56 msfocusmagazine.org Study: A group of symptoms precedes first definitive signs of MS During the five years before people develop the first clinically recognized signs of multiple sclerosis, they are up to four times more likely to be treated for nervous system disorders such as pain or sleep problems, and are 50 percent more likely to visit a psychiatrist, according to new research from the University of British Columbia. The studywas published in Multiple Sclerosis Journal. Dr. Thrower: If you ask a person with MS “when were you diagnosed?” and “when did you have your first symptoms?”, you will likely get two different answers. For many with MS, the road to a diagnosis can be long, frustrating, and frightening. On the other hand, study after study shows that early treatment of MS leads to better chances of preventing future disability. Obviously, one cannot begin treatment without a diagnosis. DiagnosticguidelinesforMS,liketheMcDonald Criteria,areconstantlybeingrevisedtoimprove the speed and accuracy of the diagnostic process. This study shows that there may be clinical clues that could also lead to a more rapid diagnosis of MS. However, some of the early symptoms identified by the researchers are common and nonspecific. Study links exposure to paint and varnish to increased MS risk People who have been exposed to paint, varnish, and other solvents and who also carry genes that make them more susceptible to developing MS may be at much greater risk of developing the disease than people who have only the exposure to solvents or the MS genes, according to a new study. The study was published in Neurology. Dr. Thrower: MS results from a complex combination of genetic and environmental factors that result in an immune system gone awry. Many different environmental factors have been linked to a higher risk of MS, including viral exposures, distance from the equator, and diet. Cigarette smoke is a toxin that has been linked to a higher risk of MS and more MS relapses in those already diagnosed. This studylooks at otherexposures, specifically paint and varnish as a risk for developing MS. As the authors state, the downside to this study is that it is based upon self-reporting. Clearly, we have no control over our genes, butasresearchuncoversenvironmentalfactors that result in a higher risk of MS, we need to pay attention. A child whose parent has MS has a higher risk of developing MS. We can’t undo those genetics but we can limit the environmental risks by maintaining a healthy Medicine & Research Doctor’s Notes The Doctor’s Notes column includes analysis from Ben Thrower, M.D., MS Focus senior medical advisor. Dr. Thrower draws from the top news stories of the quarter and explains what the news means to you, the person with MS.