“We know that early symptoms of multiple sclerosis might influence longer-term outcomes, as they can be a sign of the areas that are affected,” says Ruth Dobson, PhD, a clinical professor of neurology at Queen Mary University of London who wasn’t involved in the new study.
“In general, the more areas affected, then the more symptoms, and hence more disability someone might have in the long term,” Dr. Dobson says.
While the researchers found that several symptoms around the time of diagnosis appeared associated with more disability by the time people reached their forties, two symptoms in particular were most strongly linked with disability: Acute blurry vision (when things suddenly go out of focus) around the time of diagnosis was tied to a 20 percent higher risk of disability, and urinary or fecal incontinence were linked to a 24.5 percent greater disability risk, according to findings published by Brain Medicine on September 24.
Early MS Symptoms May Correspond to Long-Term Disability
Multiple sclerosis is a disease of the central nervous system that can cause medical problems throughout the body as it progresses. It’s thought to be an autoimmune disease, in which the immune system attacks normal tissue. It occurs when the immune system attacks myelin, tissues that are supposed to protect nerve fibers, causing disruptions to the electrical system the brain uses to control movements throughout the body.
For the study, researchers examined data on 195 multiple sclerosis patients who were 40 years old on average and had been diagnosed with this condition roughly eight years earlier. Scientists assessed patients’ symptoms around the time of their diagnosis, as well as their current level of functionality or disability.
Most of the study participants had what’s known as relapsing-remitting MS, in which symptoms can flare up and then improve again. About 10 percent of them had primary-progressive MS, in which symptoms get steadily worse over time.
Participants had a wide variety of symptoms when they were initially diagnosed, the study found. The most common symptom was numbness and tingling in the hands and feet, which about 67 percent of participants experienced, followed by partial loss of muscle control, reported by about 63 percent of participants. More than half of them also experienced reduced sensitivity to touch and diminished muscle coordination.
About 40 percent of participants reported acute blurry vision at the time of their MS diagnosis. And about 36 percent of participants experienced what’s known as autonomic syndrome, which can impact multiple body systems and was defined by the study as urinary or fecal incontinence resulting from a loss of sphincter control.
“Sphincteric symptoms may be correlated with spinal manifestations of the disease,” says the lead study author, João Pedro Fernandes Gonçalves, a medical student at the school of medicine at the Federal University of Bahia in Brazil.
When MS impacts the spinal system, this can produce symptoms like sensory deficits, gait disturbances, and muscle weakness, Gonçalves says. “Thus, sphincteric symptoms could indicate more extensive central nervous system involvement that leads to greater disability,” Gonçalves adds.
Prompt Treatment Can Reduce the Risk of Longer-Term Disability
Beyond its small size, another limitation of the new study is that researchers relied on participants to accurately recall and report on the symptoms they experienced years earlier when they were first diagnosed. Patients might not accurately report the frequency or severity of symptoms, or provide information that’s in line with what their doctors observed when they were first diagnosed, according to the study.
Even so, the findings may offer one additional way for clinicians to assess the disability risk for newly diagnosed MS patients and consider treatment strategies designed to minimize the future risk of disability, Gonçalves says.
There are also some things that all MS patients should consider when they’re initially diagnosed to minimize their risks, Dobson says.
“Things that have been shown to reduce the risk of longer-term disability include prompt treatment, and switching treatment where treatments aren’t working,” Dobson says. “Stopping smoking is also an important way that people can reduce the risk of long-term physical disability.”
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