MRI Progression vs. Activity- What does it all mean?

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I'm Alissa!

I help women who have also been diagnosed with Multiple Sclerosis make specific and personalized diet, lifestyle & subconscious changes so that they can begin to heal their body, reduce disease symptoms, and return to a life they love.

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When you have Multiple Sclerosis, going for a yearly (or whatever your schedule is) MRI is one of the ways to keep tabs on your disease. It gives an almost full picture of your brain and spinal cord, and lets you, the radiologist and your doctor see what is going on in terms of progression and activity. But what do those terms mean really? Can you have disease progression without symptoms? Is disease progression seen on a MRI the same as activity?

When thinking about disease activity, I’m sure everyone gets a little freaked out, if not totally scared when this subject comes up or the thoughts cross your mind (even me).

And that’s ok. This is a scary disease after all!

But the more we can understand the types of activity, the better off we’ll be.

Visible Disease Activity

Visible disease activity, otherwise defined as relapses, is disease activity that is visible and impactful. This is the most thought of type of activity, and what medical professionals and medications, are always aiming to reduce.

Activity and progression from relapses can either clear fully or almost fully, or leave you with some degree of lasting disability.

Underlying Disease Activity

Underlying disease activity can be a little more tricky. This is activity that shows up on an MRI, but doesn’t necessarily have corresponding symptoms accompanying it. Therefore, the only way you’ll know if you have this type of activity is to have regular MRIs. The disease activity can come from new lesions formed, or growth in lesions that are already there.


NEDA stands for No Evidence of Disease Activity, and is now the goal for treatment and what doctors are looking for. Previously, the goal of treatments were to lessen relapses. But since this is not the only way of disease progression, NEDA is now the standard for measuring disease activity. In NEDA, a few things are measured.

  • Relapses
  • Increase in disability progression measure by the EDSS (Expanded Disability Status Scale)
  • Lesions on an MRI.

The goal of any treatment or complementary treatment should be to reduce inflammation in the body that could create lesions, either felt as visible disease activity or contribute to underlying activity.

Disease activity is a scary topic for MSers, whether it is visible activity or underlying. Using as many lifestyle techniques as you can to reduce inflammation in your body is the best way to help prevent further relapses.

Interested in learning more about how to reduce inflammation? Grab my Cheat Sheet about the 5 Best Foods for MS here!

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