Q&A: On World MS day, how can you improve your brain health?

Dr Sabina Brennan offers some advice on keeping your brain healthy and active

Today is World MS day. The disease impacts an estimated 2.5 million people worldwide, including some 8,000 people in Ireland. 

Dr Sabina Brennan is the principal investigator at the ADAPT Centre, Trinity College Dublin. She spoke to Newstalk.com about MS, the Hello Brain Health app and gave some tips for keeping your brain healthy. 

What exactly is MS?

Your brain communicates via electrical signals and, just like the electrical cables in your house, the ‘wires’ in your brain need to be insulated. 

A fatty white substance called myelin provides this insulation for nerve fibers. This fatty layer helps signals to move quickly and smoothly along the fibers so parts of your brain and nervous system can talk to each other effectively.

In Multiple Sclerosis your body’s immune system mistakes this myelin for a foreign body and attacks it stripping away the layers of insulation. This leaves the nerve fibers open to damage and scarring often called lesions. In fact, multiple Sclerosis means ‘many scars’.

This demyelination of signaling cells means that messages can slow down or get a bit garbled.

Depending on the location and extent of the damage, it may lead to symptoms that involve altered sensations, difficulty with movement or vision and, in about 50% of cases, cognitive symptoms that affect how we process and remember information.

The links between MS pathology and cognition is not well understood. But we do know that - all other things being equal - people with MS who have what is called a high cognitive reserve lose less cognitive function than those with less cognitive reserve.

Having a brain-healthy lifestyle can build up cognitive reserves, which is like investing money in your brain bank. Not everyone with MS will experience cognitive symptoms, but having that investment in cognitive reserve could pay off handsomely. 

What is brainhealth4ms.com?

This website provides easy-to-understand information on brain health specifically for people living with Multiple Sclerosis. Everyone with a brain needs to consider brain health and I would encourage people to do at least one thing every day that is good for brain health. 

The free Hello Brain Health App delivers daily suggestions and support to help you to build a brain healthy lifestyle. This was an international project, which I led and was developed with funding from the European Commission. 

What can be done to protect brain health?

For cognitive function to work well, different parts of the brain need to ‘talk’ to each other as a team. Multiple Sclerosis can interfere with this communication making it difficult for you to keep doing what you do. 

In fact, the changes that MS causes in your brain can slow down your ability to process information and can make it harder to think clearly, make decisions, pay attention and even to remember things.

When this happens it can be challenging to keep up with your job, your studies or even with your social life.

However, it’s really important to stay engaged with life even if it takes extra effort. If you stay physically, mentally and socially active as well as taking your prescribed medication and looking after your general health you can optimise your brain health, protect your cognitive function and even preserve brain tissue.

So if you want to keep doing what you do despite having MS - and even if you don't have MS - embrace a brain healthy lifestyle, because everyone needs to nurture their neurons and give their brain a boost.

Does working on brain health help in a preventative way?

Our brain has the capacity for resilience  - provided we give it a helping hand by living a brain healthy lifestyle.

For example, when a brain disease like Multiple Sclerosis strikes it attacks brain and spinal cord tissue causing communication problems within the central nervous system that can lead to physical, visual or cognitive impairments.

Now, we know that some people with Multiple Sclerosis can tolerate more disease pathology than others while still retaining cognitive function. Scientists believe that their resilience, in the face of disease pathology is linked to certain life exposures. 

Here’s how Scientists think it works:

The brain has an inbuilt, but finite, resource, called neurological reserve. This reserve allows the brain to retain function, by reorganizing itself to compensate for brain atrophy and loss of nerve cells and nerve fibers

The brain does this by rerouting communication pathways to avoid damaged areas. It can also adapt undamaged areas to take on functions that were once carried out by areas now damaged by disease.

This really is pretty fantastic  - but unfortunately, it just can’t keep pace with disease activity. Eventually, Neurological Reserve is exhausted and cognitive deficits become apparent.

But that's not the end of the story. Neurological reserve has two components;

Brain reserve which refers to the size of the brain and cognitive reserve, which is the ability to actively compensate and to make more effective and efficient use of brain networks.

Our lifetime experiences can increase cognitive reserve and help to maintain brain reserves. This gives us a better chance to hang onto cognitive function if life throws us a curve ball in the shape of disease or injury.

All other things being equal, people with Multiple Sclerosis who have high cognitive reserve lose less cognitive function than those with less cognitive reserve for the same amount of brain lesions and atrophy.

Give your brain a helping hand by maximizing your brain health.

Is it ever too late to engage your brain?

No. It’s never too late or too early to consider brain health. Our brain is constantly changing and what shapes it is our behaviours, our experiences, and the lifestyle choices that we make.

What we do or don’t do influences how well it functions and even how resilient it can be when faced with challenges such as aging, injury or disease (e.g. Alzheimer’s Disease or Multiple Sclerosis).

One of the big things we can do to help our brains is to adopt a brain-healthy lifestyle. 

That means looking after our heart health, ensuring we get enough sleep, going easy on alcohol, not smoking, managing stress and mood and keep physically, mentally and socially active.

What are some simple ways that people can improve their brain health?

  • Get physically active
  • Stay Socially Engage
  • Challenge your brain
  • Adjust your attitude
  • Adapt your lifestyle

People work on their bodies and on their diets, but rarely on their brain or headspace. Do you think brain health needs to be a higher priority for people of all ages?

Absolutely - I think that the Government needs to take action on brain health - to raise awareness and to empower people to be more proactive about their brain health. Primary prevention is key - for example, 50% of all cases of Alzheimer's Disease (AD) are attributable to just 7 modifiable risk factors. We need to motivate people to live brain healthy lives to reduce their risk of developing AD.

Brain health is an investment with big payoffs for individuals and for society.

We specifically need to raise awareness among people living with MS of the importance and benefits of making brain healthy life choices. But everyone with a brain needs to consider brain health - the free Hello Brain Health app can provide daily suggestions for how you can do this.