Multiple sclerosis (MS) is often first diagnosed years after an individual’s first demyelinating event, according to a study published in the journal Neurology. Furthermore, the study found an association between upper respiratory tract infections and lower odds ratios of MS diagnosis. However, the exact cause of this is not known.

These findings could pave the way to earlier MS diagnosis and treatment. “We now need to take a closer look at which early symptoms of MS might be overlooked. This could allow us to recognize the disease at an earlier stage and thus enable earlier treatment initiation,” study first author Dr. Christiane Gasperi said in a press release.

With the aim of exploring the occurrence of diseases and symptoms in the 5 years prior to an MS diagnosis, a team led by Dr. Bernhard Hemmer, director of the Neurology Clinic at the hospital of the Technical University of Munich, systematically assessed differences in the occurrence of diseases and symptoms 5 years prior to the first diagnosis in patients with MS, Crohn disease, or psoriasis, and people without these diseases. For their assessment, the team used ambulatory claims data.

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Magnetic Resonance Imaging of the brain showing multiple sclerosis plaques, axial Flair view.
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The results showed that people with MS visited physicians or were hospitalized significantly more frequently than those without an autoimmune disease, even years before the first diagnosis.

The cause of these visits or admissions were complaints indicating typical MS symptoms. “We therefore believe that, although the disease has not yet been diagnosed, it is fully active and not in a preliminary or prodromal phase,” Dr. Hemmer said.

Interestingly, the results also showed that people with MS were less likely to seek medical help for upper respiratory tract infections. “The observed association of upper respiratory tract infections with lower odds ratios of MS diagnosis suggests a link between protection from infection and MS that, however, needs to be validated and further investigated,” the researchers wrote.

MS can lead to various neurological symptoms due to the damage that the disease causes on the nervous system, including numbness and visual disturbances.


Gasperi C, Hapfelmeier A, Daltrozzo T, Schneider A, Donnachie E, Hemmer B. Systematic assessment of medical diagnoses preceding the first diagnosis of multiple sclerosis. Neurology. 2021;96(24). doi:10.1212/WNL.0000000000012074

In many cases, MS starts long before the diagnosis. News release. Technical University of Munich; June 22, 2021.