Time matters: Early-phase multiple sclerosis is accompanied by considerable impairments across multiple domains.

Area of Science:

• Neurology
• Neuroimmunology
• Rehabilitation Medicine

Background:

• Multiple sclerosis (MS) causes disabling impairments across multiple domains.
• A
• time matters
• approach emphasizes early intervention in MS treatment.
• Optimizing MS care requires early detection of physical, cognitive, and patient-reported deficits.

Purpose of the Study:

• To review impairments in physical function, cognitive function, and patient-reported outcomes in early-stage MS (<=5 years post-diagnosis, including clinically isolated syndrome [CIS]).
• To compare these impairments against matched healthy controls.

Main Methods:

• Topical review of studies investigating early-stage MS/CIS.
• Comparison of functional and patient-reported outcomes between MS/CIS patients and healthy controls.

Main Results:

• Early-stage MS/CIS patients exhibit impairments ranging from 8%-34% across physical, cognitive, and patient-reported domains.
• Numerical effect sizes for these impairments range from small to large (0.35-2.85).

Conclusions:

• Significant multi-domain impairments are evident even in the early stages of MS.
• Early screening and targeted interventions are essential for managing MS.
• Preventive strategies to preserve or restore physical and cognitive reserve are critical.