A prodrome is an early set of signs or symptoms that indicate the onset of a disease before more typical symptoms develop. Prodromal stages are well recognized in some neurological and immune-mediated diseases such as Parkinson disease, schizophrenia, type 1 diabetes mellitus and rheumatoid arthritis. Emerging evidence indicates that a prodromal stage exists in multiple sclerosis (MS), raising the possibility of intervention at this stage to delay or prevent the development of classical MS. However, much remains unclear about the prodromal stage of MS and considerable research is needed to fully characterize the prodrome and develop standardized criteria to reliably identify individuals with prodromal MS who are at high risk of progressing to a diagnosis of MS. In this Roadmap, we draw on work in other diseases to propose a disease framework for MS that incorporates the prodromal stage, and set out key steps and considerations needed in future research to fully characterize the MS prodrome, identify early disease markers and develop standardized criteria that will enable reliable identification of individuals with prodromal MS, thereby facilitating trials of interventions to slow or stop progression beyond the prodrome.

前驱症状是一组早期体征或症状，表明在更典型的症状出现之前疾病已经发作。前驱阶段在一些神经和免疫介导的疾病中得到了很好的认可，例如帕金森病、精神分裂症、1 型糖尿病和类风湿性关节炎。新出现的证据表明多发性硬化症 (MS) 存在前驱期，提高了在此阶段进行干预以延迟或预防经典 MS 发展的可能性。然而，关于 MS 的前驱期阶段仍有很多不清楚的地方，需要进行大量研究来充分描述前驱症状并制定标准化标准，以可靠地识别具有进展为 MS 诊断的高风险的前驱 MS 患者。在这个路线图中，