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Knowing about these symptoms could help doctors diagnose and start treating MS earlier, possibly slowing the damage it causes to the brain and spinal cord, says a Canadian team of researchers.
"The existence of such 'warning signs' are well-accepted for Alzheimer's disease and Parkinson's disease, but there has been little investigation into a similar pattern for MS," said study leader Helen Tremlett, a professor of neurology at the University of British Columbia.
Her group tracked the health records of 14,000 Canadians with MS and a control group of 67,000 people without the disease.
Compared to the control group, fibromyalgia (a syndrome characterized by widespread musculoskeletal pain) was three times more common, and irritable bowel syndrome was nearly twice as common among those who were later diagnosed with MS, the records showed.
People who were later diagnosed with MS also had much higher rates of migraines and mental health conditions such as depression, anxiety and bipolar disorder, and they were 50 percent more likely to have seen a psychiatrist, Tremlett's group found.
The people later diagnosed with MS also had higher use of medications for musculoskeletal, nervous system, and urinary tract disorders, as well as antidepressants and antibiotics, according to the study published this week in the Multiple Sclerosis Journal.
The researchers said their findings provide definitive evidence that MS can be preceded by early symptoms.
"We now need to delve deeper into this phenomenon … to see if there are discernible patterns related to sex, age, or the" type of MS, Tremlett said in a university news release.
Dr. Asaf Harel is a neurologist who cares for MS patients at Lenox Hill Hospital in New York City. He said many of the findings were "not surprising," but added that more and better research may be needed.
According to Harel, the average age of MS onset in this Canadian study "was older than the accepted average age at onset of MS," suggesting that many patients were diagnosed late in life.
Also, the study "does not address any differences amongst MS subtypes," Harel said. "One would expect progressive-onset MS to present with gradual onset of symptoms that eventually reach threshold for clinical detection, which would be consistent with the results of the study. However, this may occur less frequently in relapse-onset MS."
-- Robert Preidt
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