By University of British Columbia
February 21, 2026

New research suggests that multiple sclerosis may begin influencing patients’ health far earlier than previously recognized.

Multiple sclerosis (MS) is often recognized only after unmistakable neurological problems show up, such as changes in vision, balance, or sensation. But a new study from the University of British Columbia suggests the body may be signaling trouble much earlier, in ways that look ordinary on their own and are easy to chalk up to everyday health issues.

Reporting in JAMA Network Open, the researchers examined provincial health records from more than 12,000 people in British Columbia. Long before anyone could clearly point to MS, the group that eventually developed the disease was already using medical services more frequently. That shift began about 15 years before their first MS symptoms appear.

Instead of focusing on a single dramatic event, the team traced a long arc of care seeking that included family doctors, specialists, emergency departments, and imaging services. The picture that emerges is less like a sudden onset and more like a slow buildup, with patients repeatedly returning for answers to symptoms that can be frustratingly hard to pin down.

Shifting the Timeline of MS Onset
“MS can be difficult to recognize as many of the earliest signs—like fatigue, headache, pain and mental health concerns—can be quite general and easily mistaken for other conditions,” said senior author Dr. Helen Tremlett, professor of neurology at UBC’s faculty of medicine and investigator at the Centre for Brain Health. “Our findings dramatically shift the timeline for when these early warning signs are thought to begin, potentially opening the door to opportunities for earlier detection and intervention.”

15 years before symptom onset: Visits to general practice physicians increased, as did visits to any physician for symptoms like fatigue, pain, dizziness, and mental health conditions, including anxiety and depression.

12 years before: Visits to a psychiatrist increased.

Eight to nine years before: Visits to neurologists and ophthalmologists increased, which could relate to issues like blurry vision or eye pain.

Three to five years before: Emergency medicine and radiology visits increased.

One year before: Physician visits across multiple specialties peaked, including neurology, emergency medicine, and radiology.

The study builds on previous work by Dr. Tremlett and her team to characterize the early stages of MS, or prodromal phase, when subtle symptoms appear before the hallmark signs become recognizable. Prodromal periods are well established in other neurological disorders, like Parkinson’s disease, where mood changes, sleep disturbances and constipation often arise years before the more familiar motor symptoms like tremors and stiffness.

While the researchers caution that the majority of people who experience general symptoms will not go on to develop MS, they say recognizing and characterizing the MS prodrome could one day help accelerate diagnosis and improve outcomes for patients.

“By identifying these earlier red flags, we may eventually be able to intervene sooner—whether that’s through monitoring, support, or preventive strategies,” said Dr. Tremlett. “It opens new avenues for research into early biomarkers, lifestyle factors, and other potential triggers that may be at play during this previously overlooked phase of the disease.”

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