Assessment of Anxiety, Depression and Fatigue as Prodromal Symptoms that May Precede Multiple Sclerosis First Demyelinating Event or Symptom Onset

Abstract Background Multiple sclerosis (MS) is a neuroinflammatory and neurodegenerative condition that led to chronic neurological disability in adults.it is characterized by multiple remissions and relapses that eventually lead to the neurological disability. Aim of the Work In this study we assessed the prodromal period through assessing only patients recently diagnosed with multiple sclerosis and was done through specific scales in order not to miss mild cases or vague complains. Patients and Methods This study is a cross sectional study, starting from November 2022 till April 2022 attending to ASU- neurology department – MS unit. Patients diagnosed with multiple sclerosis for the first time attending MS unit in neurology department. Results The demographic data had also no statistically significant relation to the prevalence of main symptoms of fatigue, depression and anxiety among the studied sample which was similar to the studies assessing the prodromal symptoms in MS patients yet with limited assessing of the demographic data to only age and gender. Prevalence of fatigue among the sample came higher than the overall prevalence of fatigue in the general population and higher than the overall prevalence of fatigue symptoms in the outpatient clinics which could mount fatigue symptoms to be further studied as possible marker of multiple sclerosis yet could also be linked to the much larger sample size used in those surveys and different methods of assessment. Prevalence of depressive symptoms came out to be higher than the overall prevalence of depression worldwide and the overall prevalence of depression in Egyptian population which could mount the mood symptoms to be further assessed as prodromal factors yet with the same risk of bias for the much larger sample size used in those surveys and the different assessment method. Prevalence of anxiety symptoms came out to be higher than the overall prevalence of anxiety worldwide and higher than its prevalence in Egyptian population which could also mount the subject to be presented as future factor for the prodromal period of multiple sclerosis yet with the same factors of bias as mentioned before of much larger sample size and different assessment methods. Conclusion In our study the assessed symptoms of fatigue, anxiety and depression have had higher prevalence in recently diagnosed MS patients before their diagnosis than the reported prevalence of these symptoms worldwide and in the Egyptian population. According to the results these symptoms could mount to be further studied on larger scale as prodromal risk factors trying to remove any possible risk of bias in association with assessment of other symptoms signs and investigations.