Multiple sclerosis (MS) is an immune-mediated disease of the central nervous system characterized by focal or diffuse inflammation, demyelination, axonal loss and neurodegeneration. Brain atrophy can be seen in the earliest stages of MS and is a reliable predictor of future physical and cognitive disability.

Adjusting to life with multiple sclerosis will mean a lot of changes to your previous lifestyle. Accepting your diagnosis is the first hurdle you must overcome and is an important one.

You may be offered DMDs (Disease-modifying Drugs) and they are worth considering even though your MS symptoms may be mild at this early stage.

Realising that your brain is shrinking can be a very distressing truth to have to swallow. And your thinking ability is going to be badly compromised. Multiple Sclerosis is not just a physical disability.

Brain Atrophy in MS

A life with MS takes its toll on your physical health and cognitive functioning. Factors such as medication dosage and deployability can play a drastic role in whether your physical or mental traits are amplified or diminished.

For a healthy individual, normal suddenly becomes a

bnormal as the mind starts refusing routine tasks. This can trigger personality shifts and alter your life in entirely new directions.

According to the Multiple Sclerosis Foundation (MSF), the three age groups most affected by Multiple Sclerosis are:

  • Younger than 35 years old
  • 35 to 65 years old
  • Older than 65 years old

What can you expect as you approach the age of 50?

Consider this:

  • people with progressive MS will have reduced use of their brain and body due to functional decline and muscle atrophy.
  • The body’s physical functions will also decrease with increasing severity, leading to memory and thinking skills that are difficult to remember.
  • Muscle control will also become increasingly restricted.

And what happens when you reach 70?

In many cases, this will be a death sentence. Your mobility will be limited to a wheelchair or another safe form of movement aid.

The ability to regulate bodily functions will be a task, not even the bravest person can undertake. Forever after, you’ll view this as the norm.

Human Skull

The average life expectancy for a person living with MS is around 20–30 years. A fact that I must dispute! Both my mother and I have multiple sclerosis. I am, at the time of writing, 63 years old and my mother is 86 years old.

However, Brain atrophy will show on an MRI scan as areas of shadowing throughout healthy brain tissue.

A Brain Atrophy Case Study

Marilyn Anderson M.D., a Boston native and neurologist based in Charlottesville, Virginia, agrees that her mastery of the English language, her once impish British humour and her immeasurable capacity for mischief, leads people to believe that she id younger than her years.

In fact, as a child she had always been teased and called lazy and had to grow up fast; as a teenager, she fought with her older brothers about her self-consciousness.

But when she turned 39, with her teen years far behind, the signs of brain atrophy began.

“My father’s work took him overseas and left me with about six months’ leave each year, so I was at home most of the year,” she recalls. “I didn’t go anywhere, and the house was usually just a huge mess.”

Monte was confined to a wheelchair, and not permitted to walk outside or drive a car until she was 26 years old. Again, her other ability to perform basic activities wasn’t going to change.

“As I got to my 40th birthday – just nine months away – someone asked me what I thought about — and I said, “I wish I had a brain.”

The award for the worst day I ever had with MS goes to one Sunday in 2006. I was having coffee with a family member and the old man was showing some old symptoms. He was complaining of weird sensations in his hands and feet, and the spasticity was getting worse.

A lack of Awareness

I didn’t dare ask if this was an old symptom and suggested he go to the doctor. My initial thought was that whatever was wrong with him, wasn’t improving. The symptoms sounded like he might have MS again. But when I grilled him on how he remembered exactly what was wrong, he said he had lived through the entire course of multiple sclerosis with no clues.

I didn’t realise that my old friend had lived with MS for the better part of a decade without any sign of improvement.

I didn’t realise just how badly off-track I was.

Looking back at what I’ve learned over the years, most of my life was in denial. I learned to live in denial the best way I knew how by pretending that the idea of having MS was not abhorrent to me.

The simple act of accepting my good fortune that this is just a part of the barrage of diseases that comes my way made all the difference.

Due to the interconnected nature of both the nervous and immune systems, the detrimental effects of MS transmit through the whole body with symptoms affecting multiple organs.

This memento mori is experienced as difficulties in attention, memory, planning and social interaction. It is very important that you are correctly diagnosed at this stage if you want to enjoy a good quality of life and be mentally healthy into your golden years.

The brain is the largest organ affected by MS, and the most serious. The regions of the brain affected can be broadly classified into four areas; the temporal, parietal, frontal lobes, and cerebellar.

Parts of the Brain

Source: Dana Foundation

But the neurological abnormalities do not stop there. The first sign of damage to the cerebellum can be difficulty walking and tasks requiring fine motor skill. The cerebellum is important for posture and balance.

Furthermore, cognitive changes seen in the mid-to-late stages of MS. Can affect memory and learning abilities and result in behaviour changes.

These changes for the most part are subtle and only become apparent very late during the course of MS.

However, it’s imperative you recognise the signs of damage happening to your brain and body. Ask your medical team about this.

According to the Dementia and ADL Foundation of America, around 85 million Americans have an undiagnosed cognitive disability.

Subtle cognitive changes can afflict older adults in spite of a fully functioning brain, and they are often overlooked.

A Memento Mori

This memento mori is experienced as difficulties in attention, memory, planning and social interaction. It is very important that you are correctly diagnosed at this stage. If you want to enjoy a good quality of life and be mentally healthy into your golden years.

For many people with MS. The disease pandemics that manifest in the form of progressive multi-organ diseases will set in very suddenly. This may lead to disability levels significantly higher than would be seen in the general population.

However, aside from the brain and some of the body’s other essential organs. No organ or tissue is immune to the ravages of MS.

When I was diagnosed in my early 20s. Especially as I was struggling to make sense of all the information that was flooding in. On top of getting my affairs in order, there was a lot that I wanted to distract myself with. A cup of tea and my favourite book were just some of my myriad temptations.

By the time I fully understood the gravity of my condition. And saw the effects of my existing impairments, my focus was restricted to very basic, physical activity.

This understandably limited my life; I was unable to focus on the intricacies of what was going on around me or to do creative work.

Now, almost two decades later, there is still exercise that I would crave to do. And cheery memories I have cherished throughout my life to sustain me.

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