A groundbreaking new study from the University of British Columbia is challenging long-held assumptions about multiple sclerosis (MS), revealing that the disease’s earliest warning signs may arise over a decade before any classic neurological symptoms become noticeable. Researchers analyzed medical records extending up to 25 years prior to symptom onset, uncovering a gradual increase in healthcare visits starting as far back as 15 years before a patient’s first recognized MS symptom.
The study found that patients exhibited increased visits to general practitioners for nonspecific complaints such as fatigue, pain, and mental health concerns like anxiety and depression around 15 years before symptom onset. Approximately 12 years prior to symptom onset, the frequency of psychiatric consultations showed a notable rise. This suggests that neuropsychiatric manifestations, including mood disturbances, may precede classical motor and sensory symptoms typically associated with MS.
The period eight to nine years before symptom onset marked an increase in visits to neurologists and ophthalmologists, likely corresponding to emerging neurological and visual disturbances such as blurry vision or eye pain. Between three and five years prior to symptom onset, there was an uptick in emergency medicine and radiology encounters, which may reflect the increasing acuity and specificity of symptoms.
Just one year before the first neurological symptom manifests, physician visits across multiple specialties reached their peak, likely corresponding to the transition from prodromal symptoms to overt clinical presentation. The study’s findings underscore the extended and intricate prodromal phase of MS, highlighting the need for a multidisciplinary approach that integrates neurology, psychiatry, and primary care to recognize and act upon prodromal signals promptly.
The research aligns with evolving concepts of the prodromal phase in neurological diseases more broadly, such as Parkinson’s disease. Understanding prodromal features across neurological conditions enhances our capacity to identify at-risk individuals and potentially intervene earlier in disease trajectories. The study’s methodology, integrating linked clinical and administrative provincial health data, offers unprecedented granularity into subtle healthcare behaviors preceding MS diagnosis.
While cautioning that most individuals presenting with general symptoms will not inevitably develop MS, the researchers advocate for heightened clinical awareness of these early patterns. Future research may focus on defining specific biomarkers, lifestyle factors, or environmental triggers active during this extended prodromal period, ultimately refining risk stratification and personalized care.
Source: https://bioengineer.org/new-research-suggests-ms-could-start-much-earlier-than-previously-believed