Health Care Use Before Multiple Sclerosis Symptom Onset

What are the patterns of health care use in the 25 years preceding the clinically determined onset of multiple sclerosis (MS)?In this cohort study of 2038 patients with MS and a matched cohort of 10 182 individuals without MS, all-cause physician visits were elevated 14 years before MS onset. Mental health–related visits and visits for ill-defined symptoms and signs were elevated 14 to 15 years before MS onset, followed by neurology and ophthalmology consultations (8-9 years before onset) and musculoskeletal, sensory, and nervous system visits (4-8 years before onset).These findings suggest that MS may begin much earlier than previously recognized, with mental health–related issues as early indicators, highlighting opportunities for earlier identification and intervention.

Corresponding Author: Helen Tremlett, PhD, Faculty of Medicine (Neurology), University of British Columbia Hospital, 2211 Wesbrook Mall, Room S126, Vancouver, BC V6T 2B5, Canada (helen.tremlett@ubc.ca).

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