David Bartrés-Faz, PhD is Tenure Track 2 Professor at the Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, University of Barcelona. His line of research focus on the study of the cognitive and brain imaging correlates of healthy ageing as well as of preclinical stages of dementia. His research combines neuropsychological and clinical assessments, magnetic ressonance imaging and biomarker information, as well as the use of non-invasive brain stimulation techniques (transcranial magnetic stimulation, transcranial direct current stimulation).
Cognitive or brain reserve (CR) is a theoretical construct that emerged to provide further understanding regarding the observations showing a lack of 1:1 correspondence between brain pathology or burden and clinical manifestations (e.g. considering dementia, some individuals exhibited advanced neuropathology but yet minimal cognitive or clinical symptoms). The construct was further conceptualized by Yaakov Stern from the Columbia University into brain (or passive) reserve and cognitive (or active) models. This formulation emphasized, on the one hand, the anatomical or structural brain characteristics that allow some individuals to cope with greater amounts of brain pathology with reduced clinical impact, and on the other hand, the individualized active processes that allow to compensate or optimize cognitive or functional brain resources during cognitive demands. Neuroimaging studies using variables such as education, occupation or social activity as proxies of reserve have so far supported the reserve hypothesis. Further investigations have even suggested that reserve may not only modify the relationship between brain damage and clinical expression but to actively modify the clinical course of Alzheimer’s disease. Despite the reserve theory was initially conceptualized as separate from the concept of ‘cognitive training’, most recent views tend to approach CR postulates to interventional investigations.