Warning signs of multiple sclerosis may surface years before diagnosis
Study finds higher healthcare use tied to early sensory and nerve problems
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- Multiple sclerosis (ms) appears to have a prodromal phase, marked by increased healthcare use years before diagnosis.
- Early symptoms may include sensory, nervous system, and muscle problems, as well as fatigue, pain, and mental health issues.
- Identifying MS earlier could support timelier diagnosis and treatment, with the potential to improve long-term outcomes.
Years before a diagnosis of multiple sclerosis (MS), people who later develop the disease have more doctor visits and hospitalizations for sensory, nervous system, and muscle problems than people in the general population, according to a recent study.
The findings support the idea of an early phase of MS, known as the prodromal phase, when people may begin to experience vague or nonspecific symptoms, such as fatigue, pain, and mental health issues, long before classic neurological symptoms of MS appear.
“Our findings corroborate that many symptoms and issues commonly associated with MS might manifest well before the clinical symptom onset,” the researchers wrote.
Why spotting MS earlier could make a difference
A better understanding of this early phase could help identify people at the very start of MS, when treatment may offer the greatest long-term benefit.
The study, “Reasons for Healthcare Use Before Onset of Multiple Sclerosis: A Nationwide Matched Cohort Study in Sweden,” was published in the European Journal of Neurology.
MS is a neurological disease that can cause a wide range of symptoms, including mobility issues, fatigue, problems with the urinary tract, cognitive changes, and mental health challenges.
There is growing evidence that many people who develop MS begin experiencing symptoms years before diagnosis. Because these early symptoms are often vague or nonspecific, they may not raise concerns about MS until clear neurological problems appear.
“Identifying and understanding this early phase of disease carries significant implications, including opportunities to advance the understanding of disease mechanisms, support risk assessment, enable more timely diagnosis and intervention, and consequently improve long-term outcome,” the researchers wrote.
While recognizing when someone may be in this early, prodromal phase could help improve diagnosis and outcomes, much remains unknown about how this phase appears in everyday life.
How researchers studied early signs of MS
To better understand this phase of MS, researchers in Sweden and Canada analyzed health administrative data from more than 7,000 people with MS and nearly 38,000 people without the disease in Sweden. The two groups were matched for age, sex, area of residence, and years lived in Sweden.
The team focused on healthcare use one to six years before MS symptoms began, or the same time window for people without MS, to see whether differences in medical visits might signal an early, prodromal phase of the disease.
The results showed that, in the years before diagnosis, people who later developed MS were 71% more likely to be hospitalized and 73% more likely to visit a doctor for sensory-related problems than people in the general population. They also had higher rates of medical visits and hospital stays for ill-defined symptoms, such as fatigue or pain, as well as nervous system or muscle problems.
Outpatient visits for mental health conditions, digestive problems, and urinary or reproductive system issues were also somewhat more common among people who later developed MS. At the same time, women with MS were significantly less likely than women in the general population to have doctor visits related to pregnancy or childbirth.
Medication use also differed before diagnosis
The researchers also examined prescription patterns before diagnosis. They found that people who later developed MS were more likely to be prescribed certain types of medicines for urinary problems, muscle stiffness, pain, and mental health symptoms, including calming or sedating drugs.
More detailed analyses showed that some patterns differed by age and sex. For example, men who later developed MS were more likely than men in the general population to be hospitalized for mental health issues, a difference not seen among women.
Taken together, these findings add to the growing evidence that some MS-related symptoms, such as mental health challenges or urinary problems, may appear years before diagnosis. The researchers called for additional studies to better understand these early signs and to develop ways to help identify MS sooner.
“Additional research is needed to understand the mechanisms underlying these healthcare use patterns and their potential role in MS development,” the scientists wrote, adding that, “examining whether the frequency, type, and timing of healthcare use predict disease course and subsequent disability progression will aid the development of patient-specific interventions and management strategies.”
