Mri shows no new lesions but feel worse

I’ve been on tysabri for a year now. In 2014 I had 2 big relapses. I was initially diagnosed with rrms.

I recently had a MRI scan which my consultant said that thankfully I don’t have any new lesions. But I don’t understand why I’m feeling worse. From a physical viewpoint I have improved, but mentally I’m terrible. My mental fatigue is OTT - i cant concentrate in conversations, my memory is hit & miss, i have brain fog & my speech is at times poor. All of these were not an issue a year ago.

when having conversations with family/ friends I am not alert enough to understand what is being said & contribute to the conversation. I feel slow

does this mean that my MS has progressed? Does this mean that I suffer from fatigue which has worsened? Any help making sense of what is happening would be greatly appreciated.

Hit a,

I find I can’t concentrate if environment too noisy. Try to avoid such environments, not easy i know. Great news there are no new lesions. Re memory, lists, phone reminders will help. Don’t be disheartened, your physical improvements are all positive, the rest will come. The more you worry, the harder things can be.