Cognitive and Brain Reserve in Psychotic Disorders: an Overview of Current Research and Treatment Implications

Abstract

Cognitive and brain reserve are construct designed to explain the differences between brain damage or pathology and the clinical manifestation of the condition. Brain reserve is typically introduced as a passive model dealing with anatomical and structural changes in the brain, while cognitive reserve represents variability in the synaptic organization and activation of specific areas. Proxy measures and a residual approach are often used to estimate cognitive reserve with both approaches having its statistical and practical (dis)advantages. For brain reserve, intracranial volume or specific patterns of grey matter volume seem to be the most accepted quantitative measure. In psychotic disorders, cognitive and brain reserve might have an impact on cognitive performance and serve as a predictor for cognitive and functional outcomes of patients. Since cognitive deficits are often present in psychotic disorders, the reserves could also benefit treatment targeting cognitive impairment, specifically when designing a more personalized approach to cognitive training. The present paper is a synthesis of previous studies dealing with cognitive and brain reserve mapping the current research and potential of these constructs in psychotic disorders.