A NEW study has revealed that people with multiple sclerosis (MS) have increased health care use years before their disease is clinically diagnosed, including rises in mental health visits and consultations for ill-defined symptoms. This suggests MS may begin much earlier than previously thought, offering new opportunities for earlier identification and intervention.
Multiple sclerosis is a chronic neurological condition characterised by damage to the central nervous system, often diagnosed after symptoms become apparent. Understanding patterns of health care use before diagnosis could provide insight into the prodromal phase of MS, when subtle signs and nonspecific issues begin to surface, potentially allowing for earlier diagnosis and management.
Researchers conducted a matched cohort study of 2,038 MS patients and 10,182 controls in British Columbia, Canada, analysing health records between 1991 and 2018. All-cause physician visits were significantly higher in people who later developed MS from 14 years before symptom onset, with a rate ratio of 1.19 (95% CI, 1.07-1.33), peaking the year before at 1.28 (95% CI, 1.21-1.35). Visits for ill-defined symptoms were elevated from 15 years before onset and mental health-related consultations were increased from 14 years before onset. Neurology and ophthalmology visits rose 8 to 9 years prior, while musculoskeletal, sensory, and nervous system visits increased between 4 and 8 years before MS onset. General practice visits were consistently elevated throughout the 15 years studied.
These findings suggest that MS-related changes start long before diagnosis, with mental health issues and vague symptoms preceding neurological signs. Clinicians should be aware of this extended prodromal phase and consider greater vigilance for MS in patients presenting with such early signs. Future efforts could focus on developing diagnostic tools and targeted interventions during this window to improve outcomes.
Reference
Ruiz-Algueró M et al. Health care use before multiple sclerosis symptom onset. JAMA Netw Open. 2025;8(8):e2524635.
