News Release

Kessler Foundation researchers find education attenuates impact of TBI on cognition

Results support the hypothesis of cognitive reserve in traumatic brain injury

Peer-Reviewed Publication

Kessler Foundation

James Sumowski, Kessler Foundation

image: Dr. Sumowski is a research scientist in Neuropsychology and Neuroscience Research at Kessler Foundation where he specializes in cognitive research in multiple sclerosis, traumatic brain injury, and dementia. view more 

Credit: Kessler Foundation

West Orange, NJ. February 28, 2014. Kessler Foundation researchers have found that higher educational attainment (a proxy of intellectual enrichment) attenuates the negative impact of traumatic brain injury (TBI) on cognitive status. The brief report, Sumowski J, Chiaravalloti N, Krch D, Paxton J, DeLuca J. Education attenuates the negative impact of traumatic brain injury (TBI) on cognitive status, was published in the December issue of Archives of Physical Medicine & Rehabilitation Vol. 94, Issue 12:2562-64.

Cognitive outcomes vary post-TBI, even among individuals with comparable injuries. To examine this finding, investigators looked at whether the hypothesis of cognitive reserve helps to explain this differential cognitive impairment following TBI. Kessler Foundation investigators have previously supported the cognitive reserve hypothesis in persons with multiple sclerosis, demonstrating that lifetime intellectual enrichment protects patients from cognitive impairment (for review, Sumowski & Leavitt. Cognitive reserve in multiple sclerosis. Multiple Sclerosis Journal 2013; 19: 1122-27. In the current study, they sought to determine whether individuals with TBI with greater intellectual enrichment pre-injury (estimated with education), are less vulnerable to cognitive impairment.

Researchers compared 44 people with moderate to severe TBI with 36 healthy controls. Their cognitive status (processing speed, working memory, episodic memory) was evaluated with neuropsychological tasks. "Although cognitive status was worse in the TBI group," said Dr. Sumowski, senior research scientist in Neuropsychology & Neuroscience Research at Kessler Foundation, "higher education attenuated the negative effect of TBI on cognitive status, such that persons with higher education were protected against TBI-related cognitive impairment."

"These results support the hypothesis of cognitive reserve in TBI, ie, as in MS, higher intellectual enrichment benefits cognitive status," concluded Dr. Chiaravalloti, the Foundation's director of TBI Research. "This knowledge may help identify those persons with TBI who need early intervention because they are at greater risk for cognitive impairment. It may be beneficial to encourage enriching activities among those with TBI," she added. "Although causation has not been proved, intellectually enriching activities may protect against further cognitive decline."


Supported by New Jersey Commission on Brain Injury Research (CBIR11PJT020); NIDRR (H133A070037) (H133P090009)

About TBI Research at Kessler Foundation

Nancy Chiaravalloti, PhD, is director of TBI Research and Neuropsychology & Neuroscience Research. Dr. Chiaravalloti is project director of the Northern New Jersey TBI System (NNJTBIS), a collaborative effort of Kessler Foundation, Kessler Institute for Rehabilitation, and local hospitals. John DeLuca, PhD, is co-project director. NNJTBIS is one of 16 federally funded model systems that form a national comprehensive system of care, research, education and dissemination aimed at improving quality of life for people with TBI. NNJTBIS is supported by grant #H133A120030 from NIDRR. In addition to NIDRR and NIH, TBI research is funded by the New Jersey Commission on Brain Injury Research, the Department of Veterans Affairs and Children's Specialized Hospital. Kessler Foundation researchers have faculty appointments in the department of physical medicine and rehabilitation at Rutgers New Jersey Medical School.

About Kessler Foundation

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit,, and

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