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Brain matters in relapsing multiple sclerosis (RMS) There are 86 billion neurons in a human brain2 ~12 times the world population3 Information is transmitted throughout the body by specialized cells called neurons A neuron is made up of4: While awake, your brain generates enough energy to power a light bulb1 A cell body: Information from other neurons is integrated here Dendrites: These receive information from other neurons An axon: This carries information from this neuron to other neurons Axons are often surrounded by an insulating material called myelin6. This helps information to be transmitted efficiently The brain acts as a centralized control center for the body5 Memories triggered by scent have a stronger emotional connection and therefore appear more intense12 In RMS myelin is destroyed and signal conduction is affected7 Neurons can process information as fast as 120 m/s13 – that’s faster than a Formula 1 car14 In healthy individuals, brain shrinkage (brain volume loss) occurs as you age7 Brain shrinkage is associated with the loss of physical (e.g. walking) and cognitive (e.g. memory) function and can predict a patient’s disability over time15-19 Brain shrinkage occurs 3-5x faster in people with RMS compared to those without8-11 Brain Fluid Increasingly, research in RMS is focusing on understanding the relevance of brain shrinkage and the importance of preserving brain early in the disease You can’t tickle yourself because your brain can distinguish between unexpected external touch and your own touch15 References 1. 2. 3. 4. 5. 6. 7. 8. http://hypertextbook.com/facts/2001/JacquelineLing.shtml Accessed March 2015. Azevedo FA et al. Equal numbers of neuronal and nonneuronal cells make the human brain an isometrically scaled-up primate brain. J Comp Neurol. 2009 Apr 10;513(5):532-41. http://www.worldometers.info/world-population/ Accessed March 2015. http://faculty.stcc.edu/AandP/AP/AP1pages/nervssys/unit10/neurons.htm Accessed March 2015. http://biology.about.com/od/organsystems/ss/central-nervous-system.htm Accessed March 2015. http://www.nationalmssociety.org/What-is-MS/Definition-of-MS/Myelin Accessed March 2015. Miller DH, Barkhof F, Frank JA, Parker GJ, Thompson AJ. Measurement of atrophy in multiple sclerosis: pathological basis, methodological aspects and clinical relevance. Brain. 2002 Aug;125(Pt 8):1676–95. Review. De Stefano N et al. Proportion of patients with BVL comparable to healthy adults in fingolimod phase 3 MS studies. Abstract presented at: 66th AAN Annual Meeting; April 26 – May 3, 2014; Philadelphia, Pennsylvania. Oral session S13:006. GLNS/GILE/0021 9. 10. 11. 12. 13. 14. Hedman AM et al. Human Brain Changes Across the Life Span: a review of 56 longitudinal magnetic resonance imaging studies. Human Brain Mapping 2012; 33: 1987-220. Barkhof F et al. Imaging outcomes for neuroprotection and repair in multiple sclerosis trials. Nat Rev Neurol. 2009;5(5):256-266. Bermel RA & Bakshi R. The measurement and clinical relevance of brain atrophy in multiple sclerosis. Lancet Neurol. 2006;5(2):158-170. Toffolo MB, Smeets MA, van den Hout MA. Proust revisited: odours as triggers of aversive memories. Cogn Emot. 2012;26(1):83-92. http://www.nature.com/scitable/topicpage/myelin-a-specialized-membrane-for-cell-communication14367205 Accessed March 2015. http://en.wikipedia.org/wiki/Formula_One_car Accessed March 2015. 15. 16. 17. 18. 19. Bakshi R et al. Regional brain atrophy is associated with physical disability in multiple sclerosis: semiquantitative magnetic resonance imaging and relationship to clinical findings. J Neuroimaging. 2001 Apr;11(2):129–36. Rojas JI et al. Brain atrophy at onset and physical disability in multiple sclerosis. Arq Neuropsiquiatr. 2012 Oct;70(10):765–8. Calabrese M et al. Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis. Arch Neurol. 2009 Sep;66(9):1144–50. Mowry EM et al. Quality of life in multiple sclerosis is associated with lesion burden and brain volume measures. Neurology. 2009 May 19;72(20):1760–5. Blakemore SJ, Wolpert D, Frith C. Why can't you tickle yourself? Neuroreport. 2000 Aug 3;11(11):R11-6. Review.