Brain atrophy and employment in multiple sclerosis patients: 10-year follow-up study

[ActiveMSers]

How important is preserving your brain volume? Critically. Exercise and DMTs help in that department. -D

Brain atrophy and employment in multiple sclerosis patients: a 10-year follow-up study

Cecilie Jacobsen, Robert Zivadinov, Kjell-Morten Myhr, et al

First Published January 27, 2020 Research Article
https://doi.org/10.1177/2055217320902481

Abstract

Background
Multiple sclerosis is often associated with unemployment. The contribution of grey matter atrophy to unemployment is unclear.

Objectives
To identify magnetic resonance imaging biomarkers of grey matter and clinical symptoms associated with unemployment in multiple sclerosis patients.

Methods
Demographic, clinical data and 1.5 T magnetic resonance imaging scans were collected in 81 patients at the time of inclusion and after 5 and 10 years. Global and tissue-specific volumes were calculated at each time point. Statistical analysis was performed using a mixed linear model.

Results
At baseline 31 (38%) of the patients were unemployed, at 5-year follow-up 44 (59%) and at 10-year follow-up 34 (81%) were unemployed. The unemployed patients had significantly lower subcortical deep grey matter volume (P < 0.001), specifically thalamus, pallidus, putamen and hippocampal volumes, and cortical volume (P = 0.011); and significantly greater T1 (P < 0.001)/T2 (P < 0.001) lesion volume than the employed patient group at baseline. Subcortical deep grey matter volumes, and to a lesser degree cortical volume, were significantly associated with unemployment throughout the follow-up.

Conclusion
We found significantly greater atrophy of subcortical deep grey matter and cortical volume at baseline and during follow-up in the unemployed patient group. Atrophy of subcortical deep grey matter showed a stronger association to unemployment than atrophy of cortical volume during the follow-up.

[Suebee]

Dave thanks for posting this. I'd be interested to know what proportion, if any of these patients, qualified for SSdi or LTD under employer plans, and if age or gender had any correlation to patients who did recieve benefits. One can hope that the invisible aspects of MS will become more visible with measurements of brain atrophy and studies like this. I hope data will include such social history measures so that the financial burden on MSers and possible biases by decision makers are exposed as much as the physical changes in the MS brain.

[ThailandVal]

I suspect it works both ways. People whose brains are shrinking are less likely to have a job, and they feel and seem less capable, but also people who do have a job are forced to do more mental work, are more active, and hence their brains are shrinking less, or shrinking more slowly

[Suebee]

Brain shrink is real

You’re definitely right that inactive passivity can lead to brain atrophy similar to that seen in aging. But brain atrophy measures have been recognized for awhile now to directly to correlate to neurgeneration in certain disease processes, especially MS. Doctors look at pace of atrophy, area of brain, location of prior plaque, and if it is disproportinate to other atrophy in the brain or age. This can be an important marker to MSers with secondary Progressive course, effectiveness of DMD, and a measurable difference to monitor. I point this out because neurologists don’t always discuss these findings with patient. Also Radiologists can’t provide comparisons if mris are from different labs or scan techniques. Something to keep in mind if one has a choice to have an mri at different facilities. But If you have had MS for multiple years, this is a valid question to raise with neurologist about atrophy to understand How your brain is faring.

Link to article about aging vs neurodengenartive disease https://www.alzforum.org/news/resear...g-and-dementia

[ThailandVal]

Thanks, Suebee. The Alzheimer's article in interesting. I'm glad people are studying brain atrophy in general aging, AD, MS and other conditions. There's a lot more to understand.
For me it's a little scary to think my brain is shrinking little by little no matter how much I use it.