"Brain Fog" memory lapses etc

[chubbycheeks]

Can someone please explain in simple language what actually happens when we have episodes of Brain Fog etc. Is it the blood supply to the brain that is affected by the disease or by Pred ?

Trying to explain to my family

Thanks

[polkadotcom]

Never really thought to wonder what the physical reason is for it, just know it happens! It could be inflammation in the arteries which supply the brain, making them narrower? Perhaps PMRpro will be along to say whether that's right or not.

[Badgergirl]

Glucocorticoids, whether your own natural cortisol or prednisolone, bind to receptors in an area of the brain called the hippocampus, which is involved in memory and learning. In excess these hormones e.g. prednisolone first produce euphoria. Then the receptors get used up producing confusion and memory loss. As the pred is reduced things go back to normal.

[chubbycheeks in reply to Badgergirl]

Many thanks Badgergirl for your response, difficult to understand, must be my brain fog !

[Badgergirl in reply to chubbycheeks]

Sorry! Basically the pred acts on the brain to produce brain fog.

[chubbycheeks in reply to Badgergirl]

Sorry! Basically the pred acts on the brain to produce brain fog.

I know ! ! Thanks for your response, I was led to believe it was because of the compromised blood supply to the brain x

[PMRpro Ambassador in reply to chubbycheeks]

I don't think pred compromises bloodflow to the brain - that is why it is used in GCA and PMR to deal with the inflammation in the arteries that slows the blood flow down and in extreme cases can stop it altogether

I've just written this simplified version of Badgergirl's answer - hope it helps.

"Badgergirl - I understand it - but like you I'm a scientist (not as good at pred as you but...). I hope you don't mind me pitching in and writing it in a version that is possibly not entirely scientifically accurate but explains it in normal everyday language

Steroids, like most drugs, work in the body by attaching to cells called receptors - they work as a sort of link between the medication and the tissues, like the 3-pinned plug on the cable joins your iron to the electric supply. Steroids, pred and natural cortisol the same, attach to receptors in a part of the brain called the hippocampus which is the bit that deals with memory and learning.

If there is too much of the steroid there is some left over and you can become euphoric or "high" as a result. That is often seen with the higher doses at the beginning of treatment with pred. Once all the receptors have been taken up the effect changes because of the left-over substance - and you get muddled as it results in confusion and memory problems. As the pred dose is reduced things return to the normal state."

[Badgergirl in reply to PMRpro]

That's OK! Thanks. I sometimes think I'm being clear when I'm not. Hope your version is more understandable.

[PMRpro Ambassador in reply to Badgergirl]

You were clear, perfectly so - you haven't got brain fog But we use these words in everyday life - but we're both a bit strange like that

[Badgergirl in reply to PMRpro]

Haha! That's what I meant. I forget that everyone else doesn't use those words in everyday language! ☺

[PMRpro Ambassador in reply to Badgergirl]

Oh - in that maybe you HAVE got brain fog...

Or are demented like me...

[chockybuttons in reply to PMRpro]

These replies help, thanks. I am on 9mg pred, quite low compared to some others. Was only started on 15mg a day anyway, when diagnosed in January this year. Head is improving, but I get slightly confused with certain things and thought I was going mad! I'm guessing this is 'brain fog' from the prenisolone then?? :-))

[PMRpro Ambassador in reply to chockybuttons]

Very probably!

If you have PMR then 15mg is the recommended starting dose - higher doses are for people with GCA.

[chockybuttons in reply to PMRpro]

Arrh thanks for your reply. Am luckier than a lot of people on higher dose. Am fairly mad, (ha) but good to know its the pred and I'm just not going mad-der,,, lol <ee>

[chockybuttons in reply to PMRpro]

Ah see, read your reply wrong (my brain fog) I've got GCA, so guess dose was quite low to start wasn't it. But as it seems to be getting better, that's positive. Just had latest blood test, so will see. Thanks again <ee>

[PMRpro Ambassador in reply to Badgergirl]

Badgergirl - I understand it - but like you I'm a scientist (not as good at pred as you but...). I hope you don't mind me pitching in and writing it in a version that is possibly not entirely scientifically accurate but explains it in normal everyday language

Steroids, like most drugs, work in the body by attaching to cells called receptors - they work as a sort of link between the medication and the tissues, like the 3-pinned plug on the cable joins your iron to the electric supply. Steroids, pred and natural cortisol the same, attach to receptors in a part of the brain called the hippocampus which is the bit that deals with memory and learning.

If there is too much of the steroid there is some left over you can become euphoric or "high" as a result. That is often seen with the higher doses at the beginning of treatment with pred. Once all the receptors have been taken up the effect changes because of the left-over substance - and you get muddled as it results in confusion and memory problems. As the pred dose is reduced things return to the normal state.

[chubbycheeks]

Brilliant ! Many thanks for that explanation x

[1Purplecrow]

Now I get it! Thanks