Serene brain landscape symbolizing NEDA in multiple sclerosis.

Beyond Zero: Understanding NEDA in Multiple Sclerosis and What It Means for You

Jordan Keane in Health & Wellness November 2025 • 4 min read.

"Is 'no evidence of disease activity' (NEDA) the ultimate goal in managing multiple sclerosis? Explore what NEDA means for pwMS and how it's reshaping treatment approaches."

The landscape of multiple sclerosis (MS) treatment has undergone a monumental transformation in recent years. What was once a relentless and often debilitating condition is now being approached with strategies aimed not just at slowing progression, but at achieving a state of "no evidence of disease activity," or NEDA. This paradigm shift offers new hope and improved outcomes for people living with MS (pwMS).

Imagine a future where MS doesn't dictate your daily life – where relapses are minimal, disability progression is halted, and brain scans show no new signs of disease. This is the promise of NEDA. But what exactly does NEDA entail, and how can it be achieved? Understanding NEDA is crucial for anyone affected by MS, as it empowers patients and their families to actively participate in treatment decisions and strive for the best possible quality of life.

This article breaks down the concept of NEDA in MS, explaining each component in plain language and highlighting the latest advancements in achieving this ambitious goal. We'll explore the role of various treatments, the importance of monitoring, and the challenges that remain, providing a comprehensive overview of NEDA and its potential impact on the lives of pwMS.

Decoding NEDA: What Does 'No Evidence of Disease Activity' Really Mean?

Serene brain landscape symbolizing NEDA in multiple sclerosis.

NEDA isn't just a single measure; it's a composite outcome that considers several key aspects of MS. Achieving NEDA means meeting specific criteria across clinical and radiological assessments. Here's a breakdown of the core components:

The components of NEDA are:

No Clinical Relapses: This means experiencing no new MS symptoms or worsening of existing symptoms that last for more than 24 hours. Relapses can significantly impact quality of life and contribute to long-term disability.
No Disability Progression: Disability progression is typically measured using the Expanded Disability Status Scale (EDSS). NEDA requires that a patient's EDSS score remains stable, indicating that the disease isn't causing further physical impairment.
No New MRI Activity: Magnetic resonance imaging (MRI) plays a crucial role in monitoring MS disease activity. NEDA requires the absence of new or enlarging lesions on brain or spinal cord MRI scans. These lesions represent areas of inflammation and damage in the central nervous system.

While not always included in the strictest definitions of NEDA, some clinicians also consider brain atrophy (shrinkage) as an important factor. Significant brain atrophy can indicate long-term disease progression and cognitive decline.

Looking Ahead: The Future of NEDA in MS Care

While NEDA represents a significant advancement in MS treatment, challenges remain. Accurately assessing and monitoring disease activity requires regular MRI scans and neurological evaluations, which can be burdensome for patients. Additionally, the definition of NEDA can vary slightly between different studies and clinical settings. Despite these challenges, the pursuit of NEDA is driving innovation in MS treatment and leading to better outcomes for pwMS. As research continues and new therapies emerge, the goal of achieving and sustaining NEDA will become increasingly attainable, offering hope for a future where MS has minimal impact on daily life.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/ene.13771, Alternate LINK

Title: No Evidence Of Disease Activity In People With Multiple Sclerosis

Subject: Neurology (clinical)

Journal: European Journal of Neurology

Publisher: Wiley

Authors: M. Marta

Published: 2018-08-31

Everything You Need To Know

What does achieving 'no evidence of disease activity' (NEDA) mean for someone living with multiple sclerosis?

NEDA, or 'no evidence of disease activity,' is a treatment goal in multiple sclerosis that aims to minimize the impact of the disease on a person's life. It's not just about slowing the disease; it's about stopping it from progressing. Achieving NEDA means experiencing minimal relapses, halting disability progression, and showing no new signs of disease activity on brain scans. The promise of NEDA is a future where MS doesn't significantly affect daily life.

What are the key components that define 'no evidence of disease activity' (NEDA) in multiple sclerosis?

NEDA is defined by three core components: no clinical relapses (meaning no new or worsening symptoms lasting over 24 hours), no disability progression (stable EDSS score), and no new MRI activity (absence of new or enlarging lesions on brain or spinal cord MRI scans). Some clinicians also consider brain atrophy as a factor, although not always included in strict definitions of NEDA.

What are some of the challenges in achieving and maintaining 'no evidence of disease activity' (NEDA) in multiple sclerosis?

While aiming for NEDA offers hope, several challenges remain. Monitoring disease activity requires regular MRI scans and neurological evaluations, which can be demanding. Also, the definition of NEDA isn't uniform across all studies and clinical settings, which can lead to some confusion and variability in its application.

Why are MRI scans considered so important when monitoring 'no evidence of disease activity' (NEDA) in multiple sclerosis?

MRI scans are critical in monitoring MS disease activity within the NEDA framework because they can reveal new or enlarging lesions in the brain or spinal cord, which indicates inflammation and damage. Achieving NEDA means there should be an absence of such new lesion activity on MRI scans.

How does the Expanded Disability Status Scale (EDSS) relate to the concept of 'no evidence of disease activity' (NEDA) in multiple sclerosis?

The Expanded Disability Status Scale, or EDSS, plays a role in the NEDA definition. NEDA requires that a person's EDSS score remains stable. This means that the disease isn't causing further physical impairment. If the EDSS score increases, it indicates disability progression, which means NEDA is not achieved.