Connecting impairment, disability, and handicap in immune mediated polyneuropathies

Merkies, Ingemar S.J.

doi:10.1136/jnnp.74.1.99

Cited by 81 publications

(66 citation statements)

References 27 publications

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“…Similar findings have been reported in patients with various forms of inflammatory neuropathies. 39 Although not significant, patients with SFN symptoms and impaired IENFD had more physically oriented symptoms, such as more pain, less energy, and more balance problems, and more social dysfunction compared with the other subgroups. Emotional items scores did not differ between subgroups, thus excluding emotional problems as an explanation for patients' dysfunction.…”

Section: Discussionmentioning

confidence: 98%

Intraepidermal nerve fiber density and its application in sarcoidosis

Bakkers¹,

Merkies²,

Lauria³

et al. 2009

Neurology

212

166

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Section: Discussionmentioning

confidence: 98%

Intraepidermal nerve fiber density and its application in sarcoidosis

Bakkers¹,

Merkies²,

Lauria³

et al. 2009

Neurology

212

166

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“…Motor dysfunction was quantified using the Inflammatory Neuropathy Cause and Treatment (INCAT) disability score as described previously 34, 35. Cranial nerve affection was regarded positive if the patient presented with at least one cranial nerve affected for more than 5 months, and after excluding other underlying causes of cranial nerve involvement.…”

Section: Methodsmentioning

confidence: 99%

Corneal confocal microscopy in chronic inflammatory demyelinating polyneuropathy

Stettner

Hinrichs

Guthoff

et al. 2015

Ann Clin Transl Neurol

105

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ObjectiveThere is an unmet need for better diagnostic tools to further delineate clinical subsets of heterogeneous chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and multifocal motor neuropathy (MMN) to facilitate treatment decisions. Corneal confocal microscopy (CCM) is a noninvasive and reproducible nerve imaging technique. This study evaluates the potential of CCM as a diagnostic surrogate in CIDP and MMN.MethodsIn a cross‐sectional prospective approach, 182 patients and healthy controls were studied using CCM to quantify corneal nerve damage and immune cell infiltration.ResultsPatients with CIDP and MMN had a reduction in corneal nerve fiber (CNF) measures and an increase in corneal immune cell infiltrates. In CIDP, CNF parameters decreased with increasing duration of disease. The number of dendritic cells in proximity to CNFs was increased in patients with early disease and correlated with the degree of motor affection. A further reduction in CNF parameters and an increase in nondendritic cells were observed in patients with painful neuropathy. In CIDP patients with antineuronal antibodies the number of nondendritic cells was increased.InterpretationOur findings suggest that CNF loss may reflect severity of neuropathy and quantification of distinct cells around the CNF plexus may help in stratifying CIDP subtypes, clinical course, and disease activity. However, further longitudinal studies are required before CCM can be considered as a valid surrogate endpoint for patients with CIDP and MMN.

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“…Outcome measures should solely represent one of these levels using only items at that particular domain, since the findings at one domain, for example impairment measures (such as weakness) may be correlated with activity limitations in daily and social functioning (weakness leading to disability) (Aaronson, 1988;World Health Organization, 2001;Merkies et al, 2003). Having items representing various levels of assessing outcome may inflate the final sum score and provide improper results (Tennant and Conaghan, 2007).…”

Section: Measurement and Types Of Datamentioning

confidence: 99%

Rasch‐ionale for neurologists

Vanhoutte

Hermans

Faber

et al. 2015

J Peripheral Nervous Sys

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Outcome measures are considered the most important tools to monitor patients' outcome in both clinical and research settings. Measuring the clinical state of patients is a fundamental part of our daily clinical practice and research that sometimes is taken for granted. In peripheral neuropathies, there are many scales available, but most of these are at the ordinal level. This paper will systematically address the types of scales available (being nominal, ordinal, interval, or ratio data-based) in terms of their strengths and weaknesses. The differences between classical test theory-based and modern test method-based outcome measures will be addressed with emphasis on Rasch methodology. Various steps will be highlighted as part of the evaluation and construction of outcome measures using the Rasch method, with the aim to increase the knowledge and utility of this technique. We argue that Rasch-built outcome measures should be used for future studies in neuromuscular disorders and t... Abstract Outcome measures are considered the most important tools to monitor patients' outcome in both clinical and research settings. Measuring the clinical state of patients is a fundamental part of our daily clinical practice and research that sometimes is taken for granted. In peripheral neuropathies, there are many scales available, but most of these are at the ordinal level. This paper will systematically address the types of scales available (being nominal, ordinal, interval, or ratio data-based) in terms of their strengths and weaknesses. The differences between classical test theory-based and modern test method-based outcome measures will be addressed with emphasis on Rasch methodology. Various steps will be highlighted as part of the evaluation and construction of outcome measures using the Rasch method, with the aim to increase the knowledge and utility of this technique. We argue that Rasch-built outcome measures should be used for future studies in neuromuscular disorders and their method of construction could be easily extrapolated to other neurological illnesses.

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Connecting impairment, disability, and handicap in immune mediated polyneuropathies

Cited by 81 publications

References 27 publications

Intraepidermal nerve fiber density and its application in sarcoidosis

Intraepidermal nerve fiber density and its application in sarcoidosis

Corneal confocal microscopy in chronic inflammatory demyelinating polyneuropathy

Rasch‐ionale for neurologists

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