Signs of Multiple Sclerosis Could Potentially Appear Fifteen Years Prior to Symptom Onset
In a groundbreaking study conducted in British Columbia, researchers have uncovered early warning signs of Multiple Sclerosis (MS) that can appear up to 15 years before a diagnosis [1][2][3][4]. The study, which analysed health records of over 12,000 people with MS, reveals that these individuals had elevated healthcare usage long before classical neurological symptoms of MS appeared.
The study highlights a significant increase in general symptoms such as fatigue, headaches, dizziness, and pain, as well as mental health issues like anxiety and depression, in the years leading up to an MS diagnosis [1][2][4]. These early signs are often general and nonspecific, making them easily mistaken for other conditions.
One of the most striking findings is the rise in visits to specialists such as neurologists and ophthalmologists around 8 to 9 years before diagnosis, coinciding with the emergence of more specific symptoms [2]. This suggests that MS may have a long prodromal phase—an early period with subtle symptoms before classical neurological signs manifest.
The study also reveals that certain healthcare visit upticks peaked in the year right before MS onset, including doctor visits, visits for injury, ill-defined signs and symptoms, sensory-organ concerns, and musculoskeletal-related problems [4]. Visits to the emergency room were greater 5 years before MS onset, radiology increased 3 years before, and internal medicine and neurosurgery increased one year before MS onset.
Moreover, visits for nervous system conditions increased at year four and in the year leading up to MS onset [4]. Endocrine visits increased in year 9 prior to the onset of MS, and ophthalmology visits were increased 9 years before MS onset, except at year 6 and year 2, with the highest increase the year right before MS onset. Visits related to pregnancy and childbirth decreased to a significant level in years 2 and 5.
Study author Professor Helen Tremlett proposes that we need to look back much further in time to avoid thinking that something might cause MS, when, in actual fact, the disease has already started [4]. Biomarkers (blood and imaging) are key to developing individual-level risk models for identifying individuals at high risk for developing MS.
In summary, the early warning signs before an MS diagnosis highlighted by the British Columbia study are primarily general symptoms — especially fatigue, pain, headache, and mental health issues like anxiety and depression — alongside increased healthcare engagement years before classical MS symptoms appear [1][2][4]. This comprehensive picture from linked clinical and administrative health data challenges the previously held assumption that MS onset is rapid, instead indicating a slow buildup of a variety of symptoms, including mental health and general physical complaints, well before diagnosis.
[1] Tremlett, H. et al. (2022). Pre-diagnostic health care utilization patterns in multiple sclerosis: a population-based cohort study. Lancet Neurology.
[2] Tremlett, H. et al. (2022). Pre-diagnostic health care utilization patterns in multiple sclerosis: a population-based cohort study. The Lancet Neurology.
[3] Canadian Multiple Sclerosis Society. (2022). Multiple Sclerosis. Retrieved from www.mssociety.ca/MS.
[4] University of British Columbia. (2022). Study reveals early warning signs of multiple sclerosis. Retrieved from www.ubc.ca/news/study-reveals-early-warning-signs-of-multiple-sclerosis.
- The British Columbia study highlighted a significant increase in general symptoms like fatigue, headaches, dizziness, and pain, as well as mental health issues, in individuals with multiple sclerosis (MS) years before a diagnosis.
- One of the most striking findings of the study is the rise in visits to specialists such as neurologists and ophthalmologists years before classical MS symptoms appear, suggesting a long prodromal phase for the disease.
- Besides general symptoms, the study also revealed that certain medical-conditions like endocrine issues and nervous system disorders showed increased visits in the years leading up to an MS diagnosis.
- The study proposes that we should look back much further in time to identify individuals at high risk for developing multiple sclerosis, and suggests that biomarkers are key to developing individual-level risk models.
- The comprehensive picture from the British Columbia study challenges the previously held assumption that MS onset is rapid and indicates a slow buildup of a variety of symptoms, including mental health and general physical complaints, well before diagnosis.
