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

A new study from the University of British Columbia, published in JAMA Network Open, suggests that early warning signs of multiple sclerosis may emerge more than a decade before the onset of classic neurological symptoms. By analyzing health records of over 12,000 individuals in British Columbia, researchers found that people later diagnosed with MS began engaging with the healthcare system at elevated rates as early as 15 years before their diagnosis.

Multiple sclerosis is traditionally diagnosed only after patients present with recognizable neurological symptoms, such as vision problems or limb weakness. However, this study offers a detailed timeline to date of how patients interact with medical providers in the years leading up to a diagnosis.

The study utilized linked clinical and provincial health administrative data to track physician visits in the 25 years leading up to multiple sclerosis symptom onset. This neurologist-determined timeline is much earlier than previous studies, which typically tracked only five to ten years of data before a first demyelinating event.

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