Multiple sclerosis can begin 15 years earlier than the onset of symptoms

An analysis of the medical records of more than 12,000 British Columbia residents showed that many years before the onset of typical neurological symptoms such as numbness, blurred vision or weakness, future patients with multiple sclerosis were more likely to go to doctors complaining of general malaise. Already 15 years before the onset of the disease, there was an increase in the number of visits to therapists — people complained of fatigue, pain, dizziness, as well as a deterioration in their psychoemotional state.

Approximately 12 years before the appearance of the first neurological signs, visits to psychiatrists became more frequent, and 8-9 years later, neurologists and ophthalmologists, which is probably due to the onset of visual impairments. Closer to the diagnosis, over 3-5 years, patients were increasingly admitted to emergency departments and underwent radiation diagnostics. And a year before the clinical manifestation of multiple sclerosis, the number of visits to doctors reached a peak.

According to the study’s lead author, Professor Helen Tremlett, early signs of the disease are often disguised as other conditions, which is why they are difficult to associate with multiple sclerosis. However, the data collected suggest that MS has a complex and prolonged prodromal phase — a hidden stage when the disease is already developing, but has not yet fully manifested itself. A similar stage is also known in other neurodegenerative diseases, such as Parkinson’s disease, where long before the onset of motor symptoms, patients experience changes in mood, sleep, and gastrointestinal function.

Although most people experiencing common symptoms such as fatigue or anxiety will never experience MS, understanding the characteristic patterns of seeking medical help in the prodromal phase may help in the future to detect the disease earlier.

This, in turn, will give a chance for timely intervention, support and, possibly, to slow down its development. The researchers emphasize that it is now especially important to study the biomarkers, risk factors, and potential mechanisms underlying this early stage, which has so far remained outside the field of medical attention.