ArticleAnnals of clinical and translational neurology2026
Pre-Diagnostic Features of Multiple Sclerosis in a Diverse UK Cohort: A Nested Case-Control Study.
Article in Annals of clinical and translational neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Towards primary prevention of multiple sclerosis.Nature reviews. Neurology · 2026Review
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Authors and funding
4 authors.
Funding
Abstract
backgroundMany patients with Multiple Sclerosis (MS) experience nonspecific symptoms prior to diagnosis. This period-the 'MS prodrome'-has been described in socio-economically homogeneous cohorts to date. It remains unclear to what extent events prior to an MS diagnosis differ according to social determinants of health.
methodsWe conducted a retrospective, longitudinal, population-based nested case-control study using data from Clinical Practice Research Datalink (CPRD) Aurum. Associations between pre-diagnostic symptoms and MS risk were evaluated using multivariable logistic regression models in MS cases and matched controls. To determine whether associations differed by potential health determinants, we tested for statistical interactions and used stratified models.
resultsThe study population consisted of 15,029 patients with MS (median index age 44.6, 80.3% female) and 81,027 age-matched controls. In the 5 years preceding diagnosis, MS cases were more likely than controls to have coded autonomic (OR 1.87 [1.80-1.94]), cognitive (OR 2.57 [2.06-3.20]), neurological (OR 7.91 [7.58-8.26]), pain (OR 2.21 [2.12-2.29]) and psychiatric (OR 1.75 [1.69-1.82]) symptoms. The direction of effect was consistent across gender, ethnicity, deprivation and location (urban vs. rural) strata, with over-representation of neurological symptoms in males and those living in urban areas. No statistically significant interaction between factors was found.
conclusionWe report a consistent relationship between the occurrence of prodromal symptoms and MS risk across a diverse UK cohort. No associations were specific to a particular ethnic, gender or socio-economic group. These findings strengthen the concept of pre-diagnostic symptoms reflecting a potential opportunity to identify those at the earliest stages of MS.
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