In this episode, we dive into the topic of brain health in multiple sclerosis—what it really means, why it matters, and how you can actively support it in your daily life.
Neurologist Prof. Barbara Willekens shares practical strategies around early treatment, healthy routines, cognitive function, and the role of digital tools. We also explore how patients can become stronger decision-makers in their care and what challenges still exist globally in accessing MS treatments.
If you’re looking for clarity, motivation, and actionable advice to protect your brain and manage MS more confidently, this episode is for you. 🧠💡
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More InformationTable of Contents
Introduction – Who is Prof. Barbara Willekens?
Prof. Barbara Willekens: I am a neurologist by training and have been working at the Antwerp University Hospital in Belgium for more than 15 years now. I’ve been involved in both the care of people with MS and in MS-related research. We offer dedicated consultations and work as a multidisciplinary team including two full-time MS neurologists, a dedicated MS nurse, a social worker, and a consultant.
On the research side, we’re active in both clinical and translational research, including trials with novel treatment strategies, cell-based therapies, drug repurposing, and currently a large clinical trial with metformin for people with progressive MS.
What does “brain health” actually mean, and why is it so important for people with MS?
Prof. Barbara Willekens: Brain health means trying to ensure your brain functions as well as possible across all domains—psychological, sensory, motor, and social. It’s important for everyone, but especially for people with MS. Even if you have a brain disease, you can still strive for brain health. A brain-healthy lifestyle may influence the course of MS and improve brain functioning.
Understanding the Brain Health Strategy
What does the “brain health strategy” involve, and why was it important to bring together so many voices?
Prof. Barbara Willekens: Brain health is a shared responsibility. By involving many stakeholders, we get broader and richer insights. For people with MS, it’s important to protect the brain by building resilience—through social engagement, learning new skills, healthy eating, sleep, physical activity, and avoiding harmful habits. Even people with disabilities can find ways to keep moving and stay engaged, which supports neuroplasticity.
Disease-Modifying Therapies (DMTs)
Why is early treatment with DMTs so important in MS?
Prof. Barbara Willekens: Early and high-efficacy treatments reduce immune attacks and preserve brain tissue. While we can’t completely stop MS in all patients, starting early gives the brain better resilience for the future. Many damages may not be visible at first but become apparent with age as the brain becomes less adaptive.
Are there tools that help patients and doctors choose the right DMT together?
Prof. Barbara Willekens: It’s still very difficult. We’re not yet at the stage of personalized treatment in MS like we are in oncology. Research is exploring pharmacogenomics and immunophenotyping, but clinical tools remain limited. The process is often still based on patient preference and some trial and error.
Managing Other Health Issues
What are comorbidities, and how can they affect brain health?
Prof. Barbara Willekens: Comorbidities are other health issues like high blood pressure, diabetes, obesity, depression, anxiety, or sleep disorders. These can worsen the course of MS. Managing comorbidities through lifestyle and medical care helps preserve brain health and provides a sense of control for patients.
Lifestyle & Brain Health
Are there small changes that make a big difference?
Prof. Barbara Willekens: Stopping smoking is number one. Smoking is incredibly harmful for brain health and MS. It’s hard due to addiction, but motivation is the first step. From there, help and resources can make quitting possible.
Nele von Horsten: For more tips on why and how to stop smoking check out the interview with Dr. claudia Marck.
Cognitive Function
What does the report say about protecting or improving cognitive function?
Prof. Barbara Willekens: Many people with MS struggle with attention and cognitive fatigue. This can be related to sleep, depression, and anxiety. Regular breaks, alternating between complex and routine tasks, short naps, and staying mentally active can help. Work is beneficial, but if not possible, hobbies and puzzles are good alternatives.
Nele von Horsten: The COGEx-Study showed that it always helps to be active, from physical activities to cognitive activities all the way to social interaction.
Role of Patients & Shared Decision-Making
What does shared decision-making mean in MS care?
Prof. Barbara Willekens: Shared decision-making involves the patient, neurologist, MS nurse, GP, and possibly family. We explain options clearly, including side effects and impacts on quality of life, then give the patient time to reflect and ask questions. Some patients want guidance; others prefer to choose themselves. Both approaches are valid.
Nele von Horsten: The interview with Prof. Celia Oreja-Guevara dives deeper into the topic of immunotherapies / DMTs and family planning.
Access and Global Inequality
What challenges do MS patients face globally?
Prof. Barbara Willekens: Access is very unequal. In Belgium, we have good care, but even here, restrictions exist. In low-income countries, diagnosis and treatment are major challenges due to lack of infrastructure, professionals, and financial resources. The inclusion of MS treatments on the WHO Essential Medicines List is a major step forward, but there’s a long way to go.
What can help improve access in low- and middle-income countries?
Prof. Barbara Willekens: Basic needs—clean water, roads, healthcare workers—must be prioritized. Education of nurses and clinicians is essential. Pharma companies can also play a role by conducting trials in these regions. Northern African countries are showing promising improvements that others can learn from.
Use of Digital Tools and Data
How can digital tools support brain health?
Prof. Barbara Willekens: Tools like step counters or MS-specific apps can track activity and symptoms. But continuity is key. Passive monitoring via wearables may be more sustainable long-term. Too many apps can overwhelm—better to choose one or two and stick with them. Reminders for medication or appointments are especially helpful.
Quickfire Q&A Session
Complete the sentence: "For me, multiple sclerosis is...."
Prof. Barbara Willekens: A lifelong disease you live with, but that does not need to define your life.
What development would you like to see in the field of multiple sclerosis in the next 5 years?
Prof. Barbara Willekens: A highly effective therapy for regeneration of nervous tissue and myelin. Like we’ve progressed in relapsing MS, I hope we see breakthroughs in repair and regeneration.
Farewell
Finally, what message of hope or encouragement would you like to share with the listeners?
Prof. Barbara Willekens: Being diagnosed with MS today is completely different than 20 years ago. Every day, we make progress. Stay in contact with your MS team and follow their advice as best you can. It will help you live the healthiest life possible with MS.
How and where can interested people follow your research activities?
Prof. Barbara Willekens: I’m active on LinkedIn. You can also find me via the Antwerp University and Antwerp University Hospital websites. For research publications, check PubMed. I’m less active on X (formerly Twitter) since the platform changed.
If you want to dive deeper into the topic, check out the updated ‘Brain Health – Time Matters’ report.
See you soon and try to make the best out of your life,
Nele
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