Multiple Sclerosis May Begin 15 Years Earlier with Subtle Symptoms: Study Suggests

Researchers found notable increases in general physician visits 15 years before symptoms, followed by rising mental health consultations 12 years prior, and increases in neurology and ophthalmology visits eight to nine years before symptom onset. Visits to emergency medicine and radiology surged in the final three to five years.

“Multiple sclerosis can be difficult to recognize as many of the earliest signs—like fatigue, headache, pain and mental health concerns—can be quite general and easily mistaken for other conditions,” said Dr. Helen Tremlett, professor of neurology at UBC’s faculty of medicine and investigator at the Djavad Mowafaghian Centre for Brain Health. “Our findings dramatically shift the timeline for when these early warning signs are thought to begin, potentially opening the door to opportunities for earlier detection and intervention.”

“These patterns suggest that multiple sclerosis has a long and complex prodromal phase—where something is happening beneath the surface but hasn’t yet declared itself as multiple sclerosis,” explained Dr. Marta Ruiz-Algueró, first author and postdoctoral fellow at UBC.

While not all individuals with these general symptoms will develop multiple sclerosis, the findings could pave the way for earlier diagnosis, better monitoring, and even preventive strategies.

Reference: Ruiz-Algueró M, Zhu F, Chertcoff A, Zhao Y, Marrie RA, Tremlett H. Health Care Use Before Multiple Sclerosis Symptom Onset. JAMA Netw Open. 2025;8(8):e2524635. doi:10.1001/jamanetworkopen.2025.24635