Quiet progression/ progression independent of relapse activity

Interesting see link

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I’d like to know how one ā€˜proves’ their MS is ā€œquietly progressingā€, when no new lesions show up on MRI scans. My experience of Neurologists has been if it doesn’t show up in a test, then it doesn’t count as a relapse or progression. Sometimes it feels like their word against mine, and at that point I want to point out ā€œwell you were the ones who diagnosed me with MS!ā€

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My body tells me all I need to know about progression and don’t require any other evidence.
The professor of neurology at Barts has a view on this subject.

ā€œTelling someone with MS who complains of getting worse that their MS is stable and under control, because they are not relapsing or developing new lesions on MRI is a form of medical gaslighting.ā€

Prof G chastised for discussing the real MS

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Probably by recording all your symptoms and worsening of any of them e.g my walking has deteriorated over the years. A few years back I could walk about a Km but these days I’m down to maybe a 100 metres before my leg just stops - the signals from brain to leg can’t get there and I need maybe 30-45 minutes to recover some walking ability

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Personally I follow the thinking of Professor Gavin Giovanonni: MS is MS. From what I recall the classification into PPMS , RRMS, SPMS is mainly to do with getting licences for DMTs - something to do with a faster route if the drug is for treating a condition that affects ( relatively) low numbers of people.

My thinking is very much that MS is MS. We probably all get slight or unnoticed symptoms way before we have any noticeable symptom and get diagnosed. For all of us MS is ā€˜progressive’ at various rates - some fast some slow. Most of us also have sudden ā€˜exacerbations’ , - relapses with significant new lesions and new symptoms but even with these sudden relapses there is still ā€˜quiet’ progression going on.

All I can go off is my own experience my latest MRI showed my lesions were stable but my body is telling me something different. I feel a worsening of how I feel day to day than I did when I had my other scan that showed a new lesion/more activity. That and some added extra ms related medical issues. I was fully expecting my scan to say something different based on how my body is working. Of course other factors could be affecting how I feel I just know that my body is not the same as it was last October.

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There is damage to the brain that is not detected by MRI. People with the same MRI characteristics can have very different symptoms.
Post mortem analysis can detect other things but it is a bit late by then!
The work of the MS Tissue Bank depends on the donation of your brain on death.

This gives a great gift to future generations.

Hi Hank dog and to you all
I found this post really interesting and have read the information on the link. I’m PPPMS and know that I am deteriorating (or should I say my MS is progressing), again it is my body telling me that it no longer wants to walk or grip or concentrate as well as it did only a few months ago, even my neurophysio has said I’m not able to do as much as I did just a couple of weeks ago so I had a call with my neurologist and he’s ordered MRI’s.
He mentioned that he may well not see any new changes to the lesions already in my brain spine, but ordered brain/spinal/thoracic/cervical with contrast to check just in case.
I asked if there are no new lesions does that mean I’m imagining the deterioration (I know!!), but he said absolutely not, MS is very complicated in its progression and there can be lots of reasons behind the changes, he feels it’s likely to be the next step in my ā€˜progression ā€˜ of MS and we’ll talk once I’ve had the scan.
So I have to agree that as MS’ers, our body tells us that it’s not playing

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Take a look at the unapproved LDN, as a possible treatment option and see if you think it might help. My GP has prescribed for over 20 years and sure it has helped slow down progression of PPMS.
It’s definitely not a DMT and unlikely to correct damage already done, but we are not exactly spoilt for choice when it comes to treatments and no harm in checking it out.

Low Dose Naltrexone multiple sclerosis | MS-UK | Choices booklet

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I do recommend looking up Professor Gavin Giovanonni and his references to Progression Independent of Relapse Activity , Smouldering Lesions etc .

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Thanks to both Whammel and Hank dogs, I’ll definitely look into the details of your suggestions.
My ā€˜progression’ seems way too quick in my opinion, from diagnosis on 2022 I’ve gone from being perfectly able bodied to 2025 where I’m now using my wheelchair when I’m out or if I’m being obstinate and it’s not too much walking (ha ha), two crutches (which doesn’t always go well for me).
My neurologist mentioned ocrelizumab (I did the tests for it in 2023 but then developed breast cancer so was told i couldn’t do that because of the cancer treatment I needed), I’ve just been offered a chance on the octopus trial too so I’m waiting for the next mri to see what to do as I’m struggling to know to be honest.
Have to say I often read both your posts and those from Graeme too them are full of excellent info and advice guys so a big thanks from me!!

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