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About Brain Atrophy in MS

Updated on March 6, 2019

"How's My Brain Doing?"

Seems like a strange question to ask a doctor, but when you have been diagnosed with MS and you begin having regular MRI's, there are two questions you want answered right away.

  1. Are there any active lesions?

  2. How's the brain atrophy?

What is Brain Atrophy?

The short answer, In brain tissue, atrophy describes a loss of neurons (nerve cells) and connections between them. Of course everything we do is controlled by messages sent from the brain to the body's muscles and nerves.

I view it as evidence that my brain is shrinking because the brain can decrease in size as well as function. The neurons conduct and transmit signals throughout the body. Obviously it is of no little concern when you know your nerve cells are dying.

MS causes inflammation, myelin damage and lesions in the cerebral (brain) tissue, which are best revealed in MRI results.

What Constitutes a Good MRI Report?

I am very happy when my neurologist tells me that my brain atrophy is within the normal range. I realize it means my brain is still atrophying, but at least it is doing so at a slow and steady pace.

When you have MS, you have no choice, your brain IS going to atrophy. You can only take solace in the fact that it is not happening too quickly.

By the way the same atrophy takes place in the spinal chord.


I think I got spoiled. I had years of no real change in my MRI's. I was still injecting myself with Copaxone and it seemed to be working. Of course "working" is a relative term. Copaxone does not cure MS, but it does slow down the course or pace of the disease.

I hoped the MRI results would last forever, I suppose.


My next to last MRI results showed a change. I developed a new, active lesion in the area of my spinal chord that controls leg movement. I was naturally concerned about the brain atrophy, but at least that remained in the normal range.

My latest MRI's showed NO changes. No new active lesions and brain atrophy still in the normal range.

I am expecting the same results when I do this year's MRI's since I have not had any new problems or symptoms to deal with.


People with MS can have brain atrophy with no real evidence that is happening except for the MRI results. However, there are some of us who do suffer some symptoms.

I can't say I suffer symptoms ALL the time, but I have noticed some problems that indicate brain atrophy.

  • Expressive Asphasia
  • Seizures
  • Dementia

My symptom group is Expressive Asphasia.

At times during a flare-up, I become so fatigued that I am unable to move. Along with feeling paralyzed comes the inability to speak. I am thinking very clearly, but the words do not want to come out. I am totally alert, but cannot utter clear sentences.

When the attack begins. I am naturally asked by my family member if I am alright, I can get out the fact that I'm having a flare-up, but if the questioning continues, I am less and less able to answer.

For example,

"Do you want something to drink?"

I answer, "yeah"

"What do you want, water or soda?"

I want to answer, "ginger ale". Instead what comes out is, "um . . . um . . .

I don't know"

"Do you want ginger ale?" I'm asked.

I answer, "yes".

It drives me crazy when that type of interchange occurs. I think to myself, "why can't you answer, you know you want the ginger ale, just say it!"

Seems like whatever part of my brain which can allow me to verbally identify my choice is blocked, only yes or no wants to come out.

After a little while, even answering yes or no is not possible.


I'm glad those attacks only last 1-2 hours. It is disconcerting when it occurs. Thankfully it is only once or twice a year. I am able to get through it by reminding myself that it will be over soon and then I'll be back to normal.

My family member stays close by until the worst has passed. It calms me when I know someone is with me. I've had occasion when I've had to ride it out all by myself. I find those times are much scarier to endure.


I suppose if my atrophy begins to increase, I would ask to be put on IV steroids. Studies have shown it can slow down brain atrophy. The drug Betaseron supposedly slows down the atrophy as well.

Of course if I remain at my present level of deterioration, I won't have to consider doing anything at all, and that is just fine with me!


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    • profile image


      9 years ago

      my stepdaughter is suffering with speech issues. She has not walked in a year..she has already had ccsvi and also underwent DBS surgery to control her tremors. Nothing has is like she is in a race to deteriorate.

    • Jen's Solitude profile imageAUTHOR

      Jen's Solitude 

      9 years ago from Delaware

      Mrsyarbie 1, thank you for your reply and please excuse the delay in replying. As you are well aware the ability to forget is always there. I mean to reply and I fail to remember to actually do so. LOL I hope your pain has eased up since you first wrote this. I attribute my pain to tension and stress and I concentrate on deep breathes and relaxing techniques to lower the pain.

      Belinda I hope your pain has improved as well. I am beginning to wonder if we all suffer pain but just attribute it to overall stress and not just the brain atrophy. I am going to write a newer hub and hope I can remember to include that as a poll question.

