A new study revealed the early warning signs of multiple sclerosis – including pain, mood changes, and neurological symptoms such as numbness and tingling – may appear years before diagnosis and affect all communities in similar ways.

While the MS prodrome – the constellation of nonspecific symptoms experienced by people with MS before a diagnosis – is a well-documented phenomenon, little is known about whether or how symptoms during this period vary depending on ethnicity or socio-economic status. A better understanding of this phase across the entire population could improve the understanding of the onset of the disease and could aid in early diagnosis. 

Researchers at Queen Mary University of London analyzed electronic health records of more than 96,000 people, including 15,000 people with MS, making this one of the largest and most diverse investigations into the MS prodrome to date. The study used anonymized data from the Clinical Practice Research Datalink Aurum, which covers around 20 percent of the UK population.

The findings confirm these early symptoms are consistent across gender, ethnicity and socio-economic backgrounds, strengthening the case for these symptoms being used to help detect MS earlier. 

The researchers found that, in the five years before diagnosis, people with MS were:
 

• Eight times more likely to report neurological symptoms such as vision changes or numbness 
• Two-and-a-half times more likely to have memory or concentration problems  
• Twice more likely to report chronic pain or bladder and bowel issues 
• Nearly two times more likely to experience depression or anxiety  

These patterns hold true for people of white, Black, South Asian, and mixed/other ethnicities, as well as those living in both rural and urban areas. 

Interestingly, the link between neurological symptoms and later MS diagnosis was even stronger for men and people from Black and Asian backgrounds. These are groups that are often typically less likely to be diagnosed with MS overall.  

The research team is now working on risk prediction tools that could flag high-risk individuals for closer monitoring or referral. This could pave the way for trials of preventive treatments, shifting MS care from reactive to active. 

The study was published in Annals of Clinical and Translational Neurology.