'Mens sana in corpore sano': the emerging link of motor reserve with motor and cognitive abilities and compensatory brain networks in SCA2 patients.

The ability to resiliently cope with neuropathological lesions is a key scientific concern. Ac-cordingly, this study aims to investigate whether motor reserve (MR), likely to be boosted by exercise engagement in a life-time, affects motor symptom severity, cognitive functioning and functional brain networks in spinocerebellar ataxia type 2 (SCA2), a cerebellar neurodegenera-tive disease. The MR of twelve SCA2 patients was assessed using the Motor Reserve Index Ques-tionnaire (MRIq), developed ad hoc for estimating lifespan MR. The International Cooperative Ataxia Rating Scale was used to assess clinical motor features, and neuropsychological tests were used to evaluate cognitive functioning. Patients underwent an MRI examination, and net-work-based statistics (NBS) analysis was carried out to detect patterns of functional connectivity (FC). Significant correlations were found between MRIq measures and the severity of motor symptoms, educational and intellectual levels, executive functions, and processing speed. NBS analysis revealed a higher FC within subnetworks consisting of specific cerebellar and cerebral areas. FC patterns positively correlated with MRIq measures, likely indicating the identification of an MR network. The identified network might reflect a biomarker likely to underlie MR, in-fluenced by education and cognitive functioning and impacting the severity of motor symptoms.