Multiple sclerosis starts far earlier than previously believed, study finds

The first signs of multiple sclerosis (MS) may appear much earlier than most doctors once believed. A new study suggests that changes in healthcare use begin more than a decade before the first clear neurological symptoms. This shifts the understanding of when the disease process truly begins and may one day change how doctors detect and treat the condition.

Researchers at the University of British Columbia analyzed the health records of more than 12,000 people in British Columbia. Their findings, published in JAMA Network Open, reveal that people who later developed MS started increasing their visits to doctors up to 15 years before symptoms like numbness, vision problems, or loss of balance appeared.

The study shows that the early phase of MS is longer and more complex than expected. Health concerns that seem ordinary, such as fatigue, headaches, dizziness, or even anxiety and depression, appeared more often in people who would eventually receive an MS diagnosis. These issues caused more trips to general doctors and specialists long before the disease became obvious.

“MS can be difficult to recognize as many of the earliest signs—like fatigue, headache, pain and mental health concerns—can be quite general and easily mistaken for other conditions,” explained senior author Dr. Helen Tremlett, professor of neurology and investigator at the Djavad Mowafaghian Centre for Brain Health. “Our findings dramatically shift the timeline for when these early warning signs are thought to begin, potentially opening the door to opportunities for earlier detection and intervention.”

Unlike most past studies, which focused on the five to 10 years before the first clear neurological event, this work reached further back. The team used linked clinical and administrative health data to trace physician visits over 25 years. They then compared those visits with a neurologist-confirmed timeline of when MS symptoms first began.

By looking at the data this way, the researchers identified a long prodromal phase—the period when the disease is active but not yet diagnosable.

The records revealed a clear pattern of increasing medical visits:

“These patterns suggest that MS has a long and complex prodromal phase—where something is happening beneath the surface but hasn’t yet declared itself as MS,” said Dr. Marta Ruiz-Algueró, a postdoctoral fellow at UBC and first author of the study. “We’re only now starting to understand what these early warning signs are, with mental health-related issues appearing to be among the earliest indicators.”

The idea of a prodromal phase is not new in medicine. Other brain disorders show similar early warning periods. In Parkinson’s disease, for example, mood changes, sleep problems, and digestive issues can appear years before tremors or stiffness.

Dr. Tremlett’s group has been working for years to define the early phase of MS. By extending the timeline backward and adding psychiatric visits and emergency care patterns, this study presents the most detailed picture yet of how patients move through the healthcare system before diagnosis.

Recognizing such red flags is crucial, though the researchers caution against drawing fast conclusions. Most people who experience fatigue, dizziness, or depression will never develop MS. Still, carefully mapping the prodrome can help doctors separate normal health concerns from those pointing to a possible neurological disease.

MS is an autoimmune disease in which the body’s immune system attacks the protective covering of nerve fibers. This disrupts communication between the brain and the rest of the body, leading to symptoms ranging from mild numbness to paralysis. Early treatment can reduce relapses and slow the disease’s progression. But since the first symptoms often look like many other conditions, diagnosis is usually delayed.

That is why this research matters. By spotting the hidden phase earlier, doctors may be able to identify patients at risk before irreversible nerve damage occurs. “By identifying these earlier red flags, we may eventually be able to intervene sooner—whether that’s through monitoring, support or preventive strategies,” said Dr. Tremlett.

The team suggests future research could explore biomarkers—measurable biological signals—along with lifestyle factors and possible triggers that may interact with genetics. If successful, these efforts could help create a screening process for those at risk.

The findings expand knowledge of how MS develops and highlight the importance of taking subtle, long-lasting health changes seriously. They also suggest that the disease begins far earlier than the current definition allows.

The challenge now lies in separating which early symptoms truly matter and which are just part of life’s ordinary health struggles. More research will be needed to narrow down the most reliable warning signs.

For now, the study offers hope that MS diagnosis may one day come much sooner, improving outcomes and quality of life for many patients. It also provides a reminder that even vague symptoms can sometimes carry hidden significance, especially when they persist and grow over time.

Note: The article above provided above by The Brighter Side of News.

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