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The Multiple Sclerosis Prodrome: Evidence to Action.

Helen Tremlett1, Kassandra L Munger2, Naila Makhani3

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Multiple sclerosis (MS) may have a clinically symptomatic prodromal phase lasting years before diagnosis. Recognizing this early phase is crucial for potential prevention and improved treatment outcomes.

Keywords:
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Area of Science:

  • Neurology
  • Immunology
  • Disease Progression

Background:

  • A clinically symptomatic prodromal phase preceding multiple sclerosis (MS) diagnosis is increasingly recognized, potentially spanning 5-10 years.
  • This early phase, characterized by non-specific symptoms, precedes classical disease onset and diagnosis.
  • Understanding the MS prodrome has significant implications for disease prevention, early detection, and prognosis.

Purpose of the Study:

  • To provide an overview of recent advances in understanding the multiple sclerosis (MS) prodrome.
  • To discuss current challenges in identifying and validating prodromal MS features.
  • To highlight the implications of recognizing an MS prodromal phase for future research and clinical practice.

Main Methods:

  • This perspective synthesizes current research on the multiple sclerosis (MS) prodrome.
  • It reviews characterized prodromal features and discusses diagnostic challenges.
  • It considers progress in related neurological and immune-mediated diseases.

Main Results:

  • Many identified MS prodromal features are non-specific and common in the general population.
  • No single symptom is currently sufficient for identifying prodromal MS.
  • Biomarkers are needed to improve the accuracy of detecting individuals in the MS prodromal phase.

Conclusions:

  • While knowledge of the MS prodrome is developing, research action is critical.
  • Incorporating a prodromal phase into the MS continuum concept is an immediate implication.
  • Long-term implications include earlier MS recognition, improved prognosis, and potential disease prevention.