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People with multiple sclerosis (MS) may show warning signs long before classic symptoms appear — and mental health concerns could be among the first red flags, according to new research.
A University of British Columbia (UBC) study, published last week in JAMA Network Open, examined the medical records of 2,038 patients with the autoimmune disease and compared them to 10,182 patients without it.
The researchers found that future MS patients had elevated rates of mental health-related issues, psychiatrist and general practice visits, and complaints of vague symptoms such as fatigue and pain — all as early as 15 years before the onset of clear symptoms.
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“These findings suggest that MS may begin much earlier than previously recognized, with mental health–related issues as early indicators,” the researchers wrote.
MS, which attacks the protective myelin coating around nerve cells in the brain and spinal cord, affects about one million adults in the U.S., according to Cleveland Clinic.
Mental health-related issues can be early indicators of multiple sclerosis, the researchers found. (iStock)
While there is no known cause or cure, treatment can help manage symptoms and slow the progression of the disease, which can cause muscle weakness, vision changes, numbness and memory issues.
Previous research has shown that in the five to 10 years leading up to an MS diagnosis, people typically seek medical attention more frequently for headaches, fatigue, sleep disorders, pain, gastrointestinal issues and psychiatric concerns, the researchers wrote.
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The UBC study, however, tracked physician visits in the 25 years leading up to the onset of symptoms in MS patients in British Columbia.
They found a steady uptick in general practice visits starting 15 years out, followed by more frequent trips to psychiatrists beginning 12 years before symptoms.
Neurology and ophthalmology visits increased eight to nine years prior, likely due to blurred vision or eye pain, two common early symptoms of MS.
An early increase in psychiatric visits may indicate the earliest stages of MS-related immune dysregulation, the study suggests. (iStock)
Three to five years before onset, emergency room and radiology visits rose sharply. Across nearly every specialty, physician visits peaked in the year before symptoms began.
Psychiatrist consultations, in particular, skyrocketed 159% before MS onset, and mental health visits increased 76%, according to the research.
The increase in psychiatric visits may correlate to the earliest stages of MS-related immune dysregulation, as higher levels of certain inflammation-related chemicals and problems with the blood-brain barrier can affect mood, the researchers noted.
Improving outcomes
While most people who experience mental health issues, fatigue and headaches do not develop MS, the researchers said that recognizing and characterizing the “prodromal phase” — the early period marked by subtle symptoms — could speed up diagnosis and improve outcomes.
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“Mental health and psychiatric-related issues may be among the earliest features of the prodromal phase of MS, preceding nervous system-related symptoms and neurologist visits by several years,” senior author Dr. Helen Tremlett, professor of neurology at UBC, told Fox News Digital.
“This suggests that in the future, there may be an opportunity to recognize and manage MS early, maximizing mental health and brain reserve,” she said.
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The findings also open “new avenues for research into early biomarkers, lifestyle factors and other potential triggers that may be at play during this previously overlooked phase of the disease,” the researcher added.
Early warning signs of MS may emerge more than a decade before classic neurological symptoms, according to experts. (iStock)
Monitoring for early warning signs could also potentially help to detect other brain diseases, like Alzheimer’s or ALS, and ensure early intervention, Tremlett noted.
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Between 2016 and 2021, MS cases increased globally from about 2.2 million to as many as 2.9 million, according to research published in July in the journal Frontiers in Neurology.
The disease has gained public attention in recent years as celebrities like Selma Blair, Christina Applegate and Montel Williams have shared their experiences of living with MS.