French researchers report a prodromal phase of this autoimmune pathology, that is to say a period during which the pathology sets in discreetly.
- Five symptoms are associated with a diagnosis of multiple sclerosis five years later.
- These include depression, sexual dysfunction, constipation, cystitis and other urinary infections.
- However, these signs are not specific to multiple sclerosis, as they have also appeared in the prodromal phase of lupus and Crohn’s disease.
In France, multiple sclerosis affects 120,000 people. Its treatment has improved considerably over the past ten years. However, there is still no curative treatment or therapeutic solution for the 15% of patients affected by a progressive form.
“One of the major difficulties of multiple sclerosis is that we do not observe a strict correspondence between the severity of lesions on nerve fibers and the patients’ symptoms. This considerably limits our ability to predict the evolution of the disease. (…) The challenge today is to detect the disease as early as possible, well before the lesions are visible on MRI, in the hope of delaying the appearance of the disability. declared Professor Céline Louapre, neurologist at Pitié-Salpêtrière hospital, in a press release.
Defining the “prodromal phase” of multiple sclerosis
Much research has already suggested that, in some patients, symptoms, “in particular mood disorders or genitourinary signs”, were present up to ten years before diagnosis. However, this phenomenon has not been quantified at the population level. In order to define the exact moment when the inflammatory process causing damage to the central nervous system begins, Céline Louapre and researchers from the Brain Institute, CNRS and Inria carried out a study, the results of which were was published in the journal Neurology.
For the purposes of the work, the scientists compared the medical data of 20,174 patients suffering from multiple sclerosis, 54,790 healthy people and 37,814 adults suffering from two autoimmune diseases which, like multiple sclerosis, mainly affect the women and young adults, namely 30,477 people affected by Crohn’s disease and 7,337 patients with lupus. The team analyzed participants’ health journeys, focusing on the frequency of 113 common symptoms and illnesses in the five years before and five years after diagnosis.
“The disease begins well before the appearance of classic neurological symptoms”
According to the results, five symptoms are associated with a diagnosis of multiple sclerosis five years later. These are depression, sexual dysfunction, constipation, cystitis and other urinary infections. However, they also appeared in the prodromal phase of lupus and Crohn’s disease, meaning they are not specific to multiple sclerosis. Another observation: these manifestations were also widespread among healthy people.
“On their own, these signs will not be enough to make an early diagnosis, but they will certainly help us to better understand the mechanisms of multiple sclerosis – of which there are multiple causes – and to reconstruct its natural history. Finally, these new data reinforces our idea that the disease begins well before the appearance of classic neurological symptoms”, concluded Celine Louapre.
