Medical Records Flag Future Multiple Sclerosis Patients 5 Years Before Onset

Patients who will develop multiple sclerosis can show warning signs of the disease five years before its actual onset, according to new research.

The study suggested that the disease is detectable much earlier than previously thought, which opens up the potential for earlier diagnosis, and potentially new therapies to prevent multiple sclerosis altogether.

Typically, once a patient is diagnosed with multiple sclerosis, a physician will seek to determine a first demyelinating event in order to mark the onset of the disease. However, a team of scientists from the University of British Columbia sought to go beyond the first demyelinating event to assess whether any patterns could be detected in multiple sclerosis patients prior to the disease’s official onset.

The researchers scoured 20 years of medical records from 14,000 patients with multiple sclerosis, and compared those records with 72,000 records of patients without the disease.

They sought evidence of prodromes — early symptoms that could portend eventual diagnoses of MS or other similar diseases.

The team discovered that patients who will get multiple sclerosis tend to show symptoms serious enough for them to visit the doctor well before they can be diagnosed with the disease. “There’s something going on here that makes this population of people unique,” said José Wijnands, PhD, MSc, the first author of the manuscript.

Wijnands and colleagues found future multiple sclerosis patients visit the doctor more often than the general population. These patients were also more likely to visit the hospital and fill a prescription than the average non-MS patient.

“Proving that people with multiple sclerosis have already changed their behavior in the five years before even the earliest medical recognition of the condition is very important because it means we have to look beyond those five years to understand how it is caused,” said Helen Tremlett, PhD (pictured), the study’s senior author and a professor at UBC.

The authors noted that other diseases, such as Alzheimer’s and Parkinson’s diseases, already have known prodromes, which have enabled much earlier detection of the diseases. Now, the UBC team says they hope to mine the physician visit, hospitalization, and prescription records to find out if there are specific symptoms or prescription patterns among the eventual MS patients.

“When other degenerative brain diseases have a prodrome, it suggests that something may be happening,” said Tremlett, in a press release. “We hope to uncover what this might be in multiple sclerosis.”

The study is potentially a major step forward for patients, who generally face a drawn out and expensive path to a confirmed multiple sclerosis diagnosis. It’s one of a number of studies released in recent years that aim to streamline the detection and diagnosis of the disease. Other efforts have involved blood tests, including an August 2016 study that found a blood test can help distinguish multiple sclerosis from other neurological disorders.

Studies have shown that in many patients, early detection can lead to treatments that successfully slow down the disease’s progression.

The National Multiple Sclerosis Society, in the US, funded the UBC study. The patients included in the study were all Canadian.

The study is titled, “Health-care use before a first demyelinating event suggestive of a multiple sclerosis prodrome: a matched cohort study.” It was published last month in The Lancet Neurology.

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