Study Finds Signs of Multiple Sclerosis Can Emerge 15 Years Before Diagnosis
Could subtle changes in healthcare visits reveal early signs of multiple sclerosis years before symptoms become obvious? A groundbreaking study from British Columbia, Canada, provides compelling evidence that increased physician visits begin as early as 14-15 years before the clinical onset of multiple sclerosis (MS). This research sheds new light on the timeline of MS, offering insight into the earliest indicators of the disease.
Note: This article is intended for general information and educational purposes. It summarizes scientific research in accessible language for a broad audience and is not an official scientific press release.
As reported by Neuroscience News, a newly published study in JAMA Neurology addresses key questions about how early symptoms of multiple sclerosis (MS) may appear and what they look like. According to their summary, this study answered the following key questions:
- How early can signs of multiple sclerosis appear?
The study found increased healthcare usage related to MS symptoms up to 15 years before official diagnosis. - What early symptoms did people with MS report?
General symptoms like fatigue, pain, dizziness, anxiety, and depression appeared years before neurological symptoms. - Why is this research important?
It challenges traditional MS diagnostic timelines and opens the door to earlier detection and intervention strategies.
More about the study
Multiple sclerosis (MS) is a chronic neurological condition that traditionally becomes evident at the onset of physical symptoms. However, recent research published by Marta Ruiz-Algueró, MD, PhD, and colleagues in JAMA Network Open on August 1, 2025, suggests that subtle healthcare-seeking behaviors may precede clinical symptoms by up to 15 years. Conducted at the University of British Columbia and associated MS clinics, this study examined physician visits of 2038 patients with MS compared to 10,182 matched individuals without the condition, offering unique insights into the early stages of MS.
What the Researchers Investigated
The research team aimed to explore patterns in healthcare use up to 25 years before clinical MS symptom onset. Specifically, they focused on identifying whether an increase in healthcare visits could indicate an earlier, pre-symptomatic or prodromal phase of MS. The researchers utilized data from patients who visited MS clinics and compared them with matched controls from the general population.
How the Study Was Conducted
Using data from British Columbia’s universal healthcare system, the team analyzed physician visit records spanning from January 1991 to September 2018. Patients diagnosed with MS were identified from clinic records and matched by sex, birth year, socioeconomic status, and postal code with individuals without MS. The analysis involved evaluating the annual rate of physician visits across various medical specialties and diagnostic categories up to 25 years prior to clinical symptom onset.
What Makes This Study New
This study introduces an extended observation period, examining healthcare use over 25 years rather than the typical 5-10 years prior to MS onset examined in previous research. As highlighted by the authors, this longer timeframe provides novel insights into the prodromal phase of MS, revealing healthcare patterns significantly earlier than previously recognized. Compared to earlier studies, this research uniquely anchors observations directly to clinically determined MS symptom onset.
Key Findings from the Study
According to the authors, visits to doctors for any reason among people who later developed MS began increasing significantly about 14 years before the disease was officially diagnosed, reaching their highest levels in the year just before diagnosis. Mental health-related visits were consistently higher starting 14 years before diagnosis, particularly increasing in the last three years before the official diagnosis.
- Visits related to unclear or vague symptoms also increased notably throughout the entire 15-year period leading up to diagnosis, becoming most frequent in the year before MS was diagnosed.
- Neurology visits began to rise noticeably 8 years before diagnosis, sharply increasing just before MS became clinically evident.
- Similarly, visits to ophthalmologists (eye specialists) increased from around 9 years before diagnosis, reaching a peak right before diagnosis.
- Visits for musculoskeletal (related to muscles and bones) and nervous system issues also became noticeably more frequent 4 to 5 years before the clinical symptoms of MS clearly appeared, indicating that certain specific symptoms intensified as the diagnosis approached.
Authors’ Conclusions
The researchers conclude that the observed sustained rise in physician visits starting 14-15 years prior to clinical MS symptom onset supports the existence of an extended prodromal phase (i.e., a period prior to the obvious onset of the disease, when subtle signs begin to appear). They highlight that mental health concerns, ill-defined symptoms, and early specialist consultations indicate that MS may begin earlier than traditionally understood. The authors emphasize the potential of these findings to enhance understanding of MS progression and underscore the importance of examining earlier periods for potential risk factors or early markers of the disease.
Furthermore, the authors suggest future research could integrate clinical, biological, and lifestyle data to enhance strategies for early detection and intervention. They highlight promising developments in neuroimaging, such as central vein signs and paramagnetic rim lesions on magnetic resonance imaging, as well as biochemical biomarkers like cerebrospinal fluid κ-free light chains and serum neurofilament light chains, which might help identify at-risk individuals. They also point out that the complexity and diversity of early MS presentation across medical specialties could inform optimized clinical pathways, aiding early recognition while reducing risks of overdiagnosis or unnecessary patient anxiety.
The authors also clearly outline that their findings apply to this specific clinical and demographic context, noting the importance of further research to explore these patterns in different populations and healthcare settings. They stress the potential for future studies integrating clinical, biological, and lifestyle factors to refine early detection strategies for MS.
The information in this article is provided for informational purposes only and is not medical advice. For medical advice, please consult your doctor.
The full study details are available at DOI: 10.1001/jamanetworkopen.2025.24635
References:
Signs of MS Emerge 15 Years Before Diagnosis. Neuroscience News, August 1, 2025.
https://neurosciencenews.com/multiple-sclerosis-early-signs-29547/
