Researchers at the University of British Columbia have found that early warning signs of multiple sclerosis (MS) can emerge more than a decade before classical neurological symptoms appear.
Published on August 1 in JAMA Network Open, the study analyzed health records from over 12,000 individuals in British Columbia.
The research showed that people with MS began using healthcare services at elevated rates 15 years before the first signs of MS appeared. These findings challenge the traditional understanding of MS onset and suggest that the disease may have a long prodromal phase characterized by general symptoms.
Dr. Helen Tremlett, senior author and professor of neurology at UBC, explained that early MS symptoms, such as fatigue, headache, pain, and mental health concerns, are often general and misdiagnosed. The findings offer a new timeline and potential opportunities for earlier detection.
This is the first study to analyze healthcare usage up to 25 years before symptom onset, using linked clinical and provincial health data. Previous studies focused only on the five to ten years before the first neurological event.
Key trends identified in the study:
– 15 years before symptom onset: Increased visits to general practitioners and other physicians for symptoms like fatigue, pain, dizziness, anxiety, and depression.
– 12 years before: Rise in psychiatrist visits.
– 8–9 years before: More neurologist and ophthalmologist visits.
– 3–5 years before: Increase in emergency medicine and radiology visits.
– 1 year before: Peak in visits across multiple specialties including neurology and emergency medicine.
Dr. Marta Ruiz-Algueró, first author and postdoctoral fellow at UBC, noted that mental health issues appear to be among the earliest indicators of MS. The study underscores the need to better understand MS’s prodromal phase — a concept well-established in conditions like Parkinson’s disease.
While most people with general symptoms won’t develop MS, identifying early red flags may allow for timely monitoring, support, or preventive measures. Dr. Tremlett emphasized the importance of future research into early biomarkers and lifestyle influences during this overlooked disease stage.
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The study is published in JAMA Network Open.
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