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Review
. 2024 Mar 18;16(6):5772-5791.
doi: 10.18632/aging.205667. Epub 2024 Mar 18.

Considering the response in addition to the challenge - a narrative review in appraisal of a motor reserve framework

Daniel Zeller  1 , Shawn Hiew  1 , Thorsten Odorfer  1 , Carine Nguemeni  1
Affiliations
Review

Considering the response in addition to the challenge - a narrative review in appraisal of a motor reserve framework

Daniel Zeller et al. Aging (Albany NY). .

Abstract

The remarkable increase in human life expectancy over the past century has been achieved at the expense of the risk of age-related impairment and disease. Neurodegeneration, be it part of normal aging or due to neurodegenerative disorders, is characterized by loss of specific neuronal populations, leading to increasing clinical impairment. The individual course may be described as balance between aging- or disease-related pathology and intrinsic mechanisms of adaptation. There is plenty of evidence that the human brain is provided with exhaustible resources to maintain function in the face of adverse conditions. While a reserve concept has mainly been coined in cognitive neuroscience, emerging evidence suggests similar mechanisms to underlie individual differences of adaptive capacity within the motor system. In this narrative review, we summarize what has been proposed to date about a motor reserve (mR) framework. We present current evidence from research in aging subjects and people with neurological conditions, followed by a description of what is known about potential neuronal substrates of mR so far. As there is no gold standard of mR quantification, we outline current approaches which describe various indicators of mR. We conclude by sketching out potential future directions of research. Expediting our understanding of differences in individual motor resilience towards aging and disease will eventually contribute to new, individually tailored therapeutic strategies. Provided early diagnosis, enhancing the individual mR may be suited to postpone disease onset by years and may be an efficacious contribution towards healthy aging, with an increased quality of life for the elderly.

Keywords: aging; cognitive reserve; compensation; motor reserve; neurodegenerative disease.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Cross-sectional (A) and longitudinal (B) models for studying cognitive reserve (CR). (A) Measures of brain morphology, integrity or pathology may impact clinical status via path Ⓒ. CR is represented by the orange box; working measures of CR include CR proxies or identified CR brain networks. Age, genetics and life experiences are believed to influence brain measures and CR. CR is assumed to moderate the effect of brain status on clinical status, thus producing individual differences in the clinical correlates of a given level of brain reserve and brain pathology. The effect of brain status on clinical status may be mediated in part by brain networks captured during task related activation (paths Ⓐ and Ⓑ). Path Ⓓ suggest that CR might moderate between brain status and activation. Path Ⓔ recognizes that some aspects of CR might moderate between brain and clinical function without being captured in specific task-related activations. (B) In longitudinal models, two paths can be added: path Ⓕ assesses how CR moderates the effect of brain change on cognitive change, and path Ⓖ addresses neuroprotective mechanisms. Npsy., neuropsychological. Adopted from [7].
Figure 2
Figure 2
Proposal of a conceptual model of motor reserve (mR). A selection of important parameters with an impact on mR is shown. While neural reserve and (beneficial adaptive) neural compensation are considered part of the proposed neural basis of mR, it should be noted that neural compensation may only be related to reserve if it is linked to a third (e.g. lifestyle) factor and shows individual variation.
Figure 3
Figure 3
Schematic view on the different substrates and levels where motor reserve (mR) might be located (left panel) and on examples of how to measure mR (right panel).
Figure 4
Figure 4
Motor reserve model. Motor reserve accounts for normal motor function (green) until neuropathological damage associated with aging and/or neurodegenerative disease reaches a critical threshold, after which impaired motor function may be observed (red). BTA, beneficial training activity.
Figure 5
Figure 5
A step-by-step approach to uncovering a motor reserve. Each step is motivated by an outstanding research question (RQ), and possible materials and methods (MM) to search for answers are specified [images from stock art and flaticon (https://www.flaticon.com/free-icons/mri)].
See this image and copyright information in PMC

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