Potential Early Indicators of Multiple Sclerosis

Individuals with multiple sclerosis (MS) might experience signs long before typical symptoms manifest. Recent research suggests that mental health issues could be among the earliest indicators.

A study conducted by the University of British Columbia (UBC) and published last week in Jama Network Open analyzed the medical records of 2,038 autoimmune disease patients, comparing them to 10,182 who did not have the condition.

Researchers identified that those who would eventually develop MS often reported mental health-related concerns, along with general clinic visits and vague symptoms like fatigue and pain.

The study’s authors indicated that these results imply that MS could initiate much earlier than previously thought, with mental health problems potentially serving as early warning signs.

As per the Cleveland Clinic, MS affects roughly 1 million adults in the United States by attacking the protective myelin around neurons in the brain and spinal cord.

Though no definitive causes or cures exist, treatments can alleviate symptoms and slow disease progression, which can lead to muscle weakness, vision alterations, numbness, and memory issues.

Earlier studies have indicated that in the 5 to 10 years prior to an MS diagnosis, individuals generally seek more frequent medical care for headaches, fatigue, sleep disturbances, and psychiatric issues.

However, the UBC study tracked 25 years of medical visits leading to MS symptom onset in British Columbia.

Notably, general practitioner visits increased steadily starting 15 years before symptoms, with psychiatric appointments rising 12 years prior. Visits to neurologists and ophthalmologists surged 8 to 9 years ago, often due to common early symptoms like blurred vision or eye discomfort.

Three to five years before MS symptoms emerged, visits to emergency rooms and radiology departments surged, peaking in the year preceding symptom onset. Specifically, psychiatric consultations spiked by 159%, and visits related to mental health increased by 76%.

This increase in psychiatric visits might relate to initial stages of immunoregulation associated with MS, as heightened levels of inflammatory markers and blood-brain barrier complications can impact mood, according to the study.

Diagnostic Implications

While it’s true that most individuals experiencing mental health issues, fatigue, and headaches won’t develop MS, recognizing and characterizing this “prongulum phase”—a preliminary period marked by subtle symptoms—could facilitate faster diagnoses and better outcomes.

Dr. Helen Tremlett, a neurology professor at UBC, noted that mental health issues could be one of the first signs during this precursor phase, often showing up before nervous system-related symptoms necessitate neurologist consultations.

This suggests a potential for early recognition and management of MS in the future, which might enhance mental well-being and brain health.

The findings also pave the way for new research regarding early biomarkers, lifestyle influences, and other possible triggers that could play a role in this often-overlooked phase of the disease.

Monitoring early warning signs could additionally aid in identifying other neurological disorders, such as Alzheimer’s and ALS, facilitating timely interventions.

Between 2016 and 2021, MS cases worldwide increased from approximately 2.2 million to 2.9 million, with the disease garnering attention as high-profile individuals like Selma Blair, Christina Applegate, and Montel Williams share their experiences.