Researchers Unveil Blood Test to Predict Multiple Sclerosis Early

A team of researchers from the Medical University of Vienna has developed a groundbreaking blood test capable of identifying individuals at high risk for developing multiple sclerosis (MS) years before they exhibit any symptoms. This innovative approach holds the potential to enable timely diagnostic and therapeutic interventions, which may delay or even prevent the onset of the disease. The findings were published in the respected journal Nature Communications in March 2025.

The research was spearheaded by Elisabeth Puchhammer-Stöckl and Hannes Vietzen from the Center for Virology, alongside Thomas Berger and Paulus Rommer from the Department of Neurology at MedUni Vienna. Their method relies on an immunological test that detects specific antibodies against a protein from the Epstein-Barr virus (EBV), which is a significant factor in the development of MS. Remarkably, EBV can be found in nearly all MS cases.

The test focuses on identifying autoantibodies that initially target a particular section of the EBV protein known as EBNA-1 (Epstein-Barr nuclear antigen 1), which subsequently cross-react with specific structures in the human brain. These antibodies can appear as early as three years post-EBV infection, well before any clinical symptoms of MS manifest. According to Hannes Vietzen, the first author of the study, “By repeatedly measuring these antibody levels, a significantly increased risk of a later MS diagnosis can be identified. Our research shows that people with high levels of these antibodies detected at least twice will likely develop MS in the following years.”

The study analyzed blood samples from over 700 MS patients and more than 5,000 control subjects. In a subset of this group, researchers could trace the timing of the initial EBV infection and follow the subsequent development of MS. The results indicated that consistently high antibody levels were linked to a substantially elevated risk for MS and a more rapid disease progression.

Multiple sclerosis is a chronic inflammatory condition affecting approximately 2.8 million people globally. Its development is associated with immune responses that can be triggered by EBV infection. The majority of the population—between 90 to 95 percent—will contract EBV at some point in their lives, with the virus remaining in the body for life. While primary infections may be asymptomatic, they can sometimes lead to infectious mononucleosis, a condition that can provoke a misdirected immune response, resulting in attacks on the central nervous system.

Elisabeth Puchhammer-Stöckl, the study leader and Head of the Center for Virology at MedUni Vienna, emphasized the significance of their findings, stating, “Our study shows that, when using this antibody assay, the development of MS becomes immunologically predictable long before the first symptoms appear.” Existing markers for nerve cell damage, such as neurofilament light chain (NfL) or glial fibrillary acidic protein (GFAP), tend to increase later in the disease process. Thus, the new test could serve as a vital tool for early identification of individuals at high risk for developing MS.

Co-study leader Paulus Rommer remarked on the potential implications of this research, noting, “This would allow the diagnosis and treatment of these individuals at such an early stage that the onset of MS could be delayed or perhaps even prevented.” The team advocates for screening populations with heightened risk for MS, particularly those who have experienced infectious mononucleosis.

While the implications of this research are promising, further studies are required before the blood test can be implemented in clinical practice. The ongoing research may pave the way for a new era of early intervention in the fight against multiple sclerosis, potentially altering the course of the disease for many at risk.