• People with multiple sclerosis (MS) may experience symptoms for years before being diagnosed with the condition, a German study indicates.
• Some scientists previously believed early symptoms indicated a person may be developing MS, not that the person already had the condition.
• Health care providers should focus on early symptoms to diagnose MS sooner, which would allow treatment to begin more quickly.

Researchers know that diagnosing multiple sclerosis can take time, particularly because the disease is complex and no single test can pinpoint whether someone has it. However, one 2021 study indicates that many people with MS are diagnosed years later than their first symptoms begin to show. This suggests these early symptoms may indicate a person has MS and is experiencing an active disease relapse.

Researchers in Germany reviewed insurance claims of 10,262 people with MS to evaluate the symptoms they were experiencing during the five years prior to their MS diagnosis. They compared this data to medical charts of people with Crohn’s disease and psoriasis, as well as to people without any autoimmune disorders. They found that 43 symptoms appeared more often among those with MS prior to diagnosis than in the group of people without autoimmune diseases.

In the past, scientists who acknowledged that people with MS had symptoms prior to diagnosis often believed those symptoms to be part of a “prodromal phase” of multiple sclerosis, meaning symptoms that occur before full disease onset. However, this new study suggests that these early complaints may instead be part of active disease rather than a prodromal phase.

“We suspect that unrecognized MS relapses cause these individuals to seek medical attention,” said study investigator Dr. Bernhard Hemmer in a statement. “That is because we have found that the physician appointments and hospital admissions frequently involve complaints indicating typical MS symptoms. We believe that many complaints that have been attributed to a prodromal phase are in fact caused by ongoing disease. We therefore believe that, although the disease has not yet been diagnosed, it is fully active and not in a preliminary or prodromal phase.”

One key outcome of the research, according to the authors, is that physicians may need to look closer at the early MS symptoms that are often overlooked. This would allow health care providers to diagnose the condition sooner and start treatment during an earlier disease phase.

“The sooner MS is recognized, the better we can treat the disease,” said lead study author Dr. Christiane Gasperi.