Brain reserve in MS

Brain reserve in MS

Damage control
Multiple sclerosis (MS) can affect your brain by increasing the rate of brain atrophy, impacting your life with the condition. However, the brain has a clever system to help it cope with this damage which we’re going to talk about here.

    Many people used to believe the brain stopped changing and developing in early adulthood, but we now know that’s not entirely true.

    Your brain continues to change and reorganise itself as you age, forming new pathways and strengthening others. Because of this, the brain is often described as flexible, or in fancy science terms, that it has neuroplasticity.

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    Professor Bart van Wijmeersch

    Professor Bart van Wijmeersch

    Discusses the impact of neurological reserve

    The brain’s neuroplasticity and the fact that you don’t use all of your brain, all of the time, means your brain has a backup, or a reserve. If something goes wrong in one part of the brain you might be able to use other parts to work around the problem. This backup is called neurological reserve and the more your brain has, the healthier it is. Reserve is made up of two parts: brain reserve and cognitive reserve, and both are important for your brain health.

    You don’t have much control over how big your brain is, as its size is determined by your genetics.

    Our brain very slowly starts to get smaller as we age. In other words, we all experience brain atrophy.1 But MS can also damage your brain; meaning brain atrophy may take place a little quicker, and if your brain decreases in size, so does your brain reserve.

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    Understanding MS Neurological reserve

    Professor Bart van Wijmeersch

    MS can cause damage, such as lesions, which can lead to faster brain tissue loss than usual.

    As damage takes place in the brain, new areas are recruited to carry out the functions of the damaged areas – this uses up neurological reserve and the brain might not be able to carry out all of its normal functions.

    The symptoms of MS are more likely to progress when all neurological reserve runs out.

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    Understanding MS - The downside of neurological reserve

    Professor Bart van Wijmeersch

    Neurological reserve can help your brain cope with damage caused by MS, but it can also hide it, making it much harder to notice. If one part of the brain is unable to work properly, your reserve might be able to work around the problem by using other parts of the brain that aren’t damaged. This is often why MS goes undetected in the early stages of the disease. You can be feeling well and not experiencing symptoms, but MS can still be active. Only when your neurological reserve starts to run out, do MS symptoms become more noticeable.

    You may not experience any new symptoms when new lesions form. In fact, the majority of lesions don’t result in a relapse because the brain can build other connections and work around the damage.

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    Having a backup is very important for a fully functioning and healthy brain. Neurological reserve not only helps your brain cope better as we age, it helps it deal with damage caused by MS too. Here are a couple of things about neurological reserve that are important for you to know when living with MS

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    Neurological reserve can help to hold off symptoms, but on the flip side this could contribute to damage to your brain in MS going unnoticed

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    Your neurological reserve can get used up. So you need to look after your brain as much as possible, keeping it both healthy and active

Did you find this interesting? Read our “Boosting brain health” article. Alternatively, create your own Talk to Your Doctor guide to help support conversations you have with your doctor about brain health in MS.

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