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The Brain Reserve Hypothesis in MS

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    The Brain Reserve Hypothesis in MS

    I just stumbled on this...I don't know if anyone else has heard of it, but if it's true, it makes a good case for the DMTs being taken for the rest of your life! I can't remember when I stopped my M.S. meds (I am 55 now) but if there is anything to this hypothesis, my doctor should have told me to continue or risk "losing my brain reserves" even faster!

    I plan to ask him what he thinks of this or if he has even heard of it. I just went for my appointment before ready about this.

    Marco? Myoak? Anybody??
    Last edited by KoKo; 10-14-2019, 01:26 PM. Reason: removed quotation marks from title
    Tawanda
    ___________________________________________
    Diagnosed with Multiple Sclerosis 2004; First sign of trouble: 1994

    #2
    Hi Tawanda,

    Is there a specific article you were looking at? I am familiar with the concept, but not necessarily tied to DMTs.

    I would break it into a couple of parts and different theories.

    The first part, is the theory that neurological reserve helps reroute signals from the brain after a relapse. This is why in the early phase of RRMS, some people may remain symptom free. Over time, as reserve becomes depleted, it is harder to overcome.

    The second part is the theory related to cognitive impairment. This specifically relates to larger brain volume - the larger the brain, the less likely someone is to have cognitive impairment in MS or dementia in general. Again, the reserve protects over time.

    My last neuro was a big proponent of continuous learning to sustain and build reserve. He would say the more senses challenged, the better. So while reading and puzzles are good, learning a new language (sight, sound, speech) or a musical instrument (sight, sound, touch) is even better. He acknowledged that it could be frustrating trying to learn, but he was funny - saying you don't have to be good or fast, just keep trying and learning.

    He was also a big proponent of exercise, a healthy diet and weight, and social interaction - all to sustain neurological reserve.

    So back to DMTs, they are designed to stop relapses and to my knowledge, don't help cognitive reserve independently, but just thru prevention of relapses and further damage that would try to draw on this reserve.

    I also haven't seen anything related to PPMS and cognitive reserve, just RRMS.
    Kathy
    DX 01/06, currently on Tysabri

    Comment


      #3
      Originally posted by Tawanda View Post
      I just stumbled on this...I don't know if anyone else has heard of it, but if it's true, it makes a good case for the DMTs being taken for the rest of your life! I can't remember when I stopped my M.S. meds (I am 55 now) but if there is anything to this hypothesis, my doctor should have told me to continue or risk "losing my brain reserves" even faster!

      I plan to ask him what he thinks of this or if he has even heard of it. I just went for my appointment before ready about this.

      Marco? Myoak? Anybody??
      Hi Tawanda

      Kathy explained the brain reserve theory very well.

      This article is helpful also:

      Neurological reserve: How the brain can adapt to MS damage

      https://multiplesclerosisnewstoday.c...onsored-post-2

      Take Care
      PPMS for 22 years (dx 1998)
      ~ Worrying will not take away tomorrow's troubles ~ But it will take away today's peace. ~

      Comment


        #4
        So much for my quotation marks on my subject on the opening board!

        What this implies to me, having read the same thing as Kathie, is that a bunch of brain was burned out before we even got on a DMT! We could have been born with MS for all anyone knows. Maybe had enough "brain fuel" when we were young to reroute our neurological paths for a long time and then BOOM. If I see the slightest sign of my daughter showing any MS, I would want her diagnosed quick.

        I also wonder about replenishing do-called reserves. Can it be done? Or once it's gone it's gone? They do call this a "hypothesis" so that means there aren't hard and fast answers. Just thought I'd throw this out there...
        Tawanda
        ___________________________________________
        Diagnosed with Multiple Sclerosis 2004; First sign of trouble: 1994

        Comment


          #5
          Thanks for the link to the article, KoKo.

          If the rest of you are anything like me, I don't always take the initiative to click on links. So here's a summary of the suggested strategies that we can use to help our brain adapt to MS damage:

          - Help relieve MS symptoms with exercise—staying as active as you can is a good idea
          - Reduce the number of new lesions by maintaining a healthy body weight. Obesity is associated with a higher number of MS lesions
          - Enhance neurological reserve by keeping your mind active. Activities like reading, writing, and playing board games can help
          - Help reduce relapses and lesions when you quit smoking. Smoking is particularly dangerous for people with MS and can also diminish neurological reserve.
          ~ Faith
          MSWorld Volunteer -- Moderator since JUN2012
          (now a Mimibug)

          Symptoms began in JAN02
          - Dx with RRMS in OCT03, following 21 months of limbo, ruling out lots of other dx, and some "probable stroke" and "probable CNS" dx for awhile.
          - In 2008, I was back in limbo briefly, then re-dx w/ MS: JUL08
          .

