A prodrome is an early set of signs, symptoms or other findings that occur before the onset of typical symptoms of a disease. Prodromal phases are well recognized in several neurological and inflammatory diseases, but the possibility of a prodrome in multiple sclerosis (MS) has received relatively little attention until the past few years. In this Perspective, we summarize what is currently known about the MS prodrome, including its possible duration, clinical features and potential biomarkers. We also consider what insights and lessons can be learned from knowledge of and research into the prodromal phases of other diseases. A better understanding of the MS prodrome could have profound clinical implications as it could enable earlier recognition of MS and earlier initiation of treatments that reduce relapse rates and long-term disability. Knowledge of the MS prodrome could also affect research into the causes of MS, and putative risk factors must be re-evaluated in light of the MS prodrome. We conclude by outlining the major knowledge gaps and propose future initiatives.

前驱症状是在疾病的典型症状出现之前出现的一组早期体征、症状或其他发现。前驱期在几种神经系统疾病和炎症性疾病中得到了很好的认识，但直到过去几年，多发性硬化症 (MS) 前驱期的可能性才受到相对较少的关注。在此观点中，我们总结了目前对 MS 前驱症状的了解，包括其可能的持续时间、临床特征和潜在的生物标志物。我们还考虑可以从其他疾病前驱期的知识和研究中吸取哪些见解和教训。更好地了解 MS 前驱症状可能具有深远的临床意义，因为它可以更早地识别 MS 并更早地开始治疗，从而降低复发率和长期残疾。对 MS 前驱症状的了解也可能影响对 MS 病因的研究，必须根据 MS 前驱症状重新评估推定的风险因素。最后，我们概述了主要的知识差距并提出了未来的举措。