stronger network may be better at repairing itself or adapting to damage, Bigler says.

For several decades, studies have shown that people with more education, and presumably more cognitive reserve, are less likely to develop the memory and thinking problems of Alzheimer's disease. The new study suggests the benefits of education and cognitive reserve extend to brain damage caused by injury rather than disease.

There's no guaranteed way to increase your cognitive reserve, Schneider says. But there are hints that staying physically and socially active helps, and that "pursuing lifelong learning may be beneficial," he says.

One limitation of the study is that it relied on a standard disability rating scale, which relies on measures such as a person's ability to return to work. That could have meant that a college graduate returning to an office job was less likely to be declared disabled than, "a roofer with balance issues," Schneider says. He adds that even people with a disability rating of zero may still have mental or physical problems caused by their brain injury.

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