{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T18:18:51Z","timestamp":1775067531316,"version":"3.50.1"},"posted":{"date-parts":[[2026,3,30]]},"group-title":"Neurology","reference-count":49,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,3,30]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>INTRODUCTION<\/jats:title>\n                  <jats:p>Bilingualism may confer resilience via enhanced neural integrity. However, evidence for bilingualism\u2019s neuroprotective effect is mixed, and studies across Alzheimer\u2019s disease (AD) variants are scarce. This study examined gray matter volume (GMV) differences between bilinguals and monolinguals with amnestic AD and logopenic variant primary progressive aphasia (lvPPA).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>In 136 amnestic AD and 88 lvPPA participants with neuropsychological assessments and structural MRI, we analyzed differences between monolinguals and bilinguals within each variant, controlling for demographic covariates.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Amnestic AD bilinguals exhibited less GMV in hippocampal, fusiform, and occipital regions compared to monolinguals. LvPPA bilinguals had less temporal and occipital volumes, but they had greater volumes in inferior parietal regions, which are considered a disease epicenter in lvPPA. Cognitive performance in monolinguals and bilinguals was comparable within variants.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>DISCUSSION<\/jats:title>\n                  <jats:p>Bilingualism may support cognitive reserve (preserved cognition despite reduced GMV) in both AD variants, with additional brain reserve in lvPPA.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.03.27.26349575","type":"posted-content","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T15:20:17Z","timestamp":1774884017000},"source":"Crossref","is-referenced-by-count":0,"title":["Cognitive and brain reserve in bilingual speakers with clinical AD variants"],"prefix":"10.64898","author":[{"given":"Nicoletta","family":"Biondo","sequence":"first","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Matthew","family":"Suntay","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muskaan","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanine Sandra","family":"Estaban","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janhavi","family":"Pillai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2518-2520","authenticated-orcid":false,"given":"Maria Luisa","family":"Mandelli","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94143, 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California, San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya L.","family":"Henry","sequence":"additional","affiliation":[{"name":"Department of Speech, Language, and Hearing Sciences, University of Texas, Austin, 2504A Whitis Avenue, Austin, TX, 78712, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina F.","family":"Dronkers","sequence":"additional","affiliation":[{"name":"Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, 3 Floor, Berkeley, CA, 94720, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Luisa","family":"Gorno Tempini","sequence":"additional","affiliation":[{"name":"Department of Neurology, Edward and Pearl Fein Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, Box 1207, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94143, 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