Higher Education Linked to Better Recovery from Brain Injury

Recent research by John Hopkins Medicine has found that those with more education may recover from traumatic brain injury (TBI) faster than strong brainthose with lower levels of education. What’s more, the researchers reported in medical journal Neurology that a person with a college education is 7 times more likely to be “disability-free” one year after a TBI that required hospitalization, compared with a person who did not finish high school. These findings suggest that a brain’s cognitive reserve, meaning the brain’s ability to recover from injury, may play a role in TBI resilience.

The study’s findings have been compared to results of a past Alzheimer’s disease study. Those findings found that those with higher educational attainment (cognitive reserve) were likely to experience a slower progression of dementia.

According to study leader Eric B. Schneider, Ph.D., an epidemiologist at the Johns Hopkins University School of Medicine’s Center for Surgical Trials and Outcomes Research, patients with the same level of brain damage experienced vastly different rates of recovery. “Our work suggests that cognitive reserve-the brain’s ability to be resilient in the face of insult or injury-could account for the difference,” stated Dr. Schneider.

Schneider performed the study along-side Robert D. Stevens. M.D., a neuro-intensive care physician with Johns Hopkins’ Department of Anesthesiology and Critical Care Medicine. Researchers analyzed 769 patients who had been hospitalized with moderate to severe traumatic brain injury that warranted admittance to a rehabilitation facility.

All patients were enrolled in the TBI Model Systems database, a cohort of patients funded by the National Institute of Disability and Rehabilitation Research. In the study, 219 patients (27.8 percent) were disability-free one year after injury. 23 patients (9.7 percent) without a high school diploma recovered, compared to 136 patients (30.8 percent) with 12-15 years of education who recovered. Of 194 patients who had 16 or more years of schooling, 76 patients (40 percent) made a full recovery.

Schneider stated that at the moment, researchers do not know the exact connection between levels of education and recovery rates. He does say that those with more cognitive reserve may have increased recovery ability. “People with increased cognitive reserve capabilities may actually heal in a different way that allows them to return to their pre–injury function and/or they may be able to better adapt and form new pathways in their brains to compensate for the injury… Further studies are needed to not only find out, but also to use that knowledge to help people with less cognitive reserve,” Schneider adds.

Though the findings of the study are not entirely conclusive, Schneider claims that the research is still useful and applicable to knowledge of everyday health. “What we learned may point to the potential value of continuing to educate yourself and engage in cognitively intensive activities,” he says, “Just as we try to keep our bodies strong in order to help us recover when we are ill, we need to keep the brain in the best shape it can be.” Dr. Stevens agrees with the sentiment, adding “Understanding the underpinnings of cognitive reserve in terms of brain biology could generate ideas on how to enhance recovery from brain injury.”


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