          - Betaseron NOV03-AUG08; Copaxone20 SEPT08-APR15; Copaxone40 APR15-present
          - Began receiving SSDI / LTD NOV08. Not employed. I volunteer in my church and community.

          Comment


            #6
            Originally posted by Tawanda View Post
            So much for my quotation marks on my subject on the opening board!
            Fixed it for you.
            PPMS for 22 years (dx 1998)
            ~ Worrying will not take away tomorrow's troubles ~ But it will take away today's peace. ~

            Comment


              #7
              Originally posted by Tawanda View Post
              So much for my quotation marks on my subject on the opening board!

              What this implies to me, having read the same thing as Kathie, is that a bunch of brain was burned out before we even got on a DMT! We could have been born with MS for all anyone knows. Maybe had enough "brain fuel" when we were young to reroute our neurological paths for a long time and then BOOM. If I see the slightest sign of my daughter showing any MS, I would want her diagnosed quick.

              I also wonder about replenishing do-called reserves. Can it be done? Or once it's gone it's gone? They do call this a "hypothesis" so that means there aren't hard and fast answers. Just thought I'd throw this out there...
              I don't take it that we were necessarily born with it and that we eroded our reserve earlier or from birth because of that. Once lesions are formed, the neurological reserve then might start to be used.

              Somewhere between the ages of 29 and 42, I developed brain & spinal lesions. The lesions were a result of a relapse(s).

              For me, it fits. I complained of focus issues after a relapse at 29. I was undiagnosed, vertigo, etc.. For years, I would complain that my focus and subsequent memory were not what they were before. But my reserve allowed me to still keep functioning at a high level hidden from almost everyone, then an average level where people thought I was just distracted easier. Eventually, I think enough reserve used that said enough is enough. I had to retire from the work force at 50.

              As to whether you can keep developing reserve, there are a few studies supporting that you can keep developing, but I think at a slower rate than in our youth.

              I took a course thru a neuropsychologist that my neuro recommended. It did help improve my memory some. Cardio exercise has helped me as well. Not sure if it helped with focus, so time to commit to memory, or if helped with retrieval from memory. Either way, I will take it.
              Kathy
              DX 01/06, currently on Tysabri

              Comment


                #8
                Night shades could be bad

                Thank you guys! I knew I couldn't be the only one who has heard about this theory. I have been doing research again on the computer. Perhaps we should eat less "night shade veggies" as well? "
                Tawanda
                ___________________________________________
                Diagnosed with Multiple Sclerosis 2004; First sign of trouble: 1994

                Comment


                  #9
                  Originally posted by Tawanda View Post
                  Perhaps we should eat less "night shade veggies" as well? "
                  Tawanda

                  I'm not an expert on this, but have read many articles, pro and con, about nightshade vegetables.

                  As with many foods, there are some people with sensitivities or food allergies that involve the nightshade family. When the nightshades are eliminated, they feel better.

                  Nightshades are also some of the most nutrient dense vegetables.

                  Not giving up my tomatoes and peppers!

                  Take Care
                  PPMS for 22 years (dx 1998)
                  ~ Worrying will not take away tomorrow's troubles ~ But it will take away today's peace. ~

                  Comment


                    #10
                    Originally posted by KoKo View Post
                    Tawanda

                    I'm not an expert on this, but have read many articles, pro and con, about nightshade vegetables.

                    As with many foods, there are some people with sensitivities or food allergies that involve the nightshade family. When the nightshades are eliminated, they feel better.

                    Nightshades are also some of the most nutrient dense vegetables.

                    Not giving up my tomatoes and peppers!

                    Take Care
                    Or potatoes, but I will try to make it a point to do more sweet potatoes though.
                    Tawanda
                    ___________________________________________
                    Diagnosed with Multiple Sclerosis 2004; First sign of trouble: 1994

                    Comment


                      #11
                      Einstein

                      I am guessing I am not the only person to hear this about Albert Einstein: A colleague asked him for his phone number, and Einstein reached for his telephone directory to look it up. “You don’t remember your own number?” asked the colleague, and Einstein replied, "Why should I memorize something I can get from a book?"

