Impairments across multiple domains are a disabling consequence of multiple sclerosis (MS). Originating from preventive medical strategies, the "time matters"-perspective has become a focal point when treating MS. In particular, early detection of physical and cognitive deficits, along with deficits in patient-reported outcomes seems crucial to further optimize both pharmacological and non-pharmacological MS treatment strategies. Therefore, this topical review investigates the level of impairments across multiple domains (physical function, cognitive function, and patient-reported outcomes) in the early stage of MS (⩽5 years since diagnosis, including clinically isolated syndrome (CIS)), when compared to matched healthy controls. Even at early disease stages, studies show impairments corresponding to 8%-34% and small-to-large numerical effect sizes (0.35-2.85) in MS/CIS patients across domains. This evidence call for early screening programs along with early interventions targeting the multiple impaired domains. This further highlights the importance of preventive initiatives preserving and/or restoring physical and cognitive reserve capacity if possible.

中文翻译：

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时间很重要：早期多发性硬化伴随着跨多个领域的相当大的损伤

跨多个域的损伤是多发性硬化症 (MS) 的致残后果。源于预防性医疗策略，“时间很重要”的观点已成为治疗 MS 的焦点。特别是，身体和认知缺陷的早期检测，以及患者报告结果的缺陷，对于进一步优化药物和非药物 MS 治疗策略似乎至关重要。因此，本专题综述调查了 MS 早期（诊断后⩽ 5 年，包括临床孤立综合征 (CIS)）跨多个领域（身体功能、认知功能和患者报告的结果）的损伤水平，并进行了比较。到匹配的健康对照。即使在疾病的早期阶段，研究表明，跨域 MS/CIS 患者的损伤对应于 8%-34% 和从小到大的数值效应大小 (0.35-2.85)。这一证据呼吁早期筛查计划以及针对多个受损领域的早期干预。这进一步强调了预防措施在可能的情况下保持和/或恢复身体和认知储备能力的重要性。