What is brain health?

The brain is a remarkably flexible organ. If multiple sclerosis (MS) disease activity damages tissue in one area, other areas can work harder to compensate.1,2 This extra capacity is known as ‘neurological reserve’, or ‘brain health’, and explains why disease activity may go undetected during the early phase o­f MS. Indeed, cognitive problems may develop before more obvious symptoms of MS appear – sometimes years earlier.3

MS disease activity may continue ‘below the surface’ even when someone is feeling well. Research has shown that, on average, only about one in 10 lesions (areas of acute damage) leads to a relapse.4,5 In addition, other low-grade tissue damage can also be ongoing.6 This means that neurological reserve can be depleted even during periods of remission if disease activity is not kept under control.

Brain health should be valued highly, as it helps people to maintain a good quality of life as they age.7 The MS Brain Health initiative highlights the need to maximize lifelong brain health by making recommendations to monitor and minimize disease activity.


  1. Rocca MA, Mezzapesa DM, Falini A et al. Neuroimage 2003;18:847–55.
  2. Rocca MA, Filippi M. J Neuroimaging 2007;17 Suppl 1:s36–41.
  3. Sinay V, Perez Akly M, Zanga G et al. Mult Scler 2015;21:945–52.
  4. Barkhof F, Scheltens P, Frequin ST et al. AJR Am J Roentgenol 1992;159:1041–7.
  5. Kappos L, Moeri D, Radue EW et al. Lancet 1999;353:964–9.
  6. Filippi M, Rocca MA. J Neurol 2005;252 Suppl 5:16–24.
  7. Farias ST, Mungas D, Reed B et al. Neurobiol Aging 2012;33:1758–68.