      Alisa, it is so easy for others to claim to identify with your problems. It is like replying, "I'm tired too" when someone tries to explain MS fatigue. We just have to ignore those comments because they can drive us crazy! I hope you find some friends online and at support groups that will offer helpful, encouraging and supportive advice.

      Thank you all for your comments!

    • profile image


      9 years ago

      I agree, it is very comforting to read that other people have the same exact issues as me because in the day to day I feel completely alone in my struggles and just have to hear everyone tell me the same things happens to them and its not my of the most frustrating things!

    • profile image

      Belinda C 

      9 years ago

      I don't have MS but was just diagnosed with Brain Atrophy. It kind of explains my memory issues I've been having and related it all to stress. Is neck pain common with frontal atrophy? I seen it mentioned in one of the hubs.


    • profile image


      9 years ago

      I can relate to this, its frightening to me. There so much to deal with you never know how you are going to feel every day.Right now I have constant neck pain for about 40 days, not much helps with the pain..

    • Jen's Solitude profile imageAUTHOR

      Jen's Solitude 

      9 years ago from Delaware

      Debbie, brain atrophy is never pleasant to deal with or think about for that matter. How long have you been diagnosed with MS? Atrophy can stabilize within "normal" range. Meaning it still occurs but at a slower pace.

      You can use brain teasers or puzzles to keep your mind as active as possible. Taking advantage of your good time of the day is also very helpful. Like you, I do better in the early part of the day. By 3:00 pm, I am in wind down mode. By 6:00 pm, only a fire can get me out of my bed. (smile) Of course I don't work outside the home. That adds a bigger drain on your energy level. Do you work full time or part time? I have learned to be very judicious about what I do. I divide my day into things I really need to do, followed by what I would like to do. I get what matters most to me accomplished first, and if that is all I can do, then I am satisfied with that. We can't control the brain atrophy but we can do our best to minimize the stress in our lives that makes symptoms more manifest.

      Hang in there! Sorry you are having troubles in this area. Just so you know I had problems that gradually improved, I hope the same happens for you!

    • profile image


      9 years ago

      That's me,speaking and moving very badly.Just had iv steroids to fight atrophy but so far,no change.& every afternoon ,

      mine gets worse as the day progresses :cant talk At All.

      Sound like I'm having a stroke.

      What can I do?

    • lust maker profile image

      lust maker 

      10 years ago

      nice hub

    • Jen's Solitude profile imageAUTHOR

      Jen's Solitude 

      10 years ago from Delaware

      I don't think you have to worry about that happening Cindy. LOL

      Unfortunately brain atrophy is constant but like everything else with MS, we have no choice but to accept it and hope the progression is at the slowest pace possible.

      I hope your next appointment shows just the normal range of atrophy and no new active lesions!

    • Inner Harmony profile image

      Cindy Weyant 

      10 years ago from Costa Mesa, California

      Hey girl!

      Fantastic hub. I didn't even know that MS caused brain atrophy. Learn something new every day :)

      I now have an explanation for those moments when I'm tounge-tied and embarrassed to speak. It has happened on the phone a few times. I've been told I sound like I'm drinking..slurring and trying to get words out. I can't even find the words to explain, so I have to hang up and call later to let them know.

      I'm going to ask my neuro about my brain when I get my next MRI. I fear it is shrinking at a fast pace! :D

      Thanks for the info.

    • Jen's Solitude profile imageAUTHOR

      Jen's Solitude 

      10 years ago from Delaware

      Thanks Joan, I have written about ccsvi in another hub. The MS community is waiting anxiously for the MS Society to finalize their recommendations about this procedure. I have read many good things about it and am hoping the future reports will substantiate my belief that there is something to do procedure. Appreciate the comment!

    • profile image


      10 years ago

      For those not yet aware - there is a new treatment for MS which is angioplasty of twisted neck veins. It has taken people in wheelchairs out of them and walking again. Just type in ccsvi in google and see what pops up.

    • Jen's Solitude profile imageAUTHOR

      Jen's Solitude 

      11 years ago from Delaware

      Oh my lovelypaper, that happens to me too. Why is it more comforting to read others are having the same experience? (smile) We are now trying to decide if my blood sugar falls too low, as that would explain the problem too. Still have to investigate that theory though as we never remember to take my sugar when I'm unable to speak.

    • lovelypaper profile image

      Renee S 

      11 years ago from Virginia

      Great explanation of aphasia. I get the loss of concentration and slurred speech or I can't find the right word. What's funny (or not so funny) is when I say one word but I mean another. Like, for instance, I was playing ball with my son in the street one day, kicking the ball back and forth and I told him he was a "good cooker".


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