Advancing understanding of the multiple sclerosis (MS) prodrome: a focus on understudied signs and symptoms (MS-Pro-Us)

Multiple sclerosis likely begins years before the first neurological symptom. During this period, it can present as a set of yet to be well-defined, subtle symptoms, leading patients to increasingly seek medical attention years before actual MS symptom onset, and diagnosis. Our aim is to better understand the earliest signs of MS. We will look for poorly understood signs and symptoms such as sleep disturbances, palpitations, shortness of breath, and skin conditions among others that may appear months or years before MS onset. We will see if these signs are different in men and women and how such differences vary across different age groups. In addition, previous studies suggested that women who developed MS had fewer pregnancies and increased contraceptive use in the five years before MS onset. This may reflect lifestyle changes even before MS onset. We will look at all these issues in more depth than has ever been done before. We will have access to health data from large populations so that we can look in detail at people with and without MS. Our aim is to help doctors and researchers recognize when MS actually starts and to help doctors, patients and families get prompt, appropriate treatment for everyone who develops MS.