Silhouette image of a person with a shrinking brain.

Shrinkage! Brain Atrophy and MS

Is there any symptom of Multiple Sclerosis that is scarier than brain atrophy? The literal shrinking of our brains. I guess that depends on who you talk to, but, for me, the idea that my brain is shrinking is absolutely terrifying. Some people may not even be aware that this seldom talked about symptom can occur in those with MS. In fact, after seeing some folks debate it online, I thought I’d bring it up to clear up some misconceptions.

Our brains shrink?

While it’s scary to think about, once you reach adulthood, everyone’s brain shrinks, whether you have a neurological disease or not.1 However, people with Multiple Sclerosis can experience brain atrophy at an accelerated rate (sometimes up to ten times as fast as those without MS). When you stop and think about it, it’s really not that surprising that those with MS can experience faster than normal brain atrophy. After all, MS causes our own immune system to attack and eat away at the myelin, the protective insulation surrounding our nerves. That damaged myelin is going to mean that our overall brain volume (another term commonly used for assessing the size of our brain) will lessen. So, obviously, the more progressive the MS, the greater the chances and speed of brain atrophy.

This is bad, right?

Well, as you might expect, brain atrophy isn’t the greatest symptom that MS has to offer. In fact, it’s one of the possible causes of cognitive dysfunction among those with Multiple Sclerosis. However, cognitive problems are not the only issue with brain volume loss. Brain shrinkage can affect a large number of areas and has been a good measure in determining not only the severity of one’s MS, but also in their overall level of disability. Brain atrophy is essentially a good indicator in the overall decline of an MS patient.2

Fighting it

Battling the normal brain atrophy we encounter with aging is possible, with a “use it or lose it strategy”, in other words, exercising your brain (puzzles, reading, keeping your brain active). While that same strategy is vital when fighting against cognitive dysfunction in MS, it can take a bit more to protect us against brain shrinkage. Protecting against brain volume loss is an important thing to think about when discussing your treatment plan with your doctor, as some medications are better than others at slowing the rate of brain atrophy. Regular exercise has also shown some benefits with regards to combating shrinkage.3 Tracking brain volume loss is also a good way to evaluate whether your current treatment plan is effective (it can actually be tracked via MRI with the use of special software).4

Talk to your MS specialist

As revealed at an ECTRIMS (European Committee for the Treatment and Research of Multiple Sclerosis) conference, a recent study has shown that many MS patients do not have significant knowledge about brain atrophy and its effects on them, despite the fact that “Brain atrophy is increasingly being used as an outcome measure in MS clinical trials and is strongly correlated with the development of disability and neuropsychological impairment".5 Those findings very much confirm what I’ve seen in discussions among those with MS, that people simply don’t know enough about the effects of brain atrophy with regards to their disease. The best way to remedy that is to discuss it with your doctor. I encourage everyone to ask their doctor about this topic, if your medication aids in the protection against atrophy, and if atrophy is something they are measuring.

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