VIDEO: Growing body of literature supports existence of prodromal phase in MS

In this video from MSVirtual2020, Helen Tremlett, PhD, professor in the department of medicine at the University of British Columbia and the Canada Research Chair in Neuroepidemiology and Multiple Sclerosis, shares highlights from her talk during the plenary session at MSVirtual2020.

Literature on the history of a prodromal phase in MS — a period of nonspecific signs and symptoms that occur before the classic onset of a disease — stated that such a phase did not exist for this disease, according to Tremlett. However, research published in the last several years revealed “a huge range of symptoms” in the 5 years before the first demyelinating event, including irritable bowel syndrome, sleep disturbances, bladder-related issues and more, Tremlett told Healio Neurology.

“In the 5 years leading up to MS onset, we found that women were less likely to [become pregnant] and more likely to fill a prescription for an oral contraceptive drug. You could really see that in particular in the year or so before MS onset,” she said. “I found [this part] particularly fascinating.”

The more recent research into this question of a prodromal phase demonstrates that such a phase does occur in MS, Tremlett continued, which has two potential implications.

“One is immediate. I think the community needs to be really mindful [to account for] this prodromal phase so that you’re not concluding that this factor, whatever that is, is a risk factor that causes MS. That person may even be in the prodromal phase,” she said. “A long-term, very lofty goal would be: Can we use this information to allow us to identify people with MS earlier, maybe diagnose them earlier and maybe initiate, then, drug treatment or some interventions earlier to affect long-term outcomes? That, to me, would be a great long-term goal.”