Tuesday, September 15, 2009

Matters Gray and White

Generally speaking we consider the gray matter of our brain to be the "thinking" part and the white matter the stuff that connects the gray matter. So one would think that since MS is mostly a disease of white matter, our cognitive functioning would remain untouched except for speed of processing information. But it doesn't.

We now know that the white matter of the brain functions more than as a connector. The simple fact that people with MS exhibit cognitive impairment supports this hypothesis. How MS affects our cognition depends on a number of factors; severity of MS, general health (nutrition and physical fitness), and attitude all affect our cognition. Even without MS, general health and attitude will affect our cognition. If we are eating poorly and not exercising, the brain can't operate at its optimal standard. Throw in something like MS and deterioration is bound to occur.

How do we improve our cognitive functioning in light of assured decline because of MS? Interestingly enough, the brain is already trying to compensate for any deficits by making other connections. This is evidenced by studies showing activation of different brain areas in MS patients compared to healthy control subjects when given certain tasks. This shows neuronal plasticity - the ability of the brain to make new connections in order to do previously known tasks. So our brains are already giving us a head start, so to speak, on the road to recovery.

In order to assist that recovery, or at least to help maintain or develop cognitive skills, we have to eat right, exercise, and get a proper amount of sleep. No kidding, right? I've been shouting that from the rooftops for years.

It also means developing a positive attitude despite the crap that is going on around you. I know poop happens. Take the time needed to deal with it, have a meltdown if that helps, but then move on.

In light of all this, I will remind you of a study I participated in a few years ago, the results of which I posted on this blog in late 2007. It showed evidence of brain atrophy and slower response time for MSers versus a control group. I am now going to participate in another study looking at brain connectivity in executive functioning in MS patients. Executive functioning is what is considered to be involved in handling new situations outside the purview of "automatic" responses; planning and decision making are executive functions for example. I'm waiting for more info from the study coordinator about the hypothesis, but next week I'll go in for a round of tests and an MRI, to be repeated every month for 6 months. I'll keep you updated of course. An hopefully gain a little more insight into what MS is doing to us and our gray and white matter.


The title of this post is also the title of a book by a neurologist in the states about different cases he's had. I enjoyed it, even if he spelled gray with an E.