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Why do symptoms worsen despite no new lesions?

Hello - I have Primary Progressive MS, officially diagnosed Jan '21. I've had 2 MRI scans since, both of which 'show no new lesions in the brain or spine'. I'm wondering if anyone can explain why my symptoms are still gradually worsening? I'm not drastically worse, but there's certainly a difference. Cheers!

Me too my ability to walk is decreasing and I limp now so bad but every time I do MRI it shoes nothing new. I guess it’s the progression of the case since we are PPMS.


Its called “smouldering ms”- look it up. Prof Gavin Giovanninoni talks about it.