Yes they can, it's also in the white matter of your brain. I've had new MRI'S that showed no new lesions but still got new symptoms to deal with.
July 7
Yes, advanced MS can occur even without new lesions appearing on MRI scans. This is known as progression independent of relapse activity (PIRA), where symptoms gradually worsen without any obvious flare-ups or new lesion activity.
PIRA is most commonly seen in
- Primary progressive MS (PPMS)
- Secondary progressive MS Show Full Answer
Yes, advanced MS can occur even without new lesions appearing on MRI scans. This is known as progression independent of relapse activity (PIRA), where symptoms gradually worsen without any obvious flare-ups or new lesion activity.
PIRA is most commonly seen in:
- Primary progressive MS (PPMS)
- Secondary progressive MS (SPMS)
However, research has also found that PIRA can occur in relapsing-remitting MS (RRMS), though less frequently. This means that up to half of all worsening disability in MS isn't directly caused by relapses or new lesion activity. The damage that has already built up over time in the central nervous system continues to affect how well nerves communicate, even when no new lesions are forming.
This is why regular check-ins with a neurologist are so important — progression can be happening quietly in the background, even when things seem stable on the surface.
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diagnose, treat, or cure any condition or disease. Always ask your doctor about specific health concerns.
MS Progression Timeline: Stages and What To Expect
July 7
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