Multiple Sclerosis Society of Canada

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New health conditions identified as part of the MS prodrome

Background: Neurodegenerative diseases, such as Alzheimer’s and Parkinson’s, can start years before clinical diagnosis and are often preceded by a range of health issues. For example, individuals with Parkinson’s may experience depression and constipation years before the classic symptoms, such as motor deficiencies, are detected. These early symptoms are collectively known as the “prodrome”.

Recent evidence points towards the existence of a MS prodrome, as reported by Dr. Helen Tremlett’s research team at the University of British Columbia. They found that in the five years leading to the onset of MS-related symptoms, people diagnosed with MS were up to four times more likely to visit a physician or hospital for conditions related to nervous system disorders. Higher rates of other health issues, including musculoskeletal pain, mood or anxiety disorders, and migraine headaches, were also observed among MS cases. Recognizing the earliest signs of MS years before the development of classic symptoms could be important for early disease detection and intervention. Thus, additional research must be performed to uncover the clinical characteristics of the MS prodrome.

Study: The present study sought to identify additional health issues that may occur during the MS prodromal period (five years prior to clinical diagnosis of MS). Researchers specifically looked at the prevalence of fatigue, sleep disorders, anaemia, and pain in individuals with and without MS, since these conditions are common following MS diagnosis. The study used administrative and clinical data from British Columbia and reviewed records of nearly 8,000 individuals with MS and more than 35,000 without MS (controls).

Key Results: The most prevalent conditions among MS cases in the five-year period before classic symptom onset (e.g., first demyelinating event) was pain, followed by sleep disorders, anaemia, and fatigue. The odds of having a sleep disorder were up to 161% higher in MS cases compared to controls, and the odds of experiencing pain were up to 115% higher. As expected, these conditions led to an increased number of physician visits among people eventually diagnosed with MS.

Impact: The MS prodrome could potentially represent early warning signs of MS before individuals even know they have the disease. Understanding the clinical characteristics of the MS prodrome may provide insight into the causes of MS, as well as opportunities for early diagnosis which could change the disease trajectory or even prevent MS onset.

This research study was published in the Multiple Sclerosis Journallink.

For more information on the MS prodrome, please refer to a previous article – link .

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