1. Ralph H. B. Benedict, PhD, ABPP-CN Professor of Neurology, Psychiatry and Psychology University at Buffalo, SUNY Brains & Gains November 2013

2. [In] most of the patients affected by multi-locular sclerosis whom I have had occasion to observe … there is marked enfeeblement of the memory ; conceptions are formed slowly ; the intellectual and emotional faculties are blunted in their totality. The dominant feeling in the patients appears to be a sort of almost cheerful indifference in reference to all things. Jean-Martin Charcot (1877)

3. Demyelination and axonopathy cerebral cortex r = 0.65 [Amato 2004; Benedict 2006; Tekok-Kilic 2007] 3 rd ventricle r = 0.71 [Christodolou 2003; Benedict 2004] mesial temporal r = 0.42 [Sicotte 2008; Benedict 2009] thalamus r = 0.75 [Houtchens 2007]

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9. Job Loss Reduced work hours Demotion Less Salary Miss Promotion Job Loss Reduced work hours Demotion Less Salary Miss Promotion Walking Upper Extremity Function Cognitive Ability Depression Walking Upper Extremity Function Cognitive Ability Depression Negative Work Events Work Errors Forgetting Appointments Slow Work, Reduced Productivity Unequal Work Distribution Social Difficulty Negative Work Events Work Errors Forgetting Appointments Slow Work, Reduced Productivity Unequal Work Distribution Social Difficulty Accommodations/Intervention High Tech, Low Tech Aids Overt, Covert Aids Additional Time to Complete Tasks Flexible Schedule Accommodations/Intervention High Tech, Low Tech Aids Overt, Covert Aids Additional Time to Complete Tasks Flexible Schedule Employer Patient Coworker

10. Cognitive Impairment Mild Maintain Employment Private Disability Social Security Disability Early Retirement Severe

12. 12 Hours Worked per Week Income Extra Time Spent Outside Work

14. 14 How to Monitor Clinical Status?

15. www.BICAMS.net

16. PublishedCollecting data/analysisDiscussion USACanadaPortugalPeru IranUKBelgiumOman Czech RepublicItalyIrelandPoland GermanyHungaryRomania AustriaAustraliaSlovenia EgyptSweden EstoniaTurkey LithuaniaBrazil NorwayMexico Columbia

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18. Why do some MS Patients Fare so Well? Cognitive Reserve Exercise Personality Cognitive Retraining 18

19. Dimensional models of personality: the five-factor model and the DSM-5 Timothy J. Trull, PhD; Thomas A. Widiger, PhD. Dialogues Clin Neurosci. 2013;15:135-146.

22. Conscientiousness p = 0.023 Neuroticism p = 0.001

25. Adam J. Booth Jonathan D. Rodgers Carolyn E. Schwartz, Sc.D Brian R. Quaranto Bianca Weinstock-Guttman Robert Zivadinov Ralph H. B. Benedict Active Cognitive Reserve Influences the Regional Atrophy to Cognition Link in Multiple Sclerosis In Press

26. Thank You Bianca Weinstock-Guttman MD Robert Zivadinov MD; Murali Ramanathan PhD David Hojnacki MD; Channa Kolb MD Margaret Bucello NP; Audrey Smerbeck PhD Jonathan Rodgers PhD, Natalie Emmert BA