New research, published in The Lancet Neurology, suggests that early signs of multiple sclerosis (MS) can appear 5 years before the onset of the disease.1
Using Canadian health records dating from 1984 to 2014, researchers examined the healthcare use of over 14 000 people with MS in the 5 years up to the date of disease onset (‘index date’). For comparison, each individual with MS was matched by gender, birth year and postal code with up to five people without MS. These controls were assigned the same index date as the individual with MS so that healthcare use could be compared fairly.
The researchers found that 5 years before disease onset, people who would go on to develop MS were already more likely than people who would not develop MS to:
- visit their doctor
- be admitted to hospital
- receive a prescription for medication.
This difference in annual healthcare use increased steadily between 5 years and 1 year before the index date.
These findings suggest that there is an MS ‘prodrome’ – a phase of early signs or symptoms before the development of clinically recognised MS. The authors highlight that, “identification of this symptomatic phase is important because it could provide a window for earlier diagnosis and the introduction of neuroprotective interventions.”
- Wijnands JMA, Kingwell E, Zhu F et al. Health-care use before a first demyelinating event suggestive of a multiple sclerosis prodrome: a matched cohort study. Lancet Neurol 2017;16:445-451; doi:10.1016/S1474-4422(17)30076-5.