The Brain, The Brain… The Center of The Chain

I think it’s over here… or upstairs… or in the trunk… wait, did I donate that??

Lapses in memory or just general forgetfulness can happen to anyone and doesn’t have to be directly related to any one issue or associated with any diagnosis in particular. In the world of MS though, Cognition Issues, or what is sometimes referred to as Cog Fog can be a significant concern. Cognition and overall Brain Health is a complicated beast especially within the MS community. Here are some general info and tips about helping to improve cognition and overall brain function and how to build in a defense against the Cog Fog.

The Brain, The Brain…. The Center of the Chain (yes, that’s a Babysitters Club reference)

  • While many factors may impact Cognition some big ones to keep in mind are Nutrition, Sleep and Stress
  • Nurtirion
    • A healthy diet (while there is not an MS specific diet, read balanced diet here) can help support brain function and health. Giving the body important nutrients it needs to use in cell building and repair
    • Vitamin E, Omega-3 Fatty Acids and other anti-inflammatory foods have been found to impact brain function in a positive aspect
  • Sleep
    • Sleep can be hard to come by but getting proper rest may trigger your glymphatic system which essentially helps flush your central nervous system (in part your brain) of buildup and toxins
    • Sleep allows your body to heal and repair cells that can help you get a fresh start on the next day
  • Stress
    • Stress is a big one as it can trigger an increase in the activity of your sympathetic nervous system and cause inflammation which can lead to issues associated with not only your cognitive system but also your immune system
    • Decreasing stress levels (easier said than done I know) can aid your body in being in a good spot defensively for illness as well as loss of attention and focus

Now none of that may be new news to you, but it’s good to be reminded that Nutrition, Sleep and Stress all play a part in our overall health and especially as it relates to brain health. So, what can you do to combat or alleviate some of the problems brought on by Cog Fog. We’ve heard some great tips from clients that they use and wanted to share

  • Notes, notes and more notes: when you think of or hear important information write it down on a post-it and put them up in a spot in your home that you pass by very often such as a hallway, bathroom or near the front door
  • Calendars are your friend: A large wall calendar can be purchased or if you want to be creative, drawn/painted/sketched onto a wall and similar to the notes put appointments, important dates and other information into it so you have it on hand
  • You are getting very sleepy: There are a lot of theories on how much sleep you should get, generally speaking we hear that 8 hours is optimal. But in addition to this try working on a sleep cycle. Sleep cycles last approximately 90 mins and there are 5 stages that you go thru during that time. It takes on average someone 15 mins to fall asleep. So try and schedule your sleep to include not only the 90mins in each cycle but also the 15mins at the start (its an average, I know it may not work for everyone in exactly that amount of time) and set alarms to wake up at what would be the end of a sleep cycle. You’ll definitely feel the difference
  • Meal planning: Seems like the whole world is on a meal plan or diet kick these days. But meal planning can be helpful when you are not only trying to have healthy meals but also when you are attempting to be intentional about implementing things like Vitamin E and Omega 3 fatty acids. Mark out a plan for your weekly meals (yes you can deviate to occasionally allow for that cheeseburger or pizza) and be intentional about incorporating healthy aspects into your diet

There are lots of other great tips to include, these are just some that we wanted to share and hope are helpful to you. Definitely share with us some of your tips and takes on helping with Brain Health. We’d love to hear them!

To continue the conversation about MS relapses during MS Awareness Month, MSAA will be hosting a live Ask Me Anything” event with Rohit Bakshi, MD, today, March 19, 2018 from 6:00 – 7:00 pm Eastern on MSAA’s Facebook page. And throughout the week, MSAA will be hosting free in-person events across the country.  Find an education event near you by visiting our Calendar of Events page.

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My MSAA Community – One Year Later

It has officially been one year since MSAA launched its online peer-to-peer forum, My MSAA Community!  This virtual community (powered by HealthUnlocked) has allowed individuals living with MS and their care partners and families the opportunity to share their experiences, discuss a variety of topics, and support others in a friendly and safe environment.  Community members are able to connect with other people affected by MS, contribute to ongoing conversations, or start their own conversation asking for advice or sharing their journey.

Here are just a few of the ongoing conversations being discussed on My MSAA Community:

Commemorate this milestone with us by contributing to these conversations or start your own by joining My MSAA Community!

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Ask the Expert – Cognition

Featuring Randall T. Schapiro, M.D., FAAN
President, The Schapiro MS Advisory Group
Clinical Professor of Neurology (Retired), University of Minnesota

Question: What are some ways to address and treat MS-related cognitive issues?

Answer: Cognitive issues in multiple sclerosis were basically unheard of before 1983.  That was not because they did not exist but because they were not studied.  Subsequently they have been studied extensively and problems with memory, planning, foresight and judgement are clearly present in over sixty percent of those with MS.  It is important to emphasize that everyone with MS is different and all do NOT have cognitive issues.  When evaluating cognition in MS it is extremely important to take into consideration any additional issues of fatigue, depression, and anxiety.  These may falsely lead to a cognitive impairment diagnosis and certainly can contribute to making cognitive impairment appear worse.  There are neuropsychological tests that can objectify cognitive function and are clearly superior to more subjective testing done at the “bedside” or in the office.  Investigators have tried to correlate MRI anatomy with cognitive function with varying degrees of success.  At the present it is very hard to predict cognition by looking at an MRI although clinicians often try to do so.  In my opinion, the best way to manage cognitive problems is to avoid them entirely by prevention with disease modifying medication.  That is one of the reasons we recommend early treatment with these effective medications.  Cognitive rehabilitation through a speech pathologist or neuropsychologist can, at times, be helpful but may be less that satisfying.  Like many symptoms of MS an answer to disability is mobility and remaining mobile and staying active, using your mind is essential.

Question: How can you tell if the “cog fog” is related to MS or other health issues?

Answer: “Cog-fog” is a somewhat slang expression for the feeling that may intermittently layer onto those with MS giving the feeling of increasing cognitive problems.  There is no “officially” accepted physiological explanation for this other than increased fatigue, depression, anxiety.  Medically, accompanying issues such as infection or other medical illnesses e.g. thyroid disease should be explored.  When there is an acute, sudden onset of “cog-fog” or any new symptom, the treating neurologist should be called to review the situation for something that might be contributing to this relapse.

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