Some diseases evolve in silence long before their effects become visible. They settle down discreetly, leaving behind a series of scattered signals that medicine often struggles to link. It is in this gray area that the early signs of multiple sclerosis are hidden, long confused with trivial disorders and without apparent link.
Research by the University of British Columbia, published in Jama Network Open, analyzed medical records of more than two thousand patients over a period of up to twenty-five years before the appearance of the first symptoms. This survey highlighted a gradual increase in medical consultations, sometimes fourteen to fifteen years before the official diagnosis.
These visits first concerned general complaints such as persistent fatigue, diffuse pain or anxious disorders. According to the neurologist Helen Tremlett, these signs often remain neglected because they can correspond to many common conditions, but their persistence could indicate a pathological process already in progress.
How to locate the early signs of multiple sclerosis
The study shows that patient medical trajectory changes well before the appearance of visible lesions on neurological examinations. Twelve years before typical symptoms, psychiatry consultations become more frequent, especially for depressive or anxious episodes. Between eight and nine years before diagnosis, visits to neurologists and ophthalmologists increase, often in connection with intermittent visual disorders.
From five years before the appearance of the first motor signs, the attendance of emergency and radiology services intensifies, a sign that patients undergo more severe or disturbing episodes. In the last year preceding the diagnosis, all the medical specialties involved see a peak of attendance. The data collected by the team of Marta Ruiz-Algueró thus confirms the existence of a long and complex prodromic phase, which is not limited to conventional neurological signs.
Towards medicine capable of intervening before the first symptoms
The identification of this silent period opens the way to a new approach to medical follow -up. Recognizing these weak signals could allow doctors to monitor patients at risk more carefully and, ultimately, to implement preventive strategies. Tracks are already being studied, including the use of blood biomarkers such as light neurofilaments or brain imaging techniques capable of detecting subtle anomalies before the first symptoms.
This research also highlights the importance of a global vision of the patient, where consultations for fatigue, pain or psychological disorders are no longer seen as isolated episodes but as the pieces of a larger medical puzzle. By acting early enough, it would become possible not only to delay the evolution of the disease, but perhaps even to prevent it from being established.