                      Nowadays, I guess it would be the Internet rather than a book, but I after I heard this story (as a tween or teen), I stopped memorizing people's phone numbers! Either it gave me an excuse to be lazy, or perhaps I was approaching that age when you no longer have those crazy good memorization skills anymore anyway. About that same time, I remember my half-sister, who was a little kid 12 years younger than me, handing me my butt after we played that card game, "Concentration"!

                      I started to think (uh-oh, am I wasting brain matter by thinking about this?) how far do you take this hypothesis? NOT do crossword puzzles? NOT read books? NOT take a class just for fun? According to this theory it sounds like using our brain for anything other than the really, really important stuff might be a waste of precious "brain fuel!"

                      Again, this is only a hypothesis. If this story about Einstein is true, perhaps he subscribed to this theory.
                      Tawanda
                      ___________________________________________
                      Diagnosed with Multiple Sclerosis 2004; First sign of trouble: 1994

                      Comment


                        #12
                        Originally posted by Tawanda View Post
                        I started to think (uh-oh, am I wasting brain matter by thinking about this?) how far do you take this hypothesis? NOT do crossword puzzles? NOT read books? NOT take a class just for fun? According to this theory it sounds like using our brain for anything other than the really, really important stuff might be a waste of precious "brain fuel!"

                        Again, this is only a hypothesis. If this story about Einstein is true, perhaps he subscribed to this theory.
                        Hi Tawanda

                        Do you think that the hypothesis means that using our brain (for unimportant tasks) will subtract from brain reserve?

                        I'm not so sure that's what it means. Now I'm .

                        Take Care
                        PPMS for 22 years (dx 1998)
                        ~ Worrying will not take away tomorrow's troubles ~ But it will take away today's peace. ~

                        Comment


                          #13
                          Originally posted by KoKo View Post
                          Hi Tawanda

                          Do you think that the hypothesis means that using our brain (for unimportant tasks) will subtract from brain reserve?

                          I'm not so sure that's what it means. Now I'm .

                          Take Care
                          I don't have a clue! Lol! I have a lot for "junk" in my memory stores for sure. Personally I always thought of the brain more as limitless than limited...it's much more palatable that way!
                          Tawanda
                          ___________________________________________
                          Diagnosed with Multiple Sclerosis 2004; First sign of trouble: 1994

                          Comment


                            #14
                            As the old saying goes, use it or lose it. I think that applies to the brain as well.
                            Kathy
                            DX 01/06, currently on Tysabri

                            Comment


                              #15
                              Hello,

                              IMO, not utilizing memory if doing so is possible, does not preserve brain function, but rather depletes it.

                              Memory, like muscle, is developed by use; at least that has been true in my experience.

                              But on a more formal note we do know from scientific studies that intellectually enriching activities build “brain reserve” and slow cognitive impairment.

                              Cognitive Leisure Activities
                              Read books
                              Read magazines or newspapers
                              Produce art (e.g., painting, poetry, sculpture)
                              Produce non-artistic writing (e.g., newsletter, diary, essays)
                              Play a musical instrument
                              Play structured games (e.g., board games, cards, crossword puzzles)
                              Participate in hobbies (e.g., model building, gardening, web design)

                              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524787/

                              Searching for the neural basis of reserve against memory decline: intellectual enrichment linked to larger hippocampal volume in multiple sclerosis.

                              “Active engagement in intellectually enriching activities (e.g., reading, hobbies) builds “reserve” against memory decline in elders and persons with multiple sclerosis (MS)”

                              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2822636/

                              Intellectual enrichment is linked to cerebral efficiency in multiple sclerosis: functional magnetic resonance imaging evidence for cognitive reserve

                              Conclusion

                              The current research utilized fMRI to demonstrate that intellectual enrichment is associated with cerebral efficiency in neurological patients, thereby supporting the cognitive reserve hypothesis…

                              the brain's; default network has become an important construct in neuroscience and neurology, especially because activity within the default network is reduced among patient with neurological disease.

                              Our results show that default network activity is strongly related to intellectual enrichment/cognitive reserve, at least in patients with multiple sclerosis…

                              Perhaps most importantly, multiple sclerosis patients with greater expression of the identified network appear able to withstand multiple sclerosis disease better before showing cognitive impairment."

                              https://multiple-sclerosis-research....brain-reserve/

                              CLINICSPEAK: CREATING BRAIN RESERVE

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